THE LONDON MEDICAL DICTIONARY; INCLUDING, UNDER DISTINCT HEADS, VIZ. ANATOMY, PHYSIOLOGY, AND PATHOLOGY, THE PRACTICE OF PHYSIC AND SURGERY, THERAPEUTICS, AXD MATERIA ME.TJICA-, WITH WHATEVER RELATES TO MEDICINE IN NATURAL PHILOSOPHY, CHEMISTRY, AND BY BARTHOLOMEW EARR, M. D. FELLOW OF THE ROTAL SOCIETIES OF LONDON AND EDINBURGH, AND SENIOR PHYSICIAN OF THE DEVON AND EXETER HOSPITAL. Creditur, ex medio quia res arcessit, habere Sudoris minimum; sed habet----- tanto Plus oneris, quanto venise minus. Hon. Lexican contexat, nam cstera quid moror, omnes Pcenarum species, hie labor unus habet. SCALIGEE. • .«.# .». .'• vol. r. I :;\ \y \) PHILADELPHIA: PUBLISHED BY MITCHELL, AMES, AND WHITE. William Brown, Printer. 1819. A* fe* ^4*. -^ , ANNEX TO THE RIGHT HONOURABLE SIR JOSEPH BANKS, BART KNIGHT OF THE BATH, PRESIDENT OF THE ROYAL SOCIETY. SIR, ' Your kind permission of addressing these volumes to you, as * it affords me an opportunity of acknowledging the many obligations you have conferred, I received with the greatest satisfaction. A. work, nearly approaching in its object that department of science in which you are so eminent; which \ rests on the observation of Nature in all her varied forms as her securest foun- dation;--in fact, THE NATURAL HISTORY OF THE BODY AND MIND, Cannot, I trUSt, to you be unacceptable. Should it appear to be executed in a manner worthy the approbation of yourself and the public, my highest ambition will be grati- fied. I have the honour to be, Sir, Your very obliged and faithful Humble servant, BARTHOLOMEW PARR. Exeter, November, 1808. ACf7Q&(o PREFACE. IF a dictionary be sometimes the refuge of indolence, it is an useful resource in circum- # stances of emergency. It offers a collection of opinions, at one view, and within moderate limits, suggests hints from sources beyond the reach of common acquirements, beyond the extent of a common library, and leads the inquiring mind into paths of which he might not have suspected the existence, or been unable to pursue the intricacies. If these be the general advantages of a dictionary, this form is peculiarly applicable to a science where emergencies frequently occur, where the time for reflection is short, and the practitioner, from anxiety and distress, unfitted for cool consideration. A man of sensibility is, in such circumstances, obliged to conceal his pangs under the appearance of composure, and to cover doubt and hesitation by a seeming calmness and confident decision. His situation, also, is often little adapted for deriving assistance from numerous authors, in different lan- guages; nor is his mind always so carefully regulated by education as to pursue a chain of reasoning strictly inductive, or to detect error, under the semblance of plausible improvement. To bring before him, therefore, the opinions of distant eras and countries, to offer what the ablest professors have thought, to describe how they have acted, must be a valuable acquisi- tion to one class, while, to the intelligent and experienced, it may be no useless remem- brancer—an index to those sources of information which may be more minutely, and, therefore, more advantageously followed. It is not the least of the advantages of the following pages, that they detect many reputed discoveries of modern times, in the neglected authors of former periods; and the sanguine admirer of what is new may learn, from the reception which any proposal has formerly experienced, to appreciate with greater accuracy its value. To attain these objects has been the anxious wish of the author; and, with these in view, he can scarcely have entirely failed. This work is not the design of a moment: projected in the eagerness of youth, it is completed in the maturity of experience; constantly kept in his sight; a deposit of the accumulated stores of reading and observation. vi PREFACE. To excel former works, under this title, at least such as had appeared when the plan was first laid, seemed no very difficult task. They chiefly consisted of definitions and short explanations, or were diffuse collections, from different authors, in the same form, frequently in the same words. He who consulted the latter work might well exclaim, irwpem me copia fecit; while those who applied to the former caught the shadow, instead of the substance- learnt the etymology of a title, when they wanted a remedy for the disease. The lexicon of Erotian (perhaps Herodian), the Voces Graecae of Julius Pollux, the lexicon of Herodotus Lycius, and others, published by Henry Stephens, with the (Economia of Faesius, appended to his edition of Hippocrates, are scarcely more than eluci- dations of the terms used in the ancient authors. De Gorris (Gorraeus) was more full in his explanations, and more extensive in his views. The Definitiones Medicae, first published in 1564, afterwards, by his grandson, in 1622, contain a satisfactory view of medicine, as it was left by the ancients, and no imperfect account of the medicinal plants described by Theophrastus and Dioscorides. Blanchard seems chiefly to have copied Gorraeus, and scarcely advances beyond the definitions of his predecessor. Castellus is equally unsatis- factory; but the edition of Bruno, published at Geneva, in large quarto, and the still more extensive one which appeared at Naples, in 1761, are valuable, though unequal collections. The former contains the Arabic, the Hebrew, the Greek, French, and Italian appellations, added by Bruno, under the title of Mantissa Tetraglotta, and the latter many of the modern improvements. • Our own countrymen received, early in the last century, the assistance of Quincy, who has transcribed and abridged the definitions of his predecessors, adding the principal doc- trines of the mechanical philosophy, and their application to medicine. Indeed the latter seems to have been his chief object; and, when Newton had, with the assistance of mathe- matics, expanded our view, and found the solar system subservient to one principle, gravity, it was supposed that the same success would follow their introduction into every science; and nothing but demonstration was talked of and expected. This work has been lately published, with numerous improvements, by Dr. Hooper; but within limits which, necessarily preclude any very extensive disquisitions. About the middle of this century, Dr. James offered a vast work of this kind to the public, in three ponderous folios. The erudition which he displays is extensive, and his explanations are often satisfactory. He has collected all the learning of his predecessors, preserved their controversies,^and added whatever a diligent attention to the works of the ancient physicians could contribute to the former stock. In the more strictly practical part of his dictionary, he has collected, with the same care, and has copied, not always with sufficient discrimination, the opinions of different practical authors. The diffuseness of his PREFACE. vii language contributes, however, to lessen the advantages which such a work ought to possess, as a ready resource in cases of difficulty; nor, in the mass of contending opinions, is it always easy to collect those comprehensive views, which will at once lead to a decisive and discrimi- nated practice. Some later dictionaries in our language are, in general, slight glossaries, with slender claims, which may be fairly allowed. One other work, of a more respectable bulk, and more plausible pretensions, we may be, perhaps, expected to notice; but any observations which we might offer would appear to be dictated rather by the spirit of rivalship than of sound criticism. We wish not to disturb the opinions of those who approve it. There are numerous collections from authors, sometimes of reference only, but more often copies of detached passages, arranged, in many instances, alphabetically, which, though not properly dictionaries, demand some attention. While the works which have been styled definitions and glossaries preclude disquisitions, these reject mere verbal explanations. They approach nearly to our prototypes, particularly the dictionary of Dr. James; but are differ- ent in their pretensions, as well as in their execution, and of unequal value. Moronus first published his Directorium Medico^practicum, at Leyden, in 1650, pro- fessing to give a list of the opinions of the most eminent physicians, who had written either in the form of consultations, epistles, replies, observations, or histories on different diseases. This Directory was published in octavo, and, thirteen years afterwards, a more enlarged edition, by Sebastian Scheffer, in quarto, appeared. Without impeaching the accuracy of Moronus, we may remark, that his work is very unsatisfactory, from the general objects of his references. Under each disease we find a list of authors, without the slightest hint in whose volumes we are to seek the pathology or cure, by whom the remedies are discrimi- nated and adapted with the most scientific care, or where the greatest number of idle fancies obscure the merit of attentive observation. The Sylva Medica of J. G. Walthtr is far more valuable. His references are copious and distinct; his synonyms, including the barbarous and obsolete appellations, numerous; his chemical compositions, in which, however, he could not soar beyond the state of the science at that time, detailed with accuracy. His work was published at Bautzen, in Germany, 1679, in quarto, illustrated by an index of authors and diseases. Had Walther fulfilled the promises of his title, the Sylva would have been highly useful; but his omissions are numerous, and his references so general, that they are often of little real value. A similar work was pub- lished at Frankfort, previously to the former publication, by M. Martianus Lipenius, in folio, 1759, with a copious index, which we have been unable to procure. viii PREFACE. Walther was followed by Mangetus, a most voluminous collector, who published his Bibliotheca Medico-practica at Geneva, in 1698, &c. in four thick folio volumes; and, twenty-six years afterwards, the Bibliotheca Chirurgica, in volumes equally numerous and bulky. Each collection is a tedious cento, from different authors, without a scientific arrangement, almost without any apparent design. From many vast collections, the observa- tions are selected, without a reference to the volume, and the editions are seldom so carefully distinguished as to ascertain the real merit of the passage transcribed. Yet Mangetus was not merely a tasteless compiler, but a man of sound judgment and accurate discrimination, as he has evinced by his critical remarks in his Bibliotheca Scriptorum Medicorum. Bonetus was a collector almost equally indiscriminate, and his Polyalthes, a posthu- mous work, was published at Geneva, in 1691. The title is derived from the name of a supposed daughter of jEsculapius, who appears to have received it from her extensive powers of healing. This work, however, scarcely belongs to the present subject, since it consists of a close, but extensive commentary on the syntagma of J. Johnson, the Idea Medicine Universe. A former work, entitled Mercurius Compilatitius, denominated from the statues of Hermes, placed in the highways, to point out the road, was more pro- fessedly a compilation, in an alphabetical order, but without a nice selection of authorities. In the following year, the same author's Medicina Septentrionalis Collatitia appeared containing the discoveries of the Germans, the English, and the Danes, chiefly from- their transactions, in an order not alphabetical. The Encyclopedia of Dol^eus are similar collections, arranged according to the sub- jects: the Encyclopedia Chirurgica was an early work, published in 1659; the Encyclopedia Medica only in 1691. This inundation of compilations, at the end of the seventeenth century, appears to have exhausted the spirits and the industry of collectors, since several years elapsed before a similar attempt was published. The first work of this kind seems to have been the Synopsis of Dr. Allen, a physician at Bridgewater, in octavo, which, though not in alphabetical order, contained the opinions of different physicians on the principal diseases, and it was one of the first English publications in which the opinions of Boerhaave were popularly detailed. A third volume appeared, in English, in 1756. The Lexicon Physico-chemicum Reale of G. H. Behr was published in 1738, in quarto, and followed by a smaller work, entitled Bibliotheca Medica, by Christopher William Kestner. Neither of these have we been able to procure. A French work, Planque's Bibliotheque choisie de Medecine, appeared at Paris, in PREFACE. IX 1738, and eight successive volumes were published, at different periods. It contains, how- ever, extracts only from the periodical works of France, and other countries, but chiefly from the former, with little selection or discrimination. It is, in every respect, a trifling collection. The most important publication, in this form, is the Bibliotheca Chirurgica of Jerome de Vigiliis von Creutzenfeld, in two volumes quarto, published at Vienna in 1781. This is an excellent collection, and more valuable, since the Bibliotheca Chirurgica of Haller is, in so many respects, imperfect and erroneous. The last compilation of this kind is the most valuable, the Initia Bibliotheca Prac- tice, by Plouquet, published at Tubingen, in eight volumes, small quarto, to which two supplementary volumes were afterwards added. It includes a catalogue of the best authors, under the different diseases, each arranged alphabetically, distinguishing those who have treated generally on the complaint—the causes and remedies assigned and recommended. The references are particular, accurate, and numerous; perhaps more numerous than select. The author has collected from every source, and seems to possess a most accommodating belief in all the tales of wonder, from Schenkius, the authors of the Ephemerides Naturae Curiosorum, and those whose narratives rather excite contempt than confidence. The remedies, too, are frequently the most trifling and ridiculous. But, on the whole, this collec- tion is full, correct, and instructive. A Dictionary of Medicine was, some time since, published by Dr. Motherby, and con- tinued, in successive editions, by him and Dr. Wallis. When a new work of this kind was required by the public, it was supposed that it was requisite only to add the modern improve- ments to the ancient structure; nor was it suspected that what had received the sanction of the public, in five successive editions, could be wholly contemptible. It was, however, soon discovered that the substance was no less erroneous, than the form was unpleasing; that, to render it instructive, without offending the reader of taste and education, required more attentive care than was necessary for a simple revisal. The discovery was not, however, made before a part of the first volume had been printed, which has occasioned some of the unconnected sentences of the former work, and some of the disgraceful references, to remain. When the defects appeared, in their fullest view, the whole was examined with a severer scrutiny, and the subjects investigated in the original authors; nor was a single opinion allowed to remain, which had not the support of authority or experience. The work is^ consequently, to be considered as original, and the names of Motherby and Wallis are consigned to the oblivion, from which they had, for a time, escaped, though their labours have been lately copied, often servilely, in publications professedly original. If the necessary extent of a work of this nature be considered, it will be at once obvious vol. i. b PREFACE. that the bulk should not be unreasonable, and it has been consequently limited to two quartos. The requisite additions were supposed sufficient to supply the rejected parts of the folio. But absurdity mocks calculation, and numerous observations and disquisitions, at first studi- ously retrenched, might, we found, have been retained, since much space was gained by the smallness of the type, and the size of the page; more, by avoiding controversies, employing a concise, comprehensive style, increased vigilance in detecting absurdity and error. Though the utmost care was exerted to avoid its necessity, an Appendix thus became expedient; and, when once admitted, every means of increasing its utility was adopted. The words sup- pressed were few; but it soon appeared that numerous additions and corrections might be useful. In a long period, destined to the study and practice of a profession, under circumstances which brought every new production before his eyes, and called for his decision, the author thought that the principal questions were decided in his mind, and had little doubt of render- ing his work consistent. After the lapse of several years, however, subjects must assume a different hue; and the medical questions are too numerous for constant recurrence. When, therefore, the subjects were again reviewed, some facts appeared in a different light, and it was by no means proper that truth should be sacrificed to consistency. The change of opinion was, however, pointed out in the concluding article; and, by the assistance of the Appendix, the references were not only better compacted, but the inconvenience from these variations was avoided. The minuter errors, which inadvertently crept in, before the imper- fections of Dr. Motherby were fully discovered, are by this means also corrected, and the whole work is rendered more regular and consistent. It is not, therefore, an appendix, but amendments, that might make a part of another edition. The author becomes a critic on himself, and, he thinks, has sometimes proved a severe one. For this reason, he has changed the title of the additional part, and styled it, " Second Thoughts," Cure Posteriores. A new work of this kind, from the peculiar circumstances of the era, was required. Since the.last publication of any tolerable compendium of medicine, no inconsiderable pro- gress had been made in every branch. Every quarter of the globe, and the new continent, if Australasia merits this name, have been visited, with anxious care, by the eager votaries of natural knowledge; and the highest Andes have not escaped the researches of Humbolt and his coadjutors. From these investigations medicine and natural history have gained consi- derable advantages; and if new remedies have not added to the length of lists already crowded, we have ascertained, in many instances, the true botanical relations of those for- merly known; and, from the improvement of the natural system, in the hands of Ventenat, the successor and pupil of Jussieu, the first of the French botanists, we can, in many instances, supply what accidents, or the chances of war, may for a time deny. Chemistry, during this interval, has become a new science, and the refinement of its analysis has been applied to the most important purposes of medicine. We now know, with PREFACE the most minute accuracy, the nature of the blood, and the greater number of animal fluids. we know, too, that the circulating mass is scarcely changed by diseases, once supposed to reside exclusively in it. The natural and morbid states of the secreted fluids are also, by the application of this science, more easily understood, and we are thus taught to disregard many imaginary sources of terror. The difference between the animal and vegetable mixed, and again, between vegetables and minerals, is now, also, more clearly defined: the limits of each are ascertained; and, though, in the progress of our knowledge, we find nature, as usual, passing, by almost undis- tinguishable shades, from one to the other, we can assert, with some confidence, from what points they diverge, and where they coincide. If we find the fibrin in bran, and the prussic acid in bitter almonds, we cannot, for a moment, mistake them for animal substances: if we discover the phosphoric acid in the human body, and the kali in the leucite, we shall not mis- take one for a mineral, nor the other for a vegetable. In the analysis of the vegetable substances used in medicine, and in ascertaining the real chemical nature of mineral preparations, whose utility has been established by the most extensive experience, the same science has lately become most beneficial to mankind. These acquisitions have improved and simplified our pharmacopoeias; nor are our formulae now crowded with heterogeneous, discordant ingredients, o*r mineral waters loaded with imaginary and incongruous impregnations, or disgraced by contradictory powers. We approach the era when the vegetable principles will be still more clearly understood, when the gum and the resin will not be the ultimate results of our analysis; but we shall, probably, be able to offer only the rudiments of such investigations, under the additions to the article Cortex Peru- vianus. Improvements in anatomy have been less splendid. Indeed, whatever the minutest accuracy could ascertain, in the investigation of the structure of the human body, was appa- rently found in the works of Winslow, Haller, Morgagui, Monro, and Hunter. Nature is, however, inexhaustible; and the ample harvest of former anatomists left valuable gleanings for Camper, Walther, Scarpa, Sandifort, Comparetti, Soemering, and Loder. Comparative anatomy has been, in the later periods, cultivated, with equal success, by Spalanzani, Cuvier, and Blumenbach. If the improvements which have been made in the explanation of the various functions of the human body are examined, the branch of medicine entitled Physiology, we shall not have much reason to congratulate ourselves on extraordinary success. The minuter opera- tions of nature are carried on in the first "elements" of our system: the sacred shrine of the goddess is inaccessible. The agents are also the living organs, and we can scarcely b2 x;i PREFACE. ascertain in what life ultimately consists; the operations of the body are affected by the mind, and we know neither the nature of the latter, nor the medium of the connection. The prin- cipal improvements, therefore, in this branch will consist in simplifying our views, in general- izing our facts, and, by strict induction, clearing the subject from erroneous theories. In a few instances, some advances have been made; but, while life itself is mysterious, the laws by which its operations are regulated will remain in equal obscurity. Pathology will partake of the imperfections of physiology; but it fortunately happens that although the theory may fail, the means of relief are within our reach. In this branch of medicine also our objects are more simple and discriminated. It has been the fashion to ridi- cule nosology; but, since the publication of Dr. Cullen's system, greater progress has been made in accurately distinguishing diseases than in the five hundred preceding years. The various kinds of asthma, cutaneous diseases, fevers, particularly those of the puerperal state, with many other complaints, confounded even in the best authors, are now clearly dis- tinguished. It is singular, that concussions of the brain have been very imperfectly discri- minated from the effects of fracture, of depression, and of extravasation, in works of esta- blished reputation. The practice of medicine has received equal improvement in the simplicity of its views, and the distinctness with which the circumstances of diseases are discriminated. It no longer consists of a farrago of medicines, accumulated merely because each has been recommended, nor of general formulae, without an object; but the views of the practitioner are directed by the changes often suggested by indications, and these are produced by the simplest means. Our medicines also, as their properties are more distinctly known, are selected with juster skill, withmore pointed precision, and we trust that something has been added in this work to the distinction of their more peculiarly appropriated virtues. New medicines glitter for a time,. like meteors; and the power of every new remedy is, during the prevalence of the fashion, un- doubted. The scepticism of advanced life distrusts the fallacious glare, calmly inquires, and cautiously tries, before it decides. Conscious of the various sources of error, the resolution is at last adopted with doubt and hesitation. Yet no one is wholly free from the temptation of novelty: each is apt to trust with confidence to his own plans; and, in the hands of a disr coverer, we always find a medicine infallible. Surgery is still more improved by the general discrimination and boldness of modern practitioners, and by the happy daring of distinguished characters in this department. If it has been our lot sometimes to detract from the civic wreath, by sullying the gloss of novelty, we mean not to lessen their fame. In them it may have been the first suggestions of bold decision, tempered by judgment, by experience, and a confidence in their own powers; nor should the PREFACE. xiti occurrence of the same ideas in a forgotten author lessen the credit which such improvements claim. While surgery is thus more distinct in its views, and more decisive in its conduct, it has equally succeeded in shortening the sufferings of the patient, by hastening the cure. The operations of surgery are now performed with equal intrepidity and skill. In the pursuit, however, of novelty, it must not be forgotten that our ancestors were neither blind zealots nor deliberate homicides. They must not be blamed because they were unable to anticipate the discoveries of future eras; and their merit must rather be appreciated by the situations in which they were placed, or the means in their power. They observed diseases individually, but spoke of them collectively: they did not always distinguish accidental from pathognomonic symptoms; and, from the farrago of medicines which they employed, it was difficult often to determine whence the advantages arose. Yet their attention and fidelity de- serve our regard; their judgment often claims our respect, and their sagacity our praise; nor will the practitioner recur to even their loosest narratives without interest and advantage. In the conduct of this work we have often repaired to the original authors, and been sometimes amply repaid. Boasted discoveries have been detected in their germ, and infallible remedies in the forgotten pharmacopoeias of the middle ages. A dictionary, though it apparently consist of scattered limbs, often incongruous, should, however, be rendered as much as possible a whole: one spirit should pervade it, and system should collect its diverging rays into a focus. Systems, indeed, are often employed to distort facts for their support, or to conceal those which should oppose them; and the numerous idle theo- ries which, like passing spectres, have glared and vanished, at once, rendered the word suspi- cious. To be aware of each abuse is the best means of avoiding it; but by the term system we rather mean the reduction of facts to general principles, which may connect and unite them, should the principle itself be erroneous. Thus, if in every instance we find spasm and con- vulsions connected with debilitating causes, it is no injury to science to consider them as arising from debility; and they evidently consist in irregular action. Debility, thus connected with irregular action, is a bond of union of the most extensive influence, and brings into one view observationswidely scattered. Should the principle be erroneous, it will be at once discovered, when brought to the test of observation and experience; and if these oppose it we shall be soon led to sounder views. It cannot be injurious but from suggesting inert practice, useless innovations, or dangerous refinements. Such generalizations, in the hands of Bacon, Newton, and Herschell, have been highly beneficial to science; nor can these weapons be wholly in- effectual, if wielded by inferior powers. In the present circumstances, no facts have been dis- torted to support a theory: where the principle can only be carried to a certain extent; where, in some of its bearings, the security fails; and where facts are apparently discordant, the reader is at once apprised. xiv . PREFACE. The advantages of such connected views must be obvious. In the scattered practical ob- servations, opinions have differed as widely as the statures and complexions of the authors. Each can only be with justice appreciated on its own foundation; and the motley character, a work compiled with little discrimination, must soon render it disgusting. If, in the course of the inquiry, any general connection, any link, which will connect the apparently discordant facts to one principle, be discovered; if this link be furnished, as has often happened, by the author's own limitation of his plan or remedy, these facts will at once combine with the others, and form a dependant part of the whole. It will thus be more easily retained, and contribute to illustrate the collateral subjects. Were a work of this kind a mere compilation, even the same article would not be con- sistent; for it is not easy to find the author from whom the pathology, and the whole of the practice, could be properly taken. Should the talents of each be equally exerted in every part, new views and new plans must in many instances have arisen. If, then, the plagiarist cannot find the whole in any work, he must constantly submit, like many of our predecessors, to inconsistencies. He may detail the pathology with ability; but his practice will be at vari- ance. He may explain the structure of a part; but it will have little connection with the eluci- dation of its functions. Were the practice of Burserius, for instance, appended to the pathology of Cullen, without those explanations which the different views and designs of each author would suggest, the reader might suspect that two distant parts of a work had by accident joined; or, if the theory of Darwin were followed by the solemn indications and the judicious pratical remarks of Van Swieten, they would appear the " aegri somnia," and might justly be styled "vanas species." In the conduct op this work it has been the great object to collect information the most extensively useful within the shortest compass: a concise and comprehensive language has been, consequently, adopted. In detailing the sentiments of other authors, their opinions, rather than their words, have been preserved; we thus not only avoid the tautology and diffuse- ness too common among the greater number of medical writers, but connect the.subject with other parts of the work, and point out its influence on other branches of the science. A fertile source of prolixity, in medical publications, is the detail of cases, which, though sometimes useful in illustrating the author's doctrine, more frequently shows its weakness. As these cases are crowded with circumstances, often uninteresting, the general result, and those por- tions of the narrative which limit or influence the consequences, are alone preserved. Con- troversies have been, for the same reason, avoided. Of these it is sufficient to point out the existence, and the works in which they may be most advantageously examined; and if a little dogmatism in decision sometimes appears, this tone has not been adopted without the most at- tentive consideration of the different and opposite arguments. PREFACE. xv As the form is that of a dictionary, and the object to afford a ready resource in emer- gencies, each article is designed to be in itself satisTactory, that, in the moment of necessity, it may not be requisite to turn over two quartos. For this reason, in each will be found an abridged view of the subject, with an immediate reference to those pages where it is treated more satisfactorily. The references are, indeed, the bond of union between the distinct portions of the work, and the connection has, by their means, been kept up with peculiar care. Though sometimes numerous, they are select, and, we trust, satisfactory. Anatomy is the foundation of the whole science, and the structure of the different organs is essential in the explanation of their functions; while, in the practice of surgery, the mi- nutest investigation of the course of the arteries, and the exact situation of the more im- portant organs, can alone insure success. In a work of this kind, however, extreme minuteness is unnecessary; for dissection alone can convey those accurate and vivid ideas which must direct the surgeon's hand. The descriptions are chiefly designed to convey general instruction, or, in the more important parts, to assist the recollection of what dissec- tion had, at an earlier period, taught. The great difficulty was, therefore, to steer between accounts, uselessly vague, or unnecessarily minute; nor is it to be expected that every reader will concur with the author in his determinations in these respects. In physiology the latest opinions have been detailed, and these have been carefully con- nected with former theories, sometimes showing that modern philosophers have not always those considerable claims to originality which have been so liberally allowed. Pathology, in modern medical publications, is almost a new science; but the facts which illustrate the natural history of the human body, in a morbid state, connected with the appearances on dissection, have been collected with great diligence, often from the almost forgotten pages of Morgagni, or the neglected ones of Bonetus; assisted by numerous instructive narratives from the different collections of " Essays," " Observations and Inquiries," and " Transac- tions," in our own language. This part of our labour teaches one melancholy lesson, that many diseases are beyond the reach of human art, whether the changes be considered as causes or effects. But it also represses overweening confidence, prevents disappointment, and, by a sagacious prognostic, secures the credit of the science and the practitioner. The general pathology is that of Gaubius, with the judicious retrenchments and additions of Cullen, farther improved by the new discoveries of the chemical nature of the animal fluids; for, no work has been copied through the whole article, except where the quotation is distinguished, in the usual way, by inverted commas, or where the general substance is acknowledged. The practice of medicine has been detailed with unusual care. The plans of the most approved and scientific authors have been carefully considered, anck, whatever science or empiricism has at different eras suggested, is carefully noticed, with those distinctions which xvi PREFACE. may render the discovery more useful and effectual. To accumulate every medicine which has been recommended, in the manner of Lieutaud, would not be difficult; but to discrimi- nate the circumstances, in which alone each plan will be effectual, is not equally easy, though such discrimination can only render the directions valuable or salutary. A real dogmatic practice, viz. pursuing indications, arising from the knowledge of a proximate cause, would gratify the pride of science, and be most advantageous to the patient. The expectation is, however, vain; for in very few instances can an immediate cause be established. Though this, however, be beyond our attainment, we can, in many cases, ascertain general principles, which will assist our practice. Whatever be the cause of fever, for instance, the balance of the circulation is evidently disturbed; and to restore the equilibrium contributes very essen- tially to the cure. It has been a great object, through the whole work, to ascertain such principles; but they often fail, and the physician must then pursue, under proper regulations, the juvantia and lazdentia which observation has ascertained. When the medicine is deter- mined, the form is easily adjusted; but, except in a very few instances, what are styled formulae are omitted. These are the refuge of ignorance, indolence, or quackery. Every one can transcribe what is printed, and every old woman will eagerly affix a name to a disease: few will venture, from a class of medicines, to select the particular remedy or the dose. If it were possible always to discriminate the circumstances in which the different plans are advisable, formulas might be added; but, to those who can distinguish, they are useless, and to others furnish a weapon, which may be fatal, rather than salutary. The alternative is too dangerous; and, while the disposition to quackery pervades every individual, from the highest ranks to the meanest, while those who claim distinction, in other sciences arrogate it in this also, what may prove mischievous must be concealed. Surgery has many advantages, when compared with the practice of medicine. The objects are often before the eyes of the surgeon; the changes daily conspicuous, and show not only the state of the organ, but often of the constitution. If the object be beyond his sight, the touch will assist; and, in the most doubtful cases, the inductions are fewer, the conclusion more certain. When an operation is to be performed, as the situation of every part is known, he is ready, in every emergency; and, having obtained, by experience, a steady command of his hand, his eye, and his mind, he can meet every difficulty unruffled. Yet, as in anatomy, description cannot go far. The eye must witness the conduct of some more experienced practitioner; and operations on the dead subject must assist in giving a steadiness and a command of minute muscular exertion. As practical surgery is viewed in different lights, the directions may appear too general or too minute; but, where description could best avail, it has been most full and particular. There is one step between the practice of medicine, and the particular remedies, too cursorily passed over by the authors on the materia medica, viz. the therapeutics, or those PREFACE. xvii general doctrines respecting medicines nearly related, which may facilitate our judgment in tho ovation. Aa a subdivision of tne theoretical course in universities, it has not generally obtained a sufficient share of attention; in Dr. Cullen's Materia Medica it has had an unusual portion; but it is there subservient to his own system, and not so general in its views as the im- portance of the subject demands. It may be added also, that the extensive associations, usually styled classes of medicine, are too indiscriminate to direct the practice. Subordinate groups are necessary, and these, in imitation of Dr. Duncan, have been added; but the orders are in a great measure new, and are carefully connected, on one hand, with the particular remedies, and, on the other, with the indications of cure. The means employed for the cure of diseases are either natural or chemical. By the former are meant those productions of nature which require no preparation, or only the separation of the more active from the more inert portions; chiefly the vegetable or animal sub- stances, since there are few mineral productions which do not require some process to adapt them for use. The vegetable kingdom offers numerous remedies, of very unequal value, un- certain origin, or variously mixed and adulterated. To attain the desired purpose, or to avoid injury, it is first necessary to ascertain the real plant from which the medicinal portion is pro- cured; a circumstance not easy, in a kingdom supposed to consist of more than 60,000 species. The investigations, however, of Linnaeus himself, of his pupils Bergius, Murray, and Thunberg, have greatly facilitated the task; and the lacunae have been, in a great measure, filled up by the labours of Sir Joseph Banks, Mutis, Loueiro, Des Fontaines, Bruce, La Marck Cavanilles, and Roxburgh. Few now remain, whose parent plant has not been accurately and scientifi- cally distinguished. To refer, then, to the Linnaean system, especially in its most improved form, lately published by Wildenow, is sufficient to identify the plant. As, however, the sys- tem from the pen of Wildenow is uncommon, and not yet complete, a reference to the Species Plantarum, a work in every hand, has been preferred, and Wildenow, or later observers, have only been referred to, when it did not appear in the earlier work of Linnaeus himself. No modern naturalist of credit has escaped attention in this department. The system of Lin- naeus is not only useful, in identifying the plant, but on account of its numerous references, to each observer who has treated of it: among the rest, to Caspar Bauhine. This author is the link between ancient and modern naturalists; and, under the appellation which he assigns to each plant, we may discover its name in the works, not only of the ancient physicians, but of the ancient botanists, at least so far as the identity of the plant can be ascertained. It has been usual to transcribe the specific character; but, without the generic, it would be of little value, and to add, also, the synonyms of C. Bauhine would make every trifling article disproportionally long; so that the species plantarum is only noticed. As the botanical rela- tions of plants are supposed to be connected with their medical powers, the natural orders have been particularly attended to. vol. i. c XV1JI PREFACE. Prejudice, superstition, and fancy, have greatly extended the list of vegetable remedies; but, in a work of this kind, though every absurdity has not a claim t« ^noidoratio attention, yet the most ridiculous medicines only should be wholly omitted. There are, therefore, very few which have not shared some notice. In enumerating their virtues, it was difficult to avoid the exaggerated commendations of some authors, or the sceptical, contemptuous tone of others. In many instances, therefore, the praises of the former have been adopted, with marks of hesitation, doubt, or disbelief, sufficiently pointed; and those who have not tra- velled over the dreary waste of forgotten authors, would be surprised at the number of sup- posed properties omitted. The animal substances are few, and their sources sufficiently known. It is sufficient, therefore, to have referred, in general, to the Systema Naturae, and, in the lower orders of animated nature, to Sonniui's Continuation of Button's Natural History, or the minuter French naturalists, in the Memoirs of the Institute, the Annals of the National Museum, and the numerous tribe of monographists. Natural history has, indeed, of late, approached more nearly the confines of medicine. The latter is strictly the history of the human body and mind, in their natural and morbid state, and comparative anatomy, with its physiology, is the link which unites man to the lower orders, whose structure and whose functions are often beyond the reach of our investigation. The deficiencies are those of our knowledge; for, when this is extended, the chain is less broken, the connections more obvious. The natural history of the lower orders has, however, been little cultivated in this kingdom. It is singular that an animal, so extensively useful as the leech, has never been scientifically described in our language, except in these pages, and the hydatis, so common a source of disease, is by no means generally known to be an animal. To identify the few mineral bodies which are used without preparation, we have referred to the system of the judicious and accurate Hauy, which well merits an English dress; but the greater number, which form a valuable part of the materia medica, require a careful, and often an operose, preparation. Medicine, in these cases, calls in chemistry to her aid; nor is the assistance confined to the mineral kingdom. It has Jjeen hinted that, in vegetable bodies, different means are employed to separate the more active from the inerter portions, often to change the form, or to concentrate their virtues. This art has been employed from the time of Galen, and has been styled Galenical, in opposition to chemical, pharmacy; which treats of the necessary operations in preparing medicines, more strictly chemical. On the latter subject we greatly want a system co-extensive with the present state of chemical know- ledge. Dr. Duncan's New Dispensatory is a most valuable work in this line; but as its subjects are so numerous, he is often compelled to be more concise than we could wish. The lacunae, in this part of the subject, have therefore been filled up from the works of the latest and best chemists, particularly from that valuable collection, the Annales de Chimie. PREFACE. xix The utility of chemistry, however, is not confined to the preparation of remedies. Its light has illuminated the most obscure recesses of the medical science. The nature of the animal fluids, in a state of health and disease/ has been illustrated by the more refined analysis of modern chemistry, and, by its assistance in the practice of medicine, we guard against those mixtures which might weaken or destroy the virtues of the different ingredients in a formula. It may appear that this part of our subject has been expanded to an extent, which the real connection of chemistry with medicine will scarcely justify, and that chemical disquisitions occasionally trench on medical ones. In the progress of the work, in the moment of writing, the connection, however, became daily more striking; and as this, we trust, is not the ephemera of a day, it was necessary to give the younger reader every advan- tage of which he might, at a future period, avail himself. Till near the conclusion of these pages, there was, however, no chemical system to which we could refer. Dr. Thomson's Chemistry, a very valuable work, embraced a most extensive outline, and Dr. Aikin's Che- mical Dictionary had not appeared. Neither, however, was applicable to medical inquiries, and it was necessary, not only to explain the chemical relations, but to apply them, so far as they would admit, to the principal object. When we spoke with disrespect of the mechanical physicians, it was not with a design of depreciating the utility of natural philosophy. Though we do not calculate, with Borelli, the momentum of muscular action; with Sanctorius and Keil, the proportion of the surface of the lungs to that of the whole body; with Bellini, the acceleration or retardation of the motiojus of fluids, circulating through vessels passing off at different angles; yet this science will be found highly useful. The human body, though an animated machine, is constructed on the justest and most nicely balanced mechanical principles: of these the surgeon, in reducing luxations and fractures, will require a minute knowledge. The eye is a most curious optical, the ear an exquisite acoustic, machine; and the human voice, both in com- pass, variety, and clearness of tone, excels every musical instrument. At present, indeed, our attention is chiefly directed to the evolution and communication of heat, to the effects of the electrical and Galvanic fluids, if they really differ, and their very striking relations to that principle with whose mobility our life is most intimately connected. Indeed the relation of Galvanism to the minuter component parts of bodies has rendered it an agent of peculiar power, in the hands of the analytical inquirer; and we are indebted to Mr. Davy for one of the most important steps, in this branch of science, which has added lustre to any era. Yet all these are accessary sciences, and only of value, in the present work, so far as they assist the explanation of diseases, or direct the practice of medicine. We do not offer these volumes as a dictionary of physics, or of natural history, although they contain a larger share of each than is to be found in many works, which have been distinguished by this title. We do not offer it as a continuation of Or. Motherby's Dictionary, which, with all its faults, has been unmercifully pillaged, without acknowledgment. c2 XX PREFACE. To have retained so many useless synonyms may, perhaps, require an apology. In fact, they were found in the pages of the work last mentioned, and had been introduced before its glaring defects showed that it was an unfaithful guide. Many could not be traced to an adequate authority; but it would have been improper to have rejected what others might, perhaps, find useful, and for which there might have been authorities, though we had not discovered them. Numerous, however, as they seem, more have been rejected than retained. The references may appear, also, unreasonably numerous, and almost ostentatiously con- fined to foreign authors. The medical writings of our own country have not, however, been neglected; but these are, in general, within the reach of every practitioner: these only are- pillaged, in every modern dictionary, while of many authors of credit the names are often unknown. We have too fastidiously arrogated exclusive merit to ourselves, and it appeared proper to point out the valuable observations of Senac, of Q,uarin, of Stoll, De Haen, Colin, Sarcone, &c. as well as* of many Swedish and Danish physicians. Even Morgagni, as we have said, has been, of late, neglected. To lessen the extent, the Roman numbers relate to the larger portions of the work referred to—the Arabic numerals to the lesser. In the Cur^e Posteriores many additions have been made, some of which, in the pro- gress, had escaped attention, and others were designedly omitted; lest they might render the volumes too bulky. Various observations had also occurred in different publications and dif- ferent collections since the articles were printed, and it was the author's ambition to render the work complete to the moment of publication. Somewhat may still have escaped him; but those who feel inclined to censure omissions, should look with candour on what has been done. The additions are referred to some convenient portion of the article; but they do not relate exclusively to that part, and are generally to be considered as a commentary on the whole, to -avoid breaking them into too many detached parts. To point out what is new, in these volumes, would be a tedious task: almost every article, at least every article of importance, may be styled original, scarcely in any instance copied from former authors, and usually connected with the collateral subjects. As_already observed, it was designed to render the work one consistent whole, and the general principles will be found to pervade every portion; nor are the doctrines which limited the distinction of Con- cussio, forgotten under the article Ulcus. Of the plates we shall add only a short account. The subjects have been chosen with great care; but the objects of the choice we must now explain. It is not necessary to say why the different views of the skeleton have been selected: these have always formed a portion of similar representations; and, as the basis of the whole, are highly necessary. The ligaments have been imperfectly represented, in every English publication, and the value of PREFACE. xxi the present work is greatly enhanced by the elegant and accurate views of these connecting substances, from the superb volume of Caldani. Views of the muscles have usually followed; but would have required many plates, without an adequate advantage. In the general practice of physic and surgery little could be gained by such representations, and we have already remarked, that it is impossible to teach the minutiae of anatomy by verbal instruction or engraved copies. If the osteology is well understood, descriptions will convey ideas sufficiently accurate for general purposes. The course of the larger arteries is of more importance, and these have been repre- sented, with care, from the works of Haller, not separately, but as related to the adjoining parts; and they recur in different plates, which contain the lymphatics and the vicera. The volumes of Mr. Hewson, and Mr. Cruickshanks, and the elegant engravings of Mascagni, have supplied the lymphatics; Loder, Haller, and Sandifort, the internal viscera. As the situation of these is often of considerable importance, in ascertaining the seat of a complaint, they have been represented in every view, and with great care, as the English works have been unusually deficient in this part. The separate portions have been also supplied from the best anatomists. The elegant plates of Soemering have furnished representations of the eye; Mr. C. Bell's Anatomy those of the ear. We could not find a. more accurate view of the stomach than in Cowper; and on again examining it, we perceive the constriction, mentioned by Mr. Home, as divid- ing the cardiac from the pyloric portions. Mr. Cooper has also supplied a good representa- tion of the unimpregnated uterus, and its appendages; while, for the gravid uterus, and the natural situation of the fgetus in utero, we have been indebted to the classical work of Dr. W. Hunter. Some other detached parts of less importance are represented in the plates of the arteries and the lymphatics. A view of the brain has been supplied by Loder; and, when we reflected that, in very (ew circumstances, the course of the different nerves, in their progress, was of importance, and that, in these, the minute accuracy, acquired only by dissection, was requisite, we avoided enhancing the price of our work, by plates not generally useful. The surgical instru? ments represented are those most commonly employed, in the more improved practice of the art. 1 A NEW MEDICAL DICTIONARY. ABA A The letter a, with a line above it, thus, a, is used • in medical prescriptions for ana, of each ; some- times it is written thus, aa; e. gr. !§o Mel. sacchar. et man. a vel aa, ^j. i. e. Tak^e of honey, sugar, and man- na, of each one ounce. A, in composition, implies a negative, as in a'chy- lus—from « priv. and ^f/oj, chylus—deficient in chyle. A'AVORA, a species-of palm found in Africa, and the American Islands. The.nucleus of the fruit resem- bles an almond; it is mild and nutritious, and is used by the natives as an astringent, particularly- in cases of diarrhoea. The parenchyma which surrounds the ker- nel is eaten by cows and other animals: by maceration it affords an oil which is used as a condiment, and to burn. The ajant is figured in La Marck's Illustrations of Natural History, PI. 896, but has not been arranged in the botanical systems. It has been transplanted to Guiana, and often confounded with the cocoa-nut tree. A'BACTUS, (driven away.) It is applied to abor- tions, procured by medicine. A'BACUS, (from a Hebrew word abak, dust.) A table used for preparations; so named, because ma- thematicians used to draw their figures on tables sprinkled with dust. It generally means an instrument very anciently employed to facilitate arithmetical ope- rations. A'BACUS MAJOR. A trough used in the mines, wherein the ore is washed. ABALIENA'TUS, corrupted. Cel^us. In English, we use only the word alienated, which is applied to in- juries of the mental powers. A'BANET. See Bandage. A'BANGA. See Adv. ABAPT'ISTON,or ABAPTI'STA, (from * priv. and fiatim^a, immergo, to sink under.) The perforat- ing part and shoulder of the instrument called a tre- pan, to prevent its sinking suddenly upon the mem- branes of the brain, when the operator perforates the skull: the present practice renders this precaution need- VOL. I. ABD less, by having substituted a much more manageable instrument. SeeTREPANUM. ABAR'TAMEN. See Plumbum. ABARTICUL'ATIO, (from ab, and articulus, a joint.) See Diarthrosis. A'BAS. Dr. Turton has made A'bas a synonime with Taenia, or Tape-worm ; a mistake, we presume, for Tinea, the Moth-worm. See Castelli Lexicon Me- dicum. See Tinea—Achor—Epilepsia. ABA'SIR. See Spodium Arabum. ABBA'ISSEUR, a term given by Winslow to one of the muscles of the eye, depressor oculi of Albinus. ABD'OMEN, the Belly, from abdo, to hide ; as its contents lie hid in it. The last syllable is only a ter- mination ; as from lego, legumen. It is also called Imus Venter. Alvus. Gaster. Katocxlia. P'-esius calls it Dertron ; JVedys ; and the viscera contained within, Nedya. The body is generally divided into three cavities, called, by anatomists, venters : viz. the head, or upper venter ; the breast, or middle venter ; and the abdomen, or lower venter. The belly is divided, on its outer surface, into four regions, called the epigastric, the umbilical, the hypo- gastric, and the lumbar. See Epigastrium, Umbili- calis regio, Hypogastrium, and Lumbaris regio. These are all contained betwixt the circumference of the false ribs, and the bottom of the ossa innomi- nata. The belly is separated from the breast externally, by the extremities of the ribs, and internally by the dia- phragm ; and it is terminated below by the musculi le- vatores ani. The bottom of the belly, named Neiara, on its fore part, is called the pudenda; and on its back part, the buttocks, and anus ; and underneath, betwixt the anus and the pubes, the perinaeum ; indeed, the name of pe- rineum is given to the whole space from the os coccy- gis : that part which lies between the anus and pubes is distinguished, according to Dr. Hunter, by the term B A'B iJ 2 ADD fore pcrinaeum, and that from the coccyx to the anus the hind or back perinaeum. The cavity of the belly, formed by the above-named parts, all which are covered with themembranaadiposa and the skin, is lined on the inside by the peritonaeum. This cavity contains the stomach, intestines, mesen- tery, mesocolon, liver, gall-bladder, spleen, pancreas, glands of the mesentery, vasa Iactea, receptaculum chy- ii, kidneys, renal glands, ureters, bladder, and the inter- nal parts of generation. Though we have employed common language, in the expression of the cavity of the belly, in reality there is no cavity. The peritonaeum may be com- pared to a flaccid bladder, behind and on the outside of which the intestines and other supposed contents are placed. This membrane is then folded around them, and the two sides of the bladder, after enfolding the intestines, are brought together, forming the mesen- tery : within these folds of the mesentery the lacteals pass towards the blood vessels. The peritonaeum is therefore contiguous on its internal surfaces, or only separated by a vapour called an halitus, which, after death, condenses into a watery fluid; this fluid in drop- sies is greatly augmented, and is said by the more cor- rect authors to be contained in the cavity of the perito- neum. The principal arteries of the belly are, the epigastric, w hich are the lowest portion of the internal mammary artery, the inferior aorta, the celiac, the upper mesen- teric, the hemorrhoidal artery, the renal, called emul- gent, the spermatic artery, the lower mesenteric artery, the lumbar, the iliacj the lower epigastric arteries, and the pudicx. The principal nerves of the belly are, the stomachic, formed by the extremity of the eighth pair; the lower portion of the great sympathetic nerves, the two semi- lunar or plexiform ganglions, the hepatic, splenic, re- nal, upper and lower mesenteric plexus, the nerves of the loins and sacrum, also the origin of the crural and sciatic nerves. The appendix ensiformis, the lower pointed extre- mity of the sternum, the cartilaginous portions of the last pair of true ribs, those of the first four pairs of false ribs, all the fifth pair, the five lumbar vertebrae, the ossa innominata, the os sacrum, the os coccygis, form the bony sides of the cavity of the belly. The diaphragm, the muscles called, particularly, musculi abdominis, the quadrati lumborum, the psoae, the iliaci, the muscles of the coccyx, and of the intesti- imm rectum, form the greatest part of the circumfer- ence of this cavity. As auxiliary parts, some portions of the sacro lumbares, longissimi dorsi, &c. might be added. The muscles belonging to the belly are five pair; viz. the obliqui externi, the obliqui interni, the trans- vcrsales, the recti, and the pyramidales. Their action is necessary to expiration, as they pull down the thorax, and they are very useful in efforts to speak loud : they assist also in the expulsion of the faeces and urine. Some people, who find a difficulty in going to stool, or have a suppression of urine, are said to relieve themselves by pressing the abdomen with their hand: the expul- sion of the foetus also is greatly assisted by the abdomi- nal muscles. Mr. Pott was of this opinion. He said, \hat he had seen a child, which lived nearly three weeks, though it had no abdominal muscles; that this child could not either propel or expel the faeces nor urine perfectly, without artificial aid. Mr. Haighton also found that the most violent stimuli, when applied to the stomach either externally or internally, were in his ex- periments insufficient to produce an evacuation oi its contents, without the concurring efforts of the dia- phragm, and muscles of the abdomen. There is a sinus on each side of the cartilago xiphoi- des, between the transversalis and recti muscles, into which, on the left side, the stomach is sometimes push- ed by violent vomiting; a disease called- Gastrocele. This tumor is in the upper part of the linea alba. The disorder is attended with excessive pain, which is great- er when the person is- up, and gradually goes off when he lies in a horizontal posture, a circumstance which distinguishes the disease. There is a continual vomit- ing ; every thing taken in is immediately rejected; and hence succeeds an atrophy. All hernias of the linea alba require the same management; but this of the stomach demands particular attention. They are easi- ly reduced, and should be kept up by a truss : if the rup- ture does not recede, the stricture must be enlarged and reduced in the same manner as in other ruptures. Happily this caseis very rare; when it occurs, little more can be done than to alleviate general symptoms : if it cannot be returned by the hand, any operation will be a doubtful aid, as inflammation soon comes on, and the admission of air into the cavity of the abdomen im- mediately increases it. Pain and other disorders of the belly sometimes hap- pen from keeping it too cool. The circulation of the blood from the viscera in the belly, by the vena portae to the liver, and afterwards in the liver, is greatly pro- moted by the alternate compression, which the contents of the belly receive from its muscles and the dia- phragm : and it is of service in dissecting living ani- mals, that, when the viscera of the belly are exposed to the air, this circulation of the blood towards the liver, by the portae, is much impeded, or totally stopped. Hence it follows, that in proportion as the action of the muscles of the belly is impaired, and the cavity laid open, this circulation, so necessary to the animal eco- nomy, must be obstructed. The muscles of the belly and peritonaeum are subject to inflammations, which have been mistaken for inflam- mation in the liver or the intestines: to distinguish them, see Hepatitis; Inflammatio musculorum ab- dominis, et Peritonitis. The rheumatism sometimes affects the muscles of the belly, which has been mistaken for a colic, or for an inflammation of some of the viscera within: in this case, however, the usual symptoms of inflamed viscera are absent, and the medicines which are useful in the colic are without effecf in this complaint. For the management of wounds in the belly, see the article Vulnus. ABDO'MINAL Ring. An opening in the abdo- men, formed by the tendinous fibres of the external ob- lique near the os pubis, through which the round liga- ments of the uterus, and the spermatic vessels in the other sex, pass. Through this ring portions of the in- testine sometimes come down, fonning ruptures. See Hernia. ABDUCE'NTES NERVI, part of the sixth pair; so A B i) 3 . A B 1 called because they are lost on the abductores oculi. ABDU'CTIO,(from ab and duco, to'-draw,) a species of fracture, when a bone near the joint is so divided transversely, that the extremities recede from each other. Caelius Aurelianus uses this word for a strain. Abductio properly signifies leading from or drawing away, and it is from the action of the muscles that the divided ends of fractured bones recede. Abruptio is used in the same sense, as are also Apoclasma, and Apagma. ABDU'CTOR, (from abducere, to draw from.) Those muscles are called abductors which draw backwards the moveable parts into which they are inserted; of which there are several in the human body, viz. 1. Abductor auris, called also triceps auris, and retrahens auriculam, bicaudalis muscularis, intricatus musculus, detractor auris ; a muscle of the external ear, tailed by Winslow the posterior musculus auris. It is called triceps, because it has sometimes three begin- nings. It is composed of a few fleshy fibres, which arise from the superior and fore part of the apophysis mastoideus, and descend obliquely to their insertion, in the middle of the concha auriculae. It covers the posterior ligament. Dr. Hunter thinks the ear has only two muscles belonging to its external parts that the retrahens auriculam arises from the mammillary pro- cess of the temporal bone, and is inserted into the lower external part of the ear, to pull it backward. 2. Abductor digiti minimi manus. Riolan calls it kypothenar. It rises from theos pisiformeof the carpus, runs upward on the inside of the hand, and is inserted into the external side of the little finger, or its first joint. It helps to separate the little finger from the rest, and also to bend it. It is the flexor parvus minimi digiti of Albinus. 3. Abductor digiti miniMi pedis. It rises fleshy and tendinous from the semicircular edge of a cavity on the outside of the inferior protuberance of the os calcis; it has another tendinous beginning from the os cuboides, and a third from the upper part of the os metatarsi minimi digiti. It is inserted into the upper part of the first bone of the little toe externally and laterally. It draws the little toe outwards from that next to it. 4. Abductor indicis. It arises fleshy by two heads from the metacarpal bone of the fore finger, and the first bone of the thumb, and is inserted by its tendon into the basis, or first joint of the fore-finger, laterally next the thumb. It brings the fore-finger from the middle-finger, and near to the thumb. Cowper calls it adductor pollicis. Douglas says, its use is to bring the index towards the thumb; whence, in respect of this, it may be styled adductor ; and, in respect of that, abductor. 5. Abductor occuli, called also indignatorius, or the scornful muscle ; musculus exterior ; also, abducens, iracundus, and rectus extemus. It rises tendinous and lleshy from the foramen lacerum, without the orbit. It is inserted by a thin tendon into the sclerotis, on that side next the nose. It moves the eye towards the little angle. 6. Abductor pollicis manus, called also thenar oy Riolan; and abductor brevis pollicis manus, by Al- ! : ius. It r.ses by a broad, tendinous, and fleshy be- ginning, from-the inner part of the traversa ligament of the carpus, and from one of its bones which articu- lates with the thumb, and is inserted tendinous into the second joint of the thumb. It draws the thumb from the fingers. 7. Abductor pollicis pedis, called also thenar. It rises fleshy from the inside of the os calcis, and ten- dinous from the os naviculare, and forms a strong ten- don, which is inserted at the inner part of the first bone of the great toe, upon its sesamoid bone. It pulls the great toe from the rest. It often has a tendinous origin from the edge of the os cymbiforme, receiving- near this bone some tendinous filaments from the ti- bialis anticus. These two muscles, No. 6, 7, are called Thenar, because they make part of the Thenar. ABELICE'A, (from « priv. and /3=A«$, a dart; i. e. without thorns.) See Brasilium lignum. ABELMO'SCHUS.(A-bel-mosch, Arab.or Granum Moschi Rumph. hirsuta Margr. Brazil, Moschus Ara- bum. Also, Alcea Indica, Alcea, Abrette.) The seed of a plant which has the flavour of musk, called the musk mallow. The plant is the hibiscus abel- moschus Lin. Sp. PI. 980, indigenous in ./Egypt, and many parts of both the Indies. The seeds are flat, kidney-shaped, the size of a pin-head, grey or brownish without, and white within. They are very fragrant, and their scent is like a mixture of amber and of musk ; to the taste they are of a slight- ish aromatic bitter. The Arabs mix them with their coffee; though their chief use is as a perfume; but, from their peculiar flftvour, as well as other sensible qualities, they seem to merit more attention than has hitherto been paid, to them as a medicinal substance. The best comes from Martinico. Those which ap- pear new, plump, dry, and well scented, are pre- ferable. ABERRA'TIO, (from aberro, to wander.) In me- dical writings it expresses Nature's deviating from her usual progress. A Lusus Nature. See also Luxatio. ABESAMUM, dirt or clay. ABE'SSI. See Rebis. ABEVACU'ATIO, or ABVACUATIO, (from ab dim, and evacuo, to pour out,) a partial or incomplete evacuation of the faulty humours, whether by nature or art, called Apocenos, partial fluxes, as watery eye, gonorrhoea, Etc. A'BHEL, one of the appellations of savine. Q. V. A'BIES, (probably from «ar<«s, a wild pear, the fruit of which the cones of the fir resemble.) Fir, called also Elate Theleia. The fir-tree is an evergreen, and coniferous, with numerous, narrow, stiff leaves, standing solitary, or unconnected at their bases with one another. Six species afford materials for medical use. Lin- naeus includes the abies in the genus offiinus. 1. Abies, Pinus sylvestris Lin. Sp. PI. 1418. 2. Abies, the yew-leaved or silver fir. Pinus alba Lin. Sp. PI. 1418. These two species are natives of the northern re- gions ; the second grows on dry mountainous places; the first in lower and moister grounds. Norway, Swit- zerland, and some parts of Germany, afford great quan- tities of them. They are indigenous in some parts of Britain ; but are chiefly to be met with in plantations. The branches, and the fruit gathered in autumn, abound B 2 AB1 4 ABL with resinous matter, and yield, on distillation, an essential oil, and a liquor impregnated with a peculiar acid, called acidum abietis ; and, when added to water, is thought to communicate to it both the flavour and other properties of tar-water. This acid resembles the acetous, differing only by the addition of the tur- pentine which comes over with it; and the famous tar-water was not very different: it contained only a larger portion of the essential oil. This acid and the tar-water have produced good effects in some obstinate coughs, particularly in that chronic catarrh which is benefited by warm diuretics. Decoctions of the wood and tops promote perspiration and urine; are some- times useful in rheumatic cases; and been considered as serviceable in healing internal ulcerations, particu- larly of the urinary passages. They are injurious if any fever attends ; but may be useful where the cir- culation of the fluids is too languid. 3. Abies Canadensis, vel Virginia'na, the Canada or Virginian fir ; pinus Canadensis of Lin- naeus, Sp. PI. 1421. 4. Abies balsame'a, balm of Gilead fir ; so called from the fragrance of the leaves when rub- bed. Pinus pines Lin. 1418. Pinus Larix Lin. J420. It is the pinus balsamea of Linnaeus, 1421. All the parts of these trees contain a bitterish, pun- gent, essential oil, which by exposure to the air be- comes a resin : turpentines are obtained by making in- cisions in their trunks at a proper season. For the different kinds of turpentines, see Terebinthina. The common red fir affords tltfe greatest quantity of mrpentine ; and from the turpentine is obtained white resin, see Resina ; tar, see Pix liquida ; pitch, see Pix nigra ; and Burgundy pitch, see Pix Bur- gun dica. The silver fir produces the Strasburg turpentine; it is far more grateful than the common sort, and called liquid resin, to distinguish it from the dry resin, which resembles frankincense. From the Canada fir is obtained a still finer and more grateful turpentine, called Bals. Canadense ; it is discharged, during the summer heats, through incisions made in the trees, transparent, and almost colourless. It is a good substitute for the bals. capivi. See C a pi vi balsamum. The balm of Gilead fir emits from its cones in large quantities a turpentine with a fragrance resembling the balm of Gilead. Spirit of wine extracts a resin both from the cones and the leaves of a similar quality. See Balsamum. Rectified spirit of wine, digested on fir, extracts all its active parts, with some of its mucilage. The cones of all the sorts yield the most agreeable tincture. Water dissolves a portion of the oil by the assistance of the gum combined with it. The wood and the cones are taken at the latter end of Autumn, for their oil; and in distillation with water a large quantity of essen- tial oil arises. The oil drawn from the wood is nearly similar to the oil of turpentine. That obtained from the fresh cones is superior in subfility and fragrance to nil the oils of turpentine usually met with. Neumann. The tops and the cones of the fir-tree are mode- rately warm, promote perspiration, and increase the discharge by urine. Four ounces of the fresh tops are put to a gallon of diet-drink. Fermented with beer, they impart to it a very salutary warmth, highly useful in cutaneous complaints, scurvy, 8cc. A spirit distilled from the young leaves is a suc- cedaneum for the aq. Hungarica. The Ess. Abietis Pharmacop. August, is the balsam of the fir-tree, joined with scurvy-grass : the fir-cones, while young, tender, and of a red colour, are bruised and digested two days in four times their quantity of spirit of scurvy-grass, then the tincture is pressed out. The tops and leaves of the silver fir are used in mak- ing Brunswick mum. A'BIES CEMBRA,Lin. 1419, affords the balsam oj Libanus, or the Carpathian balsam. A'bies munghos scopoli, an alpine tree of Hun- * gary,which produces the oleum templinum, or Krumholze . oil. ABIETA'NUM*. OLEUM. See Terebinthina argentoratensis. A'BIGA HERBA, chamepytis, or ground-pine. It is probably so called from abigo, to expel, as it is said to promote delivery. Blancard thinks its name is derived from its leaves resembling those of the abies. ABLACTA'TIO, (from <* priv. and lacto, to suckle.) Ablactation, or Weaning a child from the breast. Also called Apogalactismus. When the mother wants health, or strength; is affected with any constitutional disease, or the milk is in small quantity ; has too small nipples, or ill-formed ones; when the infant will not take the breast;—it is adviseable to wean the child; indeed, often absolutely necessary. It can never be useful to continue the breast more than eight or nine months; but generally^ if a child is favoured with a good supply by sucking, during its first three or four months, -and is healthy, it will rarely be the worse for weaning at a more early period. If it feeds well with the spoon, and is free from disorders in its bowels, a tendency to convulsions, Sec. weaning may be attempted at any time. But, if the child refuses to feed; or, though the diet be changed to gravy and beef tea, the bowels should be disordered, another nurse should be sought for, and weaning must be deferred until more favourable circumstances attend. In general, the sooner a child is weaned, the more easily it parts with the breast. Prudence direets to accustom a child to early feeding with the spoon, and to continue it until the breast may be wholly omitted. In general, children should be fed during the first months three or four times a day ; and, if not suckled in the night, once at. least, if not twice, during that period. Suckling in the night should, if possible, be avoided ; for the mo- ther, especially in the higher ranks of life, wants some hours of respite. If the child is early brought to regu- lar hours of feeding, it will soon give little trouble. The food should be simple and light; without wine, or spices. Well fermented bread, baked hard, and re- duced to powder, will make a proper food, w hen boiled smooth in water. Should the stomach be flatulent, a few caraway seeds may be added. If this food turn sour, beef or mutton tea (prepared by infusion only) may be occasionally substituted, or a little beef gravy may be given. A child will in feeding always first en- deavour to drink. He may be allowed to do so with moderation. A little time should be suffered to elapse, and the soaked bread should then be offered. If re- fused, he may drink again, but in less quantity ; and ABO 5 ABO should he still refuse the bread, it is a sign that he does not require any solid food.. In feeding, he should be in a sitting posture, or, if recumbent, should be oc- casionally raised, gently moved, and amused. After feeding, he will soon sleep ; but a child should never be awakened, unless the sleep be uneasy or morbidly continued.—Moss, Cadogan, and Armstrong. See Teething. ABLE'PSIA, ablepsy, (« priv. and $*.ticu, video.) Blindness, want of sight, rashness, indiscretion. ABLU'ENTIA MEDICAMENTA, (from abluo, to wash off.) Medicines suited to wash off from the ex- ternal or internal surfaces of the body any matters im- properly adhering to them. ABLU'TIO, (from ablu'gf to wash away,) ablu- tion. A washing or cleansing either of the body or intestines. In chemistry, it signifies the purifying of a body by repeated effusions of a proper liquor: this is done various ways, by cohobation, circulation, &c. See Cohobatio. ABO'MASUM, (from ab, dim. and omasum, the sto- mach of a beast.) The name of the fourth stomach of a beast that chews the an abscess ; (from abscedo, to de- ABSCE'SSUS, $ fiart;) or from abs and cedo, to retire.) A cavity containing pus, or a collectkm of matter in a part. So called, because the parts which were joined are now separated; one part recedes from another, to make way for the collected matter. Terme'd also Diapyema; dubletus, an Arabic term; and exi- tura. A7roo-Ti)i*.ct and a,7rotrTx0es, gurges profundus, a deep whirlpool or gulf). It was a mystic term of the followers of Paracelsus. ACA'CIA, (from ax«£«y, to sharpen). The Egyp- tian thorn, Or BINDING BEAN-TKEE. Several species are enumerated by botanists; but the two sorts used in medicine are, 1. Acacia Vera; called, by Caspar Bauhine, acacia foliis scorpioidis leguminosse; and, by others, acacia ueravet, spina Egyptiaca. It is the mimosa Nilotica. Sp. PI. L. 1506. The true acacia, or Egyptian thorn, pro- duces the true gum arable. See Gummi arabicum. It is remarkable that the leaves and flowers of the black thorn are purgative, though the juice from the other part is astringent. The acacia used in medicine., and brought from Egypt, is ? mild, subastringent, gummy substance. We receive it in roundish pieces, wrapped up in blad- ders ; and it is of a blackish brown colour outwardly, but of a tan colour inwardly ; of a hardish consistence, but not quite dry. Lemery says, that " it is made by ex- pression out of the fruit of the Egyptian thorn, either ripe or unripe: from the ripe fruit there is a black juice, from the unripe a red or yellow one, and of a sweet scent; and that this last is what is intended by Dioscorides." It hath no smell: applied to the tongue it soon softens; is of a moderately rough but an agree- able taste, which is followed by a swcetisbness: it totally dissolves in water; so that any fraudulent ad- dition may be discovered : rectified spirit dissolves but a small proportion, though vegetable astringents gene- rally give out their virtue to spirit of wine as well.as to water. The Egyptian acacia is now seldom used as a me- dicine, but is superseded by the terra japonica, the production of-a similar plant belonging to the same genus, whose appellation, kate or kataa, is not very different from that of the substance we are now con- sidering. It was used in all cases of laxity and exces- sive discharges; indeed in every disease where astrin- gents are indicated. 2. Aca'cia Germa'nica, called also Prunus Syl- vestris, Lin. Sp. PI. 681. It is the prunus spinosa ; or prunus sylvestris spinosa, foliis lanceolatis pe- dunculis solitariis of Linn^us. German acacia, or the German black-thorn, or sloe-tree. The German acacia .is the inspissated juice of the German wild sloes; it is of the same nature as the true sort; but in England the inspissated juice of unripe sloes of our own growth is the general substitute : it is harder, heavier, darker coloured, being almost black, and sharper tasted than the true sort. Dose 3ss. ACA'CIA ALTERA TRI'FOLIA, see Cytisus spinosus ; for that called gloriosa, see Bonduch in- dorum ; acacia gummi, see Gummi arabicum. Aca'cia Indica. See Tamarindus. Aca'cia Malabarica globosa. See Intsia. Aca'cia orbis Americani. See Poinciana. Aca'cia Zeylonica. See Campechense lig- num. ACA'JA, also called prunus Brasiliensis. It is a large tree growing in Brasil. It produces clusters of yellowish white flowers, which are followed by yellow plums, with a large stone in them. The leaves are acid and astringent, and are an agreeable' sauce with meat; the wood is light as cork, and of a red colour; the buds and tops are used as pickles. Raii Hist. ACAJA'IBA, or Acaia'iba. Arbor pomifera et prunifera Indica. It is also called cajum, cassu, catee, cajou, acajou, and kapa mata. Sp. Fl. 548. The cajou or cassu-tree. There is but one species yet known, and this is the acajou, or cashew-nit, so common in Ame- rica, and in the West Indian islands. It produces its fruit in August and September; except in Brasil, where it is a native, and there it flowers in these months, and bears its fruit in December, which, when roasted, is as agreeable as an almond. If you bite the whole fruit when raw, it excoriates the mouth ; therefore it must be first cut open, dipped in water, and sprinkled with salt. The acrid oil in the shell destroys tetters, ring- worms, chiques, &c. The painters use it to make their black colouring durable. The tree, when wounded, yields a gum, which re- sembles the gum arabic. Raii Hist ACA'JOU. See Acajaiba. ACALE'PHE, a nettle, (from «, negative, v*A», agreeable, and «$*, a touch), because the touch, as it hurts, is not agreeable. See Urtica. There is also a fish and sea-fowl thus named. AC^A NOR, a chemical furnace. ACA'NTHA, (from «*„, a point,) any sort of AC A 21 ACE thorn; any thing prickly, or with sharp points; also the shin or spine of the tibia; and sometimes the spina dorsi. ACANTHA'BOLUS, (from .«*«v0es, a thorn, and fiuXXu, to cast, or cast out). It is an instrument, de- scribed by Paulus JLgineta, for taking out thorns when stuck into the flesh. It resembles the instrument styled Volsella, for extracting bones from the Eso- phagus, and any foreign matter from wounds. Celsus, viii. 30. ACANTHA'CEOUS, (from ukuv6x, a thorn,) acan- thaceous, a botanic term applied to the plants of the thistle kind, which are prickly ; also to any other prickly or pointed substance. ACANTHA'LEUCE, (from u.y.xt6ct, a thorn, and XtvMs, white). White-thorn. ACA'NTHALRUCA. See Echinopus. ACA'NTHE. The name of the artichoke in an- cient authors. ACA'NTHI'CE, ukudSikti, supposed to be the pro- duct of the carline thistle. ACA'NTHI'NA MAS'TICHE. See Carduus pi- NEA. ACA'NTHINUM (gum). See Gum arabic • Acanthinum lignum, Brasil wood. ACA'NTHION, the hedge-hog. See Echinus. ACA'NTHUS, (from «t«itf«, a thorn). A. Mollis,- Lin. Sp. PI. 891. Branca-ursina of the shops. Bear's breech, or brank ursine. Nat. Order Personate. It is a native of the southern parts of Eu- rope, cultivated in our gardens, flowers in June and July, and is perennial. The roots are very mucilaginous, and the leaves are so in a lesser degree. This mucilage is demulcent, and a good substitute for the marsh-mallow. See Plica Polonica. The herb-women too often sell the leaves of helle- boraster, or bear's-foot, and of sphondylium, orcow's- parsnep, for the bear's breech. ACAPA'TLI. See Piper Longum. De Laet. Ind. Occid. 231. ACA'PNON. See Origanum Anglicum. (From x, neg. and kxitvos, smoke). Applied also to honey ta- ken from the hive without smoke. ACA'RUS, (from «»«£*!«, small). A small insect which is said to breed in wax; also an insect in the skin like a louse. Vide Phthiriasis. A'CARON, (from u.*.ctpm, small,) small myrtle. See Myrtus Brabantica. ACA'RTUM. See Plumbum, N° 4. ACA'TALIS, (from « neg. and x«.rtw, to want,) from the abundance of its seed : the juniper is so named. See Juniperus. ACATA'POSIS, (from «.,non, and x-xtxtivu, deglu- tio). See Deglutitio. ACATA'STATtE, (from «, neg. and KctBio-Tn^i, to de- termine). Fevers anomalous in their appearance, and irregular in their paroxyms. ACATH'ARSIA, (from «, non, and xaBaipu, to purge). The impurity in a diseased body not yet purged off. ACAU'LIS, ~) of a, negative, and k.uv\o<;, caulis, ACAU'LOS,) a stalk or stem, without stem or stalk. A plant is said to be acaulis which has no stem, but whose flower rests on the ground, as in the carline diistle. ACCELERATO'RES URI'NJE, accelerator* of the urine, (from accelero, to hasten). Called also uri- ne stimulatores. They hasten the ejection of the urine and semen. The acceleratores urine arise fleshy from the sphinc- ter ani, and superior part of the urethra, and tendinous from the ischium. They are inserted into the corpus cavernosum, from near their beginning to a little below their union. Douglas. Dr. Hunter observes, that the acceleratores urine are fixed to and surround the bulbous part of the urethra, meeting in a middle line or tendon at its ex- ternal posterior part. They are blended, at the end of the bulbous part of the urethra, with the other muscles of the part; when these muscles are put into action, they contract upon the urethra, thereby making it nar- rower, and expelling the last drops of urine. The semen also meets with a fresh impulse from these muscles contracting upon it, when it is in the bulbous part of the urethra ; and this seems the chief reason of its being larger in one part than another, that the semen and urine may meet with a reservoir in their passage, where they found a fresh contracting force or power to-forward their expulsion. ACCE'SSIO, (from accedo, to approach,) acces- sion. The beginning of the paroxysm of an intermit- tent fever, Sec. ACCESSO'RlUS, (from accedo, to approach to- wards,) accessory. So the eighth pair of nerves is named. Willis hath given the same appellation to some branches from the eighth pair of nerves. They arise by several filaments from both sides of the medulla spinalis of the neck. Having advanced to the first ver- tebra, each is fixed to the back side of the ganglion of the nervus suboccipital'^, or tenth pair; then again run upwards into the cranium by the great occipital hole, communicate with the ninth and tenth, return out of the cranium,* and in their passage join the eighth pair ; afterwards turning backward, and perforating the mus- culus sterno-mastoideus, terminate in the trapezius, having first sent some branches to the rhomboides. ACCESSO'RlUS, (musculus). Vide Flexor di- gitorum accessorius, and Longus pedis. ACCESSO'RIUS-SACRO-LUMBA'RIS,velLUM- BA'LIS. See Sacro lumbaris. AC'CIPITER, (from accipio, to take,) the hawk. In chirurgical language, it is the name of a bandage which was put over the nose ; and it was so called be- cause it resembled the claw of the hawk. ACCIPITRINA, (from accipiter, the hawk,) herb hawkweed. Because hawks were said to scratch it, and apply the juice to their eyes to prevent blindness. The flix weed has also the same appellation. See Hi- eracium and Sophia. ACCLI'VIS, (from ad, and clivis, an ascent). See Obliquus ascendens abdominis. ACCOUCHEMENT, (Fr. lying in, delivery,) and hence the practitioners have been styled Accou- cheurs. AC'CRETIO, {from ad, and cresco, to grow to,) accretion, growth, and nutrition. See N'utri- catio ; also a growing together, as the fingers or toes to one another. ACE'PIIALOS, (from «, negative, and xs0*au, a Jiead,) applied to monsters born without head*, in- A C h) -2.2 A C 15 stances of which occur in Schenkius Paraeus, Wolfius, Mauriceau, &c. These are collected by Wepfer, and modern collections contain similar instances. A'CER, the Maple-tree, (from acer,) because of the sharpness of its" juice. The great maple-tree, falsely called sycamore, is the pseudo platanus. Lin. Sp. Plant. 1495. It is also called platanus tragi. The maple is a large tree, common in England, but a native of Austria and Switzerland. It is not much in use as a medicine, though its juice, if drunk whilst fresh, is said to be a good anti- scorbutic. All its parts contain a saccharine fluid ; and if the root, trunk, or branches^ are wounded in the spring, a large quantity of liquor is discharged, which, when in- spissated, yields a brown sort of sugar, and a syrup like the molasses. Large quantities of this sugar are ob- tained from the trees in New England and Canada, and is much used in France, where it is commonly known by the name of saccharum Canadense, and saccharum acernum, maple-sugar. It has been supposed that all Europe might be supplied from the maples of America, but the sugar is coarse and ill-tasted. A'CERATOS, (from a.,-non, and %tfxo>, to mix). Hippocrates applies this term to the unmixed, uncor- rupted humours of the body. A'CER V1RGINIANUM, odoratum. Liquid am- ber. See Liquid amber. ACE'RBITAS, (from deer, sharp,) acerbity, sour- ness. ACE'RBUS, souu, harsh ; or a sourness with as- tringency ; also bitter. ACE'RIDES, Awpihs, (from «, negative, and xypoq, wax). Plasters made without wax. ACERO'SUS, (from x%vpov, chaff). It is used to signify that sort of brown bread which is made with- out first separating the bran ; and in botany it is ap- plied to a leaf which is surrounded at the base by branny scales. A'CESCENT, substances which readily run into the acid fermentation ; sometimes applied to fluids in which this fermentation has commenced. ACES'TIDES, (from «xjj, a point). The names of the chimneys of the furnaces where brass was made. They were narrow at the top to receive the fumes of the melting metal, and to collect them, that the cadmia might be produced more abundantly. Also the roof of the furnaces in which copper is fused : they are closed so as to detain the corpuscles which fly off. ACE'STIS. See Borax. ACE'STORIS, (xxtFTopis, from ukso^xi, to cure). It -Arictly signifies a female physician, and is used for midwife. Hence curable diseases are called \cestje. ACE'STRIDES. Midwives. ACETA'BULUM, (xotv/jj, x«tkAj7>v, which is the same measure as the ancients called ace- tabulum, seems to be derived from og»«, vinegar. The acetabulum, which receives the head of the thigh-bone, called also costyle, is formed by the juncture of the os ilium, ischium, and os pubis ; the edge of this cavity- is called supcrcilium, and is very prominent on the up- per part; the cavity is deeper on the upper and back part than on the lower and fore part. In the natural state, this cavity is increased by an additional elastic circle, which is united to its edge ; it yields easily both ways to any pressure, but recovers itself when the force is removed. Acetabulum also signifies a sort of glandular sub- stance found in the placenta of some animals. Set COTYLEDONES. The ancient measure thus named was about the one- eighth of a pint. Acetabulum, see Crassula. Aceta'bulum mar. min. See Androcase. ACETA'R, (from acetum, vinegar,) a sallad of crude- vegetables, to be eaten with vinegar, oil, and salt. ACETARIA, Pickles. The unripe melons, young cucumbers, the seeds of the nasturtium, are preserved with vinegar and rendered warmer with garlic and shal- lot, under this name. The East-India mango is a plum highly flavoured with garlic ; and, in imitation of this flavour, cabbage shred in slips, broccoli heads, onions, Sec. with garlic, and Cayenne pepper, are sold under the title of Pickalella. See Condiments. ACETA'RIUM SCORBU'TICUM. A kind of pickle, in which Dr. Bates advises scorbutic patients vto dip their victuals before they eat it. It is thus made : &. Fol. cochlear, marin. | iij. sacchar alb. \ vj. sal cochlear. | i. bene contund. simul. et adde succ. aurant. § vj. ACETO'SA. See Acetosella. ACETO'SELLA, so called from the acidity of its leaves. The plants of this acid nature employed in medicine belong to the genus oxalis L. and are the O' Acetosella Sp. PI. 620, O.Cornuculata623 ; O. Cernua Wildenow, vol. ii. p. 717. This genus of plants, by the labours of Jacquin and Thunberg, is considerablv augmented ; and the last edition of Linnjeus, by Wil- denow, contains 83 species, the greater number of which are subacid, containing, in modern chemical language, super-oxalate of potash, viz. the alkali more than saturated with the oxalic acid. Some of these species are more acid than others : the common wood sorrel is the least so. Some species of the rumex have had the same appellation, (Rumex Acetosa L Sp PI 481,) as the leaf stalks are sour ; and the same acidity occurs in the leaf stalks of the rheum compactum, a plant nearly allied to the docks. The juice of sorrel is sometimes used as an agreeable refrigerating drink in fevers, and sometimes the leaves are boiled in milk, o form a pleasant whey. Externally, they are thought to promote suppuration, particularly in indolent scro- fulous humours. I he seeds are slightly astringent ■ and indeed we seldom find astringent in any far 'o \ plant, but we discover acidity in some other. The ex-' Z^lfc JU1(,liS?OWnever used' and the conserve is re- ser e bTne" f1S?enSat°rieS : h is P1™** as a con- serve, but nearly inert as a medicine. The salt of lemons, as it is called, is only the salt of wood sorre^ and sometimes supposed to be cream of tav:.:r, wrh ACE 23 VCE a little sulphuric acid. It is chiefly used for taking out the stains of ink from linen; and, were the muriatic acid added, the salt would be scarcely inferior in this power. A great part of the acid of sorrel may be obtained in the form of a concrete salt, which is more acid than that of tartar, more easily soluble in water, and less, if at all, purgative; the wood sorrel yields near one-hundredth part of the weight of the fresh leaves. Different methods have been proposed to separate the mucilage of the expressed juicesr which is the great impediment to their crystallization. The method of Stahl, and the elder chemists, consisted in repeated affusions of alcohol. The process of Scheele is .now generally adopted: it consists in combining the acid with calcareous earth, Avhich forms a neutral nearly in- soluble in water: this neutral may then be repeatedly washed, and the vegetable acid recovered by the addi- tion of the sulphuric. This was the process recom- mended for the salt of lemons, and is the method by which Mr. Coxwell's concrete salt is prepared. But he wisely, we have been told, directs the chalk to be com- bined with the acid in the country; and it is imported in the form of the earthy salt; so that the fruit is not liable to injury by packing," and the inconveniencies of a sea voyage. ACETUM, Vinegar. This is the second state in which the saccharine juices of vegetables appear in consequence of a spontaneous fermentation, in a heat of about 80° of Fahrenheit. In the first it becomes a wine; but a saccharine substance seems to be the principle, from which spirit is mostly formed, and mucilage that of vinegar. In the general subjects of fermentation they are united, and the acetous follows the vinous state. Should gluten predominate in the mixture, ammonia is soon discoverable, and the liquor turns putrid. In the acetous fermentation, much air is absorbed, which is apparently oxygen. See Fermentation. Acetous acid may be formed in other ways, inde- pendent of fermentation. It is separated from many vegetable substances by distillation. Water and car- bonic acid gas are at the same time raised, and char- coal deposited. The action of nitric acid on many ve- getable substances, particularly gum and farina, also produces it with the same residuum of charcoal, and exhalation of carbonic acid gas and water. This acid also appears in some changes where putrefaction is ap- parently going on; as in the animal economy, where the urea is separated from the urine. Acetated lead produced from this acid, and the metal, forms a curious subject of speculation. By means-of the lead it appears to regain its original state of a saccharine matter; for this substance may be fermented, again produce a vinous spirit, and ultimately again vinegar. See Neumann's Chemistry. Vegetable liquors, in proportion to the quantity of their saccharine parts, ferment into a weaker or stronger kind of wine; a second fermentation forms vinegar. When malt liquor becomes acid, it is called allicar, Allegar. It is not so proper either for medical use, or preserving pickles, as the wine vinegar; for it abounds too much with mucilage, which is productive of many disadvantages; yet this is the only vinegar that we pro- cure in England. I f vinegar be distilled with a heat not exceeding that of boiling water, it yields first a phlegmatic liquor (w in u is a spirit slightly vinous); then a slightly acid one, which is succeeded by stronger acids, till the matter re- maining becomes thick as honey; if now it is urged with a greater heat, an empyreumatic oil ascends, and a penetrating acid spirit, tainted with the ill smell and yellow colour of the oil; and at last there remains v. black coal, which, when burnt into white ashes, yields a considerable proportion of fixed alkaline salt. By distillation, vinegar is separated from its muci- lage, tartar, Sec. -Its specific gravity is then reduced from 1.0135 or 1.0251 (for it generally varies) to 1.0005. By boiling a few minutes, it keeps a long time with little change. The stronger and more spiritous the wine, the stronger is the vinegar into which it is converted. Geoffroy says, that vinegars made of the German and French wines saturate from one-fortieth to one-twelfth of their weight of fixed alkaline salt. Vinegar is mixed with the mineral acids by some fraudulent dealers, and the vitriolic, as the cheapest, is most commonly employed. The slightest portion may be detected, by adding a solution of muriated barytes, or a larger, by a saturated solution of chalk. In either case, a white sediment is deposited. Lead is sometimes accidentally present, and may be disco- vered by the liquor probatorius. See Liquor Proba- TORfrUS. The fermentation which changes wine into vinegar gives the latter several properties extremely different from those of the former, which are well known. Vi- negar is ultimately decomposed by nitric acid, or by fire, when combined with fixed alkali to repress its vo- latility. It is then found to consist of carbone, hydro- gen, and oxygen, but the proportions are not known. It is concentrated by freezing; but the purest acetous acid freezes at about 22° of Fahrenheit, and by distilling it when combined with powdered charcoal. For its affi- nities, see Elective attractions: Vinegar dissolves animal earths, if not very much mixed with gelatinous matter; the earth of alum, and calcareous earths; it oxidates several metallic substances, as zinc, iron, copper, nickel, tin, and lead. It combines with earths, alkalis, and metallic oxides; it dissolves the vegetable inspissated juices, and extracts the virtues of many plants ; to many of which it seems to impart ad- ditional power, particularly to the onion tribe. In in- flammatory and putrid diseases, in many instances, its efficacy is considerable: in ardent fevers it is an useful antiphlogistic and sudorific: in putrid disorders it is a preservative and restorer. Fainting, lethargic, and hys- teric paroxysms are much relieved by it, if applied to the nose and mouth ; even in many instances more than by volatile alkaline spirits, or fetid gums. In the mili- ary fever it is a powerful assistant. Th,e vegetable acid has a peculiar power in restoring sweetness to putrid bile ; and that obtained from the fresh vegetable fruits is more useful than the mineral acids. Besides, when a putrid colluvies is lodged in the first passage, this acid gently tends to solicit its discharge by stool; an advan- tage not to be expected from the mineral tribe. Externally applied, vinegar is a powerful resolvent and relaxant. When applied to any sensible membrane, it acts as an astringent; and, more or less diluted with water, is an excellent gargle for an inflamed throat. ACE 24 AC 11 and for an injection to moderate the fluor albus. See Acida. It has been lately recommended in burns, whether there is a loss of substance or not. The burnt part is to be bathed in vinegar, till the pain ceases; then a com- mon poultice with finely powdered chalk strewed on it is to be applied. This poultice at first must be changed every four hours, and afterwards two or three times a day. When there is no loss of substance, the vesicles are filled with a coagulated fluid, under which the skin soon heals. As a cooling application in bruises, its use is well known; and it is frequently applied in its cold state to the nose in cases of, haemorrhage. In monorr- hagia, particularly the profluvia after parturition, ap- plied cold to the loins and abdomen, it is very service- able. Chilblains are also often relieved, corns and galls softened by it. An imprudent use of vinegar is not without consider- able inconveniences; large and frequent doses produce leanness and an atrophy; when taken to excess, to re- duce a corpulent habit, tubercles in the lungs and a con- sumption have been the consequence : young children, old people, those whose circulation is languid, vital heat defective, and digestion weak, should perhaps be spar- ing in its use. The dose, according to the different circumstances of the case requiring it, and the constitution of the patient, may be from ^ ss. to § iij. See the Dictionary of Chemistry, translated from the French of M. Macquer, edit. *2, article Vinegar. Cul- len's Mat. Med. Chaptal's Chemistry, vol. iii. 268. Thompson's Chemistry, 2d edit. Parkinson's Chemi- cal Pocket-book. ACE'TUM DISTILLA'TUM, seu Sp. Aceti. Dis- tilled vinegar. Acetous acid. Distil wine vinegar with a gentle heat as long as the drops fall free from an empyreuma. The first pint that is drawn off is a weak vinous spi- rit, and should be taken away, another receiver being placed for the acid. Malt vinegar, however strong, is improper for distilling, because it so readily receives an empyreumatic taste from the mucilage which it con- tains ; a circumstance to which the best wine vinegar is subject, if more than about two-thirds is drawn over. If given, in the quantity of two or three ounces in a day for some time after bleeding, and purging where neces- sary, it has been recommended in maniacal cases. When vinegar is concentrated, it creates an appetite; hence Acetum Esurinum.—-LYTHARGYRI'TIS. See Plum- bum, N° 2.—PROPHYLA'CTICUM (see Prophy- l vce) is thus made. §, flor. lavend. et rorism. fol. ruts, absinth, salviae, menth, aa m. i. aceti vim cong. i. infund. in B. A. per 8 dies. R, hujus tinct. ffc i. camph. 3 iij. m.—Acetum proph. also called the vinegar of the four thieves; for, during the plague of Mar- seilles, four persons, by the use of it, attended many of the sick unhurt; under the colour of their service, they robbed the sick and the dead: one of them being ap- prehended, saved himself from the gallows by discover- ing this remedy. In the foreign pharmacopeias there are many prepa- rations in which vinegar is the menstruum; and luxury has introduced many as sauces, or to add a flavour or poignancy to sallads. With these last we have no busi- ness, and need only remark, that when the object is to give an additional warmth or stimulus, they arc not misap- plied. Vinegar of horse-radish and elder (Plenck Phar- mac. chirurg.) are chiefly useful as cosmetics. Vinegar of rue (idem) is supposed to be highly antiseptic; but the most useful acetum is the camphorated. A drachm of camphor is dissolved in ten ounces of good vinegar (id.); and a preparation not very dissimilar is recom- mended in mania by Mr. Pargeter. Numerous prepa- rations under the title of aceta prophylactica, occur in the foreign dispensatories, which consist only of differ- ent aromatics infused in vinegar, differing from the fan- cies of the prescriber, but scarcely varying in the in- tention or effects. Vinegar, we have said, may be concentrated by cold, and by distillation from powdered charcoal. What is called the acetic acid is vinegar, hot only more con- centrated, but somewhat different in its properties. It certainly possesses a larger proportion of oxygen, as will be evident from its preparation, which consists in distilling vinegar from its combination with metallic oxyds, chiefly from copper; and that this method not only enables it to rise without the usual proportion of water, but imparts oxygen, is evident from the same effect being produced by adding sulphuric acid to the union of vinegar with soda," when a part of the mineral acid is decomposed. The acetic acid is peculiarly volatile and pungent, the most carefully ground glass stoppers being unable to confine its fumes. Glass and gold can alone retain it without being injured. Its specific gravity is 1.0626. The salts produced by this acid are called acetats, while those made with the common acid are styled acetites. Though these salts differ somewhat in their properties, we have no evi- dence of their differing in their medical virtues. See Fourcroy Connoissances, v. viii. Annales de Chymie, xxvii. 299. ACHA'HI. See Aqua aluminosa under Alu- men. ACHANACA, an Indian plant much used by the natives as a remedy for venereal complaints : its genus is unknown. ACHE, a pain: in old authors the name of the apium palustre : the smallage. ACHIA, ACHIAR, ACHAR, the buds of the bam- boo tree pickled with spices and other ingredients, im- ported from India to Holland in earthen vessels: they partake of the virtues and inconveniences of Pickles. See Condiments and Acetaria. ACHI'COLUM. The fornix, or sudatorium, suda- tory, of the ancient baths, which was a hot room to sweat in, called also architholus. ACHILLE'A. The achilleas take their name from Achilles, because with this he is said to have cured Telephus. Linnaeus uses the word achillea as the ge- neric term for yarrow, milfoil, or sneezewort. For an account of the different species see Ageratum. The naT™!ST? ,°TfT!ieJed Sum' now called dragon's blood, ACHIL'LIS TENDO, see Tendo Achtllis. ACHIMENUS. A genus of plants formed by Vahl among the didynamiae angiospermse, in the family of the personatae. It consists of a single species only, hgured in Rheed's Malabar, ix. tab. 87, growing in Cochin China, called by Louveiro dicera. It resembles wood sorrel in taste, and is eaten in sallads as well as dressed. A C JI 25 A C 11 ACHIO'TE. The red grains of acbiotl made into lozenges. ACHIOTL: also the bixa oviedi, daburi. A sort of orleana, growing in New Spain and Brasil, from the bixa orellana Lin. Sp. PL 730. The tincture from the fruit used in chocolate is thus made: take the grains when ripe, infuse them in hot water; the sediment is made into cakes, and is used as a paint for the face. The roucou, which the Indians call achiotl or urucu, the Dutch orleane, and we roucou, is a meal or flour of a seed from the Leeward islands and the isle of St. Do- mingo : these seeds are of a Vermillion colour. The roucou is made in these islands, as we make starch. Choose the roucou of the deepest violet colour, and very dry. Its chief use is among the dyers. See Or- leana. A'CHLYS. A dimness of sight, (from «^A^s3 darkness or cloudiness). It also signifies a small scar or mark over the pupil, of a light blue colour. .It is usually synonymous with caligo cornee, or blindness from opacity of the cornea. See Cullen's Nosology. It is the Leucoma nephelium of Sauvages, and is de- scribed as a speck of the cornea, somewhat pellucid, which occasions objects to appear as if seen through smoke, or a cloud. By inspection obliquely it is disco- vered to be different from the opacity of the aqueous humour, accompanying some diseases of the eye. This disease consists in an obstruction of the lymphatic ar- teries of the cornea, and is often the consequence of more active inflammation. Any powder, mild and so- luble, thrown into the eye; a drop or two of emetic wine, or of tincture of opium, will remove it; but in children it vanishes spontaneously. A very complicated ointment is recommended by Mr. Bell for this cqmplaint, and for diseases of the eye- lids, copied from Pellier. We shall not transcribe it, since, from frequent experience, we have found equal parts of unguentum mercuriale and saturninum as ef- fectual. In fact, it is only a combination of mercury, zinc, and lead, though operose and inelegant; the bal- sam. Peruv. adding nothing to its efficacy. The oint- ment of M. de Gravers has no lead, but the zinc sup- plies its place, and the efficacy is increased, by the ad- dition of one-fifth of the compound tincture of benzoin. See Albugo oculorum, and also Wallis's Nosologia Methodica Oculorum. A'CHNE, xx,n. Chaff or the froth of the sea. Hippocrates expresses by it a whitish mucilage observ- ed in the eyes of patients who have fevers : also a white mucus in the fauces thrown up from the lungs. Be- sides these it signifies Lint. See Carbasus. ACHOAVAN. A kind of chamomile mentioned by Prosper Alpinus : its species is not known. V. Cha- momile. Avicenna seems to have meant by it the marum. A'CHOLOS, (from *, neg. and #«>nj, bile,) applied to animals supposed to be without-bile. A'CHOR, *x.uh 9.u- *WU?> (from *%v>i, bran; so called from the branny scales thrown off). Lac- tumen : abas, acores, cerion ; favus. The crusta lactea of authors, and in England the scald head. Trallian says, that it is a sore on the outside of the head, full of little perforations, which discharge a humour like ichor. He adds, that the cerion resembles an achor ; but that the mouths of the perforations are larger, re- VOL. I. sembling the cells of a honey-comb, whence the name ; the matter is also nearly of the consistence of thin honey. When these diseases spread, the serum which oozes out dries, and forms a scab. It is, however, in general, only an obstruction in the circulation of the bulbs of the hair, and sometimes of the sebaceous glands. Dr. Willan, in his description of different kinds of pustules, defines the achor, a pustule of intermediate size between the phlyzacium and psydacium, which contains a straw-coloured fluid, having the appearance, and nearly the consistence, of strained honey. It ap- pears most frequently about the head, and is succeeded by a dull white or yellowish scab. Pustules of this kind, when so large as nearly to equal the size of phly- zacia, are termed ceria, or favi, being succeeded by a yellow, semi-transparent, and sometimes cellular scab, like a honey-comb. The achor differs from the favus and tinea only in the degree of virulence. It is called favus when the perforations are large; and tinea when they are like those which are made by moths in cloth: but gene- rally by tinea is understood a dry scab on the hairy scalp of children, with thick scales and an offensive smell; when this disorder affects the face, it is called crusta lactea, or milk-scab. Mr. Bell, in his Trea- tise-on Ulcers, says, that the tinea capitis' and crusta lactea may both be reduced to the same species of herpes, viz. the herpespustulosus,(which see,) they being naturally the same, differing only in situation; the tinea is on the hair scalp, and the crusta lactea on the face. Dr/Cullen improperly places this disease under Ulcus ; as a synonyme; where also he places the Crusta lactea ; but the whole class locales is very carelessly arranged. When it happens to children, if in other respects they are healthy, the best treatment, besides keeping the belly moderately lax, is cleanliness and a moderate diet; an issue may be made and con- tinued till the disorder is cleared and the strength of the constitution established; the hair must be kept short, and the head washed with soap-suds. Some instances of this sort are very difficult of cure, and attended with violent itching, a pale countenance, &c.; but still the same method generally succeeds in all the species and degrees of virulence. Small doses of calomel may he given as an alterative rather than as a laxative, and the vinum antimon. in such doses, at proper intervals, as the stomach will easily retain. Though in general it is a local disease, yet the constitution is sometimes in fault, and internal remedies should not be neglected. When hastily and imprudently repelled, also, disagreeable-con- sequences have ensued. Externally, washing with soap, particularly the black soft soap, and occasionally using the ung. e pice, will succeed; but, in the more inveterate cases, the un- guentum ad scabiem of Banyer's Pharmacopoeia Pau- perum, (quod vide,) lowered with an equal part of axyngia, is necessary. Should this fail, the only remedy is to pull out each hair, by tweezers, or to put on a pitch cap, which when taken off draws them out at once—a cruel practice, but sometimes indispensable. A wash, consisting of a solution of corrosive sublimate, in the proportion of ten grains to a pint of water, has sometimes succeeded. The unguentum picis cum sul- phure of the Pharmacopoeia of Guy's Hospital is often A C I 26 AC I advantageous ; but the head must be constantly close shaved, and an oil-skin cap worn, which, alone, will sometimes cure the complaint. This ointment is com- posed of half a pound of tar, half an ounce of wax, and two ounces of flour of sulphur. More lately, shaving the head, and keeping up a steady pressure by means of slips of sticking plaster, have appeared more effectual than the oil-skin cap. Among the ancients, Aetius, iEgineta, Trallian, Oribasius, Galen, &c. treat professedly on these dis- orders : amongst the later authors, Heister and Turner may be consulted, with the still later writers, as Bell, in his Surgery, and his Treatise on Ulcers, p. 376; Moss on the Management of Children, &c.; White's Surgery, p. 69. A'CHY, («£t/,) a species of cassia growing in Arabia, called also Jet^y/rajs. ACIA, a method of healing wounds among the ancients, which is now not easily understood. It is most probably derived from acu, and may be only the twisted suture. ACI'CULARIS,(from acicula,apin or needle,) aci- cular, shaped like a small needle. The trivial name for a species of scirpus. ACID A. Acids, (from acesco, to sharpen). Acids form a species of salts, exciting upon the organ of taste the sensation called sour; which may be regarded as synonymous with acid. Every substance is called acid which gives the impression above specifled to the taste, will change certain blue vegetable colours into red, as the juice of turnsole, syrup of violets, &c. and will, usually, effervesce with alkalies ; we say usually, because this property is not general; for the carbonic acid, and almost all weak acids, cannot be distinguished by this property; and the purest alkali, or what is called caustic or deaerated, combines with acids without effervescence. By a variety of experiments in modern chemistry, acids are found to consist of different sub- stances : to the name of one they give the term oxygen ; and to the other radical; the former considered to be the acidifying principle, the latter the acidiflable base. They further prove, that the oxygenous principle, in all the variety of acids, is universally the same; and that acids themselves only vary on account of the dif- ferent radicals with which that principle is combined. Chemists have also altered the terms, in order to ex- press the degrees of power acids possess; the weaker hey express by the termination ous, the stronger by ic, added to the base or radical; as sulphurous, sul- phuric ; carbonous, carbonic, &c.; except the muriatic and nitrous acid; for the lower order of the former, they say muriatic ; for the higher, oxygenated muriatic; taking the appellation from the acid, and not from the base. Acids are animal, vegetable, and mineral. The ve- getable are the native, as the juice of lemons, &c.; or the product of fermentation, as vinegar and tartar. The mineral are those of sulphur or vitriol, nitre, and common ialt. The animal acid is obtained from ants, and some other insects, in considerable quantities; it is also contained in human fat, and in the suet of animals that ruminate; and an acetous fermentation is some- times excited in some of the animal secretory organs, forming a kind of animal vinegar; in this way the urea of the urine is produced. See Adeps. A vague, volatile, and liquid acid is in all parts of the earth: uniting with various substances, it forms different fossils. Except in the essential salts of vege- tables or in tartar, acids are rarely found m a solid There is great analogy betwixt acid and cold. The spirit of nitre increases the cold of ice. Acid and cold alike preserve from putrefaction, by increasing the co- hesion of the component parts of the respective bodies. Strong acids, and excessive cold, it is true, when ap- plied to the flesh of living animals, mortify them; but this mortification differs greatly in its nature from that produced by fire, and by alkaline salts. South winds favour, but north winds check, the progress of putrid disorders. Acids differ in their specific gravity when compared with water. The acid of vitriol, as 18 to 10 Nitre . 14 to 10, some say 15 to 10 Sea salt 12 to 10 Vegetables 10 plus to 10. This difference shews that some acids are more tena- cious of water than others. If the weaker acids are used, you must pour on more of them to the same quantity of alkaline salt to saturate it; yet the salt will have only attracted the same weight of acid from each. Acids differ in their colour : for the vitriolic is quite pale; the nitrous a dark yellow, frequently fuming, and sometimes of an orange red; the marine a pale golden colour. If bottles containing these three acids are stopped with cork, the cork is soon tinged, by the vitriolic acid, with a black colour ; by the nitrous, with a yellow ; and by the marine, with a whitish one. The vitriolic acid emits no visible vapours in the heat of the atmosphere, but imbibes moisture from it ; the nitrous and muriatic emit copious corrosive fumes ; the nitrous, yellowish red ; and the muriatic, white fumes. For the virtues of the vegetable acid, see Acetum. The mineral acids, when intimately joined with vi- nous spirits, produce effect so similar to those of the vegetable class, that their properties, as medicines, are almost the same. In other respects, the effects of all the kinds of acids are similar. Acids gently irritate and contract our fibres when taken in a dilute state, and thus corroborate; they resist -a putrid tendency, and powerfully oppose pu- trescence when actually existing: by the irritation they promote various secretions; they excite an ap- petite, and aid digestion; their efficacy in fevers of every kind is not exceeded by any thing in use, nor equalled for their general safety, where causes so widely opposite produce such similar complaints: in some instances of coughs and asthmas, in conse- quence of irritation, their efficacy is singular: if the vegetable acid is made use of, the breathing is never disordered by it, though in some instances the mineral acids may offend. In dysenteries, and in diarrhoeas, produced by unripe fruits, the fossil acids allay the fermentation in the bowels; and when a putrid col- luvies in the pnmse viae is the cause, they will be a proper remedy. By their sedative quality, hemorrhages are restrained;- and as bitters are neutralised by vege- table acids, so the excess and acrimony of the bile are allayed by their use. . Acids, astringents,, and bitters, have a great affinity AC1 27 A CI with each other. By a mixture with each other they tose their properties. Vegetable acids lessen the astric- tive power of galls on leather, &c. The mineral acids have a contrary effect. Bitters, both animal and, ve- getable, are neutralised by vegetable acids, less per- fectly by those from the mineral kingdom. See La- voisier and Chaptal's Elements of Chemistry. Dictionary of Chem. Neumann's Chem. Works. Per- cival's Med. Essays. Vegetable acids correct the deleterious effect of most, if not all, narcotic plants; but injure the phleg- matic habit, where the circulation is languid, the bile defective, or the digestion naturally weak. ACIDITAS, (from acesco, to sharpen,) acidity, also acor. Diseases from this cause are frequent. The seat of acidity in our bodies, as a disease, is prin- cipally the stomach and the small intestines. An acid acrimony is never sensibly prevalent in the blood; though it sometimes appears in the urine. An acid acrimony may arise either from too great laxity and debility of the organs of digestion, or from an excess of acescent food. When the digestion is imperfect, an acidity is the consequence, though no such process as fermentation has preceded. The food of children is for the most part of the vegetable kind, and readily turns sour in the stomach, if the body be any way disordered ; hence most of their disorders are accompanied with the evident signs of acidity, as green stools, gripes, &c. Many assert a prevailing acid to be the cause of all diseases in children; but acidity in their stomach is more often an effect than a cause of their complaints. It is not acidity, but its excess that injures. The redundant acid in the primae viae is known by the sourness of the eructations, the frequent cardial- gia, in the stoma.ch,flatulence, and spasms in the in- testines ; the belly is costive, and the nourishment is unduly supplied, a paleness becomes general in the skin, an itching comes on, pustules appear, and a train of nervous symptoms soon succeeds. Indeed, in all diseases peculiar to children, there are, for the most part, symptoms of an excess of irritation: the pufo: sometimes beats one hundred, or one hundred ana twenty in a minute, the stomach is disordered, the ves- sels of the skin are contracted, and epileptic or con- vulsive symptoms appear. Infants are" frequently swept off by this disorder. Among adults, the weakly and sedentary are the only subjects of it, except among the poor, whose scanty supplies reduce them to this unhappy state. The cure, when adults are the subjects, consists of a diet fitted to oppose this faulty habit; animal food and vegetables of the aromatic kind: these, with mo- derate exercise at proper intervals, will often succeed with warm tonics. Absorbent medicines may palliate symptoms in the stomach and intestines, but the lima- tura ferri. will most conduce to an effectual and lasting cure. Children should be exercised more, and fed less than is usual. Antimonial emetics, repeated at intervals of two or three days, until the more dis- agreeable symptoms abate, are highly useful. Small doses of p. rhei, with magnes. alb. so as to keep the belly soluble, is better than more active* purging; and small doses should be given frequently. In- deed, in some cases, small doses of fixed or volatile alkali, particularly aqua ammoniae, have been highi. beneficial, and warm stimulant plasters, applied to the umbilical region, have added to these advantages. Acidity is not peculiar to children, nor does it alway.s depend on the nature of the food. It is a mark of a disordered digestion from many different causes. Cur- dled milk, ejected, is supposed to be a decisive proof of an acid stomach. This, however, is by no means the case : for the stomach of an infant will curdle milk, when it will nof, to the nicest test, discover the slight- est particle of acid. A gouty habit, and the pregnant state, will always bring it on; and, in many constitu- tions, food of every kind will soon become acid, for reasons that we cannot understand. All that can be known is, that the principles of the vegetable acid, for of this nature is the morbid acid of the stomach, arc found in fopd of every kind, and that, when their union is destroyed in the first periods of digestion, a new com- pound takes place. Perhaps this always occurs, and the acid is again enveloped or forms a part of an- other compound, by a subsequent operation. Cal- careous and magnesian earths, therefore, only pal- liate the complaint: the cure depends on strength- ening the stomach. As palliatives, in the chronic cases of acidity, lime-water is one of the best. In the pregnant state, aq. ammoniae purse is preferable. See Van Swieten's Commentaries on Boerhaave's Aphorisms. Medicamentorum Formulae, Dris. Hugh Smith. London Practice of Physic, edit. 6. Ann- strong on Diseases fatal to Infants. Moss on the Ma- nagement of Children, 5cc. ACI'DULjE, (from acidus, sour). Mineral wa- ters that contain a brisk spirit, when unaccompa- nied with heat, are thus named : but if they are hot also, they are called therme. In Paracelsus, Fontale acetosum is of the same import. As to the antiquity of their use, see Galen, Ccelius Aurelianus, Pliny, &c. who speak also of their virtues. Hoffman and many authors highly extol them, whilst others observe that a pure water, on account of its simplicity, such as that from Malvern and Toplitz springs, is to be preferred both for drinking and for bathing; and that these may be well supplied by dis- tilled rain, or any other water that is soft and pure. Objectors allege, that the medicinal qualities in these waters only quicken their operation as water, but con- tribute nothing further, and that solutions of the same materials are of equal efficacy: to which the best reply has been, that the mineral contents are often vola- tile, and more subtile than art can produce ; and that, when the powers of nature are expiring, experience proves their efficacy by their success as a last resource. From the qualities of their contents their use is easily determined. See Aqu.e Medicinales. Bleeding, or purging, or both, are frequently pre- scribed before the use of mineral waters; but, except a plethora attends, they are unnecessary. As these waters are designed to act, so rest or exercise must be advised: rest and a cool situation favour their diuretic tendency; exercise and a warm air determine them to the skin; with temperance and moderation in the re- gimen, these are the principal directions on which suc- cess depends. Their brisk sparkling property is owing to the quan- tity of uncombined carbonic acid gas which they possess; E2 ACM 28 A C O Acidum vitriolicum, vel sulphuris. Olim, Spiritus Salis -Glau- ^nd indeed to this, perhaps, is owing their chief use as medicine. To increase this gas when defective, or to communicate it where it is totally wanting, see Dr. Priestley's directions for impregnating water with fixt air. ACIDULOUS, Subacid. ACIDUM PINGUE, a fancied acid which Meyer substituted to explain the causticity of lime, which Black attributed to the loss of its fixed air or carbonic acid. A'CIDUM FORMIC.E. Formic acid. See For- mica. ACIDUM ARSE'NTCUM. Arsenic acid. This is produced by distilling six parts of nitrous acid, from one of the calx of arsenic. Acidum ^ethe'reum. Acidum alumino'sum. Acidum catho'licon. Acidum primige',nium. Acidum sulphi/reum.^ Acidum muria'ticum. beri. See Mari'num sal. Acidum nitrosum. See Nitrum, N° 5. Acidum vitrio'licum. Olim Oleum Vitrioli; called also Stagma. See Sulphur and Vitri'olum viride, and also A'cida. Acidum vitrio'li vino'sum, i. e. jE'ther vitriolicus. See jE'ther. ACIES, (from xk-k, a point). Steel. See Cha- lybs. ACINAFO'RMIS, (from XKtvxxtn, a scymitar, and forma, shape,) applied to leaves, one of whose edges is sharp and convex, ai\d the other straight and thick, like a Persian scymitar. ACINE'SIA, (from x non, and *.mu, to move). A privation of motion. A'CINI, (from «*jj, a point). The distinct com- ponent parts of the fruit of the mulberry, blackberry, and raspberry. ACINIFO'RMIS. > The coat of the eye, called ACINO'SATU'NICA.5 uvea, or posterior lamina of the iris; because the ancients, who dissected brutes, observed that in them it was usually the colour of an unripe grape. See Uvea. ACINOS, (from «*jj, a point;) so called because its branches are prickly. See Basilicum. ACINUS. Properly a grape, but is applied to other fruits or berries that grow in clusters, as elder berries, privet, ivy, &c. These are distinguished from baccae, or berries that grow single, as those of the laurel. But acinus is also used for the stone of the grape ; hence \j'\m exacina't.e, grapes that have their stones taken out. The glands which grow together in clusters are called by some acini glandulosi. A'CINUS. See Staphyloma. ACIPENSER,Lin. The sturgeon. The species in- troduced into the Materia Alimeritaria and Medica are the A. sturio, huso, and ruthenus, Lin. The roes are salted and dried, and the flesh pickled. These, which may rather be styled condiments than aliments, will be considered in their proper places. Isinglass is pre- pared from the roes of each species, but that from the A. huso is preferred. See Aliments, Condiments, and Isinglass. ACMA'STICA, (from «*/*«.£«, to flourish). See ^WOCHUS. ACMASTICOS, (**a*«£«, vigeo,) a species of fever described by Actuariusjas follows : " Fevers from putrefaction are continual or inter- mittent: of the former some are called isotoni, or ac- mastici, which, during the whole course, are at the same pitch; others are called epacmastici,or anabases ; these proceed and increase to their time of solution; a third sort called paracmastici, which diminish by de- grees till they cease." See Fever. A'CME, (from «xpv, a point). The , height of a disease. That state of a thing in which it is at its utmost perfection. It is also a term in gymnastics, ex- pressing the highest pitch of exercise. ACME'LLA, a plant growing in Ceylon, the verbe- sina acmella Lin. 1271 ; but a similar plant, the siges- beckia orientalis, has been employed. It is commend- ed in nephritic disorders by Linnaeus, but is rarely used. A'CMO. See Corallium rubrlm. ACNE, (from xxw, chaff). A small purple or hard tubercle on the face is thus called, covered with a branny scale. ACNE'STIS(from«negative, andx»«£/», to scratch). That part of the spine which reaches from betwixt the shoulder blades to the loins. This name seems only applicable to quadrupeds, because they cannot reach it to scratch. There is a herb to which this name is given, but the real plant has not been determined. ACO'E, (axev», audio). See Auditus. ACOITUS, honey, (from x non, and koi%, sedi- ment). See Mel. Pliny speaks of it by this name, be- cause it has no sediment. A'CON, an instrument used in the ancient exer- cises ; like the discus, or quoit. ACO'NDYLUS, (from a priv. and xevJWies, a joint). Applied to a flower whose stalk is not divided by joints. ACONE, (xKMti, a hone,) mortar, or rather a hard stone, on which to levigate; more generally, a whet- stone. ACO'NION, (from xovw, a hone,) an ancient Greek name of a medicine prepared by levigation; probably aWollyrium, or some form of powders for the eyes. ACONITIFOLIA, (from aconitum, wolf's-bane, and folium, a leaf). See Anapodophyllon. ACONI'TON, (from x neg. and kovix, lime or plas- ter). Not plastered. This word is applied to vessels not lined within. ACONI'TUM; also called Camarum, Canicida, Cy- nococtanum. Various derivations are given by etymolo- gists; as, 1st, xkow, a whetstone or rock, because it grows on bare rocks. 2dly, * negative, and *«v,s, dust, because it grows without earth. 3dly, x*m, x*v, dart, because they poison darts therewith. 4thly, x*ouo£thood, or common Wolf's-bane, ot which Dr. Storck speaks so much in favour, is the Aconitum napellus tin. Sp. PI. 751, Wilden, G. 1062, Sp. 9. N. Ord. multisiliquae. It is cultivated in our gardens as an ornament; but is spontaneously pro- duced in Germany, and some other northern parts of Lurope. Some authors have supposed that Storck em- ployed the A. camarum: in fact, however, he used the A. neomontanum, and mistook it for the \ na- ACQ 29 AC II pelhis. The different species have been mistaken for each other, but all seem to possess the same proper- ties. The expressed juice of the fresh herb was nfade into an extract by a gentle evaporation, then for internal use the following powder was directed: & extract, aconit. gr. ij. Sacchar. alb.—3 'li m- ^ pulv. subtil. In several instances, this was given from gr. vj. to 3 ss. three times a day,Avith the .happiest success. Its chief sensible effect was its exciting a copious perspira- tion. The cases in which Dr. Storck succeeded by the use of the above powder were, an inveterate gonorrhea, ob- stinate pains after intermittent fevers, tophi and nodes, scirrhous tumours, indurations of the parotid glands, spina ventosa, itch, amaurosis, gouty and rheumatic pains, convulsive disorders, and an anchylosis. Some have given it in tincture, made by adding one part of the dried leaf to six of spirits of wine; the dose, 40 drops. But it has often been given from one. grain, gradually increased to ten, for a dose : indeed Stoll and some others carried it much further. A person who had eaten a small quantity of monk's- hood was presently attacked with a sensation of tin- gling heat in the tongue and jaws, and the teeth seem- ed as if they were loose, and the face as if it was swell- ed. This tingling sensation gradually spread all over the whole body, particularly to the extremities; the knees and ankles lost their strength, and frequent twitching of the tendons came on; soon after a sensible check to the circulation of the blood through the limbs was felt; at length a giddiness supervened; then a mist seemed to collect itself before the eyes; in the ears was a hum- ming noise, the senses failed; the eyes and teeth were fixed, the nose contracted, breathing short, and cold sweats were perceived on the hands, feet, and forehead. All these symptoms followed in less than two hours from the time of eating the sallad, in which the monk's- hood unfortunately was mixed. His friends forced down into'his stomach a quantity of oil and water, and afterwards carduus tea, by which he vomited; these were repeated so as to encourage a thorough discharge from the stomach, and, in the intervals, a few spoonfuls of a stimulating cordial were given: and thus he soon recovered. Some writers say, that the napellus is not poisonous in Sweden, Poland, &c.; but it should be noted, that the napellus, which is not poisonous, is the aconitum lycoctonum Lin. Sp. PI. 750. See Wilmer's Observa- tions on the Poisonous Vegetables of Great Britain. Storck, de Aconito, and the Article Venenum. A'COPA. Acopon, (« non, and *«;*•««, labour). At first this word signified the quality of the medicines to relieve pain, stiffness, and other ill effects of excessive weariness; but, afterwards, it implied soft, easy medi- cines, prepared with little difficulty. It is also the name of the trifolium paludosum. A'COR, (from aceo, to be sharp). Sourness, acri- mony, particularly an acid acrimony in the stomach. See Aciditas. ACO'RDINA. Indian tutty. A'CORES. See Achor. A'CORI, (rad). The greater galangal root, (from * neg. and nopx, the pupil of the eyes,) because this root was thought injurious to the eyes. See Ga- langa. ACO'RIA, (from x neg. and Kopcu, to satiate). In- satiability. Sometimes it signifies a good appetite, or digestion. ACORI'TES VINUM, a wine made of the acorus and liquorice roots, each eight ounces; of wine, six gal- lons ; infused cold for six months. ACORN, the seed of the oak used as an astringent. See Oak. A'CORUS, CALAMUS VE'RUS. See Calamus AROMATICUS. A'corus adulterinus. See Iris palustris. A'corus Asiaticus. See Calamus aromaticus Asiat. A'COS, (xK(6f*Mt, sano). A remedy. ACO'SMIA. Irregularity, or disturbed state of things, particularly of the critical days of fevers, as xoe-^o? meant tfieir regular order; called also madises, ma- drotes. Bald people are called acosmoi, because they had lost their greatest ornament. Blanchard says it is an ill state of health, joined with a loss of colour in the face. ACOTYLE'DON. Applied to seeds when they are without cotyledons. ACO'USTICA, medicines against deafness (from xkovu, to hear). But no internal medicines of this kind are known. ACRAT. See Satyriasis, and Furor uterinus. ACRAI'PALA, a Greek word for medicines against a surfeit or drunkenness, from x non, and KpxnrxXi), crapula. ACRA'SIA, Intemperance, (from x negative, and x.epxvwfu, to mix). This word, implying wine un- mixed with water, signified excess in eating, drinking, yenery, &c. By Hippocrates, and some others, it sig- nifies imbecility. By physicians, it means the predo- minancy of one quality above another, either with re- gard to artificial mixtures, or the humours of the body. ACRA'TIA, (from * negative, and %pxr<&>, strength). See Imbecillitas. ACRATI'SMA, a breakfast. The derivation of this word is the same as that of acrasia, because the wine used on this occasion was not mixed with water. A breakfast among the old Greeks consisted of a morsel of bread steeped in wine. ACRATOME'LI, (from xKpxlov, unmixed wine, and [*.tXi, honey). See Mulsum. A'CRE, (xxpog, extreme). See Nasus. A'CREA, also ACROTE'RIA, (from «*;•$, ex- treme,) the extremities, i. e. the legs, arms, nose, and ears. Coldness in the extremities, not easily removed, is a bad presage in fevers. A'CRID^E, (from accr, sharp). Acrid medicines. Acrids are substances of a penetrating pungency: applied to the skin, they inflame it ; chewe'd, they pro- mote a discharge of the saliva ; and snuffed up the nose, they provoke sneezing. The first class, as mustard, horse-radish, scurvy- grass, 8cc. give out their properties by distillation. The 2d, viz. the greater celandine, pyrethrum, 8cc. by in- fusion. The 3d, neither by infusion nor distillation, as happens with the arum, dracunculus. The general effects of acrid medicines are to stimu- late the solids. In leucophlegmatic habits, they are A C tt 30 ACT •) '. erful expectorants, dcobstruents, diuretics, and em- menagogucs; and, if the patient is kept warm, they are good diaphoretics. In constitutions disposed to inflammation, or where there is already a degree of irritation, where the juices are tod thin and acrid, or the viscera not sound, these medicines aggravate the disorder. The trouble which acrid medicines give to the sto- mach, is that on which their virtue frequently depends. ACRIFO'LIUM, (from acris, sharp, and folium, a. leaf). Any prickly-leaved plant. ACRIMO'NIA, acrimony, (from accr, sharp),. This term is applicable to any substances that produce particular sensations from the actions of that stimulus which they possess, and which we express by the differ- ent terms, sharpness, eagerness, tartness, acid, alkali, Sec.; but it is more strictly applicable to some states of the humours in the human body, as acrimony of the bile, and other fluids, which are, by the laws of the animal economy, constantly thrown out of the ma- chine ; for, except when in a morbid state, the fluids are free from all acrimony. Acrimony is often accused as a cause of various diseases, without a distinct idea of its nature, or indeed a sufficient evidence of its existence. Modern pathologists are more moderate; yet we hear of gouty and scrofulous humours, of cancerous and other acrimonies which affect the skin. Nothing is more evi- dent, than that the two former are diseases of the solids, and that the depositions are the effects, not the cause, of the disease. In the two latter, acrimony may be suspected. A cancer often naturally heals, and soon affects other parts: repelled from the glands, it falls on the joints, the head, and other organs. The cutaneous diseases of children shew marks of acrimony^ since, when they take place, they improve the general health; and .issues, in such cases, often inflame violently. When bile is absorbed in jaundice, there is an itching on the skin; and in those who have injured their stomachs by spirituous liquors, eruptions are often extensive and inveterate. A'CRIS, (xKpi$). The top of a mountain; also the sharp extremities of fractured bones. It is also a lo- cust, i. e. the insect so called, and which the Africans, and some others, commonly eat. ACRIS'SIA, ACRI'TUS, (« non, and r-pnujudico). It is when a distemper is in so uncertain and fluctuating a condition, that it is difficult to pass a right judgment on it. Blanchard. ACRIVIOLA, (acer, sharp, and viola, a violet). See Nasturtium Indicum. ACROBYSTIA, (from xxpes, extreme, and (ivv, to cover). See Acroposthia. ACROCHORDON, (from ar.pos, extreme, and zoph, a string). A name given to*a sort of warts, from their hanging by a string or neck. Wiseman calls them pensile warts. See Verrucs. Celsus observes, that if they are cut out, they leave no root, so do not grow again. ACROLE'NION, (xxptv, the extremity, and uXtn, the'eubit). See Olecranon. ACRO'MION, > (from xx,pos, extreme, and a^©-, the ACRO'MIUM,$ shoulder). See Scapula, 2. ACROMPHA'LION, (from «>^«s, extreme, or the tip, and eppaXot, navel). The tip of the navel, or the middle of the navel. A'CRON, in general, means the top or summit; hence, in a medical sense, it is the best of its kind. In botany, ji is the top or flower of thistles. ACRO'PATHOS, (from *kPos, extreme, and irxfoz, a disease). It literally signifies a disease at the height; or, a disease which affects any superior part of the body. Hippocrates applies it to the internal orifice of the uterus, when affected; to occult cancers, and to cancers on the surface of the body, to distinguish them from internal ones. A'CROPIS, (from «*f«s, extreme, and e^, the voice,y when the voice cannot be exerted. An inarticulation of the voice, from an imperfection in the end of the tongue. It is once used adjectively in the spurious works of Hippocrates, but no where determined in its signification and orthography. ACRO'PSILON, (from xk?®*, the extremity, and ipitef, naked). The extremity of the glans when naked. ACRO'SAPES, (from «*£«?, extreme, and o-yxa, to putrify). Galen means by this term, easy of digestion. This mode of speaking originates from a dogma of phy- sicians, that digestion was performed by a certain de- gree of putrescency; for often names originate from a false principle, and are retamed by authors who do not acquiesce in that principle.* ACRO'SPELOS, (from ux.pof, extreme, and weAes, black). A name of the wild oat-grass, or bromus sterilis. See'-^GYLOPs. ACROTE'RIA. See Acrea. ACROTERIA'SMUS. The amputation of an ex- tremity. (From xKpt»%pix, extremities, and this from «*£©■', summus). ACROTHY'MIA, C(from «*^5, extreme, and ACROTHY'MION, \ Sv^, thyme, from being the colour of thyme). See Njevus. A sort of wart de- scribed by Celsus as hard, rough, with a narrow basis, and broad top; the top is of the colour of thyme, it easily splits, and bleeds. This tumour is called thymus. ACT. MED. An abbreviation of Thomse Bartho- lini Acta Medica et Philosophica Hafniensia. ACT. PHILOS. and TRANSACT. PHILOS. The Philosophical Transactions. ACT. REG. SC. The Histories and Memoirs of the Royal Academy of Sciences at Paris. ACT. S. R. Acta Societatis Regiae, or Philosophi- cal Transactions, London, 4to. ACT^EA. Herb Christopher. A poisonous plant, which has been formerly used externally as a repel- lent, and internally by the ancients in female diseases. It is not now employed. The A- spicata, Lin. is the species that has been preferred, which belongs to the multisiliquae and ranunculacise of Jussieu. A'CTE, (xktv, from xya, to break,) elder, so called from its being easy to break. See Sambucus. A ClTNE,(from uk],v, a ray; from its radiated rami- fications). See Bunias. FACULTAS^01" *7"' l° ^^ VCl FUNCTI°; also The actions or functions of the body are divided into the vital, natural, and animal. The vital functions, or actions, are those which are absolutely necessary to life, as the actions of the Heart, lungs, and arteries. On the action and reaction ot the solids and fluids upon each other, depend the A CU 31 A JJ A vital functions. The pulse and respiration are the ex- ternal signs of life. Vital diseases are all those which hinder the influx of the venal blood into the cavities of the heart, and the expulsion of the arterial blood from them. ' The natural functions are those which are instru- mental in repairing the several losses which the body sustains ; for life is destructive of itself: its very offices occasion a perpetual waste. The manducation, the deglutition, and digestion of food, the separation and distribution of the chyle, and excrementitious parts, Sec. comprise natural functions, as by these our aliment is converted into our nature. They are necessary to the continuance of our bodies. The animal functions are those which we perform at will, as muscular motion, and all the voluntary ac- tions of the body ; they are those which constitute the sense of touch, taste, smell, sight, hearing, perception, reasoning, imagination, memory, judgment, and other affections of the mind. Without these a man may live, but not so comfortably as with them. The sexual actions are those of the organs of ge- neration of either sex. Private actions are such as regard particular parts. Public actions are those which are performed for the sake of the whole body ; such is the action of the stomach in digesting the aliment, &c. These are called functions. But each part hath an action peculiar to itself. Thus the offices performed by the muscles, vessels, glands, and viscera, are called their respective action. See Pro- fessor Whytt's Treatise on Vital Motions. ACTON, a town near London, where is a well that affords a purging water; from a gallon of which Dr. Rutty got 340 grains, or five drams, two scruples, of sediment by evaporation : of this, five drams and twen- ty-one grains were vitriolated magnesia, or vitriolated lime, called formerly nitrum calcarium, which took for- ty-eight times its own weight of water to dissolve it; and nineteen grains of aluminous earth. This is es- teemed one of the strongest purging waters near London. It is drunk from one to three pints in a morning. Mon- ro's Medical and Pharmaceutical Chemistry. See Aqu.s: cathartics amarx. ACTUA'LIS, actual, (from xyu, to act). This word is applied to any thing which acts by an imme- diate power inherent in itself : it is the reverse df po- tential ; thus, a red-hot iron or fire is called an actual cautery, in contradistinction to cauteries, or caustics, that have the power of producing the same effect upon the animal solids as actual fire : these last are called virtual or potential cauteries. Boiling water is actually hot; brandy, producing heat in the body, is potentially hot, though of itself cold. This is the medicinal sense of the word ; in logic and metaphysics it is used otherwise. ' ACTUA'TIO, actuation, (from xyu, to act),. That change wrought on a medicine, or any thing taken into the body, by the vital heat, which is necessary to make it act, and have its effect. ACUI'TIO, (from acuo, to quicken). This is ap- plied often to medicines which are added to others weaker than themselves, in order to increase their me- dicinal action ; as vegetable acid may be sharpened by the addition of mineral acid, or mild purgatives may be quickened by the addition of small doses of those which are more powerful. ACU'LEI, (dim of acus, a point,) the prickles and thorns on vegetables. A'CULON, or ACULOS, the fruit or acorn of the ilex, or scarlet oak, (from x non, and xvkXou, to roll round) : this is called aculon therefore, because its fruit is not involved in a cup or sheath, like the others. ACUPUNCTU'RA,(from acus, a needle, andpungo, to prick,) acupuncture. Bleeding performed by mak- ing many small punctures with a silver needle on the part affected. This method is practised in Siam, Japan, and other oriental nations, on all parts of the body ; and employed in head aches, lethargies, convulsions, colics, Sec. See Phil. Trans. No. 148. In some parts of America this practice is also in use, according to the accounts given in Dampier's Voyages, though as an ornament rather than a remedy. A'CUS, (from acuo, to sharpen,) a needle. This instrument is necessary in confining the lips of wounds, taking up and tying blood-vessels, &c. They are of various forms, according to the use for which they are designed : it is of considerable importance that they should be sharp and made of good metal that is well tempered. See Bell's Surgery, vol. i. A'CUS PASTORIS. See Scandix. A'cus moscha'ta. See Geranium moschatum. ACU'STICUS, (from xxwtt, to hear, belonging to hearing). It is applied to the auditory nerve, and to medicines or instruments used to assist, preserve, or recover hearing. ACUTENA'CULUM,(from acus, needle, and teneo, to hold). Heister calls the portaiguille by this name ; it is a handle for a needle, to make it penetrate easily when stitching a wound. Bell's Surgery, i. 16. ACU'TUS, (from acuo, to sharpen). In botany, it is applied to a leaf ending in an acute angle, but not so taperingly as the acuminated leaf. ACU'TUS MO'RBUS. An acute disease proceeds quickly to its termination, and always is attended with danger. Though there are diseases without danger, of a short duration, so are distinct from the acute, as an ephemeris, &c. In general, this term is ap- plied to fevers ; for apoplexy is never styled an acute disease, though its duration is short. Acute diseases are the opposite to chronic, which are slow in their progress, and not immediately dangerous. Wallis's Sydenham, 1. ACY'ISIS, (from « non, and x.vu,to conceive). In Vogel's Nosology it is a defect of conception, or bar- renness in women. Acutus has a similar meaning. ACY'RUS, (from « non, and xvpos, authority). A term for the herb German Leopard's bane, so named from the little note it used to be thought of in medicine; though lately highly recommended as tonic antiseptic, and considered in Germany, as a valuable remedy.in putrid fevers. See Arnica Montana. ADAMI'TA, (from adamas, a diamond,) is properly the stone in the bladder; adamitum, the lithiasis, or disease called the stone. See Calculus. A'DAMUS. The philosopher's stone. The alche- mists say that it is an animal, and that it has carried A 1) JJ 32 XDJE Us invisible Eve in its body from the moment they were first united by the Creator. It b also called Aquila, Philosophorum Lapis, Bafaliscus, Benedictus, Boritis, Gryphus ; by way of eminence, Antidotus. This stone, the greatest object of alchemy, is a long sought for pre- paration ; which, when found, is to transmute or exalt impurer metals, as tin, lead, and copper, into gold and silver. Authors who have written on this stone call sulphur the maritus, or husband ; and mercury, the uxor, or wife. AD AMI POMUM, the convex part of the thyroid cartilage of the larynx. ADANSO'NIA, from Adanson, the name of the person who first described the vEthiopian sour gourd. See Baobab. ADARCE, (from x neg. and fopxu, to see). A salt- ish concretion, found about the reeds and grass in marshy grounds in Galatia, which prevents the herbs upon which it forms from being seen ; it is also called calomohanus, or calomochnus. It is lax and porous, like bastard sponge. It is used to clear the skin in lepro- sies, tetters, freckles, &c. Dr. Plott gives an account of this production in his Natural History of Oxfordshire. ADARTICULA'TIO, (from ad, and articulus, a joint). See Diarthrosis. ADCHER, the name given by Avicenna and Sera- pion to the schenanchus, or camel's hay, q. v. ADCORPORA'TIO,^from ad, and corporo, to in- corporate). Adcorporation, or uniting in one body. ADDEPHAGIA, or ADEPHAGIA, (from «A»», abundantly, and (of « neg. and $xi(*Mi, a genius, AD.£MONIA,5 °i* divinity, or fortune). Hip- pocrates uses this word for the uneasiness, restlessness, or anxiety, felt in acute diseases, and some hysteric fits. ABE 33 A 1) E A'DEN, a gland. See Glakdula. Sometimes it signifies the same as bubo. Blanchard. ADENDE'NTES, (from aden, a gland, and edo, to eat). Ulcers which eat and destroy the glands. See Phagedena. ADE'XES CANADE'NSES. See Battatas Ca- nadensis. ADENIA. A genus of Hexandriamonogynia. One of its species, viz. the A. venenata, an Arabian tree, is poisonous; and the capparis spinosa is supposed to be an antidote to it Forskhal. ADENOI'DES, (from «fo, a gland, and nl1©-, a form). Glandiform, or like a gland. This word also is used for the prostate, q. v. ADENO'SUS ABSCE'SSUS. A hard tubercle, re- sembling a gland, difficult to be resolved. A'DEPS, fat, called also pinguedo, axungia, buty- rum, arvina, arabus, See. Fat is a condensed oily juice, contained in that part of the cellular membrane called membrana adiposa. When superfluous, and found in the upper eye-lids of children, it was called axirnach. In the young foetus is scarcely any fat; the omentum seems only to contain a jelly ; but in the more advanced stage, fat begins to appear. When the child is born, and during a few years after, it hath much fat imme- diately beneath the skin ; in men the fat is most abund- antly spread on the glutei muscles : it is separated from the blood by a~ glandular secretion. There is also a fatty substance, butter, obtained from the milk of animals, by agitating "its oleaginous part, separated by standing, in an instrument called a churn: called also alumbair. From the most accurate analysis of Crell, it ap- pears that fat is a kind of oil, or butter rendered con- crete by an acid. This, the sebacic acid, exists ready formed in suet, two pounds affording somewhat more than seven ounces. • By adding alkalis to animal fat, a soap is formed;,which is decomposed by alum. We thus obtain the sfebate of potash, which is decomposed by the sulphuric acid. When chemically examined, it is found to resemble very nearly the acetous acid. Six parts of fat contain nearly five of carbon, and one of hy- drogen, with some of the acid, not decomposed; nor does it yield so much oxygen and nitrogen; as the fleshy parts. The accumulation of fat. is a process not com- pletely understood; nor are its uses known. It con- tains, as we have seen, the acetous acid; and, on the whole, seems a morbid secrction'when in a large quan- tity, since it predisposes to many diseases, and is itself a disease. We should suspect that it was designed to in- viscate a proportion of the acetous acid when in excess; since it is favoured by indolence and inactivity, when we find acids morbidly accumulated in different secreted fluids, as in the urinary and arthritic calculi. It has been supposed to be the accumulation of a stock of nu- triment, to supply accidental and temporary deficiencies, or to cover morbid* acrimony in the fluids. It must be allowed, that, from want of food, the fat wastes and is absorbed; but we are yet to learn, that fat persons can bear famine better and longer than lean ones. At the same time, it is observed that the fat is not so much wasted in those who are worn down by the gradual decay of a hectic; who, from a scirrhous oesophagus, or a cancer of the throat, die from inanition, as in dropsies, vv here the appetite continues with little diminution. It vol. I. has also not been ascertained that it imparts any heaj to the body, or the viscera, which the omentum covers. Berthollet discovered, in animal substances, what he considered as a peculiar acid, and he called it the zoonic acid. It had the smell of broiled flesh, was liquid in a temperate heat, more volatile, than boiling water; form- ed soluble salts with barytes, strontian, lime, and alkalis; precipitated the nitrat of lead and the acetite of mer- cury; deposited charcoal, and was, in time, decom- posed. Subsequent inquiry has, however, shewn that this is not a new acid, but the acetous acid, containing some animal matter in solution. It is of more* impor- tance, since it shews the acetous acid in a new com- pound in the animal machine. Fat differs from suet principally in the great quantity of water it contains, which, being slowly evaporated, is converted into a sebaceous substance. Steatoms, which sometimes are found in the membrana adiposa, are of a very different nature. The human fat does not become fluid when Fahren- heit's thermometer rises to the ninetieth degree ; but when it begins to putrify, it easily, and with a small de- gree of warmth, runs into oil. In cetaceous fishes the fat is thin as oil; in animals that live on herbage only the fat is harder, and yet harder in those that chew the cud. The Arabians used a great variety of fats in medi- cine ; but to relax the parts to which they are applied, and to stop perspiration, are their chief virtues. In the present practice, three kinds are employed, and these only on account of their different consistence; they are the fat of vipers, hog's lard, and mutton suet. The fat of geese is now wholly rejected. Their use is chiefly external. As to viper's fat, it is well supplied by the oil of olives"; for it does not appear that animal fats, and insipid, flavourless vegetable oils, of similar consistence, differ in their effects when used exter- nally : in other instances, there seems to be a greater similarity between animal and vegetable fats, or insipid oils, than between any other similar animal and veger table substances, such as gums and animal jellies : ani- mal fats, in their resolution by fire, yield neither the peculiar stench, nor much, if any, of the volatile alka- line salt, which substances completely animalised af- ford. Mutton suet is sometimes taken internally as a mild nutrient; occasionally, as a demulcent in diarr- hoeas, when the mucus of the intestines is abraded; but it seems to possess no very considerable power in either respect. Animal fats are not'soluble in rectified sp. vin. nor in water. When scented with essential oils, the latter may- be totally extracted by digestion in rectified spirit, and, in a less degree, by water. Fats may thus also be freed from their ill smell; and those that are become rancid may be made sweet. Animal fats preserve steel from rust better than ve- getable ones; mutton suet prevents brass from grow- ing ill coloured, longer than any other fot; and if a little camphor and white lead are added, these ends are still better answered. The fat of vipers being separated from their intes- tines, may be melted before a gentle fire, and run through a thin linen cloth. See Hallcr's Physiology, on the cellular membrane. ADE'PTA PHILOSaPHIA. Adept philosophy. F A 1)1 34 ADO It is that philosophy, whose end is the transmutation of metals, and an universal remedy. The professors of this philosophy are called adepti, adepts. Paracelsus calls that medicina adepta, which treats of the diseases that are contracted by celestial operations, or communi- cated from heaven. ADHATO'DA. The Malabar nut. Referred by Lin. to the genus justicia; not employed in modern practice, and seemingly useless. ADHE'SIO, (from ad, and hereo, to cleave to,) ad- hesion. In medicine, a term used for two parts stick- ing together, which are naturally separate. If any of those parts in the thorax or belly that lie in contact inflame, they commonly grow together. The lungs very frequently adhere to the pleura. On this subject see Dr. Flemyng's treatise on adhe- sions, or accretions of the lungs ; or an abstract from it in the Med. Mus. vol. i. To this head must be referred the modern improved method of healing wounds as is said, " by the first intention :" the lips are brought to- gether, and thus adhere. See Vulnus. ADIA'NTHUM, ADIA'NTUM, (from *, non, and hxtiu, to grow wet,) so named because the leaves are not easily made wet. Maiden-hair. Also called polytrichon and polytrychum, (from weAf«, much, and fyt\> hair,) expressive of a capillary herb. Two species are only employed, viz. A. capillus Vene- ris, Lin. Sp. PI. 1558, and. A. pedatum, 1557. From the latter, the French prepare their sirop de capillaire, which they flavour with orange-flower water: a propor- tion of honey, it is said, is usually added. It acts chiefly as a demulcent, sheathing the inflamed and irritable epiglottis. ADIAPHOROUS, a spirit distilled from tartar; said, by Mr. Boyle, to be neither acid, vinous, nor urinous. ADIAPNEU'STIA, (from x, neg. and hmmt*, to perspire). Impeded perspiration; which was con- sidered by the ancients as the primary cause of fevers, from what they termed vaporosa et fuliginosa effluvia, not being permitted to pass through the cutaneous pores. ADIAPTO'TOS,(fromx,neg. awddixirnfla, to stum- ble or slide). The word signifies firm; but in medi- cine it is the name of a remedy against the colic, of stone-parsley, henbane-seed, white pepper, Sec. formed into an electuary. ADIARRHQE/A, (from x, neg. and hxp'peu, perfluo, to flow out or through). It signifies a total suppression - of the necessary evacuations from the bowels. ADIBAT. See Argent, vivum. A'DICE, (xhxeu, to hurt). See Urtica. A'DIPIS SUI'LL,E PRjEPARA'TIO, olim \XU'NGI^ PORCI'NiE CURATIO. See Adeps. ADIPOC1RE. The modern appellation of Sper- maceti, q. v. ADIPO'SiE ARTE'RIjE, et VENtE. They are branches from the phrenitic arteries, which are spread on the fat# that covers the kidneys, from which the blood is returned by the veins. See Capsulares VRTERIjE. ADIPO'SA MEMBRA'NA. See Cellulosa mem- brana. ADI'PSIA, (from *, neg. and ft-^x, thirst). Want of thirst. Dr. Cullen ranks this as a genus of dis- ease, in the locales dysorexie. But he thinks it is gc- nerallv, if not always, symptomatic. ADI'PSON, Aa«,plentiful). A prolific grain. See Alica. ADSCE'NDENS, (from adscendo, to ascend). Ap- plied to a stalk, growing first in an horizontal direc- tion, and then curving upwards. In anatomy, it refers to the direction of the vessels, as the ascending aorta. ADSTRI'CTIO, (from ad, and stringo, to bind toge- ther,) Adstriction. It either expresses the styptic quality of medicines, or the retention of the natural evacuations, by the rigidity of the respective apertures. It most commonly refers to the state of the bowels. See Constipatio. ADSTRINGE'NTIA, (from adstringo, to bind up,) astringents. See Astringentia. ADU'NATOS,(fromx,priv.and$vvxn.xi,to be able). See Adynamia. ADU'STA. Adust, burnt, scorched, or parched, (from aduro, to burn, isfc). This term is applied to the fluids of the body when acrid, and particularly when the acrimony is supposed to have arisen from great heat. Those constitutions are bilious only, and the term is chiefly employed, when the bile from stagna- tion has become brown or black. ADUSTION. See Cautery and Moxa. It is sometimes applied to violent inflammations of the brain, and cooling applications are used externally. A'DY, vel PALM A A'DY,(from «?», or»ft», sweet). A palm-tree in the island of St. Thomas, which affords plenty of juice, that ferments into wine. The en- tire fruit is called by the Portuguese caryoces and cariosse ; by the natives abanga. The fruit externally is like a lemon, and contains a stone, the kernel of which, if heated in hot water, gives out an oil of a saf- fron colour; it concretes in the cold, and is used as butter: of these kernels the inhabitants give three or four as a restorative, two or three times a day. ADYNA'MIA, (from x, neg. and JWft<«, strength, force,) languor, weakness, impotence from sickness or disease: adunatos, leipopsychia. Also drowsiness, or sleepiness, lassitude, defect of vital powers. In' Dr. Cullen's Nosology, this word distinguishes an order in his class neuroses: he defines it to be diseases consisting in a weakness or loss of motion, in either the vital or natural functions. These diseases are by others called defect ivi. ADY'NAMON, (from the same). A factitious wine. It is made of two parts of must and one of water, which are boiled together till as much is con- sumed as there was added of water. iEDOI'A, or AIDOIA, (from «*&>$, modesty). See Pudenda. iEDOSO'PHIA, (from «<&»?, pudenda, and faQe*, strepitum edo). In Sauvages, and Sagar, it is defined to be a flatus passing from the uterus, or from the urinary bladder, through the vagina or the. urethra; hence it is formed into two species, ^dosophia ure'thr^e et uteri'na. - This flatus is sometimes very fetid, which circumstance cannot always be ac- counted for. It sometimes happens when women are in labour, and hath been taken for a sign that the child is dead, but this cannot be depended on; an intolerable stench sometimes attends, when the child is living. See Sauvages' Nosologia Methodica, vol. ii. p. 417. iEGAGRO'PILA, (from Aiyxypos, the mountain- goat, and 7rifaf, pila vel globulus,) the rock-goat. See Capra Alpina. -EGEI'RIXON,(*/y£^^', a poplar). An ointment so called, because the fruit of the poplar, or its catkins, are an ingredient in it; not now employed. jEGEI'ROS. See Populus. .E'GIAS, (from «v, a face). See .Egidion. ^'GYLOPS or iEGILOPS. A disease in the inward corner of the eye, (so called from <*<£, a goat, and w^, an eye, or goat's-eye,) because goats are supposed to be subject to this disease.. F2 AIGY 36 M O 11 Paulus iEginetu calls it anchylops before it bursts, and •rgylops after; but these are only different states of the fistula lachrymalis. Dr. Wallis thinks that the distinc- tion should be preserved.—See his Nosologia Methodica Oculorum. Article, Epiphora a Rhyade. Sometimes it is with, and at others .without, inflam- mation. If it is attended with erosion, it terminates, though seldom, in a cancer. In opening this abscess, we should be careful not to cut the edge of the eye-lid, lor an incurable wateriness will be occasioned. When it is strumous, it proceeds from congestion, and the tubercle is round without discolouring the skin. If it is caused by inflammation, pain and redness ap- pear over the eye. Sometimes it begins with a weep- ing, and is not suspected until a redness appears in the eye; and then, by a gentle pressure on the part, a mat- ter is discharged, a part of which resembles the white of an egg. If this matter makes its way into the nose, it acquires a fetid smell. . As to the cure, if the case is recent, we should begin with a cautious use of bleeding and purging; or if these are contra-indicated, the alteratives most esteemed in scrofulous disorders should be used. The tumour may be resolved by anodyne and discutient applications; but if there is a. tendency to a suppuration it should be hastened, and the discharge of the pus procured, with all convenient speed, lest the bone underneath should be affected: the abscess must be cleansed and healed, ■with the tinct. of myrrh and aloes mixed with mel rosae. If the matter had passed also under the cilium, a pow- erful desiccative, such as strong lime-water, assisted by a compress, should be used. If the periosteum under the tumour be laid bare, an exfoliation must be hastened by a caustic, and a passage opened into the nose, after which dry lint alone is sufficient. Too constricting medicines may produce a rhyas, see Rhyas : too digestive applications may give rise to an encanthis. See Fistula lachrymalis* See also Galen, Aetius, Celsus, Paulus ./Egineta, Actua- rius, Sennertus, Wiseman, Heister, Pott, Bell, Kirk- land, Ware. iE'GYLOPS, or iE'GILOPS. Bromus Arvensis,Un. Sp. PI. 113. The great wild oat grass or drank. It grows in hedges and the sides of fields in May. By culture it becomes a species of corn. In the northern parts of America it is improved to great advan- tage ; and in the low wet boggy grounds in Great Bri- tain it would be profitable, as it thrives best in water. It grows like oats, but in quality resembles rice. A de- coction of the roots is said to kill worms. iEGY'PTIA ANTIDOTUS, the Egyptian an- tidote. The name of several compositions. --------- moscha'ta. See Abelmoschus. . ■ u'lcera, also called Syrian, ulcers. Aretaeus describes an ulcer of the tonsils and fauces by these names; they are attended with a burning pain; the matter discharged from them infects the whole frame, and the patient is rendered miserable by its of- fensive smell. ^LGYPTIA'CA. See Papyrus. ^GYPTIA'CUM BALSAMUM. Bals. Gilead. See Balsamum. ------------- ung., called also mel JEgyptia- clan* It was attributed to Mesue, but its place is sup- plied by the oxyniel aeruginis in the last London phar- macopoeia : it is a detergent, and slightly caustic. An- other kind, described by Hildanus, consists of mithri- date, camphor, and treacle. Another kind, composed of lily roots and aromatics, was used as a cosmetic, and stvled cicinum. They resemble each other only in their colour, from which they are styled -Egyptiaca. , jEGY'PTIUM OLEUM. See Cataputia; also the name of a topic used by the ancients in uterine disorders. .----------album. See Crinomyron. ----------croce'um ung. Both these are de- scribed by Aetius. ---------- pha'rmacum ad au'res. The name of one of Aetius's compositions. jEGY'PTIUS PE'SSUS. A pessary described by Paulus .Egineta: it is made of honey, turpentine, saf- fron, oil, verdigris, &c. jEICHRY'SON, (from- xst, always, and %pv?, life). See Sedum. A'EL. See Alla. .ELU'ROPO, syr. de, (from uiXovpn;, a cat, and rrovs,pes,) so called from the resemblance of its leaves and flowers to a cat's foot. See Gnaphalium Mon- TANLM. jEMBI'LL.E, (from x\{a.x, blood; because the seeds are of a deep red colour).' See Lacca. -ENE'A. An epithet given to the instrument called a catheter, from brass, the matter of which it was for- merly made. iE'ON, xim, the whole age of a man. But Hippo- crates uses it to signify the remains of a man's life. Sec also Medulla spinalis. AO'NION, (from «<»v/(»s, eternal; because the se- dum majus is an evergreen). See Sedum. -EO'RA, (from xiupzu, to lift up,) to suspend on high. Gestatio, a species of exercise used by the an- cients, and of which Aetius gives the following account: Gestation, while it exercises the body and limbs, still they seem to be at rest. Of the motion there are several kinds. 1st, Swinging in a hammock, which, at the decline of a fever, is beneficial. 2dly, Being carried in a litter, in which the patient either sits or lies alone. It is useful when the gout, stone, and such other disorders attend, that do not ad- mit of violent motions. 3dly, Riding in a chariot, which is of service in most chronical disorders, especially before the stronger exercise can be admitted. 4thly, Sailing in a boat or a ship. This produces various effects, according to the different agitation of the waters, and in many tedious chronical disorders proves efficacious beyond what is observed from the M O II 37 A E R most skilful administration of drugs. These are in- stances of passive exercise, and are useful, particularly when active exercise would be improper or impractica- ble. Asclepiades was the first who brought passive exercise into practice, which was used after severe ill- ness, in order to conquer debility, and invigorate the system by gentle means. The use of exercise in preserving or restoring health is too well known to require either arguments to en- force it, or regulations to conduct it. The exercises Tiere enumerated, we have said, are passive only ; and it is not easy to explain in what manner these can be useful. It may be remarked that all are attended with renovation of the air, which surrounds "the body ; all require some little exertion to preserve or restore the equilibrium. Dr. Cullen, taking the idea from the motion of a vessel containing a fluid, and observing that the momentum imparted to the latter continued when the motion of the former was suddenly stopped, supposed that the motion of the fluids in the blood ves- sels continued in the same way, stimulated the vessels, and thus promoted the circulation. The idea was in- genious ; but, as the blood vessels are constantly full, we suspect that the analogy cannot be transferred; and the whole advantages of exercise must probably be at- tributed to the renovation of the surrounding air, and the exertion necessary to preserve the equilibrium. The kinds of exercise here mentioned, are progressive in these respects ; and of course adapted to different states of debility. Swinging is a more active exercise ; riding and walking progressively more so, and consequently adapted to the less delicate and infirm. Other circumstances must, however, influence the choice of our modes of exercise. Sailing has been thought best adapted to hectic cases. The effluvia of the pitch, in the ship, may have some effect, but these could be obtained on shore ; and, when this has been tried, no particular benefit has resulted. The sea air is certainly not peculiarly salutary in such cases ; though, if the idea of Dr. Rush be admitted, that the mixture of sea and land air is rather injurious than use- ful, it will account for the disadvantages sometimes ex- perienced from a residence near a harbour. The bene- fits, therefore, probably result from the exercise, which is constant ; the general tendency of the circulation to the surface thus excited, assisted, perhaps, by the nau- sea. The tendency to the surface is evinced by the constipation of the bowels, and the rare occurrence of catarrhal affections on shipboard. Riding on horseback has been equally commended in hectic cases by Sydenham, though not confirmed by more recent experience. This remedy is certainly bet- ter adapted to the more languid circulation, in the chylopoietic viscera ; to obstructions of the liver ; bad digestion ; and want of appetite. The succussions which the viscera experience by the motion in the horse, must undoubtedly assist the circulation, when languid from indulgence and plethora, or when ob- structed from indolence, or the immoderate use of wine and spirits. Swinging, another remedy for phthisis, should have been mentioned after sailing. It has certainly been of service : the constant renewal of fresh cool air, for air constantly renewed in this climate must produce cold, checks a too high temperature, and lowers the pulse, while the exercise determines the circulation to the surface. For preserving health, however, walking is the best exercise : in all the other species, the extremities are not sufficiently warmed, while, by walking, the deter- mination of the blood to the surface is general, every muscle has its share of exertion, and the viscera expe- rience sufficient agitation to preserve their circulation undiminished in force, though perhaps not sufficient to restore it, if the organs are previously diseased. A'ER, Ar,p, air, (from the Hebrew term aor, light,) called also gas ventosum. From a variety of experiments, atmospheric air is proved to consist ot a mixture of about seventy-two parts of azotic gas, to twenty-eight of oxygen, or vital air. Lavoisier says, of about twen.ty-seven parts of vital air, and seventy- three azotic. But the proportion of these two gases is subject to variation in'the mixture which forms the atmosphere ; depending upon local causes. From the decomposition of the atmospheric air, these two gases are obtained ; and sometimes in their simple state, sometimes in a proportion different from what they hold when forming- atmospheric air, are used for medicinal purposes. The oxygen, or vital air, may be considered as a stimulant, and invigorator of the system ; whilst the azotic gas is a sedative, and hurtful to the constitution, by destroying its irritability. Before the present sera of chemistry, it was the only gaseous substance known ; and, indeed, almost all that has been formerly written on the air relates only to its physical properties. The chief of which are : First, That it is a fluid of extreme rarefaction, obedient to the smallest motion : the slightest agitation deranges its equilibrium, which is continually endeavouring to restore itself. Though very fluid, it passes through those orifices with difficulty, through which grosser fluids can pass with ease. Secondly, It is invisible ; it refracts, but does not reflect the rays of light: it is inodorous, through the vehicle of odoriferous particles : it is insipid ; and its physical qualities, chiefly, affect .us variously. Thirdly, The weight of the air is not perceived but in large quantities ; nor is the compara- tive weight easily, if at all, to be ascertained, as no two portions are ever of the same weight at different heights in the atmosphere. However, from long and repeated observations, the greatest gravity of the air in ' Europe is found to be equal, in equilibrio, with thirty inches and half of quicksilver in the barometer, and the least raises it only to twenty-seven and half. The weight of the common air about the surface of the earth, at the time of the middle weight of the atmo- sphere, and in every temperate season, is to that of water as one to 850. Fourthly, The elasticity of the air is one of the properties upon-which natural philoso- phers have made the greatest number of experiments, and it has ever been applied with considerable advan- tage in the arts. Fifthly, Air is necessary to animal existence. This is evident from the experiments made with the air-pump ; though not without some excep- tions, for toads, vipers,, eels, insects of all kinds, and fish, live for a time in the exhausted receiver. They cannot indeed live without oxygen, but they expend it slowly, and separate it more perfectly from the injurious part of the atmosphere. \ Sixthly. The partick s of air are said to be too small for any microscope to discover, A E R 38 A E Jl and yet they are supposed to be larger than those of fire, water, oil, and many other fluids, since fire pervades glass ; oil, water, Sec. will pass through many compact substances, whilst air is resisted by strong paper. This argument is, however, fallacious. Seventhly, Air is a vehicle of sound, of the objects of taste, of effluvia to the nose, as is evident from observations made on the tops of high mountains, where our senses become duller than when we are nearer the plains. Eighthly, It is a part in the composition of all bodies. Ninthly, It can- not be rendered of itself solid by any known means. Tenthly, By contact and cohesion in the parts of bo- dies it becomes solid and unelastic ; but when sepa- rated by heat, fermentation, Sec. its elasticity returns. Heat rarifies, and cold condenses it. The physical qualities of the air have occasioned nu- merous disquisitions. But extensive inquiries, the comparison of the tables of mortality, experience long continued, have allowed us to draw few conclusions which will bear the test of careful examination. In spring, we find inflammatory complaints ; in autumn, bilious diseases : in every season, fevers, in the com- mencement inflammatory, in the conclusion more or less putrid. To be more particular. Continued cold produces that tension of the fibres, that strong and steady action, which we style inflammatory diathesis : high situations, with a pure bracing atmosphere, pro- duce similar effects. These are partly owing to an excess of oxygen, as we shall presently notice ; but, in a great measure, to moderate, continued cold. A previous moist, temperate winter, which predisposes to scrofulous complaints, will, at this period, pro- duce the most fatal consequences in hectic cases. The fever will increase, the ulceration proceed with rapi- dity, and the heat of the ensuing summer close the scene. Those, however, who are moderately healthy and not peculiarly robust, will find a winter, of no ex- treme cold, healthy ; and the opening spring, expand- ing the fibres, will give a genial glow and new life to every organ. Summer, of course, may produce its own diseases ; but, if we peruse the history of epi- demics,we shall, with difficulty, trace any particular bad effects of the heat, till the evenings begin to cool, the fruit to be plenty, and the bile to become a conspicuous cause of disease, from its accumulation and excessive discharges'. Winter again recurs, and Dr. Heberden has endeavoured to shew, from the bills of mortality, that it is a fatal season. It may be so in general : old people resist cold with difficulty, and the catarrhus suffocativus, asthma, and similar complaints, are often fatal at this period. In our experience, however, it is not the cold, but the early warmth of spring succeed- ing cold, which is most injurious : the constitution, braced by cold, cannot bear the subsequent relaxation. A long damp summer has had similar effects. Philosophers have taught us how much pressure we hear from the atmosphere ; and of course, from the diminution of that pressure, we shall feel the want of tension or tone which results from the removal of any support. Thus, when the air is lighter we find a lan- guor come on ; when heavier, our spirits are more brisk and lively. The whole is not however owing to the absolute weight of the air, but, in part, to its elas- ticity ; or rather our feelings of health and activity are in the compound ratio of both. Thus, at the height of from 1200 to 2000 feet above the level of the sea, the pressure is greatly diminished ; but we feel in- creased activity, as we are in general above the region of clouds, and the air is more elastic ; and the lan- guor felt in very high situations is not uniform or con- stant ; so that it cannot depend on a constant cause. During rain, the mercury in the barometer is not de- pressed half an inch, yet we feel more languor than on the top of mountains, where it has probably fallen from five to ten inches. In other respects the physical properties of the air seem to have little influence : the warmest and longest summers are often healthy : the coldest winters, with the exception of accidental inflammatory complaints, are the same : the warmest weather, with the dampest fogs, have been followed by no peculiar epidemic. It is what Hippocrates long since called the ro Seiev, some- thing divine or inexplicable, that produces fevers and similar diseases ; but, before we notice the " divinity that stirs within us," we must add a few remarks on situation, as connected with the physical properties of the air. A dry elevated spot, on a gravelly soil, is said to be most wholesome, especially if sheltered from the east wind. Elevation is however relative ; light clouds float in the atmosphere, about 1600 feet above the level of the sea ; and the healthiest spot is said to be some way above this elevation. This appears, however, to be fanciful ; and it has not been proved that atmospheric moisture alone is injurious. In dry gravelly elevated spots, experience has fixed the most salutary residence for consumptive cases ; yet, in.these, oxygen seems to abound, which is peculiarly injurious in such com- plaints ; and air of a lower quality, as it has been styled, is seemingly as good ; in the opinion of some, preferable. In asthmatic cases elevated spots are ma- nifestly injurious. In fact, theorists may declaim, but facts give the lie to the most plausible declamations. A change is often necessary; and from the effects of that change, the conduct proper for each individual must be ascertained. It is observed by some authors, that vaults, corn- magazines, apple-garrets, &c. should open to the north ; for that point is invariably proper : but the south and west are constantly improper. The most healthy exposure, if a house is to be built, is said to be found by cutting one of the trees that grow there trans- versely with a saw, observing the rings : the side of the tree on which the distances between each ring are widest is the most healthy exposure, and the windows of the house, all other circumstances being the same, should ever face that way. We have mentioned the effects of the east wind in general, and we shall now notice them more particu- larly, though it cannot be yet determined whether they belong to the chemical or physical properties of the air. The atmosphere, while the east winds prevail, is lurid ; and, even when clear, the sun has not its brilliant hue. The strength is not equal to the usual exertions ; the respiration is not free ; the spirits not lively. Asthmatics and hypochondriacs feel it severely ; yet it is often dry, and, when it rains during a south- east wind, its fall is frequently periodical, extending only to twelve or twenty-four hours ; while the clouds constantly display a promise of fair weather : there is A E U 39 A E R seemingly a perpetual contest between the causes of rain and their antagonists, whatever they may be. As we have now instruments by which the quality of the air may be measured, it might be presumed, that these would inform us of the cause of this singular state of the atmosphere. The east wind is not peculiar to any situation, so that it is not injurious from passing over a baleful desert, or a successive series of marshes ; nor does the eudiometer show any particular ingredient which may impair health or induce disease. We have not mentioned this instrument in our disquisitions re- specting air, as it chiefly informs us of its chemical qualities. As we now approach this subject, we may remark that, in all its forms, the assistance it affords is inconsiderable to the medical chemist. In crowded cities, and the most apparently healthy situations, re- mote from " the busy hum of men," its results are nearly the same. Chemists must decide whether this similarity in the appearances is owing to the imper- - fection of the instrument, or whether the. injurious qualities of the air are not cognizable by it. We have now mentioned this instrument to excuse our future silence respecting it. Its forms, however, we shall afterwards describe, as future enquirers may be more successful. See Eudiometer. We have said that air consists of oxygen and azote in a gaseous state. To this, when we speak more cri- tically, we must add carbonic acid gas, It has been disputed, whether the principal ingredients are che- mically combined, or only mixed mechanically. Nei- ther is true. m We cannot indeed mix oxygenous and azotic gas, so as to form a gaseous fluid like our atmo- sphere ; yet they are not chemically united, so as to form a tertium quid; nor even in the more general sense of the word, so as to produce a substance par- * taking of their united properties; as, when we mix spirit with water, or dissolve sugar in any fluid, it seems that the particles are united in their nascent state, and adhere together rather than form a compound. It appears at first sight singular, that the oxygen which supports life should be in so small a proportion; but the singularity will soon vanish when we reflect, that oxygen alone Avould be as fatal in the lungs as arsenic in the stomach. It is, literally, like fire which warms; but in excess, will burn. This we chiefly mention to explain the inconveniencies arising in hectic and in asthmatic cases, from air too pure; in the latter it sti- mulates the weak lungs too violently; in the former it adds to the tone and the irritability of the vascular sys- tem, already too great. The mountaineer and farmer, who breathe air highly oxygenated, are strong, robust, and active, but scarcely ever fat. Oxygen makes no part of this animal fluid; and hydrogen and carbone, of which it chiefly consists, do not abound in these regions. Hydrogen, indeed, has been discovered by Saussure on the highest mountains; but its levity carries it beyond human habitations; it is an extraneous body, found in air, but not a component part of it. As its elasticity is inconsiderable, it certainly contributes to the languor experienced in highly elevated situations. The aerial pathology has not yet been successfully cultivated. Man can live and enjoy health from the heat of twenty-eight to one hundred and eight degrees of Fahrenheit. He can exist in a constant fog, where the hygrometer proceeds beyond the extreme of hu- midity ; and, in air which supports the mercury only at twenty-two or twenty-three inches, he is robust and active. The sudden changes are indeed injurious ; but the injuries are often transitory and inconsiderable ; or, if severe, producing only temporary and acute diseases. But that our observations respecting the effects of the different airs may be more distinct, it is necessary to enlarge a little on the chemical properties of the differ- ent gases. Besides the common, or atmospherical air, there are various other sorts, distinguished by their respective characteristics : ^st. Air, fixed or fixable. By Van Helmont, it was called gas sylvestre, from being pro- duced in vast quantities from the burning of charcoal; from its apparent acid properties, aerial acid, creta- ceous acid, and carbonic acid ; and fixed air, as readily losing its elasticity, and fixing itself in many bodies. It is an invisible and permanently elastic fluid, superior in gravity to- the common atmospheric air, and most other aerial fluids. It consists of twenty-eight parts of carbone, and seventy-two of oxygen, with some caloric, forming about one sixty-sixth of the common atmo- sphere, though, from its gravity, generally falling to the bottom. It is unfit for respiration; easily dis- solved in water ; exceedingly destructive to animal life, and produced in great quantities naturalty from com- bustible bodies and many chemical processes. It is found at the bottom of pits ; it rises from fermenting liquors ; it is one and a half heavier than pure common air ; water imbibes more than its own bulk of it; flame is extinguished, and animals are destroyed, by its in- fluence : when the fixable air is separated from chalk and other calcareous substances, they become caustic, or, as they are now styled, pure: it is antiseptic, pow- erfully preventing and recovering from putrefaction, whence lime-kilns, which discharge great quantities of this air, would be useful in the neighbourhood of popu- lous towns ; in clysters it hath been very advantageously administered against putrid disorders, and, mixed with the drink, has been thought to conduce to the relief of patients labouring under putrid fevers. In the form of yeast it has also been administered with good effect in these disorders: but though it may be introduced into the stomach and intestines with advantage, if breathed into the lungs, it is mortal. To fixable air the chief property of some mineral waters is attributed: the Pyrmont and Seltzer water owe their brisk acidulous taste and sparkling appearance to it; and it dissolves iron in a small proportion, when it is mixed with wa- ter. Fixable air hath been found useful in cancerous, consumptive, scorbutic, and other disorders, where an antiseptic medicine might be expected to afford relief. It has not only been considered as antiputrescent, but also lithontriptic. When the stomach is disordered, carbonic acid air often gives a temporary and an useful stimulus. It is administered united with water by swallowing kali, or soda, in an effervescing state, or the one immediately after the other, that the effervescence may take place in the stomach. Air, vital ; called also dephlogisticated, empyreal air, and oxygenous gas. From a variety of Experiments, modern philosophers have proved, that in respiration a portion of air is lost; that the first effect produced, is the blood assuming a vermillion colour, by com- bining with pure air. The second is to establish a AER 40 A E tt real focus of heat in the lungs, maintained and kept up by the air of respiration. See Heat, vital; and Res- piration. Air, inflammable. It is the lightest of all the aeriform fluids : in general about twelve times lighter than atmospheric air. All animal and vegetable sub- stances, which can be burned in the open air, char- coal excepted, will afford inflammable air, if heated in close vessels : though this is usually mixed with air of other kinds, with water, and with oleaginous matters. Charcoal, and several metals, afford inflammable air by heat, if water be present. Some metallic substances, during their solution in acids, afford, or extricate in- flammable air, which is of the purest kind. The com- mon process for obtaining it is by dissolving iron filings or shavings in diluted vitriolic acid. It occupies the upper parts of subterraneous caverns; and has been commonly found in mines and coal-pits, where it is called Fire damp, because it is liable to take fire, and explode like gunpowder. When not combined with oxygen it extinguishes fire; kills animals as rea- dily as fixable air; takes fire by the contact of the electric spark, provided vital air be present, or any combustible body already in a state of ignition, and burning with a brilliant flame. If about two parts, by measure, of inflammable air, and one of vital ah\ are mixed together, and set on fire in a vessel strongly closed, which may be done by the electric spark, the air, if pure, will almost totally disappear, and the pro- duct be water, and an acid. It holds about half its weight of water in solution, which imparts to it a dis- agreeable odour; is absorbed by vegetables, and be- comes a component part of their oils and resins. The sulphureous, the muriatic, and some other acids assume the form of air : but as they are neither found in the atmosphere, nor applied to medical pur- poses, they form no part of the present subject. Nitrous air, or nitrogenous gas, or azotic gas, forms an object of considerable importance in chemis- try and medicine. It is fatal, when alone, to animal life; though, in combination, highly advantageous to it. This gas, we have seen, forms a large proportion of atmospheric air; and the gaseous nitrous oxide pro- duces effects in respiration highly animating and sti- mulant. It is also the distinguishing ingredient of animal substances; the principle of animalisation. Nitrogen gas, or the mephitic air of former au- thors, is very extensively diffused. Its specific gravity is inconsiderable, for it is lighter than atmospheric air, in the proportion of 985 to 1000. Nitrogen, with ca- loric, forms this gas; and, with different proportions of oxygen, the nitrous acid in its various forms. With the full proportion of oxygen, it forms the nitric acid, the aqua fortis of the shops : with a less proportion it becomes nitrous acid ; with still less nitrous gas ; and with a very small quantity the nitrous oxide. Nitro- genous gas is neither acid nor soluble in water; and the nitrous gas is employed as a test of the purity of air in the eudiometer, q. v. If the air contains oxygen, it thus changes the gas into nitrous acid; and a larger proportion of the acid is formed when the oxygen is more abundant; while with impure air no change is produced. In medicine it has scarcely been employed: it is said to be antiseptic, and to kill worms, but expe- rience has neglected to register its effects, or has dis- regarded it. The nitrous oxide is heavier than air, and soluble in double its quantity of water. The taste it imparts i.s sweet, and the odour agreeable, though slight. Com- bustible bodies, at a high temperature, decompose this oxide; and it unites with alkalis, though not with acids. In fact, if an acid, it is the lowest in the scale, and to dispute whether it be so, is to contend with air. Its effects on respiration are singular. It is said to animate the person who breathes it to a degree Jittle inferior to phrensy : the sensations produced are highly pleasurable, and no languor follows.. Though much must be allowed to the enthusiasm of a discoverer, and to the experience of effects wholly new and unexpect- ed, yet very pleasing sensations have been undoubtedly felt on its being inhaled. To what these are owing has not been ascertained. A slight reflection will shew, that though life is really sustained by oxygen, yet this air is not proper for breathing for any continued period. The pleasure excited by fresh air does not arise from the oxygen, for it is not increased, or at least to an inconsiderable extent, in proportion to the quantity contained in the air breathed. Why azote, that is alone fatal to life, should be the necessary ingredient, is not clear. The great principle of distinction of animal substances, chemically considered, is indeed azote: this principle, so copious in these, is found in a small proportion, and only in particular parts, of the vegeta- ble kingdom; and it is the great problem in the func- tion of animalisation, to discover the sources of the azote. May it not then be the air, and may not the animal system feel a peculiar pleasure in the supply of ■ this principle, which must neutralise, or assimilate, the vegetable food ? It is not an improbable supposition, but it has escaped us, if it has been noticed by any for- mer physiologist. Air, in so many various ways injured, viz. by breath- * ing, by burning bodies, &c. is restored by many means ; a few of which only have been discovered. Plants ab- sorb carbonic acid gas, and restore, in their turn, a pure air; and thus, combining with azote, may, imper- ceptibly to our senses, renovate the atmosphere. We may thus account for the different result of the expe- riments of philosophers, some of whom have disco- vered that plants exhale pure air, while others deny it. Inflammable air seeks the upper regions of the atmo- sphere, and is destroyed in the meteoric explosions, when too copious; while the portion arrested in its progress contributes, as we have said, to the produc- tion of the oils and resins of vegetables. Thus nature very completely restores the various changes in the constitution of our atmosphere, which the different processes cohstantly going on may, in her regular course, have occasioned. Yet the air is ac- cused as the cause of numerous diseases; and it really is so. Sudden cold checking the perspiration will ap- parently produce almost every form of the pyrexiae. Partial cold will produce rheumatisms; damp air, ca- tarrhs ; and in old people those defluxions. which are called humoral asthmas, and catarrhi suffocativi. The continued heat of summer occasions bilious disorders; and the cold of winter a return of the more active in- flammations. The air is, however, chiefly a vehicle of injurious effluvia; some of which only can be ascer- tained. Marsh miasmata, as they are styled by patho- logists, are the cause of numerous intermittent "and re- mittent fevers, as well as those apparently of a more M R 1 4 1 iUU continued form. It has been ascertained, that a clayey soil, when moistened, will attract the oxygen of the air, and leave its azotic part not sufficiently guarded to sup- port the vis vitae ; and it is found that districts become unhealthy chiefly when the earth begins to appear, in consequence of a diminution of the water. It is singu- lar, that Linnaeus, with a view to prove the cause of in- termittents to be an argillaceous earth, has traced very minutely the prevalence of intermittents in clayey coun- tries ; a circumstance which may be explained from the views just assigned. To this diminution of the oxygen must be added a larger and unusual proportion of in- flammable air from the parts of marshes still covered by water. To these conjoined causes many epidemics are owing : and when the changes in the physicarpro- perties of the air appear to produce fevers, they act only as exciting causes of these miasmata, in a manner to be afterwards explained. See Infection and Epide- mics. It is not found that an unusual proportion of fixed air is injurious: it falls to the lowest strata of the atmo- sphere ; and, whatever be the quantity, it is apparently absorbed. The very extensive diffusion of catarrhs and other epidemics, of small pox, measles, Sec. is from causes combined with the air, and no part of the at- mosphere. The contagion of putrid fevers, viz. the contagion conveyed by the patient, or by the medium of the attendant's clothes, are substances combined with the air which the nicest instruments have not yet been able to detect, though much may be expected from the persevering ardour of modern experimental philoso- phers. Hoffman, in his Med. Rat. Syst. artic. De Aere, and Boerhaave on Air, have collected all that is valuable from their predecessors and contemporaries. . Hale's Statical Experiments. Chaptal's and Thom- son's Chemistry. Huxham on Air and Epidemic Dis- eases. Shaw's Abridgment of Boyle's Works, in the article Air. Parkinson's Medical Pocket Book. Dob- son on Fixed Air. Chaptal's Elements of Chemistry ; also Lavoisier, Fourcroy, and Nicholson. jE'RA, (from xipu, tollo, to take away). So called, because it is necessary to remove it. See Lolium. AERATED WATER. See Aqu* minkraLes and Aqu^e minerales artificiales. jERE'OLUM^, a weight of about twenty grains. AERIFICA'TIO, (from a'er, air, and fio, to become). It is the producing of air from other bodies, or rather converting them into air. .'E'RIS FLOS, (from es, copper,) flowers of cop- per ; anthos, phrasiu?n viride, Sec. Copper reduced to small grains, by pouring cold water on it when in a state of fusion. The cold water is poured on the copper as it runs out of the furnace into the receiver. --------squam.e, flakes of copper, fly off in ham- mering the metal when heated. The best are of a.deep yellow colour, and rust if sprinkled with vinegar. These, from the Cyprian copper works, are called helitis. •• vel Ve'neris tinctura. R ^Erug. aeris 5 j. aquae ammon. et sp. vin. R. aa ^ ss. m. et stent simul, donee aqua colorem saphirinum acquisiverit. This tincture is an admirable preparation to make an injec- tion for a gonorrhoea, if care be taken duly to dilute it, vol. 1. and skill enough is possessed to know when the infec- tion is only in the urethra: to an ounce of pure water, add one drop of the above tincture. Astringent injec'- tions are, however, especially in the early stages of the complaint, dangerous. Dr. W. Saunders observes, in his Lectures on the Mat. Med. that all solutions of metals are sedative, or ease pain, provided that the solution is not too strong. Veneris volatilis tinctura: R. Limaturae cupri. 5 j. aquae ammon. 5 xij. m- This solution hath been given internally to the quantity of four or five drops at a dose, as a diuretic. Boerhaave directs to be given three drops, in a morning fasting, with a glass of mead, and this dose to be daily doubled until the dose is twenty-four drops, to be continued for some days : thus he succeeded sometimes in curing dropsies, though in other instances it failed. When effectual, it produced very copious discharges of urine. This tincture is a good substitute, for the cuprum ammoniacum of the Edinburgh Dispensatory. Metallic astringents are more active than alum, more powerful, more easily and more quickly dissolved in the stomach; are more diffusive and extensive in their influence on the habit, and to be preferred when speedy effects are to be obtained. Of all the metals, copper is the most astringent, and most soluble in the stomach ; but the dose is difficultly ascertained, because of the uncertainty of acid in the stomach, so that it is rarely- used. Dr. Saunders observes, that an over dose of the aerugo aeris is active, stimulant, and astringent, and so quickly proves emetic as to be thrown up before it hurts; that an under dose excites a nausea. This is of course most advantageous; but the tine. Veneris vol. if given so as to purge and vomit, by its sudden action produces very good effects. Dr. G. Fordyce advisesNus to avoid cupreous prepa- rations, when the intention is to strengthen; but when it is designed to lessen irritability, he observes, they are extremely useful, particularly in hysteric cases attended with plethora, and in epileptic spasms. In several in- stances of intermittents, and of mortifications, the pre- parations of copper, such as were in a saline state, as the cuprum ammoniacale, the cuprum vitriolatum, and the tinct. Veneris vol. were equally efficacious with the- bark; in this last case, the cuprum vitriolatum to gr. ss. for a dose has been very successful. The copper, combined with the volatile alkali, either in the tinctures above described or in the cuprum am- moniacale, is undoubtedly an excellent remedy in epi- lepsies, and seems to act by lessening irritability. This is perhaps the principle by which also iron, zinc, and arsenic, produce their effect; but of these, iron seems to approach more nearly to what we with greater strict- ness call an astringent, q. v. Combined with zinc, the zincum ustum, or vitriol of zinc, the copper is often more effectual. Of intermittents, the copper and zinc are best adapted to the partial cases of the disease, as the hemicrania, Sec.; the arsenic to the more general forms. Dr. Brown, in his Natural History of Jamaica, pre- fers preparations of copper in those dropsies which pro- ceed from a general languor of the solid system, in which case they prove very useful as diuretics and strengtheners. He prefers the tine. Veneris vol. to all ' G - iERU 42 MS other preparations of this metal. In hot climates, where the body is much relaxed, the vitriol of copper is, he thinks, the best detergent of foul ulcers. See Neumann's Chem. .Works. Diet, of Chem. edit. ii. jERI'TIS, (from «jjf, the air,) so named from being of a sky-blue colour. See Anagallis. AEROLO'GIA, (from xqp, and Aeyes, sermo). That part of medicine which treats of air, explains its proper- ties and use in the animal economy, and its efficacy in preserving and restoring health. AEROME'LI, (from xvp, air, and y.s\t, honey), ho- ney dew. See Mel and Manna. AEROPHO'BI, (from xv>p, air, and (poGea, to be afraid). According to Ccelius Aurelianus, some phre- nitic patients are afraid of a lucid and others of an ob- scure air, and these he calls aerophobi. So that, AEROPHO'BI A, (from xvp, and QoStx, timor, fear,) is a symptom of the phrenitis. It is a fear of light, a kind of insanity, in which the patient dreads the air or light. AERO'SIS, (from xyp, air). An imaginary resolu- tion of the blood into vapour, supposed necessary to the support of the vital spirits, and to be brought about by the ventilation of the air during inspiration, in the man- ner that the flame of fuel is kindled by blowing it. ^ERO'SUS LAPIS, (from es, copper). So Pliny calls the cadmia, because of its sky colour, resembling the salts of copper, which is supposed to be Galen's cadmia lapidosa. See Cadmia. jE.RUGINO'SUS, (from erugo, verdigrise). Rx\x- ginous, of the colour of verdigrise, or green. This word is often applied to what is discharged by vomit- ing of this colour, and to the bile. jERU'GO, (from es, copper). The rust of any metal, but particularly of copper, called verdigrise : it is also named azagor, almizadir. See &%. The natural aerugo is a greenish marcasite, like the drops of iron ; it is found in copper mines, but contains only a small proportion of the metal. Hungarian mountain or sea verdigrise is found in the mountains of Moravia, in the form of sand. ——• ra'silis. Hang a copper plate over the strong- est vinegar, so as not to touch it, and after ten days scrape oil* the rust, which is thus called. ----scole'cia. Of the two sorts, viz. the fossil and the factitious, the fossil is the best; but either is of no further use than the blue vitriol. jERU'GO jE'RIS ; called also viride eris, cupri ru- bigo, calcithos, Hispanicum viride, verdigrise. It is copper, corroded by a fermented vegetable acid into a bluish green substance. The copper is made into very thin plates, which are suspended over the vapours aris- ing from wine, during its acetous fermentation: or the husks and stalks of grapes are dried, and, when bruised, are dipped in wine and made into balls. When they have acquired the acetous acid they are broken with the hand, and stratified with these copper plates, and left until the verdigrise is produced. The best, as well as the greatest quantity, is made at Montpellier, where there is one sort in powder and another in lumps. The whole process, as now practised in Montpellier, may be seen in the Cyclopedia under Verdigrease. The sort which we receive from France is generally mixed with the stalks of grapes, which may be separated by pulverisation, as they are more difficultly powdered than the verdigrise itself. It is purified by dissolving in six or seven times its weight of distilled vinegar, de- canting and evaporating the solution. If good, it is dry, of a beautiful deep green, with a few white spots; and when rubbed on the hand with a little saliva or water it forms a smooth paste, free from grittiness. It is adulterated by mixing pumice stone, marble, vitriol, Sec. The first two are discovered by rubbing the sus- pected verdigrise betwixt the thumb and the finger, previously wetted, by which the pumice stone and mar- ble become white: the latter is discovered by burning a little on a tile, by which the vitriol is turned into a red substance. In spirit of wine, and in water, this concrete is partially soluble: in vinegar it is wholly so. If a saturated solution of it in vinegar is set to exhale in a warm place, the greatest part of the verdigrise may- be recovered in a crystalline form; and if these crystals are distilled in a retort, the acetous acid ascends from them in a highly concentrated state, forming the acetic acid, and the crystals are then called distilled or cal- cined verdigrise, or the vitriol of Venus : if set in a damp place to dissolve, it is called the liquor of Ve- nus. Verdigrise is used by dyers, skinners, hatters, painters, Sec. as well as in medicine : in miniature paint- ing the distilled sort is the best. Its use, as an external medicine, is to deterge foul ulcers, as in the ung. basil. viride and the mel aeruginis. If it is made into a paste with saliva, or any thing not oily or unctuous, it will dissolve hard calli. In phagedenic ulcers, and the most unpromising sores, with ichor, fungus, Sec. copper is useful. Foul chancres, that yield not to mercury in- wardly, have been removed by a solution of the cuprum vitriolatum. Internally taken, a vomiting is instantly provoked by a grain or two of verdigrise, or vitriol of copper, so for its speedy effect it may be used to dis- charge any poisonous matter received into the stomach. Large portions, as four drams or more, have been swallowed without any other inconvenience than the present vomiting; yet, in smaller quantities, besides the vomiting, it excites a pain in the stomach and grip- ing in the bowels, tenesmus, ulcerations, bloody stools, difficult breathing, and contractions of the limbs, which often terminate in death. Hence great care should be taken of copper or brass vessels, in which acids or fats are boiled, lest the verdigrise should be productive of disease. Though acids, &c. while boiling, do not cor- rode the metal, this is soon effected when the boiling heat is abated. In case of verdigrise being swallowed, oil and warm water, or large quantities of milk and water, both by the mouth and by the anus, in order to wash away the whole of this offensive matter, must be given; a discharge by vomiting with all possible speed must be excited; and, after due evacuations, an ano- dyne may be given: if there is great pain, cordials, with a milk diet, will be useful. Pills made of aerugo, we are informed by Gmelin, have been given as a re- medy in cancers. Verdigrise cannot be reduced to powder but by levi- gation. jES, (from the Hebrew term aes, fire, uins, from, xtiw, to burn,) called also cuprum, xxteos, Venus, cop- per. It is found in many countries, but chiefly in Sw e- den, Hungary, and Germany. iES 43" jl: t a The chemical character for copper is o . Its gravity is to silver as eight to ten; to gold, as eight to nineteen; and to water, as eight to one : more strictly, it is from 7.780 to 8.584. A wire Js of an inch will support about 300 weight. It is considerably, but not entirely, fixed in the fire ; changing first to a blue, then to a yellow, and then to a violet colour. • It is malleable, and ductile into a fine wire. It is elastic and sonorous. It melts not before ignition, or a strong white heat, but calcines by a. weaker red heat into a red powder; and when in contact with the coals gives a greenish blue colour to the flame. " # By heat, if the air has free access, it forms an imper- fect blackish red oxide; with greater heat, a brown glass. When cooled slowly, it is said to crystallise in quadrilateral pyramids. The sulphuret of copper is s very fusible mass : the phosphoret a grey and brilliant substance. It unites with the sulphuric acid when concentrated only with the assistance of heat, forming oblong rhomboidal crystals, which contain 0.32 of the metal, and 0.33 of acidi Lime and magnesia precipitate the copper of a bluish white. Ammonia has a similar effect; but if in the slightest excess the precipitate is re-dissolved, forming the cuprum ammoniacum, the re-dissolved copper forms the aqua ccelestis of the pharmaceutists. Copper is dissolved in diluted nitric acid, and forms crystals in long parallelograms or rhomboids. The muriatic acid only dissolves it when boiling and con- centrated. The crystals are acid, of a green colour, and the precipitate is not very readily dissolved by ammonia. The green colour indicates, according to Guyton, a greater degree of oxygenation than the blue. The blue colour, we are told by Gren, when dissolved in ammo- niac, does not take place unless air be aflmitted. Some authors have informed us, that fixed alkalis and neutral salts act on copper best also when exposed to the air and in the cold. Rancid fats and oils equally dis- solve it. Dissolved by fixed alkalis, it is green ; by the vola- tile, it is blue. Dr. Lewis observes, that if the TJW part of a grain of copper be dissolved in a pint of water, a blue colour will be produced by adding a volatile alkali to it. So great is its divisibility, that one grain dissolved in aqua ammoniae will tincture 385,200 times its weight of water. A small quantity of arsenic gives to copper a great degree of hardness and whiteness: thus pins may be made white and brittle by it. The hydrargyrus muriatus also whitens it; but pins are usually whitened with a solution of tin. If a piece of bright iron be immersed in the acid solution of copper, the acid quits the copper to attack the iron; and the copper, in its separation from the menstruum, adheres to the iron, which soon appears covered with a metallic cuprous coat. On these principles very minute quantities of copper dissolved in liquors may be readily discovered. The affinities of copper to other metals form no part of our subject at this time: we shall only add, that copper and tin make a good bell-metal, useful in microscopes and reflecting telescopes; copper and zinc, princes metal; copper with bronze and zinc, the white tonbac; with zinc, by fusion, the similor or Manheim gold; or l>v ceiheiv tation with lapis calaminaris, brass. For an account of the different ores of copper, see Mineralogie de Hauy, vol. iii. 520, Sec. If copper is swallowed in its pure state, it is inoffen- sive. Some practitioners observe that copper, when dissolved, is strongly styptic; so far from causing exul- ceration of the intestines, that it heals them : it vomits by its nauseous stimulus, which will continue for se- veral days. jESECA'VUM, (the etymology of this word is un- certain,) brass, made by .the union of copper, and ca- lamine stone, which is owing merely to the zinc con- tained in the calamine : this is called aurichalcum, azoth. The alchemists found it out by attempting to turn cop- per into gold. Brass is not so readily dissolved as copper. The vapours of the zinc, which join with the copper in making brass, increase the weight of the copper sometimes to near one-half more than its original weight. The following preparations are made from this metal: jES CORONA'RIUM. See jEs. EJ& U'STUM, burnt copper. Thin plates of copper are laid stratum super stratum in a crucible, with sulphur and sea-salt; then they are placed over a hot charcoal fire, and there continued till all the sulphur is consumed, or until the plates can be reduced to a powder. If good, it is of an iron-grey on the outside, of a reddish grey within; and if two pieces are rubbed together, a vermilion red is produced : it must also be brittle and glittering when broken. It was formerly- used for destroying fungous flesh, and drying up fis- tulous ulcers. With some aromatics, it has been given internally in epilepsies, and is recommended in diseases of the eyes. If the burnt copper is made red-hot, and quenched in the ol. lini nine times, then powdered, it takes the name of saffron of copper. jESCHYNO'MENE.(from x, ardeo, splendeo, bright and splendid,) is called liquor ethereus vitriolicus, nitrosus, muriaticus, according to the acid from which it is formed, combined with al- cohol. The idea of Macquer, who considered ether as x. spirit of wine, dephlegmated, or deprived of water, has little foundation; for the distillation of spirit of wine from the driest alkali does not resemble ether. Various are the processes by which ^ther is made. The following seems to be the best. Put a certain quan- tity of alcohol into a receiver, and very gradually add an equal quantity of concentrated sulphuric acid, shak- ing them together, and waiting till the first addition is incorporated before any more is put in; for, if they are poured together too rapidly, the succeeding heat and ebullition will dissipate a part of the mixture, break -the vessel, and endanger the operator. After having. n^xed the whole in this gradual mode, the retort must be placed on a warm sand-bath, a receiver adapted, and the mixture heated to ebullition, keeping the retort cool with ice or the coldest water. Alcohol first passes over; soon after which, streams of fluid appear in the neck of the retort and within the receiver, which denote the rising of the aether. Its smell is agreeable : vapours of sulphureous acid succeed the aether; and the receiver must be taken away the moment they appear. If the distillation be continued, sulphureous aether is obtained; and the oil, which is called aethereal oil, or oil of wine, and that which remains in the retort, is a mixture of undecomposed acid, sulphur, and a matter resembling bitumen. The chemical nature of aether is still little known. Fourcroy and Vauquelin think that in the process the alcohol is decomposed, and its ingredients form a new compound; but aether contains a larger proportion of hydrogen and oxygen, and a less proportion of carbone. Yet in various experiments with aether charcoal is de- - posited more copiously than from spirit of wine. Dabit, on the contrary, contends,, that aether is only an oxyge- nated sulphurous acid. He has, however, failed in his proofs. Othef chemists have, with greater reason, thought that the acid is decomposed, and that its oxygen unites with the hydrogen and carbone of the alcohol. Were this the place for chemical discussions, we could shew, that, though the latter opinion is nearer the truth than the former ones, yet that it is far from correct. When the aether is mixed with sulphureous vapours, it must be rectified by a gentle heat; some alkali being first added, to combine with the acid; or, what succeeds better, some black oxide of manganese. This fluid, besides its appellation of ether, is by some named acidum vitrioli vinosum ; by others, spiritus ethereus ; and in the Pharmacopoeia Edinburgens. it is entitled spt. vini aethereus; and as it may be obtain- ed by means of the different acids, so from the acid employed an appropriate epithet has been added. It should be noted, that ethers produced by the differ- ent mineral acids possess different properties. The col- lege of Physicians of London, in order to fonn the LiquoR ano'dynus minera'lis Hoffma'nni, order spiritus aetheris vitriolicus tb ij. et oleum vini ^ iij. by weight. Chaptal says the composition is spirit of wine and aether, of each-two ounces, and twelve drops of the aethereal oil. This is nearly also the compo- sition of Tickel's ether. See Liquor anodynus Hoffmanni. Various modes of preparing this fluid may be seen in the different writers, particularly London and Edin- burgh Pharmacopoeias. HTH 45 .ETH Some of the properties of this liquid are as follow: It is the most light, volatile, and inflammable, of all known liquids; with oxygenated fluids, it explodes. Its specific gravity is 0.758. It swims on the highest rectified spirit of wine, as oil does upon water. In consequence of its volatility, it produces a high degree of cold in evaporating: boils at 98°; and in vacuo, at 20° ; and freezes at 46°. It is one of the most powerful solvents known in chemistry. It will not mix with acids, alkalis, nor vinous spirits ; but mixes with ten times its weight of water, by agita- tion ; and is an effectual solvent of oils, balsams, resins, gum resins, wax, Sec. Equal parts of alcohol or aether with sulphuric acid, distilled or passed through ignited tubes of clay, pro- duce what is called a carbonated, oily, hydrogenous gas. This, mixed with oxygenated muriatic gas, forms oil. It is from this property styled by the Dutch che- mists, who discovered it, olefant gas. If the tube is of glass, carbone is deposited, and no such gas appears. If two parts of sea-salt, one of manganese, three of al- cohol, and one of sulphuric acid, be distilled, a dulcified oxymuriatic acid first comes over, and then an oil called oil,of salt. It extracts gold, wherever it is, from any one or all of the baser metals ; and thus gold is better and sooner purified than by any other means. jEther is first described in the Dispensatory of Valerius Cordus, published in 1540 : the public attention to it was, however, first excited by a publication in the Phi- losophical Transactions, A. D. 1730, by a German, who calls himself Frobenius. The late Dr. Ward was the first who is known to have used it in England; with ether he instantly relieved the headach, and other pains in the external parts; but for the first publication on its internal use, we are indebted to Mr. Turner, surgeon, in Liverpool, by whom it was prepared for a very ex- tensive sale. He mixed two drams of ether with six or eight ounces of water, and gave from one to four large spoonfuls at a time, repeating the dose as required. Its general effects internally are anodyne and antispasmodic. Others give five or six drops for a dose, first dropping it on sugar; but five times the dose is not too great. In obstinate headachs, vertigos, convulsions, hysteria, rheumatism, flatulent and other disorders of the sto- mach and bowels, asthmas, hiccough, &c. by its ap- plication externally, or administration internally, or both, the most desirable effects have followed. When it is applied externally, procure a bit of linen rag, of such a dimension as to be conveniently covered with the palm of the hand : moisten the rag with the ether, and press it close to the part affected; in two or three minutes the rag will be found dry, and may be taken away: the application must be frequently repeated. Fred. Hoffman, indeed, employed it, in the form of his mineral liquor, as a sedative and antispasmodic. The aether prepared by Mr. Tickel, of Bath, is re- commended chiefly in hydrothorax, but none of the aethers are remarkably diuretic; and, from what we have seen, this medicine apparently acts only as an anodyne and an antispasmodic. In complaints where a remedy of this nature is required, Hoffman is extra- vagant in the praises of his mineral liquor; and, in later times, Mr. Clutton's febrifuge spirit is little more than an aether acidulated, and disguised by some of th$ warmer vegetables. .flLther is either administered on sugar or mixed with water, by means of an almond or mucilage. It is how- ever given with least loss in the former way, or dropped into any fluid in a vial, which must be immediately corked and inverted. As to the tests of the goodness of ether, Mr. Turner informs us, " that the most perfect sort is obtained by the assistance of the vitriolic acid; that it is colourless, and strikes the nose very stronglyvwith the sulphureous smell; a drop let fall on the hand instantly vanishes, without leaving any moisture "behind; five or six drops dropped together upon a table will disappear in a few seconds, and leaves only the appearance of a large oily ring behind." The best ether requires the greatest quantity of water to be mixed with it; if, therefore, to six tea spoonfuls of water, in a small phial, you add one of the ether to be examined, cork it up, and shake them well together; and if, upon standing a little while, some of the ether appears at the top, in the form of oil, sufficient to cover the surface of the mixture, it is good, provided also that it answers the other methods of trial; but if none appears, or not enough to cover the face of the mixture, it was either adulterated or not well rectified: if to this mixture of ether and water you add a little salt of tartar, and any fermentation ensues, the ether was not well rectified. To obtain a powerful medicine, it is necessary that it be free from all adherence of the sulphureous acid, for in proportion to the acid, its virtues are greatly impaired. See Malouin's Chimie Medicinale, torn. ii. p. 451. Dictionary of Chemistry, edit. ii. Dr. Frobenius's ac- counts of JEther, inserted in the Philosophical Transac- tions for 1733 and 1741. Pharm. Col. Edinb. TheLond. Med. Obs. and Inq. vol. ii. p. 176—186. An Account of the extraordinary Medicinal Fluid called JEther, by M. Turner, surgeon, in Liverpool. Abridgment of the Phi- losophical Transactions, vol. viii. p. 744. Cyclopedia, edit. A. D. 1788. Beaume's Dissertation on JEther. This last is the most complete work on this subject. Cullen's Mat. Medica. Chaptal, Lavoisier, Fourcroy, Thomson, Annales de Chimie, vols. 21, 23, 24, and 29, 34, 43. Journal de Physique, 45 and 46. Parkinson's Chemical Pocket Book. .ETHE'REA HE'RBA. See Eryngium. ETHEREAL OIL, an animal or vegetable oil, highly rectified. iE'THIOPIS, (from xi6a, to burn, and u$, the face ; so called because it is abundant in Ethiopia, and very hot climates,) Ethiopian clary. Salvia JEthiopis. Linn. Its leaves are like those of mullein, hairy and thick ; the stalk is quadrangular, like that of balm ; the seeds are two in a cell. A decoction of its roots is commended in pleurisies and rheumatisms; but is an inert insignificant remedy. Raii Hist. jETHIO'PICjE. This epithet is applied to many medicines from their black colour, like the skin of an Ethiopian. ■ Pilul. R. Merc. pur. cum mu- cilag. £ gum. Arab, extinct. 3 vi. sulph. ant. precip. res. guaiac. et mellis aa. ^ ss. f. mas. et divid. in pilul. No. ccxl. quarum detur i. ad iv. mane nocteque. These are in every respect equal to Dr. Plummer's in JR T II 46 A F F point of usefulness, but not so apt to run off by a stool; see Plummeri pilule. jE'THIOPS ANTIMONIA'LIS, antimonial jethi- ops. Dr. Cockburn, in his Treatise on the Gonorr- hoea, directs us to melt equal parts of antimony and sea salt in a crucible, and separate the scoriae, then to rub equal parts of the regulus made in this manner and mercury together, till they are incorporated. He extols it in cutaneous diseases, glandular obstructions, and many other chronical diseases : a -few grains are given at first, and the quantity is increased as the pa- tient can bear it. Malouin, in his* Chemistry, gives various processes for uniting antimony with mercury, some of which are more speedy, and others more per- fect in forming this combination ; but all the prepara- tions where the crude antimony is employed are inert, in consequence of the sulphur it contains. The Pillulae JEthiopicse, taken from a former edition of the Edin- burgh Dispensatory, are now omitted in the Pharma- copoeia of both colleges. --------martia'lis, martial jethiops. Put filings of steel into an unglazed earthen vessel, with water enough to rise four inches above the filings; the whole is to be stirred every day, and more water supplied as that in the vessel exhales, so that the filings remain always covered; continue this process till they are re- duced to a powder of an inky blackness. This medi-_ cine seems never to have attained the notice of phy- sicians, though it may probaby be an useful one. The iron is evidently oxygenated by the decomposition of the water, and it may be recollected, that in Griffith's medicine it experiences a similar change. --------minera'lis. Now called Hydrargyria cum Sulphure, Lond. Ph. 1788. ./Ethiops, so called from its colour. Ethiops mineral is prepared by uniting equal parts of sulphur and mercury, with or without heat. , As sulphur so eminently abates the power of all the more active metals, this medicine is thought by many to be no further useful than as it is of efficacy in the stomach - and bowels ; others assert, that it enters the circulation, and is productive of very salutary effects. It is indeed possible; that a portion of the mercury may be separated from the sulphur, during the passage of the ethiops through the body. The dose is from gr. v. to 5 ss. It is equally useful with the cinnab. antimonii for fumigating venereal ulcers : and, like the cinnabar, it is hard to say that it is useful in any other way. In the present form with a double proportion of mercury it may be more active. --------vegeta'bilis. Vegetable ethiops. By burning the sea-wrack in the open air, it is reduced into a black powder, and is then called vegetable ethiops. The soap-boilers call this kelp. The best is from Scot- land. From 9 i. to 9 ij. is given twice a day to remove scrofulous swellings. --------jovialis, is mentioned by Gmelin as use- ful in destroying taeniae. It consists of equal parts of tin, mercury," and sulphur; but is probably a medicine of little value, as tin acts mechanically. —------ ANTIPTHYSICUS, ANTIRHEUMATICS, DIURE- ticus, and purgans, are denominated from their colour, and consist of mercury, with the Peruvian balsam; with gum guaiacum ; with juniper gum; and with manna or jalap. These combinations are wholly un- known in this country, and perhaps scarcely deserve to be known. --------a'lbus. See Mercurius alkalizatus. --------mercurii per se, is a simple oxyde of mercury, prepared by trituration, with or without mu- cilage. It has been given in venereal affections, in in- flammations of the liver, and intermittents; and seems to have been at one time a favourite with the German physicians. jETHO'LICE_S, (from cn6a, to inflame or burn). Superficial pustules in the skin raised by heat. jETHU'SA MEOJM. See Meum. jETIOLO'GIA, jetiology, (from xmx, a cause, Myos, a discourse on). A treatise on the causes of dis- eases, and their symptoms. iE'TOIPHLE'BES, eagle veins, (from «««$, an eagle, 8. Alcohol. Water /Ether Volatile Oils Volatile Alkali Fixed Alkali Sulphuret of Alkali Sulphur Muriates Phosphoric Alkali 59. JETHER. Alcohol Volatile Oils Water Sulphur Phosphorus Caoutchouc 60. Volatile Oh. Ether Alcohol A F F 54 A F F Fixed Oil Fixed Alkali Sulphur Phosphorus 61. Fixed Oils. Lime Barytes Potash Soda Magnesia Ammonia Oxide of Mercury Other Oxides Alumine Sulphur Phosphorus Lime Magnesia Ammonia Alumina Jargonia Oxides of Metals III. Wu.it 01 i ins in Distillation*, or Sublimations, and re q,i'ihes Heat. 62. Pyromucous Acid. Potash Soda Barytes 63. Pyroligxeous Acid. Lime Barytes Potash Soda Magnesia Ammonia Metallic Oxides Alumina 64. Jargonia. Vegetable Acids Sulphuric Muriatic Nitric Acids The affinities of oxygen, as ascertained by later ob- servations, appear to be nearly in this order:__ Oxygen—Charcoal, titanium, manganese, zinc, iron, tin, uranium, molybdenum, tungstein, cobalt, antimony, hydrogen, phosphorus, sulphur, nickel, arsenic, nitro- gen, chrome, bismuth, lead, copper, tellurium, platina, mercury, silver, nitrous gas, gold, muriatic acid. TABLES OF DOUBLE ELECTIVE AFFINITIES, OR AT- TRACTIONS. I. What occurs in Mixtures bt Fusion. , < ''"in, mixed with '* Silver, 2 C Copper, with ' I Gold, M.S. 3. 1 Gold, ? C Iron, mixed with ~) j-5? Lead. j ? s 5 Sulphur, with > i-i Lead. \ C'S CSul|luir. with > I "■* <. Regulus of antimony. J Wuat occciis in Mixtures of Watert Substances. {Acids, mixed with Calcareous earths, or Metallic substances, {Vitriolic or marine acid, wilh Alkalis or earths, r Lead, , \ Nitrous, marine, t or *- Acetous acid, Silver, iolic, nitrous, J Volatile alkali, ■s mixed with I Fixed air. T Mercury, silver, S Vitr ' Ace Acetous acid, . S Volatile alkali, '" J Acids, f Nitrous, marine, 6 J anc' ' j Acetous acids, ' Calcareous tarihs, Lead, with / Nitrous, or acetous L acid. * C Vitriolic acidsi < Alkalis, earths, or C M.S. f Marine acids, J Alkaline salts, earths, C or ^ M. S. v Fixed air, ■S and C Fixed alkali. r Volatile alka'i, 3 magnesia, earth of > alum, *- Vitriolic acid. ^ all Hi £§•«.£-$ = a i -r 2 S °"='8,a £ - "2 b B'" -IS'3 Hi'8 O " - « c _ SJB r, S mixed with ' Calcareous earths. ^ Nitrous, marine, ■£ ~) acetous at id '» ' Fixed alkali. Acetous acid, Fixed alkali, or _ Abso rben t ea ri hs. C Marine acid, \ Quicksilver. See Dictionary of Chemistry, translated from the French; Black's Lectures; Chaptal, Fourcroy, and Thomson's Chemistry; Morveau's Papers in the An- nates de Chimie; Kirwan; Phil, and Irish Trans.; besides those above quoted, may be consulted on this subject. Affinity, compound, implies the union of different bodies in one homogeneous mass. Thus, alum, vitrio- lated tartar, a small proportion of alcohol and water, form a transparent fluid. --------compound, elective, we thus distinguish what is called double elective attraction, since, in many cases, there are more than four substances. If, for in- stance, nitric acid be added to the sulphat of ammonia, no decomposition takes place; but let nitrat of potash be added, and two new bodies are formed ; that is, the potash attracts the sulphuric acid, while the nitric acid solicits the ammonia. This was familiarly explained by Dr. Black in the following manner: Pot-ash Nitric acid Sulphuric acid Ammonia Suppose the two lines, two rulers, moving freelv on the centre, if the affinity between the potash and sul- phuric acid be equal to 62, that between nitric acid and ammonia equal to 38, the sum of these affinities will be superior .to the affinities supposed to keen the sulphuric acid and ammonia—the potash and nitric loo tnT «' m thC Pr?P?rtion <>f ^eir sums, viz. 100 to 96. Bergman and Elliott have given different diagrams which we need not copy. Berthollet has shewn that these representations are not chemically exact; but this would lead us into the intricacies of another science. ,.~~7-----.intermediate, means the union of bo- dies by an intermede. The usual instance of water uniting with oil by the medium of mucilage, is incor- rect; for this is not an union, but an intimate mixture of particles unaltered. Azote will not unite with fixed A G A 55 A G A alkalis, but when combined with other bodies in the form of nitric acid, the union is ready and perma- nent. Affinity, quiescent and dwellent. These terms are employed by Mr. Kirwan; the former to express the force exerted to preserve the old combination ; the latter that which tends to destroy it. In the former example, the quiescent affinity between the ingredients of the sulphat of ammonia and the nitrat of potash, respectively, was equal only to 96; that of the other two bodies, respectively, equal to 100. -------- reciprocal, forms a singular phenome- non in chemisiry. A body consisting of two princi- ples may be separated by another, which, with one of the principles of the first, forms a new compound ; but the separated principle, after some time, will effect a separation of the new union. A'FFION, (assun,) an Arabian name of opium ; also of an electuary, in which opium is a part of the composition. See Opium. AFFLA'TUS, or ADFLA'TUS, (from ad, andflo, to blow). When a vapour or air strikes any other body with a certain degree of violence, or, as the country- people call it, a rlast, it affects the body suddenly with a disease ; it is a species of erysipelas. AFF" SIONS. i spe AFFLI'CTIO, (from affligo, to afflict). See Pas- AFFO'DILUS. See Asphodelus luteus. AFFRODI'NA, or Affrodi'te, (from x («, non, and yevo,u.xt, gusto). De- AGEUS'TIA, 5 fect, or loss of taste, called also Apogeusia, Apogeusis. Dr. Cullen ranks this as a genus of disease, in the class locales, and order dysest- hesia. The causes are fever, or palsy, whence he forms two species: the first he calls organic, arising from some affection in the membrane of the tongue, by which relishing things, or those which have some taste, are prevented from coming in contact with the nerves; the second atonic, arising from a weakness of the nerves, without any affection of the tongue. Sauvages thinks the cause of this disease to be either in the brain, in the tongue itself, or in the passage of the lin- gual nerves. He forms two species: first, febrilis, where a suppression of taste accompanies fevers, from the rough tongue; delirium, or coma: second, para- lytica, when it accompanies a paralysis of the tongue or some comatous disorder.—Nosologia Methodica, vol. i. 751. AGIAHA'LID. See Lycium. A'GIS. See Femur. AGITA'TION. Exercise is sometimes useful, by agitating the whole system; and violent agitation is re- commended by Bartholine in fits of tooth-ach and deaf- ness. Agitation of mind from any cause has certainly relieved nervous complaints, and prevented the access of fevers or of spasmodic attacks. AGLACTA'TIO,(«, non, and yxXx, lac). Defect of MILK. A'GLIA, (from «yAe?, shining). See ^Egides. A'GLITHES, (from xyXvofmi, to be offensive). The division or segments of a head of garlick, which we call its cloves. AGLUTI'TIO, (from x, priv. and yXv^u, to swallow). A difficulty of, or impediment to, swallowing. See Degi.i titio. A'GME, (from xyu, to break). See Fractura. A'GN AC AT. A tree which grows about the isthmus of Darien; it resembles a pear-tree, both as to its gene- ral appearance and its fruit, the pulp of which is said to be highly aphrodisiac. Raii Hist. AGNA'TA. See'Adnata. A'GNIL. See Indicum. AGNIV'NA MEMBRA'NA, (from *yv«5, a lamb, and membrana,amembran.e,) velPELLI'CULA. Aetius calls one of the membranes which involves the fcetus by this name, which he derives from its tenderness. This name is adopted by Drelincourt and Bartholin?. See Amnion. vol. I, AGNOI'A, (from «, neg. and ytvoTxa, to know). It is when a patient in a fever forgets his acquaintance. When it is joined with rigor, it is a dangerous symp- tom. A'GNUS CA'STUS, (from agnus, a lamb, and the Hebrew term kadash, chaste). It is called agnus, from the down on its surface, which resembles that upon a lamb's skin; and castus, because.the chaste ma- trons at the feast of Ceres strewed them upon their beds and lay upon them. The chaste tree, vitex agnus castus Lin. Sp. PI. 890. The qualities of this seed do not support its name or use. The smell is foetid, the taste warm. It is not now used in medi1 cine. A'gnus scy'tuicus. The Scythian lamb, called also in the Scythian language, barametz, i. e. lamb, or baro- metz, or baronetz. This sort of plant is said to be found in Tartary, Russia, &c. and is described as growing in the resemblance of a lamb. In fact, however, it is the root of a fern, covered with a whitish down, which the Tartars trim so as to represent a lamb, and sell' it for a vegetating parasite animal. It would be endless to re- count the ridiculous stories told of this animal plant; nor is it a part of our subject. The fern is the poly- podium barometz of Loueiro; the dictisoma culcita of Heritier. Sertum Anglic. PI. 43. AGOM'PHIASIS, (from x, neg. and ye^a?, com- pact,) or GOM'PHI ASIS. A distemper of the teeth; it is when they are loose in their sockets and pained. A'GONE, (from x, priv. and yevo?, offspring). Hen- bane ; so named because it is supposed to occasion barrenness. See Hyosciamus niger. AGO'NIA, (from x, neg. and yeves, an offspring). See Sterilitas. Ago'nia, (from xym, a combat or struggle). Ago- ny, as when there is a struggle between life and death. To avoid this painful struggle, which has agitated the minds of the wisest and best of men, different plans have been suggested. But death is the last scene which we must all act; and, to the mind possessing an awful sense of the power and goodness of the Almighty, there is but a shade of difference between our voluntarily shortening our lives for a few hours or minutes, and the abridging half an age. Also fear and sadness of mind, with agitation. AGONrSTICUM,(from«y«v<««,?o strive). Galen, in speaking of Marasmus, uses this word to signify wa- ter extremely cold, which he directs to be given in large quantities in erysipelatous fevers, that it may overpower the excessive heat of the blood. A'GONOS, (from x, neg. and yeves, an offspring, or yevjj, barren). Hippocrates calls those women so who have not children, though they might have, if the impediment was removed. In botany it means not bearing seed or fruit. AGO'STUS, from xya, to bring or lead). That part of the arm from the elbow to the fingers. See also Palma. AGRE'DULA. A species of frog. AGRE'STA, verjuice, (from xypus, wild). The juice of unripe grapes, or the sour grape itself,, called omphax, or the juice of the sour apple. See Malt:s hortensis. AGRES'TEN. Acid stone tartar. I A Gli 58 AG Y is the AGRES'TIS, wild, (from xypw, wild). It is ap- plied to vegetables that grow without cultivation (see Malus sylvestris); to wild, as distinguished from tame, animals; and to express an ungovernable malig- nity in a disease. A'GRIA, holly, (from the same). Also a ma- lignant pustule, of which there are two sorts; one small, and casts a roughness or redness over skin, slightly corroding it, smooth about its centre, spreads slowly, and is of a round figure; this sort is cur- . ed by rubbing it with the saliva before breakfast: the second sort ulcerates, with a violent redness and cor- rosion, so as to make their hair fall off; it is of an un- equal form, and becomes leprous; its cure is the appli- cation of pellitory of the wall in the manner of a poul- tice. AGRIA'MPELOS, (from xypm, wild, and x^tXex;, a vine). The wild vine. Bryonia alba. See also Bryonia nigra. A'GRIC. The abbreviation by which is meant Geor- gius Agricola de Re Metallica, Natura Fossilium, Sec. Basilian, 1657, folio. AGRICULTU'RA, (from ager, afield, and cultura, tillage). Agriculture is the art of cultivating the ground; tillage, husbandry, as distinct from pasturage. But it is not connected with medicine, except in the instance of benefit supposed to be received from vapours which arise while ground is fresh or newly turned up, parti- cularly the light gravelly soils. On this subject much satisfaction may be derived from the Georgical Essays by A. Hunter, M. D., second edition, in five volumes. Fordyce's Elements of Agri- culture and Vegetation. AGRIELiE.'A,(from*yfdian words^ See Cas" AIPIPO'CA J ' SADA> AIR. See Aer. AI'RA, (xipta, to take away ;) so named, because it ought to be removed. See Lolium. AISTHETE'RIUM, (from xm-Sxto^xi, to perceive). See Sensorium commune. AJUGA. The bugula of Jussieu. The plant used in medicine is the A. reptans Lin. Sp. PI., the common bugle; consolida media of medical authors. It is a slight astringent, and has been styled a vulnerary. To this genus, Dr. Smith has annexed the tucrium chama?- pitys, the ground pine. See Cham.£pitys. AIX LA CHAPELLE, is a large imperial city,'si- tuated in the duchy of Juliers, on the confines of Flan- ders, seven leagues from Spa ; it contains many springs of hot sulphureous waters, which supply a number of baths. On the vaults above the springs and aqueducts of these waters is found every year, when they are opened, a quantity of fine white-coloured flowers of sul- phur, which Has been sublimed from the waters. The heat of the waters of the hottest spring, Dr. Lucas says, raises the quicksilver in Fahrenheit's thermometer to 136; Mons. Monet to 146; and the heat of the foun- tain, where they commonly drink, to 112, according to Dr. Lucas. Sir T. Bergman obtained from a Swedish kanne 27 grains of lime saturated with aerial acid, 29 grains of sea salt, and 70 grains of mineral alkali. These waters are powerfully diaphoretic, and diuretic; and, if taken in quantity, prove purgative. Of the three hot European waters of note; viz. that of Aix la Chapelle, Bourbon, and Bath, the first abounds more eminently with sulphur, and is the hottest, the most nauseous, and purgative. The Bath waters possess the least of these qualities. In all cases it is the best to. begin with small quantities, and low degrees of heat, and gradually increase them, agreeable to the effects and constitution of the patient. In cases of dyspepsia, and foulness of the primae viae, they are said to be effi- cacious : in rheumatism, scurvy, scrofula, cutaneous diseases ; in hysteria, and hypochondriasis; melancholy, stone, and gravel; in paralytic complaints, and in many other cases, they should be considered as invigorators of the system, deobstruent, and evacuant. They are improper in all hectic cases, putrid disorders, where the blood is in a dissolved state, or the constitution much broken down. The times of drinking these waters are from the beginning of May to the middle of June ; or from the middle of August to the latter end of Septem- ber. See Aqu.E minerales. See Monro's Medical and Pharmaceutical Chemistry, vol. ii. Dr. Williams on the Waters of Aix la Chapelle, Sec. AIZO'ON, {xti, always, and £«», vivo, to live). See Aloides. It is also a name (or sedum. AJA'VA,v(Indian). So the Portuguese call a seed which is brought from Malabar, and is celebrated in the East Indies as a remedy in the colic. When the gout affects the stomach, these seeds are very effectual in dispelling the wind, and procuring speedy relief from this painful disorder; they sometimes relieve by pro- curing stools. The descriptions of travellers are not so minute as to enable us to refer it to its place in the Systema Naturae. Dr. Percival takes notice of these seeds in his Essays Med. and Exp. vol. u. AJUBATI'PITA BRASILIE'NSIUM. A shrub bearing fruit like an almond ; but it is black, and con- tains much oil. A'JUGA, (x priv. and fyyoy, a yoke). See Cham.e- pitys. A'JUGA. Reptans. See Bugula. AKMEL'LA. See Acmel'la. AL. The Arabian article which signifies the; it is applied to a word by way of eminence, as the Greek a is. The Easterns express the superlative by adding God thereto, as, the mountains of God, for very high, or the highest, mountains; al may therefore relate to the word Alia, God ; and alchemy may be the chemis- try of God, or the perfection of chemical science. Sec Alchemia. A'LA, an arm-pit, also a wing, (Hebrew term ahla, a leaf). It is often employed in the descriptive language of every science, for any thin expanded pro* jections. In botany, it is the two side-petals in a papilionaceous corolla: also membranes affixed to the seeds. It used to be applied to the angle formed by a branch with the stem, or by a leaf with the branch; but this is now named axilla or axil, from its similarity to the arm-pit. In Anatomy. A'la au'ris, or Pinna Auris, is the upper part of the external ear. A'l^e na'si, or Pinne Nasi, the cartilages which are joined to the extremities of the bones of the nose, and which form its lower moveable part. The name also of the helenium or elecampane. ALABA'NDICUS, > lapis, so called from Ala- ALABA'NDINUS,$ banda, the place from whence it is taken. A blackish stone intermixed with sallow spots. It is pellucid, and looks as if it was divided by fissures into segments. Aetius says, that the pow- der of this stone makes grey hairs black. Probably black-lead. ALA'BARI. See Plumbum. 12 A L B GO A L i3 A wast- ALABA'STRON ; an ointment. Myrepsus gives the formula, and says that it is the same as that with which Mary anointed the feet of Jesus Christ. Ala- bastrum also means a solid kind of white gypsum, of which utensils " were formerly made; probably from Alabastrum, a town in Egypt, where it was plentifully produced. A'LACAB. See Ammoniacus sal. A'LJE INTERNA, ? clitorides. See Nym- -----mixo'res, 5 PH^- ,_____m\g'nje os'sis sphenoi'dis. The two tem- poral apophyses of the os sphenoides. -----pa'rv^e os'sis spiienoidis. The two thin, sharp, transverse apophyses of the os sphenoides, which form the superior orbitary fissures. A Li Art f - at cm i A'LAFOR, and A'LAFORT, $ AIX AL1- ALAI'A PHTHI'SIS, (from xXx,o,blind) ing from a flux of humours from the head. ALAMA'MDINA, supposed to be the alabandicus lapis. ALA'MBIC. See Argentum vivum. A'LAMAD. Antimony. See Antimonium. ALA'NA TE'RRA, (from xxxivog, oily, and terra, earth,) English oker; called also alha'nna. It is esteemed drying and astringent; its principal use is to mix with salts in distillation, in order to keep them from melting. It is probably the Samian stone, and the Terra Tripolitana. ALA'NDAHAL,(an Arabic term—ahlan, bitter). See Colocynthis. ALANFU'TA, (an Arabic word, from the same de- rivation). A vein betwixt the chin and upper lip, for- merly opened to cure a foetid breath. A'LA POU'LI. See Bilimbi. ALAQUE'CA, (Indian). A stone found in little polished fragments in the East Indies, used externally to stop bleeding. ALA'RE EXTE'RNUM, (from alaris, winged, and externum, outward). See Pterygoides externus. ALA'RIS VE'NA, (from ala, the arm-pit). The inner of the three veins in the bend of the arm, because it comes immediately from the arm-pit: this is attended with an artery, and the median with a nerve; but the outer one, as P. ^Egineta long since observed, is safe for bleeding. ALARIS, in botany. The term means growing out of the angles formed by the branches of the stem. ALA'SET. Ammoniacus sal. A'LATAN. Lithargyrum. ALA'TAR. Burnt brass. See jEs ustum ALATERNOI'DES, (alaternus, uh<, likeness,) AFRICA'NA. ALATERNUS. ALA'TI,(from alatus, winged). Those who have prominent scapula; are so called, and are subject to con- sumptions ; since, from the pressure of the muscles in consequence of this disadvantageous attachment, the sides of the sternum are compressed. ------pro'cessus, or ala'res. The wing-like pro- cesses of the os sphenoides. ALAU'RAT. See Nitrum. A'LBA Si'MPLEX. See Ocimastrum. A LB AD A RA (from albadar, an Arabian word). See Sesamoidea. us1: '} SeeCAS- ALBAGIA'ZI. See Sacrum °s. ALBAME'NTUM, (from albus, white), bee Albl- Ml'.N OVI. ALBA'NUM. Salt of urine. ALB VRA, (from albahrah, a Chaldaean word). A species of the.white leprosy, see Alphius. It also signifies the white poplar. Albarus nigra is the lepra Grecorum. Avicenna calls the lepra icthyosis by this name. ALBA'TIO, ALBIFICA'TIO,(from albeo, whiten- ing,) called blanching of metal. ALBE'DO, (from albis,) whiteness. In urine is observed four sorts of whiteness, viz. the crystalline, the snowy, the limy, and the limpid. A'LBERAS. White pustules upon-the face. See Albora. It is also a name given to staves-acre, because its juice is said to remove these pustules. See Staphis agria. ALBE'STON. Quick-lime. See Calx. A'LBETAD. See Galbanum. A'LBI. Sublimate. See Merc, corrosivis alb. ALBICA'NTIA, corpora, (from albeo). Willis's glands. See Cerebrum. A'LBIMEC. Orpiment. See Auripigmen- tum. ALBI'NUM, (from the whiteness of its blossom). See Gnaphalium. A'LBIN INS. The abbreviation for Albin Eleazer, a natural history of insects. London, 1720, 4to. A'BIR. Pitch from the bark of the yew-tree. A'LBOR URINiE. SeeURiNA. A'LBOR O'VI. White of an egg. See Albu- men ovi. A'LBOR A. A sort of itch, or rather leprosy. Para- celsus says, it is a complication ofthemorphew, serpigo, and leprosy. When cicatrices appear in the face like the serpigo, and then turn to small blisters of the nature of morphew, it is the albora. It terminates without ul- ceration, but by fetid evacuations in the mouth and nos- trils : it is also seated in the root of the tongue. Inter- nal medicines, as well as corrosive ones, are forbidden. ALBO'RCA. Mercury. See Argentum vivum. A'LBOT. See Crucibulum. A'LBOTAT. Ceruss. See Plumbum. A'LBOTIM, or Albo'tai. See Terebinthina. A'LBOTIS. See Terminthus. ALBUGI'NEA, vel TENDINO'SA TUNICA. The inner proper coat of the testicle, named from its white and transparent colour. It is a strong, thick, white membrane, smooth on the outward surface, rough and uneven on the inner: into the upper part of this mem- brane are inserted the blood vessels, nerves, and lym- phatics, which send branches into, and receive them from the testicle. This coat being distended, is the cause of that pain which attends an inflammation of the testes. Albuginea is also the name of the adnata, q. v. ALBUGINO'SUS HU'MOR. See Oculus. ALBU'GO CORA'LLII. A name of the magisterv of coral, which it hath obtained from its whiteness. Albu'go oculorum. White speck on the eyes. The Greeks generally named it leucoma: the Latins and ancient authors, nubes, pterygium, pannus oculi,onyx,paralampsis,argema,andagides; Dr.Wallis ALB 61 ALB the albuginous, or pearly corneal speck. The French name it tache blanche, if it shines; the Latins, marga- rita; the Greeks, ttx^xXx^to-h ; the French, perle ; Dr. Cullen, caligo cornce. See Achlys. All cicatrices appear white in the black part of the eye, and astringents thicken them. It is sometimes called nubecula, when superficial; and albugo, when deep : when the speck appears of a shining white, and without pain, it is called by some a cicatrix; when of an opake whiteness, an albugo : seat- ed superficially, it hath been termed a speck ; and more deeply, a dragon; when it projects a little, it is called a pearl. The disease consists in a chronic inflammation of the eye, from erosion, measles, small-pox, wounds, burns, Sec. When deep, the cure is difficult; when the conse- quence of a wound or ulcer, it is rarely cured; when the natural shape of the eye is altered, the prognostic is unfavourable. The albugo which follows an inflam- mation generally disappears spontaneously. The aqua cupri ammon. alone sometimes succeeds in the cure; and in general saturnine and mildly astringent or stimulant applications are useful. When the film is very tough, and the eye not inflamed, common glass finely levigated may be blown upon it through a quill, and repeated once in a day or two. Dr. Kirkland thinks, that, in general, nature, assisted by strengthening the eye with cold water, will affect the cure. A single drop of laudanum, dropped into the eye night and morning, will often cure it. Boerhaave prescribed the repeated use of calomel and cathartics to dissolve the lymph, and free the cornea from leucoma. See Unguis. See Kirkland's Inquiry, vol. i. p. 492. Bell's Surgery, iii. 356. Wallis's Nosology of the Eyes, p. 134. White's Surgery, 228. A'LBUM BALSAMUM, (from albam, a Chaldaean term). See Capivi balsamum. A balsam also so call- ed is thus made: R. Aquae lythargyri acetati ad con- sist, mellis evaporat. et ol. rosar. aap. aeq. m. A'LBUM CANIS, > The white dung of dogs ; ------- gr^e'cum,5 also called spodium Greco- rum, nihil album—gryseum,cynocoprus. It is slightly stimulant and discutient, and was formerly applied to the outside of the throat in quinsies, being first mixed with honey. A'LBUM HISPANIC, et H1SPANICUM. Spa- nish-white. It is also eaWed'bianca Alexandrina. It is made from tin and bismuth, in the same manner that ceruss is made from lead, and is a cosmetic. ALBUM JUS. White broth. Boil whiting, had- dock, cod, or any similar fish, in water, with a little oil; a small quantity of aniseed and leeks. When the fish is parboiled, add a little salt. A'LBUM NIGRUM. Mouse-dung. A'LBUM OLUS. Lamb's lettuce, or corn sal- lad. See Lactuca agnina. ALBU'MEN O'VI, white of egg; called also al- bumor and albor ovi, ovi albus liquor, ovi candidum, al- bamentum, clareta, isfc. The white of an egg is a pellucid viscous liquor, thinner towards each end, and thicker in the middle. That part which is more dense and close than the rest is called gallatura. The industry of later physiologists has discovered three different kinds of albumen in each egg, of differ- ent densities. The external is the most liquid; the second is less so, and the third still less fluid. It is to this third portion that the shape of the albumen is con- fined ; the others surround the yolk: this consists of two segments of spheres of unequal diameters, applied to the sides of the yolk, and connected with it by a some- what denser albuminous process, near each extremity ; though not, as has been represented, at the poles. These albuminous processes are styled chalaze. Each of the portions of this internal albumen is penetrated by a convoluted cord: that, on one side, is membran- ous ; the other, vascular. The former is contiguous to the pellicle of the yolk; the latter, analogous to the umbilical cord in the mammalia, forms the communi- cation between the albumen and the yolk. The albumen of the egg, in its early period, is less homogeneous than at a later; since, in boiling, it con- cretes into a curdly fluid. Some water escapes from it, and is collected in a pellicule, on the top; and it is probable, though by no means certain, that some oxy- genous gas is absorbed. It is said to be destined for the nourishment of the chicken; but, in the process of in- cubation, it is not materially diminished in quantity, and we know that the yolk is the real nutritious sub- stance, and is taken into the body of the chicken at the end of the period of incubation. A milder nourishment may probably be required in the early stages: nor is it very improbable that the three kinds of albumen may be designed as nourishment for the chicken at its differ- ent ages, and the waste repaired by the absorption of humidity. If this is prevented, the progress of the embryo is checked, and the egg continues in its first state. The albumen is peculiarly mild, resembling the serum of the blood, which is a watery fluid, with an admixture of the gluten; a portion of which appears to be chemically combined, and the larger part mechani- cally mixed. It is soluble in hot or cold water, coagu- lated by heat of 165° of Fahrenheit; by acids, and by alcohol. When diluted by ten times its weight of water, heat does not coagulate it; but acids and alcohol con- tinue to produce this effect until it is more largely diluted. In the coagulation, the bulk is not increased; and the coagulum neither absorbs nor emits air. The cause of the coagulation is probably the addition of caloric; but to ascertaih this idea, which is originally Scheele's, the capacity of the albumen in each state for heat should be ascertained. Albumen naturally contains a proportion of soda and a little sulphur. In water of 80°, it soon becomes pu- trid, and exudes through the broader end of the shell. Alkalis and alkaline earths dissolve it; disengaging some ammonia, in consequence of its decomposition. A solution of tanin precipitates albumen in the form of a yellow precipitate, of the consistence of pitch; and, however minute the proportion of albumen combined with water may be, it is discoverable by means of tanin. When dissolved by alkalis, and precipitated by acids, its qualities are altered. When coagulated, water no longer dissolves it, but mineral acids have this power, and tanin only will precipitate it: alkalis have no effect. In its analysis, it resembles the gluten of the ALB 62 ALK blood, but contains a less proportion of azote than the fibrin: the other ingredients are carbone and hydro- gen. See Blood and Tanin. The yolk of the egg differs in appearance, rather than its nature, from the albumen. It has a portion qt the gluten, and contains a resinous, or rather an oily num. By heat, the oil is entangled in the coagulable sub- stance ; but a portion may be expressed, and is employ- ed as an antiphlogistic remedy against sun-burns, i ne colouring matJkl is not known. * ourcroy supposes it to be iron ; but it is more probably sulphur, as a putrid egg exhales a strong hepatic gas. The shell of the egg consists chiefly of carbonat, and phosphat of lime, v,ith irelatinous matter. The membrane that lines it, though apparently dense, suffers some fluids to escape, and some gases probably to be absorbed, since acrid and de- leterious vapours destroy the chick. This membrane is a part of the albumen, and, of course, a part ot the em- bryo, since its vessels may be injected from those ol the chick Eggs are chiefly employed as nourishing substances. In the arts, the albumen forms, with quick lime, a strong cement for china; and, diluted with water, it has been used to lessen the rigidity of the tendons ; in pharmacy the yolk is employed as an intermede, to mi»or sus- pend oils, balsams, and resins in water. The oil ol the yolk we have already mentioned. . Asa nutritious substance the yolk is the most distm- - guished. It is not certain that the albumen abounds in nourishment. It is very bland when fresh, and highly deleterious when in the slightest degree putrid. Even in its best state it disagrees with many stomachs; producing eructation, sickness, and sometimes ery- sipelatous eruptions. The yolk is very nourishing; but, when firmly coagulated by boiling, it is slow of digestion. It was some years since in high reputation as an aliment for weak stomachs. A fashionable phy- sician ordered it, in one instance, and every one took it. The consequence might be easily supposed; but the practice continued while the physician was fashionable. In jaundice and liver complaints, a fresh unboiled egg has been recommended every morning, and it is said with success: we know not for what reason, except that it is yellow. In general, it is useful in weak sto- machs, as it contains much nutriment within a small compass; and, though the hard egg is slow of diges- tion, we have not found it increase hectic exacerbations. We shall see that slow and difficult of digestion are not synonymous. Nature seems anxious to retain the food in the stomach; and the best digestives are those which retard the process. Too rapid a digestion is, in many views, productive of inconvenience. See Digestion. The eggs of different birds do not differ essentially : those of geese and ducks are said to be the most gross and alkalescent: those of pea-hens andgallinas the least so. The latter have certainly less flavour. ALBU'MOR. See Albumen ovi. ALBU'RNUM, (from albus, white). The softer and paler part of wood next the bark : artificers call it the sap, to distinguish it from the heart, which is deeper coloured, and harder. See Santalum album. ALBUS LIQUOR. See Albumen ovi. A'LBUS ROMA'NUS PU'LVIS. See Magnesia alba. Albus, besides its well known Ration to^ex- press white, is also the name of a fish. See Capito LAa"'LCAHEST, or A'LKAHEST. The universal menstruum, or dissolvent. A name first used by Paracelsus, and derived from the German words al and gest'I e- all spirit. Van Helmont borrowed the word, and applied it to his invention, which he called the uni- versal dissolvent. Alcahest is also a name of the liquor of flints, and of all fixed salts volatilised. . A'LCALI, or A'LKALI, (of al and kali, 1. e. the essence or the whole of kali, the plant from which it was originally prepared, though now derived from plants of every kind). Alkaline salt is called alafi, alafor, alafort, and calcadis. As alkalis effervesce with acids, all volatile or fixed salts, and all terrestrious matters which ferment with acids, are called alkalis. Alkalis are mineral, vegetable, and animal, which three were particularly distinguished by the term, adding to it the peculiar epithet; but the College of Physicians of London have now distinguished them by three dif- ferent appellations; calling them natron, kali, and ammonia ; but they are either earthy or saline. The former terms are now indeed found to be pecu- liarly improper; since the kali is discovered in some minerals, even in some granites, and the ammonia is . obtained not only from plants, but seeds. The soda or natron occurs both in vegetables and animals. Besides these, there are several earths, which, in their more general properties, resemble alkalis; particularly lime, magnesia, barytes, and strontian. Earthy alkalis are those substances which of them- ■ selves scarcely dissolve in pure water; but if added to acids, form a neutral. Of this sort are chalk, limestone, crabs'-eyes, oyster-shells, egg-shells, Sec. Thus, if pure water is acidulated with oil of vitriol, it effervesces, if you scrape chalk into it; and during the effervescence, the water hath a brisk taste; when enough of chalk is added, the acidity is lost. Their taste is in general acrid and urinous; they change the blue colours of vegetables to a green, de- stroy the taste and other properties of acids, and dis- solve with peculiar facility in water. As the volatile alkali is known to be a compound of azote and hydro- gen, it is probable that the fixed kinds are formed of ■ similar ingredients. Thus hydrogen, with lime, may form pot-ash; with magnesia, soda. Some experiments supposed to prove these combinations, have been found fallacious; yet the principle is highly probable. The saline alkalis are fixed and volatile. The latter of which differs from the former only in volatility and its consequence; the volatile alkali rises sooner than the rectified spirit of wine. Tachenius is said to have first made the fixed vegeta- ble alkali: he established the general use, but it was known long before his time. A fixed alkali is the basis of sea salt. ■ vegetabile. This was formerly pre- pared from wormwood, and named sal absinthii ; but the College of Physicians have supplied its place with the kali preparatum, which is made in the usual method of dissolving, filtering and crystallising the salts of vegetable. The same salt may be prepared ALK 63 ALK from tartar, burnt till it becomes of an ash colour: and, indeed, of all the substances from which a fixed alkaline salt is obtained, tartar yields the largest quantity, and with the least trouble. The college has ordered the solution of potash to be set apart a whole night for the neutral salts, which are part of the composition, to.crys- tallise, but that is not sufficient; for, in order to have the alkali in its purest state freed from those salts, which is their intent, the solution will require to be ex- posed to crystallisation three times, at least: otherwise it will retain too great a share of vitriolated tartar. Ob- servations on the Pharmacopeia Collegii Regalis, &c. London, 1788. The quantity of pure-potash usually employed in commerce, is estimated by Vauquelin according to the following table: Potash. Sul. of Pot. Muri. of P. A. Insol. Car. Ac. & W Russian potashes 772 65-5 56 264 American ditto 857 154 20 2 119 Pearl ashes 754 80 4 6 308 Potashes of Treves 720 165 44 24 119 Dantzic ashes 603 152 14 79 304 Potashes of Vosges 444 148 510 34 304 A'lcali minera'le. This mineral fixed alka- line salt may be procured from sea salt, and from the waters of many springs, either by distillation of the acid, or the superior affinity of the vegetable fixed alkali. This alkali differs from that of vegetables, by being milder, and less acrid to the taste ; melting more easily in the fire; requiring more water to dissolve it; in its concreting into crystalline masses on evaporation after solution in water; not becoming liquid by exposure to the air; and in being a less powerful solvent of the stone in the bladder. As a less deliquescent salt, it is best adapted to form pills. The crystals are prismatic, resembling those of the natron vitriolatum. With this mineral alkali the Spanish soap is made. This salt, joined with the vitriolic acid, forms the natron vitrio- l vium ; with the nitrous, nitrum cubicum ; with the muriatic, sk\' salt; and with vegetable acid, the na- tron tartarisatum. The Egyptian soda was usually reckoned the strongest; but it is usually mixed with sea salt, with sand and a kind of steatite; then the Spanish (barilla). After this came the trona from Tri- poli, and then that prepared from different species of kelp. We have now, however, an ample supply from another source. In preparing the oxygenated muriatic for the purposes of bleaching, the muriate of soda is de- composed by the sulphuric acid. The sulphate of soda is afterwards decomposed in different ways; for which see Accum's Chemistry. --------ve'getabile. The vegetable alkali, or potash, and the mineral alkali, or soda, possess the general properties of alkalis; and most inflammable substances are acted upon by them. They melt in a moderate heat; and in a stronger they are volatilised : in the dry way they dissolve earths and the calces of metals. Fixed alkaline salt is obtainable from sea salt and nitre, and from all vegetables, except perhaps some of the' vojatile acrid kind, which impress the nose sharply with their scent, such as mustard seed, garlic, &c.; these contain parts that are volatile, and become vola- tile salt. The fixed salt of some plants vary greatly from one another, in strength, Sec. if taken in the state wherein they are first extracted from the ashes: they sometimes contain some neutral salt of the vitriolic or of the muriatic kind, which are discovered by shaking them in a vial, with equal part of spirit of wine, the fluid with neutral salt becomes milky. Sometimes a bitter crystalline hard salt, that is neither acid nor alkaline, but a mixture of earthy and alkaline neutrals, is found among the fixed alkaline salt; readily separated by means of cold water, in which it will not dissolve. This hard salt is never met with in making the salt of tartar, but in potash it is often found. The salts of the leaves, and other herbaceous parts of plants, are more difficultly brought to a state of purity than those of the more woody and compact por- tions, a portion of the oil being so tenaciously retained : some endeavour to retain this oil in the salt, by burning the vegetables in a smothering heat until they are re- duced to ashes. They do this to render the salt more mild, or to combine the virtues of the oil; but the mi- neral alkali is sufficiently free from acrimony to sit easy on the most irritable stomach, when administered in the usual modes; and the empyreuraatic oil, retained, will occasionally, it is supposed, excite nausea. To this, however, there are objections. Some practitioners have thought that saline draughts made from the alkali, which still retained a portion of the oil of wormwood, sat more easily on the stomach: we are confident that the taste was more pleasing. In other instances, the advantages * are less equivocal: we allude to the ashes of broom and tobacco, which certainly possess a stronger diuretic power from the oil adhering to the salts. In estimating the strength of alkali it has been usual to add the muriatic acid, and for each dram saturated, so many one-sixteenths of pure alkali were allowed. Alkalis, when pure, from whatever plants obtained, are entirely the same. What was, however, formerly styled pure alkali, is not so in the modern acceptation of the term. Mild alkalis are carbonated; that is, neutral- ised by carbonic acid. When exposed to heat, or com- bined with quick lime, which has a greater affinity for the carbonic acid than alkali, they become what has .been styled caustic : in reality they are pure ; and, when a mild alkali is united with a stronger acid, the separa- tion of the carbonic acid, in the form of gas, occasions the effervescence. As a medicine, if largely diluted with water, and-taken in bed or a warm room, vegetable fixed alkali promotes perspiration; but its tendency is more directly to become diuretic, and this is promoted by the patient resting in a cool situation. In this way it appears sometimes slightly laxative ; and is useful to the studious, in whose stomachs acids usually abound. It destroys acidity in the primae viae, converting them into a mild aperient salt, and thus removes a cause of many chronical diseases. It loosens the texture of cal- careous concretions by strongly attracting" their air; and when pure, this power is increased. In those flatulent disorders -which arise from a defective bile, it affords great relief. The dose may be from gr. ij. to 9 j. twice, a day, but always plentifully diluted; the dose of 9 j. should be mixed with at least 3 x. of water. Considerable doses may be long continued, as is evident in those who take the aqua kali puri to remove calculous complaints; but the tone of the stomach, and the powers of digestion, are sometimes destroyed by large doses and long use. It was supposed that alkalis thinned tiie blood; and numerous are the diseases attributed by the humoral pathologists to alkaline acrimony. It has indeed been ALK 64 ALK suspected in scurvy, but seems to take place only in a small degree; and the alkali is the volatile in the form of an ammoniacal neutral. Fixed alkalis have been generally found diuretic; and perhaps in a greater de- gree when not neutralised in the stomach, or when de- fended from its acid by bitters. On the contrary, they are laxative only when they meet with such an acid as the stomach affords. The absence of an acid also seems necessary to their operation, as lithontriptics. The fixed alkalis have lately been recommended in cutaneous complaints, and have been employed with some success. It is probable, however, that they chiefly act by correcting an acidity in the stomach, which oc- casions them ; or by the discharge of urine which they excite. It is singular that acids have a similar power; nor docs the distinction of the species adapted to each appear in any medical author. In general, the acids seem best adapted to the cases where the eruptions occur in worn-out constitutions, and are of the tettery kind : the alkalis in the drier, scurfy eruptions. Yet even this distinction will not hold in every instance ; nor indeed in our hands have the alkalis been emi- nently successful. The fixed alkali has been sometimes thought useful in adding to the power of different menstrua, or in cor- recting the drastic acrimony of some resinous purga- tives. With bitters, it has been supposed to be a fe- brifuge ; and with camomile flowers, it has been in high esteem as a remedy for intermittents. It seems topro- duce some chemical change on bitters, as it reddens the infusions of bark and of rhubarb : and in many cases of dyspepsia appears an useful addition to as- tringents or tonics. Externally, it is used in the form of a lotion in rachitic cases, as a stimulus in indolent ulcers, and in some cutaneous eruptions. The solution soon abates the pain arising from the stings of bees and wasps, and has been applied in'burns. With sulphur, under the title of hepar sulphuris, it is also often useful. See Kali sulphuratum. The fixed alkalis have obtained a variety of appella- tions, partly from fancy, but more frequently from the ignorance of chemists; who, having obtained these salts from different sources, supposed that they had discovered a new substance. The fixed .vegetable alkali has been styled Cineres Russici and clavellati,pot blanch, and pearl-ashes, alka- hest glauberi 7narcoft,cendresgravelldes, sml tartari,sal absynthii nitrum fixum, cassob and lapis infernalis. It has been more lately styled by Dr. Black, lixiva ; by the French chemists, potassa ; by the London College, kali ; by others, oleum tartari and lixiva tartari. The fixed mineral alkali has been styled by Dr. Black, trona, from a district of Tripoli where it abounds ; soda, by the French chemists and the Edinburgh college, &c. Anatron, also called nataron, anachron, sonde blanche, nitrum antiquorum, litron, aphronitum, baurach, sal alkalinus salis marini, barilla, soda, salitron, bariglia ; anatron, anatrum. Alcali volatile. Ammonia, called also Asa- non. Volatile alkaline salt is either in a dry or liquid form ; when dry, it is called salt; when liquid, water ; the salt is obtained by sublimation, the water by distillation. The volatile alkaline salt hath been chiefly obtained from the horns of deer, by distilling them in large iron pots, with a lire gradually increased to a strong red heat; but a similar salt, liquor, and oil, may be extracted from - all animal substances except fat, from blood dried by a gentle heat, from urine first evaporated to the consist- ence of honey, and subjected to putrefaction. Urine, distilled with the addition of quick lime, yields an ex- tremely pungent spirit. Ivory, and the bones of ani- mals, are used for this purpose ; bones are, indeed, preferable to hartshorn ; as the salt and spirit of ^bones require less rectification, are less disgustful to the stomach, and the spirit retains its limpid appearance longer than that from horns :. when bones are used, their fat must be extracted first by long boiling. Wood- soot affords a salt liquor and oil, not differing from those of hartshorn, except as it is less easy to rectify.^ From crude sal ammoniac, mixed with any fixed alkaline sub- stance, the volatile alkaline salt of the sal ammoniac is obtained, and with very little trouble rendered perfectly pure ; the spirit of sal ammoniac is free from the in- conveniences which attend those spirits obtained from horns, ivory, bones, Sec. Li'quoR, olim spiritls, sal, et o'leum cornl cervi. The liquor, salt, and oil of hartshorn. These preparations are brought to us by the practical chemists in a state sufficiently pure for common pur- poses, and the process will be found in the commonest chemical author. As the fixed alkalis, from whatever plants they are prepared, do not essentially differ when pure,* so the volatile is the same from every source. The crude sal . ammoniac, as it is styled the muriated ammonia, is prepared in large quantities in Egypt from camel's dung, and other animal excrementitious fluids. This affords the ammonia usually employed, and it is pre- ferred, in general, as a medicine. That from the harts- horn has always a little of the animal oil ; which, though better adapted as a smelling salt in some hysteric affec- tions, is less agreeable to the stomach. The volatile alkaline salt is very penetrating and pungent to the smell and taste, and is the only concrete salt that in its pure state emits sensible effluvia ; it dis- solves oils, resins, fats, &c. more slowly than the fixed alkalis, on account perhaps of its not being susceptible of any considerable heat by which its solvent power might be promoted. In the bodies of animals it ope- rates more powerfully than the fixed alkaline salt, and is more disposed to pass off by the pores of the skm, and acts more remarkably on the nervous system. It is peculiarly useful in lethargies, apoplexies, hysteric and hypochondriac disorders, languors, head-ach, flatulen- cies, and other symptoms attending these complaints ; in languors and faintings this salt often gives immediate relief; in low fevers it is an useful remedy ; it relieves rheumatic pains, particularly joined with blisters, and purges. The fanciful idea of its promoting putrefaction has prevented its being employed in putrid fevers ; but when a quick, active stimulus is required, no medicine is preferable ; and the very small quantity given can have no bad effect on the whole mass, even were it« septic power less equivocal. When united with the vegetable acid in the aqua ammoniae acetatae, it is eminently useful, if given in a sufficient dose, which is at least half an ounce, or six drams. Externally it is used as a stimulant, in the form cf ALC 65 A L C the volatile liniment, united with oil, or in that of a soap, styled in common language opodeldoc. The dose of volatile alkaline salts may be from gr. ij. to 9 ss. given in a draught or in a bolus ; in the latter form, to prevent the pungency of the salt from affecting the throat, it may be proper to mix.it with a splution of gum tragacanth, or some other mucilaginous substance. See Ammonia. Sp. sal. ammon. dulc—now called Spiritus am- monite. Dulcified, or sweet spirit of sal ammoniac- Spirit of ammonia. Take of a fixed alkaline salt 5 vi. of crude sal ammo- niac 3 iv. of proof spirit lb iij. and mix ; with a gentle heat draw off JJ3 i. ss.; the dose is from fifteen drops to a dram or more. The volatile alkalis, not caustic, do- not unite with vinous spirits by simple mixture ; yet asolution of them in sp. vin.R. is obtainable by distillation. This prepara- tion is deservedly in great esteem both as a menstruum and a medicine ; it is a solution of alkaline salt in spirit of wine, for though proof spirit is used, its water does not rise ; it only serves to facilitate the action of the pure spirit upon the ammoniac salt ; it might, perhaps, for some purposes, such as making the sp. ammon. comp. &c'. be more adviseable to make a dulcified spirit with the pure liquor of ammonia, for it may be mixed at once with rectified spirit of wine in any proportion, without the hazard of separating the volatile alkali; and readily form an extemporaneous dulcified spirit of sal ammoniac: Take the spirit of sal ammoniac prepared with quick- lime, rectified spirit of wine, of each a pound. Spi'ritus vola'tilis cau'sticus, vel Spirit, sal. ammon. cum calce. viv. ppt. Now AQUA AMMO'NIjE PURjE. This spirit, prepared with quick-lime, is thought to be too pungent and acrid for internal use ; but in the dilute state of administering this medicine, it is as safe as that prepared with an alkaline salt. It is an excellent menstruum for some vegetable substances; and when saturated with such ingredients, is so sheathed as to be as safe as the other. If this spirit is not pure, a slight proportion of it will make lime-water turbid. The aqua ammoniae purae appears in many cases pre- ferable to that prepared with an alkaline salt. It is bet- ter suited for the sp. ammon. compositus, and sp. am- moniae foetid, as being perfectly miscible with the sp. vini rect. in any proportion, without any separation of its volatile alkaline part, and as being a more powerful menstruum for some oils, difficult of solution. The eau de luce, for example, is made with the aqua ammoniae purae, et ol. succin.rect. ; but the oil must be rectified until it hath lost its smell, and is become limpid, and then the process will be the following : R. 01. succin. rect. ut supra gtt. xxxvi. alcohol, vini 5 ss. bene misceantur, et adde paulatim aquae ammo- niae purae, 3 vi. This appears milky ; but if required limpid, it may be made so by distillation ; or if it is only designed for smelling, it may be tinged of a fine blue colour, with a drop or two of a solution of copper. See Malouin's Chimie Medicinale. The College of London give the following prescrip- tion for making the eau de luce, under the title of Spiritus ammonia: succinatus ; Succinated spirit of vol. 1. ammonia. Take one ounce of alcohol; ^vattr of pur« ammonia four ounces;- rectified oil of. amber one scruple ; soap ten grains : digest the soap and oil ol amber in alcohol, until they arc dissolved ; then add the water of pure ammonia, and mix them well by shak- ing :—it is chiefly used externally. There is a great nicety in this preparation, known only to those who prepare it, and which chemists have not attained ; but this accuracy docs not affect its medical virtues. The chief imperfection is, that the ingredients separate, but they will unite again by agitation. Divers mixtures of volatile and vinous spirits, fla- voured with aromatic and other oils, or tinctured witii different ingredients, according to the intention of the prescribers, have been, and yet may be, used with great advantage. Of this kind are the following : Sps. ammo'ni.,e compo's'itus, instead of the sps. yo latilis aromaticus. R. Ol. nucis moschatae et ol. limon. esscnt. itu. 3 u\ sp. ammon. foij. in. Distil these with a gentle heat. This is from the Pharmacop. Collegi; Lond. 1788. By this method a volatile oily spirit may be pre- pared occasionally, and at pleasure adapted to particular purposes, by choosing an essential oil proper for the in- tention ; thus in hysteric cases, where the uterine excre- tio7is are deficie7it, a sp. ammon. comp. may be made with the oils of rue, savin, penny-royal, asafoetida, Sec. For weak7iess of the stomach, the oil of mint may be- taken ;—for a cephalic, the oils of marjoram, lavender, and rosemary ; against fainting and coldness, the oil ol cinnamon;—to remove flatulencies, the oil of aniseeds and sweet fennel. The spirits thus made by simple mixture, or by dropping essential oils into sp. ammon. with which they easily mix, are nowise inferior in medical efficacy to those prepared by distillation, thougb the tinge which they receive from the oil may render them to the sight less pleasing. The small quantity, however, of any medicine which can be thus conveyed into the system, can have no very powerful effect ; while, as a warm stimulant, it greatly assists the power of other medicines. The ammoniated alcohol conveys very rapidly the effects of aromatics, as in the spiritus ammoniae C. of the London Dispensatory ; the alcohol ammoniatum aromaticum of the Edinburgh ; or the spiritus alkali volatilis of the Dublin. The com- pound tincture of castor, the volatile tincture of guaiacum, and the ammoniated tincture of valerian, are, in their respective uses, excellent medicines. The ammoniated tincture of bark is less useful; as from bark we do not want an immediate effect, and the quantity of this medicine introduced is inconsiderable. The objection does not apply to the volatile tincture of guai- acum, as the menstruum, in this instance, directs and increases the power of the medicine. Some vegetables are considered of an alkalescent nature, as they do not become acid by putrefaction; and from them no vinous spirit can be procured by fermenta- tion ; to this class belong most of the acrid aromatics ; some of which are the alliaria, allium, arum, asparagus, brassica, capsicum, cardiaca, centaurium min. cochlea- ria, cepa, nasturtium aquat. et hort. porrum, raphanus com. et rusticanus ; ruta, sinapis, See. The signs of alkaline acrimony in the blood, viz. thirst and desire of sour drinks, loss of appetite, and aversion to alkalescent food, nidorous eructations, putrid K A L C 66 A LC ulcers on the lips, tongue, and other parts in the mouth, bitterness in the mouth,, sickness in the stomach, and a frequent diarrhaa, a sense of heat, lassitude, and general uneasiness, a dissolution of the texture of the blood, the urine high-coloured and red, in fact only show that it exists in the stomach. Ai.KALi.Nt (.\s. This is only volatile alkali in the form of air, and has never yet been applied to medical uses. Alkaline earths. Many of the earths are absorb- ents ; but some approach so nearly to an alkaline nature, that they have obtained this appellation more pointedly. These are magnesia, lime, barytes, and strontia : all but the last are used in medicine ; the barytes, in compo- sition only, with the muriatic acid. Alkali in botany. See Saxicornia. ALKALI'NA, Infusio. R-. Kali | ss. croc. Anglic. 3 ss- rafl- liquorit. rec. 3 ij. aq. font, bullientis lb iij. infund. per horas vi. vel vii. et cola. Vel, R. Fol. absinth, vulg. sice. 3 ss. kali pp. 3 ij. infund. in aq. font, bullient. | xij. colaturae ; adde aq. juniperi 1 hese are useful methods of administering the fixed alkaline salt ; small doses may be given warm every three or four hours, interposing occasionally a purgative, when such medicines are required. If intermitting fe- vers return, this method, for a few days, is an excellent preparation for the bark. ALKALISA'TIO, alcalisation. The impregnat- ing any thing with alkaline salt. ALKALFNUS SAL, SA'LIS MA'RIN^E. See Anatron. ALCA'NCALI. See Angelocalos. ALCA'NNA, (Indian word). See Ichthyocolla, Anchusa, and Ligustrum Indicum. ALCA'RNI, (an Arabic term). A name of a con- fect made by Messue. A'LCARA. See Cucurbita. A'LCE, (from xXkii, strength). The elk. It is a large animal of the deer kind, met with in Muscovy, Germany, and very cold countries. The hoof of the hind foot on the left side hath been celebrated against epilepsies, from a ridiculous opinion that the elk is him- self subject to disorders of this kind, and prevents or removes them by scratching his ear with his hoof. ALCE'A, (from xXx*>, strength,) so called, on ac- count of its force in expelling poisons. Alce'a vulgaris major. See Doronicum Ger- man kum. Alce'a ; vervain mallow. See Malva verbe- na CE A. Alce'a indica. Alce'a jEgyptiaca, villosa. A'LCEBAR. See Agallochum. A LCEBRIS VIVUM ; i. e. Sulphur vivum. ALCE'DO. A bird called the king's fisher. It is also called i&pida, halcyon, ulcyon,fluviatilis, piscator regis. It is said to make its nest in the sea, and then it is a sign of fair weather, whence the word halcyon days —calm and peaceable times. A'LCIIABRIC. See Alkibric. A'LCHACHIL. See Rosmarinus. A'LCHARITH. See Argentum vivum. VLCHEMIA, ALCHIMIA, or A'LCHYMIA. See Abelmoschus. A'LKIMA, alchemy. That branch of chemistry which relates to the transmutation of metals into gold ; the forming a panacea, or universal remedy; an alkahest, or universal menstruum ; an universal ferment ; and many other absurdities. The pursuits of the alchemists obtained more attention, as they offered two of the most powerful attractions—riches and immortality. With the former we have no concern ; but it is necessary to remark, that the fifteenth century was the era when these fancies began to influence medicine. To the al- chemists we are indebted for our mercurial and antimo- nial preparations ; and their pretensions—in some measure their success—produced a considerable revo- lution in medicine, by undermining the authority of Galen, till that time supreme. Basil Valentine seems to have been the earliest of these authors; and his Cur- rus Triumphalis Antimonii, though abounding in en- thusiastic reveries, displays reflection and knowledge. Paracelsus was an ignorant boasting enthusiast ; but Van Helmont, though of the same sect, appears to have been a man of good judgment and acute observation. In pursuit of their fancies, they discovered many che- mical changes produced by the mixture of bodies; and, among other sciences, medicine received considerable improvement from their misdirected labours. A'LCHERON, la'pis, (so called from the Arabic term alcheran, a horn ; because it was found of a horny consistence). The stone in the gall-bladder of a bull, or OX, called bezoar bovinus. A'LCHIBRIC. a'lchibert. See Alkibric ALCHIMFLLA,(so called, because it was celebrat- ed by the alchemists) ; called also branca, and pes-leo- 7iis ; stellaria ; lady's mantle, and lion's foot. Ru- landus calls it diapencia. The leaves are gently astringent, the. root is of the same quality; but this plant is not in any repute as a medicine. . Alchimi'lla supina gramin fol. See Kna- wel. A'LCHI'TRON, oil of juniper ; see Jumperus. Also the name of a dentifrice of Messue. ALCHO'LLEA, (Indian term). A sort of animal food made of beef or other flesh, pickled and dried, then boiled and potted for keeping. It is used by the wes- tern Moors. See Philos. Trans. ATXHUTE. See Morum. A'LCHYMY. A composition of copper, with a small quantity of arsenic, resembling silver. ALCIBIA'DION, so called because Alcibius first used it against the bite of a serpent. See Anchu- sa. A'LCIMAD. See Antimonium. A'LCOB. See Ammoniac, sal. ALCO'CALUM. See Cinara. A'LCOFOL. See Antimonium. A'LCOHOL, or A'LCHAHOL ; a'l-ka-hol. It is an Arabian word, signifying an impalpable powder, which the Eastern women used to tinge the hair and the edges of their eye-lids. As this powder, viz. an ore of lead, was impalpable, the same name was given to other subtile powders, and to spirit of wine exalted to its highest purity and perfection. See Vinum adls- TUM. A'lcohol ma'rtis. It is the filings of iron rusted by adding urine to them. When the whole is per- A L K 67 A L E fectlv runted, pure spring water is repeatedly added, until'all that is urinous is washed away,, and the re- maining powder is the alcohol martis. Musgrave em- ployed it with the theriaca in misplaced gout, to bring it to the joints. A'LCOL, (alcal, Arab.). See Acetum. A'LCOLA, (alcala, filth, Heb.). Aphtha, which see. Paracelsus gives this appellation to the tartar or excrement of urine, whether it appears as sand, or mucilage. ALCOHOLIZATION. The rectification of alco- hol ; and, according to Starkey, the union of alcohol with fixed alkalis, which forms a neutral, and the al- kali is volatilised. ALCOLI'TA. See Urina. ALCOLI'SMUS, (from alcohol). Reducing any thing to powder by corrosion. ALCO'NE. See ^Lsecavum. A'LCOR. See &s ustum. AL'CTE. It is the name of a plant mentioned by Hippocrates; Foesius thinks it is the Elder. See Acte. ALCU'BRITH. See Sulphur. A'LCYON FLUVIA'TILIS. See Alcedq. ALCYO'NIUM. Bastard sponge. It is the froth of the sea hardened by the sun, of different shapes and colours. It is so named, from the bird alcyox, which builds on the sea, and whose nest it is said to resemble. It is difficult to say what the Greeks called by this name. Dioscorides names five sorts; viz. 1. Alcyo'mum du'rum. Hard bastard sponge. 2. Farra'go ; called also farrago australis, alcyo- nium, vessicaria ma7'ina nigra. 3. Alcyo'nium vermicula'tum, or vermicula'te. Vermiculate bastard sponge. 4. Alcyo'nium supposum. Lemery calls this alcyo- nium molle. Thready bastard sponge. 5. Alcyo'nium tubero'sum. Lemery calls this al- cyo7iium foraminosum. Tuberose bastard sponge. There are many other species; they are calcined with a little salt as dentrifices, and are used to remove spots on the skin. ALDABA'RAM. See Albadara. ALDIN, ET ALDIN. HORT. FARN, i. e. Exact. Descriptio rariorum quarandum Plantarum Horti Far- nesiani Tobiae Aldini. Rome, 1625, fol. ALDROV. MUS. MET. i.e. Ulyssis Aldrovcndi Musaeum Metallicum Bononiae, 1648, fol. Aldrov. de quad, iusul. i. e. Aldrovandus De Quadrupedibus bisulcis. Aldrov. de quad. dig. i. e. Aldrovandus De Qua- drupedibus digitatis. Aldrov. dendr. i. c. Aldrovandi Dendrologia, Bo- non. 1668. Aldrov. exang. i. e. Aldrovandus De Animalibus exanguibus, Bonon. 1642. ALE, (oel, Dan.; aile, Fr.; from alo, to nourish). The ancient Saxons called it ael. The Germans first invented and brought it into use. Ale is distinguished from beer, by being fresh or new, while beer is kept until the remaining saccharine matter is more completely changed to a vinous spirit by a slow fermentation. Beer, called by the Latins, Cerevisia, from Ceres, because corn is its principal ingredient; also liquor Cereris ; vivum hordeaceum, barley-wine; visum regionum septentrionalium ; sometimes bira. Ale produces colics, and is occasionally, when not well fermented, acescent; but does"not produce calca- reous diseases, as has been asserted. Those who drink ale are stronger than those who drink wine; and those who do not drink strong liquors are said not to be able to labour so well as those who do ; but this does not ap- pear to be invariably true. Ale-drinkers are fat, occa- sionally gouty, but, on the whole, healthy. Cordials may fit the person for extraordinary exertions, but should not be commonly used. Ale, however, must not be considered as one of these. When well ferment- ed it is an wholesome beverage, and seems only to dis- agree with those subject to asthma, or any disorder of the respiratory or occasionally the digestive organs. See Drinks, Beer, Porter. If malt liquor, of any ddgree of strength, is become flat and acid, as it is used, it should be drawn out of the cask into a jug, in which as many drams of powdered chalk should be put as pints of liquor; thus an effer- vescence will be raised, a sprightly, though not very agreeable, taste will be restored to the liquor, and its acidity will be destroyed. Ale being in some countries cheaper than wine, hath occasioned it to be medicated for the same purposes; and there are two ways of impregnating malt liquors with medicinal substances; first, by macerating the in- gredients in the ale after it is duly fermented ; secondly, by adding them to the liquor while it is fermenting, that by the power of fermentation the medicinal virtues may more fully be extracted; of nutmeg, for instance, one dram powdered will flavour a large vat of ferment- ing ale, but when the fermentation ceases, it flavours but a very small quantity. Branches of the spruce fir, fermented with beer, render it wholesome, antiscorbu- tic, and useful in cutaneous diseases. It is the plea- santest form of turpentine; and many who have begun it as a medicine, have continued it as a luxury. The following is an agreeable bitter, and far prefera- ble to any of the purls. Cerevt'sia ama'ra. Bitter stomach-c ale. R. Rad. gent. cort. limon. rec. aa. §iv. piper, long. §i. cerevis. Cong. i. infund. sine calore. Cerevi'sia antiscorbu'tica. Antiscorbutic ale. R. Fol. cochl. hort. rec. m. viij. ras. guaiac. ^j. sem. coriand. §ij. fol. senn. ^ss. infund. in cerevis-. recent. durant. fermentat. Of these medicated ales lb ss. may be taken night and morning. Various other impregnations of ale have been used as diet drinks or medicines. We find in the old dispen- satories, ale against the gout; for the eyes; for the head, &c. Vulgar practice still retains an infusion in ale of some virtue ; viz. of the broom ashes, which con- tain an alkali, with the diuretic oil of the broom. Syrup of ale consists of the ale inspissated before it is atte- nuated by fermentation, and is little more than a muci- laginous infusion of malt, employed as a demulcent, in the diseases for which this class of medicines is used. Gill ale is an infusion of ground ivy, and supposed to heal internal wounds, and to relieve diseases of the breast. Dr. Butler's purging ale is indeed purgative, from containing senna; but has numerous other ingre- dients, which tend to no one purpose unless it be slight- K 2 ALE 68 ALU ly expectorant. Ale berry is a sudorific, and consists of jle boiled with bread and mace. ALE'CARITH. Stc Argentum vivum. ALEFA'XTES? i. e. Flos salis. Flower of salt. ALE'IMMA, (from xXti$e>, to anoint). A greasy ointment, or a liniment, without wax, to give it a con- sistence. ALE ION. Hippocrates uses this word as an epithet for water. ALF/IPHA, {xXu,volvo). A bodily exercise", which seems to be rolling on the ground, or rather in the dust, after being anointed with oil. Hippocrates says, that it hath nearly the same effects as wrestling. ALI'NTHISAR. See Hypostaphyle. ALIO'CAB. See Ammoniacus sal. ALIP^'NOS, } (from «, neg and Xtirxivet*, to grow ALIPANTOS,5 fat). Any external dry remedies that have no fat in them. ALIPA'SMA, (from xXuQa, to anoint). A powder which, when mixed with oil, is rubbed on the body to prevent sweating. ALIPE, xXittti. Remedies for wounds in the cheek to prevent inflammation. Galen. A'LIPILI, (from alarumpilos, evellentes.) Servants so called from their pulling off hairs from the arm-pits with tweezers, from persons in the baths. ALIPOW, a species of turbith found near Mount Ceti, in Languedoc. It is a powerful purgative, used instead of senna, but much more active. ALI'PT^,, (from xXeiQa, to anoint). Servants of the baths, whose office was to anoint the persons after bathing. ALISANDERS. See Smyrnium. ALI'SMA MATHI'OLI. See Doaia. Ali'sma, (from «A$, the sea, the name of many aquatic plants) ; called Acuron. A name of Doria's wound-wort, and of the German leopard's-bane. See Doria Narbonensium, and Arnica Montana. ALI'STELES, (from xX?,salt). See Ammoniacus sal. A'LITH. See Asafcetida. ALITURA, (from alo, to nourish). See Nutri- catio. ALKAFI'AL. Antimony. See Antimonium. A'LKAHEST GLAUBERI, i.e. Sales alkaline See Alcali. A'LKALE. The fat of a hen. A'LKALI FIXUM, sal. i. e. Kali. See Alcali. A'lkali vegetabile fixum causticum. See Ka- li. ALKA'LIA. See Vas. A'LKARA, or ALCARA, (alkaragh, Arab). See CUCURBITA. ALKA'SA, (alkasah, a cup, Arab). ? See Cruci- ALLAZO'AL. 5 bulum. A'LKAUT. See Argentum vivum. ALKEKE'NGI, (alkakangi, Arab). Winter- cherry ; also called halicacabum, solanum vesicarium. vesicaria vulgaris. The species used in medicine is the physalis alke- kengi Lin. Sp. PI. 262. It grows wild in France, Germany, and Italy, and thrives well in our gardens. The fruit ripens in Octo- ber, and continues to December, when the plant dies to the ground. These cherries have an acidulous and not unpleasant taste, with a bitterishness ; but their covering is very bitter. They are diuretic, but neither heat nor irritate ; five or six cherries, or an ounce of their juice, is a dose ; and if given in the strangury from cantharides, a speedy relief is said to be obtained. Hoffman recom- mends them in haemoptysis, and some authors have thought them useful in dropsy. % ij. of the berries in- fused in a pint of water, are extolled in the jaundice ; but they are rarely called for in the English practice. The plant itself is of a poisonous class, and consequently suspicious ; yet, as they seem to combine an ano- dyne with an astringent quality, they may deserve a trial. ALKE'RMES, (alkarmah, Arab). See Chermes. ALKE'RVA. See Cataputia. A'LKES. Burnt brass. See M.s ustum. A'LKETRAN. See Cedria. ALKI'BRIC, A'LCHI'BRIC, A'LCHIBERT, A'GIBIC, A'LKIBIC, A'LCHABRIC, A'LKIBRIE. According to some, the sulphur vivum is meant by these words ; but others say they signify an incombusti- ble sulphur. A'LKIN. See Clavellati cineres. A'LKIR. Smoke of coal. A'LKITRAM. See Pix liquida. A'LKOSOR. See Camphor. A'LKI PLU'MBI. It seems to be the cerussa ace- tata. See Plumbum. ALL-HEAL. See Heracleum and Stachys. ALL-SPICE. See Myrtus. A'LLABOR. Leda. See Plumbum. ALLANTOIDES,ALLA'NTOIS. The membrane, which forms part of the secundines, (from xXXxs, a sau- sage, or hog's pudding, because in some brutes it is long and thick, and cths, likeness). It is also called alan- toidesfarciminalis, the urinary membrane ; but its ex- istence in the human species is generally denied. If any anatomists have ever demonstrated, not one of them has given a distinct figure of it; all the engrav- ings designed to represent it are too incorrect to afford us a distinct idea. Dr. Hunter, in his lectures, abso- lutely denies the existence of this membrane, except in brutes. r Dr. Hales in the Phil. Trans. Abr. vol. iv. and Mons. Littre in the Mem. Acad, de Sciences, 1701. ALLARI'NOCH. See Plumbum. ALLELUTA, (hallelujah ! praise the Lord. Heb. wood-sorrel, so named from its many virtues). See Acetosa. ' ALLEGER, ALE AIGRE, vinegar made of ale. It ALL 79 ALL is almost the only vinegar now employed in this coun- try. A'LLENCE. See Stannum. A'LLIAR iE'RIS. A term used in preparing the philosopher's stone, to signify philosophical copper, which is also called water of quicksilver, white copper, and many other names. ALLIA'RIA, (from allium garlic; so named from the likeness of its smell and" taste to garlic). Sauce alone, or Jack by the hedge; also called pes asini- nus, and hesperis allium. It is the erysimum alliaria Lin. Sp. PI. 922. The leaves are somewhat acrid, and of a garlic smell; on drying they lose much of their scent, and also of their taste. Its medical virtues are similar to those of the onion tribe, but the plant is not much in use. Their great acrimony renders them occasionally stimu- lant, and they are probably, as has been said, diuretic and errhine. Externally they have been supposed use- ful in putrid ulcers. A'LLICAR. See Acetum. ALLI'COL. See Petroleum. ALLIGATU'RA, (from ad, and ligo, to bind). Scri- bonius Largus uses this word for a ligature or ba7idage. See Fascia. ALLIO'TICUM, (from xXXiou, to alter, or vary). Galen. An alterative medicine, consisting of various antiscorbutics. ALLIUM, (either from oleo, to smell, because it stinks, or from xXeu, to avoid, as being unpleasant to most people). Common garlic Called also, from its antiputrescent property, theriaca rusticorum. It is the allium sativum Lin. Sp. PI. 425. Nat. Ord. Liliacee. It grows wild in Italy, Sicily, and other warm coun- tries; but in England it is raised in gardens from seed: :t flowers in July. The roots only are used in medicine; their virtues consist of a very acrid putrescent volatile oil, combined with a large proportion of mucilage, the principal ef- fect of which is to warm and stimulate the solids, to promote a discharge from the bronchial glands and the kidneys; perhaps in a slight degree to resist putrefac- tion. Applied to the skin they excite inflammation; and sometimes raise blisters: they are used as a stimu- lating epithem to the soles of the feet, in the low stage of acute fevers, for raising the pulse and relieving the head. Sydenham says, that garlic excels all other ap- plications for occasioning a derivation from the head in fevers of any kind; and he adds, that the efficacy of garlic is more speedy than that of cantharides, without a dissolution of the juices as when the common blis- tering plaster is applied. This, however, we now know to be hypothetical merely. Garlic beat up with an equal quantity of soft bread is occasionally applied to the feet, but is found of little service^except in chil- dren, who cannot swallow any medicine. It certainly is absorbed, as it affects the breath, and consequently may be useful as an expectorant. Sometimes the garlic cataplasm causes much pain, but this would not happen if it was removed as soon as an inflammation appeared, and immediately after another cataplasm of bread and milk to supply its place. The cloves of fresh garlic are bruised, and applied to the wrists as a cure of agues; and to the bend of the arm to cure the tooth-ach : held in the hand they are said to relieve hiccough; beat with common oil into a poultice, they resolve sluggish humours; and if laid on the navels of children, they are supposed to destroy worms in the intestines. If garlic is taken inwardly, its action manifests it- self through the whole habit, the breath, urine, and the matter of perspiration are scented with it. It assists di- gestion, and is certainly heating and inflammatory to the whole system. Its diaphoretic and diuretic powers have been useful in dropsy: it is a remedy for the scurvy; and in pituitous, and even in spasmodic asth- mas that require expectoration. It has been said to be efficacious even ih subduing the plague, and its stimulant powers have been employed for preventing the recur- rence of intermitting fevers. Bergius says, quartans have been cured by it, and he begins by giving one bulb, or clove, morning and evening, adding every day one more till four or five cloves be taken at a dose. If the fever then vanishes, the dose is to be diminished, and it will be sufficient to take one or even two cloves twice a-day, for some weeks. This author also recommends it in deafness, and Dr. Cullen is inclined to believe it may be beneficial, as he has found the juice of onions in such cases very useful. A clove or small bulb of this root wrapt in gause or muslin, and introduced into the meatus auditorius, is the mode of applying it in these cases. Some authors have considered it as alithontriptic. Where people cannot take the garlic in substance, the best forms are either the syrup or oxymel. See Cul- len's Materia Medica. If cows happen to eat the leaves of garlic, their milk will be strongly impregnated with its flavour. In cold phlegmatic habits it is particularly useful, by its corroborant, expectorant, and diuretic effects. In the asthmas of such constitutions it is more eminently useful, and in these chiefly it has been supposed to pos- sess a lithontriptic power. Hoffman says, that if the cloves of fresh garlic are boiled in milk, they are one of the best anthelmintics; but garlic should be taken in the form of a pill or a bolus, fresh made. The syrup and oxymel of garlic have been thrown out of the British pharmacopoeias. Swallowing the clove of garlic entire, or cut into pieces, after having been dipped in oil, is considered as a very effectual mode of administration. In hot bilious constitutions garlic is improper; for it produces flatulence, head-ach, thirst, heat, and other inflammatory symptoms : a free use of it soon promotes the piles in habits disposed to this complaint. In drying it loses nine-fifteenths of its weight, but fresh or dry it equally gives out its virtues to boiling water, vinegar, or brandy, though it has been suspected that its powers are somewhat weakened by drying; and an infusion in the latter is highly useful to relieve or prevent uneasiness in the stomach and bowels from gout. The oil, or active principle, is small in quantity, yel- lowish and ropy; but the juice may be inspissated into an extract by a gentle heat. Rectified spirit of wine, digested on dry garlic roots, extract their virtues more readily, and more perfectly, than either water or vinegar. For those called Allium Alpi'num, ~) Allium aginum, > See Ophioscorodon. Allium monta'num,J Allium latifo'lium macula'tum. Allium ce'pa. See Cepa. ALN so ALO Allium Gallicum. SeePoRTULACA. Allium latifoi.ium liliflorum. See Moly. Allium ultricum. See Antiscorodon. ALLOBRO'GICUM VINUM. A sort of austere wine, produced in Savoy and Dauphiny. ALLO'CHOOS, (from xXXog, another, and Xiya, to speak). One who talks deliriously. ALLO'GNOON, (from xXXos, another, and Av«», to know). To be delirious, or to conceive of things dif- ' fcrent from what they really are. ALLOGOTRO'PIIIA,? (from xXoyos, dispropor- ALOGOTRO'PHIA, \ tionate, and rpeiptu, alo, to nourish). A disproportionate nutrition, when one part of the body is nourished disproportionately to another. Blancard. ALLO'PHASIS, (from xXXo<, another, and Qxu, to speak). A delirium, or to speak of things different from what they are. Hippocrates often expresses light headed, by the word xXXotpxe-evres. ALLOTRIOPHA'(UA, (from xXXolew, alienus, and pxyeiv, com7nedere). See Pica. A'LMA, (aglma, pure, Heb.: xX^x, water). See Aqua. Also the first motion of a foetus to free itself from its confinement. A'LMAGRA. A name for a kind of ochre used as an astringent. See Ethel. ALMAKA'NDA. ~> c T A'T MAKIST V LlTHARGYRUM. ALMA'NDA CATHARTICA, Lin. PI. Suppl. Murray's Syst. Vegetabilum,p. 209. A plant growing on the shores of Cayenne and Surinam, used by the inha- bitants as a remedy for the colic; supposed to be ca- thartic. ALMA'RAGO. See Corallium. ALMA'RCAB. (almarcab, mixed, Arab.). Li- tharge of SILVER. ALMARCA'RIDA. See Lithargyrum. ALMA'RGAN. (Arab.). See Corallium. ALMARKASI'TA. See Argentum vivum. ALMAR'TACK. Powder of litharge. ALMELILE'TU. A word used by Avicenna to express a preternatural heat less tharuthat of a fever, and which may continue after recovery. ALME'NE. See Sal gemmae. AMI'SA. Musk. See Moschus. ALMISA'DAR, or ALMIS'ADIR, or ALMIZ'A- DAR, or ALMIZ'ADIR. See Ammoniacus sal. ALMISA'RUB. Earth. See Terra. ALMIZ'ADIR. See^ERUGO. „ ALNABA'TI. In Avicenna and Serapion, means the siliqua dulcis, a gentle laxative. A'LNEC. Tin. See Stannum. A'LNERIC. See Sulphur vivum. A'LNUS, (Alno. Ital.). The alder tree. Betuia alnus Lin. Sp. PI. 1394. A'lnus rotundi, folia glutinosa viridis, C. B. The common alder tree, called amcndanus. The black alder is the Rhamnus frangula Lin. Sp. PI. 280; called also Avnus. All the parts of this tree arc astringent and bitter, the bark is more astringent; a decoction of it hath cured agues, and is often used to repel inflammatory tumours in the throat. The black or berry-bearing, alder, is a shrub found in the moist woods. The inner yellow bark of the trunk or root has a bitter and styptic taste: given to 3 ij. vomits, purges, and gripes ; but joined with aromatics it operates more agreeably; though an infusion, or decoction of it in water, inspissated to an extract, acts yet more mildly. It is said also to be di- uretic and anthelmintic ; externally, useful in itch and in varices of the anus. The berries of this species of alder are purgative; they are not in use under their own name, but are often substituted for buckthorn ber- ries. The berries of the black alder, however, have a black skin, a blue juice, and two seeds in each ; while the buckthorn berries have a green juice, and com- monly four seeds. The error is not, however, of much consequence: the plants belong to the same genus, and the berries do not differ greatly. ALOE, (ahlah, growing near the sea—xXoq) ; call- ed also Fel Nature ; a plant which affords the purging gum of the same name ; all the.species have thick suc- culent leaves like those of the house-leek, but much larger, and run two or three feet high. The best is said to grow in India, but all Asia produces excellent plants; and in most warm climes they are found, as in the West Indies, &c. ALOES GUMMI, gum aloes. This is the in- spissated gum of the whole plant described above. It is reported that Alexander, landing on the island of Succotora, or Zocotria, at the mouth of the Red Sea, in one of his expeditions, took notice of the aloe plant, and from that it was brought into use, and called Sue- cotorina. Of the gum we have three kinds in the shops. 1. A'loe Succoto'rina, vel Zocotorina. Succo- TORINE ALOE. It is imported from the island Succotora, in the In- dian Ocean, wrapped in skins ; it is obtained from the aloe spicata, according to Thunberg. This species is not in the edition of the species published by Linnaeus, but occurs in the Supplement, p. 205, and is the second species of the 659 genus of Wildenow's edition. Its natural ojjder is the Liliacee. The gum is bright on its surface, and of a reddish colour, with a purple cast; but when powdered it is of a golden hue : it is hard and friable in very cold weather, but in summer it softens very easily betwixt the fingers. It is extremely bitter, and also accompanied with an aromatic flavour, but not so much as to cover its disagreeable taste. Its scent is rather agreeable, being somewhat similar to that of myrrh. It is said to be the juice exuding from an in- cision of the leaves. 2. Aloe hepatica, vel aloe Barbadensis. The common, Barbadoes, or hepatic aloes, called kada- naku, and catevala, is from the aloe perfoliata Lin. Sp. PI. 458. The best is brought from Barbadoes in large gourd-shells ; an inferior sort in pots, and the worst in casks. It is darker coloured than the Succotorine ; drier, and more compact, though sometimes that in casks is soft and clammy ; to the taste it is intensely bitter and nauseous, being almost totally without that aroma which is observed in the Succotorine ; to the smell it is strong and disagreeable. 3. A'loe cabali'na, vel aloe Guinee'nsis, horse aloes. It is not easy to believe, as is gene- rally reported, that this is only the more impure part of the Barbadoes aloe, or rather the residuum after the hepatic aloes have been expressed, because the differ- ence does not consist in the purity, but in the quality. It is very distinguishable from both the others by its ALO* 81 ALO strong rank smell; in other respects it so agrees with the Barbadoes species, as to be often sold for it. Some- times its purity and clearness are such, that it cannot be distinguished from the Succotorine aloe; but either its offensive smell, or its want of the aromatic flavour, betrays it. This aloe is not admitted into the materia medica; but employed by veterinary surgeons. The general nature of these three kinds is nearly the same; their particular difference only consists in the different proportions of gum to their resin, and in the flavours they possess, which render them more or less pleasant for internal use. Aloes consist of a small portion of resin, and a large one of gummy matter. Twelve ounces of the Barba- does aloes yield nearly four ounces of resin, and eight of a gummy extract. The same quantity of the Succo- torine yields three ounces of resin, and nearly nine of gummy extract. The aloes may be purified by solution in water, and an evaporation so immediately after, that the resin may not have time to settle. When it settles, it may be se- parated by spirit of wine. The resin of aloes hath but very Utile scent; that from the Succotorine hath very little taste, from the Barbadoes a slight bitter, and from the caballine some- what more of the aloetic flavour. The gummy extracts are less disagreeable than, the crude aloes; that of the Barbadoes smells rather stronger than that of the Succotorine, but in taste is less ungrate- ful ; that of the Succotorine has very little smell, and is scarcely unpleasant to the taste ; that of the caballine aloes hath a rank smell, but its taste is not worse than that of the Succotorine. In the resinous part consists the healing qualities, hence for external uses the Barbadoes is the best; inter- nally, however prepared, the resin hath very little ca- thartic power. In the gummy extract resides the pur- gative, and all the other qualities. The gum of the Succotorine aloes is more irritating and active than that of Barbadoes: its effects are uncertain; but it does not seem to leave a costive habit. In small doses, twice a day, it occasions a considerable irritation about the anus, and sometimes a discharge from the hemorrhoidal ves- sels. These small doses cleanse the first passages, warm the habit, and promote the secretions. In phlegmatic, sedentary, and cachectic habits, and oppressions in the stomach from irregularity, it is useful; and, in common with bitters and purgatives, has been considered as an anthelmintic, but it is so only in cases of ascarides. In all diseases of the nervous tribe, aloes is useful, and is supposed to assist digestion. In jaundice it has been thought a succedaneum for the bile, and its title oT fel nature has been the cause or effect of this opinion. Aloes is injurious where inflammation or irritation exists in the bowels or neighbouring parts; in preg- nancy, and in habits disposed to piles; from three to five grains are a sufficient dose. Alkaline salts lessen the purgative quality of aloes ; and long boiling quite destroys it. By means of heat, the crude aloes may be wholly dis- solved in water; but the resin is deposited when cold. iA mixture of pure water two parts, and proof spirit one part, perfectly dissolves it without heat; though recti- fied spirit of wine dissolves it most speedily. If water or wine be the menstruum, the aloes becomes tenacious, VOL. l> and dissolves slowly ; in this case, white sand should be previously mixed with the powdered aloes. Cloves cover the offensiveness of aloes the most per- fectly, but are too stimulating. The canella alba, or the cassia caryophyllata, is preferable. The pharmaceutical forms of aloes arc various. It was for ages fashionable to combine them with myrrh and saffron; a form still in use in the pills styled Ru- fus's. These additions were supposed, though with little reason, to correct their acrimony ; but the formula answers every purpose desired in a mild eccoprotic, and consequently still retains its credit. There is little rea- son for supposing the myrrh and saffron useful, except for the more minute division, and soap answers this pur- pose, at least as well. In the common aloetic pill, called from Dr. Anderson, aloes is corrected only by the car- damom seeds. With alkaline salts, aloes loses its bitterness, probably its efficacy ; and when the gummy extract is prepared by long boiling, exposed to the air, it becomes inert; as from the absorption of oxygen its extractive matter is changed to a resin. The resin of aloes, as has been said, is very weakly, if at all, purgative. For the reasons assigned, the volatile aloetic tincture, viz. aloes dis- solved in the volatile alkali, is a very inefficient prepa- ration; and the vitriolic elixir proprietatis, which con- sists of aloes dissolved in vitriolic aether, is perhaps little superior. Van Helmont's vinum aloeticum alkalinum, appears to be a preparation of greater efficacy. It con- sists of aloes dissolved in mountain wine, with the ad- dition of kali and crude sal ammoniac. It is not how- ever now employed; and seems to have obtained a great partof its credit from the attachment of the Boerhaavian school to alkaline tinctures, which they considered as saponaceous. In stomach complaints, however, it pro- mises to be of service. In our college we find the pill of Rufus; pil. ex aloe cum myrrha : a similar tincture, styled the compound tincture of aloes; and the aloes dissolved in a weak spirit, the common tinct. aloes. This medicine is also joined with more active purga- tives, as the scammony and colocynth, with guaiacum, asafoetida, and iron, to answer the various purposes of a more powerful cathartic, a more effectual stomachic, antihysteric, and emmenagogue. Any other purgative joined with aloes, neither increases its powers nor les- sens any inconvenience it may produce. See Cullen's Materia Medica, Murray's Apparatus, and Woodville's Medical Botany. Aloe rosata; violata; violata tartarea; insuccata; insuccata tartarea. These are old forms, in which the aloes is repeatedly dissolved in the juice of roses and violets, and as often exsiccated by evaporation. When dissolved in the juices of roses, violets, borage, and bu- gloss, it is styled ' insuccate ;' when with the addition of one-third of its weight of cream of tartar, it has the appropriate epithet of' tartarea.' For other preparations, whose principal ingredient is aloes, as Aloeticus pulvis. See Hiera picra. Aloeticus pulvis cum myrrha. See Aromatic-b piluljE ; for which it is a substitute. - Aloes vinum. See Sacra tinctura. Aloes pilule cum myrrha. See Pilul* rufi. Extractum colocynthidis cum aloe, ait compo- M ALO 32 ALS situm. See Catharticum f.xtractum. Of this kind are supposed to be the famed Scoi's and Hooper's fe- male pills. A'loe pur'gans. See Aloe. A'loe aromatica lign. See Agallociivm. A'loe Brasiliensis. See Caraguata. A'loe palustris. See Aloides. ALOEDARIA, ALOEPHANGINA, and ALO- FT 1CS. Compound purging medicines; so called from having aloes as one ingredient. The aloephangina con- tains aromatics. ALO MBA.? c „ ALO'OC. 5 See Plumbum. ALO'PECES, (from «A»^e|, the fox,) so are the pso^e muscles called, because in a fox they are particu- larly strong. Lat. Vulpes. See Pso*. ALOPE'CIA, baldness, the falling off of the hair, (from xXw7re%, a fox,) because the fox is subject 10 a distemper that resembles it. Athrix, Depilis, Pha- lacrotis ; v.hen particularly on the sinciput, Calvities, and Calvitium ; which Galen thinks is owing to a de- fect of moisture. When the bald part is smooth and winding, like the track of a serpent, it is called ophiasis: but the general name of all the different appearances of bald places is area ; and the hair is said to fall off areatim, by shedding; whence in general this disease is called area. Celsus says, that the alopecia comes at any age, but the ophiasis only affects infants. In childhood, it often succeeds the tinea, achores, and favi. The cause is a disease of the roots of the hair. Ga- len says, that eating mushrooms may occasion these disorders; and that malignant or contagious diseases of various kinds may produce the same effect. The alopecia spreads itself on the beard, as well as on the hairy scalp, and is irregularly formed. The ophiasis usually begins at the back part of the head, and creeps about the breadth of two fingers, till it hath extended its two extremities to both the ears, and some- times to the forehead. It seems to be more malignant than the alopecia, since the cuticle is also corroded so far as the roots reach; the skin also changes its colour, and is pale, or darker coloured, and, if pricked, a se- rous blood issues out. In the tinea the excoriations and exulcerations are deeper, and often the hair does not grow again. In infants these disorders commonly go off as age advances; but in adults, the cure, especially of the ophiasis, is very difficult. In proportion as a redness appears readily on rubbing the part, the cure may be expected to be easy. If a leprosy is the cause, the case is more difficult of cure. The most favourable is when hairs begin to push out on the edges of the areas. If any other disease attends, its removal will often cure the alopecia. If the disease is formed, the head must be shaved, then washed with lye in which are in- fused the abrotanum and other warm stimulants: the part must then be rubbed until the skin grows red, and gentle stimulants should be continued. See Celsus, Sennertus. AL'OSA, (from xaitxu, to take, because it is a raven- ous fish). Shad. Clupea alosa Lin. Tritta, of an- cient authors. A sea fish ,the size of a salmon, with large scales, b- thin and easily taken off. This fish is in season in the spring, but if pickled it keeps well all the year. AU?!oHOC. I See AR°ENT- V,VU>'- ALOSAN'THI, (from xXi, the sea, and xv6o<, a flower). Flowers of salt. ALPHENIC, (alphanac, tender, Arab.); an Ara- bian word for sugar-candy, or barley-sugar. So called from its frangibility. See Saccharum. A'LPHI'TA, the plural of xxpirov,(from xXQos, white). The meal of barley that has been hulled and parched.- Hippocrates uses this word for meal in general. Galen says, that xpifwx is coarse; xXevpx, fine; and xxpifrx, middling sort of meal. ALPHI'TIDON, (from xxpnov, meal). It is when a bone was broken into small fragments like alphita, i. c. bran; also called caryedon ; and catagma, when like a broken nut. A'LPHI'TON. Greek". A hasty-pudding ; in Latin, polenta ; it is made of barley meal, moistened with water, wine, &c. commonly used by the soldiers. A'LPHUS, xxp^, (from x, to change,) M. A; Severinus calls it Baras. This disorder is a species of that sort of white lepro- sy called vitiligo, and which is divided into the alphus, melas, and leuce, called also albara; in the alphus the skin is white and roughish in spots ; sometimes the patches are broad, bearing the same analogy to the leuce as the scabies to the lepra; the first is superficial, chiefly affecting the skin ; the second sinks deeper into the flesh : but these disorders only differ in their de- grees of inveteracy. See Lepra. Oribasius commends lime water as a lotion in all the species ; and says, that the alphus requires a thin lime water, the scabies a thicker or stronger, and the lepra the strongest. Aetius commends, as equally proper for the white or the black alphus, the following lini- ment : R. Fol. ficus, sulphuris vivi et alumin rup. aa. aeq. p. acet. acerrim. q. s. f linim. cum qua inung. partes af- fectae. In all kinds of cutaneous complaints, the itch ex- cepted, internal medicines are necessary, and generally mercurial alteratives. Their operation may be assisted by the warm bath, and decoctions of elm bark or me- zereon. This subject will, however, be treated at length, under the article of Cutaneous complaints; q. v. See Celsus. Actuarius Method. Medend. Oribasius ce Morb. Cutan. Curat. Aetius's Tetrab. iv. Germ. cap. 1. 132. Willan on Diseases of the Skin AtPHINI, Bals. Balm of Gilead. See Bal- samum. ALPIN. JLGYPT. The abbreviation for Prosperus Alpinus de Plantis --Egypt. ^,ALP' JE^OT" The abbreviation for Prosperus Alpinus de Plantis- Exoticis. a^c a?h" ?G' The Same author de Plantis /Zgypti. r .u u n F' !^e UNGUIS odoratus ; and the murex, ?TeQn«iSf^.TrCh h Was suPP°sed to be a part. ALbGHNEf U, a term for wormwood. TnHAL?IMB?L ^ SIMBALA, the SPIKENARD of India, from the number of its ears or " spikes." • Au'L|SNN?\(from aA5"a5' a grove, because it delights m shade). It is also called morsus galline,centunculus; A L T 83 A L U in English, chickweed and mouse-ear ; ceraatium vul- gatum Lin. 627; called in English from its leaves re- sembling the ears of mice. It is cooling, but scarcely ever employed as a medi- cine. It is used to promote an appetite in linnets and Canary birds. The name also of a species of saxifraga, or the whitlow grass. See Paronychia. ALSIRACO'STUM, (alsiraka, evacuation. Arab). The name of a compound purging medicine in MessUe ; called also siracostum. ALSURE'NGIUM. See Hermodactylus. ALT. The abbreviation for alter and altdorf. A'LTAFOR. See Camphora. ALTERA'NTIA, (from altera, to change). Alter- atives. Medicines of this kind claimed formerly a considerable share of the physician's. attention, when acrimony was the most common reputed cause of dis- eases. This subject will be considered at length under the title of Pathology. It is sufficient at present to remark, that many of the supposed acrimonies have no existence, and the class of alteratives is consequently limited. We have, however, still the inspissants and attenuants, which, though they do not permanently af- fecrrhe state of blood, yet change that of the excretory fluids; and so far, in a remote view, may be styled al- terants. These are to be considered under their proper heads. Alteratives, in the present more scientific views of pathology and therapeutics, are those medicines sup- posed to correct the acrimony which appears in erup- tions on the skin, formerly called the scorbutic acri- mony. These are almost exclusively mercurials, as- sisted by the medicines just spoken of under the article Alphus. They do not act by any chemical affinity on the mass of fluids, but by their power of gradually in- creasing the secretion from the skin; for we shall show, that cutaneous complaints are seldom owing to any in- creased acrimony, but sometimes to an obstructed cuta- neous discharge ; and, at others, to the excessive rapid- ity of this evacuation. The only instance of a real change in the circulating fluids, is in sea scurvy, and in high putrid fevers. The latter admit not of alteratives ; and in the sea scurvy, the only useful medicine of this kind is a vegetable diet, Alteratives have been given with other views, and seem occasionally to have some effect. We allude to the use of sea water in scrofula, to burnt sponge and mercurials in the same disease. In scrofula, there is evidently a want of irritability; and we may suspect-a want also of a due proportion of neutral salts, which give fluidity to gluten, when dissolved in the serosity, forming the serum. This defect may occasion the stag- nation of fluids in the conglobate glands, and we should be more confident in this explanation, were the contents of these glands gluten. The saline remedies, above mentioned, are undoubtedly useful, and probably act as attenuants; the mercurials are alterants by increasing the action of the vessels, deficient from the want of irritability. Emmenagogues and tonics are sometimes also considered as alterants, hut with little accuracy. In fact, if there is any real medicine of this kind, it is mercury used in venereal complaints; to which we cannot deny some alterative power. It is proper, how- ever, in this early part of our work, to declare our opinion, that it chiefly acts by exciting and supporting the evacuation from the- skin. ALTERCAXGENON. ALTERCUM. See Ht- OSCIAMUS NIGER. ALTERNUS," alternate. Used in medicine when two different remedies are employed in turn. A'LTEY PLU'MBI. Most probably the Cerussa ACETATA. ALTHJL'A, (from xx9ea, to heal,) called also bis- malva, hibiscus, malvaviscus, bolus Judaica, anadendro- 7nalache, anadendron, aristaltheca ; in English, marsh- mallow. It is the althea officinalis Lin. Sp. PI. 966, and Wildenow, G. 1289, Sp. 1. Natural Order, Columnacee. All the parts of this plant abound with a mucilagi- nous matter, with little odour or taste. The dry roots, if boiled in water, give out near half their weight of gummy matter, which, in evaporating, forms a flavour- less yellowish mucilage; the leaves afford nearly one- fourth, the flowers and seeds still less. All its virtues depend on its mucilage, and conse- quently its demulcent and emollient qualities, where the membranes become abraded, or the mucus thin and acrid: it moderates tickling coughs, gives relief in hoarseness, erosions of the stomach and intestines, dy- sentery, difficulty and heat of urine, and nephritic com- plaints : two or three ounces of the fresh roots, or one ounce of the dry, may be boiled in a sufficient quantity of water to a quart, to which one ounce of gum arabic may be added, and one dram of nitre: a little of the juice of liquorice renders it more palatable. From long boiling, it acquires a bitterish taste; and when ordered in a decoction of the woods, it must be put in some time after the other ingredients. The London College has introduced a syrup of al- thea ; and more refined practice a very pleasing and more efficacious form—a paste made from its powder, viz. pate de guimauve. The custom of sitting over an infusion of marshmal- low leaves for curing the piles, is useless, for nothing of the mucilage arises with the watery vapours. Externally it is employed in emollient poultices; and in the foreign Pharmacopoeias it is an ingredient in, and gives a name to, an ointment. The great comfrey root is preferable in all the cases wherein the althea is used. ALTHA'NACA, or ALTHANACHA. See Auri- PIGMENTUM. ALTHEBE'GIUM. An Arabian name for a swelling observed in cachectic and leucophlegmatic habits, and such as is seen under the eye-lids of those who sleep too much. ALTHIT. (Halthvth, Arab). See Laserpi- TIUM. A'LTIMAR. Burnt copper. See jEs ustum. ALTI'NGAT. Rust of copper, or flowers of copper. See .Eris flos. ALTINURA'UM. See Vitriolum. A'LUACH, or A'LUECH. See Stankum. A'LUD. (Alhud, Arab). See Agallochum. ALUD'EL. (Arab, vessel). A chemical sub- liming vessel; called also Cementerium. Many are to be employed at once; the matter to be sublimed is put into a body or pot, the upper part is fitted into the aludel, and this aludel into another, Etc. : to the top aludcl a head or alembic is fixed to receive the sublim- ed matter. M 2 ALU 84 ALU A'LUM, (from xXvxofjtxi, to wander ; from its creep- ing roots). See Consolida. ALU MBAIR. Butter. See Adeps. ALU MBOTI. Calcined lead. See Minium, under Plumbum. ALUM EX (Alum, Arab.). The Greeks called it srvTTiipix, Assos, azub, Ascb ; and when extremely hard, as iron, Elanula. It is an earthy salt, consisting, in a great measure, of the vitriolic acid and a pure clay, changing the purple juices of vegetables into a red co- lour ; and extracted from substances usually called alum ores, which either are, or probably were, originally composed of clay and sulphur. The present practice employs only the last two of the following species; but all the four have been in use. 1. Alu'men plumo'sum officina'rum. Earth flax. It is entirely rejected from medicine, being more dan- gerous than vrseful. See Amianthus. 2. Alu'men plumo'sum ve'rum, also called scissile, jamenum, plumeum, trichites. The plumose, fea- thered, Or HAIRY ALUM. It sometimes shoots upon the surface of those mine- rals that afford the factitious alum, and is also found on other bodies in the form of fibrous efflorescences. It seems to be the native alum of the ancients; and is formed by the evaporation of water that hath passed over beds of alum stone. 3. Alu'men commune, common alum ; also called alumen crystallinu7n,rupeum,factitiicm. Factitious or rock alum ; English alum. 4. Alu'men Roma'num, Roman alum ; also called alumen rubrum, rutilum, rochi Gallis. Rock, red, or roch alum, by the French. These two latter agree in their general qualities. The greatest quantities of them are artificially produced from different minerals, such as a blue slate, which is found about Scarborough in Yorkshire, Preston in Lan- cashire ; and a whitish stone at Tolfa near Rome : these stones are calcined and exposed to the air. They thus absorb oxygen and become an acid salt; for in all alum the acid is in excess, which occasions its changing the blue colour of vegetables to a red. In the alum of com- merce, or rather in the form offered to us as a medicine, there is a proportion of potash or ammonia. Each of these is supplied in its preparation; the latter from urine; and the former, at least, is essential to its cry- stallisation, but the excess of either, above the other, does not seem to injure its medicinal properties. It gene- rally contains, according to Vauquelin, 49 parts in 100 of sulphate of alumine ; 7 of sulphate of potash ; and 44 of water. This proportion of water occasions by heat the watery fusion ; but, in a higher temperature, the wa- ter, and at last the acid, escape. Its crystals are regular octaedrons, representing an indented column, whose sides are equilateral triangles. It is soluble in about 16 times its weight of cold water, in a temperate heat, and in about 3-fourths, at the boiling point. Its specific gravity is 1.71. As the acid is in excess, its proper name is super sulphas alumine et potasse. When more completely saturated with the aluminous earth, it crystallises in cubes, and is called cubic alum; but it then loses its medicinal powers. The English or common alum is colourless, and commonly in large masses, into which it is past by melting the crystals after the alum is perfectly made, and then pouring the fused matter into vessels, whose cavities give the forms it appears in. The Roman alum is of a reddish colour, and in small crystallised masses ; but its chief difference from the English is in its being less styptic, and less nauseous. The name of roch, or rock alum, is applied to our alum, on account of the hardness and size of the masses; but foreigners apply it to the Roman, on account of the hard stone, or rock* from which it is extracted. Alum hath a peculiarly sharp, rough, astringent taste ; it melts over a gentle fire, sending up in a va- pour nearly one-third of its weight, and becomes a light, white, spongy substance, called alumen ustum, burnt alum ; it is the only salt that, with other ani- mal ingredients, or vegetable matters, will make the black pyrophorus, which is owing almost exclusively to its potash. With an infusion of galls it becomes turbid and whitish. Upon adding a fixed alkaline salt to a dis- solution of alum, its earth is precipitated, and its acid uniting with the alkali forms a tartarum vitriolatum, sulphas potassae. It is used by dyers to strike, fix, clear, and brighten their colours : it serves as the mordant to all coloxirs ; and by.dipping paper in it, ink is prevented from spread- ing : vintners fine their liquors with alum; fishermen use it to dry codfish; it preserves animal substances from putrefaction, and wood from burning; it is used in the manufacture of leather; by calico printers, en- gravers, and soap-boilers; and bakers mix it with flour to make their bread white and compact. Medicinally, it is employed as a powerful astringent; as such it is prescribed to preserve the gums, to restrain uterine haemorrhages, and check the fluor albus; but though in these diseases it is highly commended, it is rarely, and with great caution, to be admitted in dysen- teries, particularly in the beginning. Though cele- brated as an astringent in some cases, it is no less ex- tolled in the colic and other painful disorders of the bowels, attended with obstinate constipation. See Percival's Essays, vol. ii. The doses in these cases are from fiye to twenty grains, and may be repeated every four, eight, or twelve hours; and when duly persisted in, prove gently laxative, mitigate the pain, abate flatu- lence, restore the appetite, and strengthen the organs of digestion. Alum is powerfully tonic, and is supposed to contribute to the relief of pain in the intestines, by blunting the morbid sensibility of their nerves. In robust habits, after due bleeding and purging, it cures agues; and Dr. Cullen thinks it ought to be employed with other astringents in diarrhoeas. In active haemor- rhages it is not useful, though a powerful medicine in those which are passive. It should be given in small doses, and gradually increased. It has been tried in the diabetes without success: joined with nutmeg it has been more successful in intermittents, given in a large dose, an hour, or a little longer, before the ap- proach of the paroxysm. In gargles, in relaxations of the uvula, divested of acute inflammation, it has been used advantageously; as well as in every state of the cynanche tonsilaris. It is also preferable to white vi- triol, or acetated cerusse, in the ophthalmia membrana- rum; trom two to five grains are dissolved in an ounce ol water, for this purpose. Cullen's Mat. Med. The Roman alum is counterfeited with common alum ALV 85 A M A coloured ; but break it, and the counterfeit will be found pale within, while the true is of a deeper red. Its pharmaceutical preparations are well known. The aqua aluminosa contains a drachm of the salt to six ounces of water. In the compound alum water, as much vitriolated zinc is added : in many hospitals, however, the proportions are greatly increased. The alum curd consists of the white of two or three eggs shaken with a little alum, recommended for chronic inflammation of the eyes ; and alum whey is made by adding two drachms of alum to a pint of cow's milk. The purifi- cation of alum by chalk, as directed by the London Col- lege, seems to injure its virtues. See Styptic us hel- vetii pulvis. In extemporaneous prescription, the greatest cau- tion is requisite. Almost all the salts destroy the union of its ingredients, but fortunately selenite is not of that number; so that hard water may be employed in its so- lution. Yet carbonat, nitrat, and muriat of lime, will decompose it. Mild ammonia and magnesia with its various neutrals, and all salts whose bases are barytes, potash, soda, and perhaps strontian, will have the same effect. It is decomposed also by the gallic acid; pro- bably by tanin; certainly by the gummy resin kino; by various colouring matters ; by different animal and vegetable substances. A similar effect is produced by eau de luce, by the different mercurial salts, and by the sugar of lead. Alu'men ca'tinum. A name of potash. See Cla- VELLATI CINERES. Alu'men glaciale. When transparent like ice. Alu'men plumosum.) c_ . . , > See Alumen. ALU MEN USTUM. } ALUMINO'S.E, Aq. Waters impregnated with the particles of alum. What gives efficacy to these waters is said to be an acid aluminous mineral salt, dis- solving-a slight mixture of iron, and united with other materials. They are supposed to be deobstruent, and beneficial to hypochondriac and cachectic patients ; and not astringent, as the idea of their being solely impreg- nated with alum would induce us to conclude. ALU'NSEL. A drop. See Gutta. A'LUS. ( c r, . , ^ , > See Consolida. A LUS Ga llica. y AL'USAR. See Manna. ALVEA'RIUM, (from alveare, a bee-hive). The bottom of the concha or hollow of the external ear ; it terminates in the meatus auditorius. It is in this cavi- ty where the ear-wax is principally lodged. ALVEOL'ARIS PROCE'SSUS. So called from the likeness to an honey comb. See Maxillaria su- PERIORA OSSA. ALVE'OLI,(adim.of alveus,a channel,) called also botrion, or bothrion ; frena, mortariolum. The sock- ets in the jaws in which the teeth are set; they are lined with a very sensible membrane, which also incloses the roots of the teeth. There are usually sixteen of these alveoli, or sockets, in each jaw. A'LVEUS, a channel. Medicinally, it is applied to many tubes or canals through which some fluid flows, particularly to ducts which convey the chyle from its receptacle to the subclavian vein. ALVIDU'CA, (from alvus, the belly, and duco, to draw). Medicines which purge. See Purgantia. A'LVI'FLU'XUS, (from alvus, and fluo, to flow j. See DlARRHCEA. A'LVUS, (from alveus, a channel). The belly. Celsus uses this word for the belly, relative to the in- testinal discharge, as Hippocrates and others use the words koiXix, or xoiXty. See also Abdomen. A'LYCE, (from xXva, to be anxious). See Alys- mos. ALY'PIA, ALY'lTAS, A'LYPUM, (from * neg. and Xvrrtj, pain). The herb terrible. It is also called white turbith. Frutex terribilis, empetrum, thymelea, and globularia fruticosa. Globularia alypum Lin. Sp. PI. 139. Not used at present in medi- cine. ALY'SMOS, A'LYCE, (from xXvu, to be uneasy, or anxious). Anxietas, anxiety. Hippocrates uses it to express that restless uneasiness that is attendant on acute diseases. Duretus distinguishes between the xXvsfios xve/ieros and the xXve-fMt vxvnS'v.q. The first is caused by an oppression of the vital powers ; the latter by sickness in the stomach; but of this last alysmos, called also diaporema and aporia, there are reckoned four sorts. The 1st and 2d of which are without, the 3d and 4th with fever; and occasioned, 1st, By something un- easy in the stomach, producing an irregular contraction of the heart, and a difficult passage of the blood through the lungs. Uneasiness of the stomach by sympathy, as from a stone in the kidneys, &c. produces this dis- order. 2d, By vapours or spasms in the stomach, or other viscera ; as in the cholera morbus, hysteria, Sec. 3d, From a difficulty in the passage of the blood through the lungs, which may be from a spasmodic stricture in the smaller vessels, in which case the blood is confined to the larger. In inflammatory fevers, this symptom is attended with a low pulse, oppression in the breast, and difficult breathing. 4th, From a stricture of the vena portae, which pre- vents a free circulation of the blood in the lower belly. In this case there is great weight and oppression of the hypochondria. ALYS'SUM, madwort, (from «, for anti, and Xvc-rx, that madness which the mad dog occasions by his bite). It is the marrubium alysso7i Lin. Sp. PI. 815, and has been considered as a diaphoretic. Alys'sum galeni. The marrubium. Alys'sum Plinii. The mollugo. Alys'sum verticillatum. See Marrubium ver- TICILLATUM. ALZE'MAFOR. See Cinnabaris. ALZI'LAT. The name of a weight of three grains. ALZO'FAR. Burnt copper. See iEus us- tum. ALZUM, ALDUM, and ALRUM. The name of the tree that produces gum bdellium in some ancient authors. A'MA, A'ME, or A'MES, (Syriac). A sort of small cake. Aretaeus uses this word to compare the quantity of hellebore for a dose. AMA'LGAMA, (from k^x, simul, and yxf4.cn, nu- bere, vel i^xXxttuv, 7nollire). Its chemical character js AMA 86 AMA A. A. A. In chemistry it is a soft paste, produced by mixing mercury with a metal. All metals may be amalgamated with mercury, ex- cept iron ; but gold amalgamates the most readily ; then silver, lead, and tin in order; copper with diffi- culty. With amalgamated gold, silver and other metals are gilt; but this subject does not belong to medicine. A'MALT. The abbreviation for amaltheum. AMAME'LIS, (from x^tx and wXex, an apple). The amamelis of Hippocrates is supposed to be the same with the epi77ielis of Dioscoridcs, which is the small bas- tard medlar. There is another medlar in Italy, called the epimelis, also setanium. See Mespilus. AMANI'TA, (from x, priv. and pxnx, madness). The eatable mushroom, not poisonous. Their tribe is therefore called Aminita, Fungi, and Tubera. The fungous productions called mushrooms, truffles, &c. Among the ancients these are noticed only by Oriba- sius," Paulus jEgineta, and N. Myrepsus. Among the moderns, they have only within about fifty years claimed particular attention, and it was long doubted whether they were really vegetables, or only the nidus of numerous animalcules. It is needless, on a point not connected with medicine, to enlarge by ad- ducing the history of opinions on this subject. M. Bul- liard has, at last, proved them to be really organised bodies of the vegetable kingdom. That they are pro- pagated by seed is highly probable ; but what Bulliard seems to have mistaken for the seed, Gaertaer and Mir- bel have shown, with some success, to be buds. Par- mentier joins in the same opinion. What has been de- scribed as the male and female organs are consequently parts whose uses have not yet been discovered. Mush- rooms, however, resemble plants in this respect, that their nutrition is derived from fluids drawn in by ves- sels ; and the more solid kinds, resembling cork, show the annual deposition of concentric coats : in those still more solid, the resemblance to plants is stronger ; while, in the transitory productions of short duration, the fluids, instead of being conveyed by vessels, seem to pass through a cellular substance by capillary attrac- tion. From analysis they appear, as we have said, of an animal nature ; and, under water, give out hydroge- nous, azotic, and carbonic acid gas ; by distillation, am- monia. Parmentier considers mushrooms only as condiments. He thinks them incapable of being assimilated, and without any nutritious particles. In this, however, he is evidently mistaken; since tanin precipitates an albu- minous substance from the water in which some of the species have been infused. A few only of the mush- rooms are eatable : some are insipid, and some poison- ous. Of the eatable ones, however, the flavour is deli- cious ; and, as it is volatile, mushrooms are employed in Piedmont to give a flavour to some liquors. The poison of the injurious kinds is of a sedative nature, re- sembling, as we shall find, in its effects, hemlock. Some authors have therefore advised substituting a si- milar flavour from other vegetable substances. We know that an Indian bean, a species of dolichos, will, in a great degree, supply it as in the soy. The bottoms of artichokes resemble it very nearly; and, by some management, even celery is not-very unlike. The only sorts in general use are the mushroom, the truffle, and the morille. The true mushrooms, agaricus campestris Lin. are known by their external whiteness, and by being of a pale red within when young, and of a deeper red, or dark, when older; they are, at their first appearance, of a round figure, and not much larger than a small nut; after they have a little unfolded their membranes, they appear red, full, and close ; on the top is a disagreeable softness, equal and white ; the matter within is very white, with short and thick stalks. They grow in fer- tile ground, and should be gathered for eating as soon after springing up as possible, for they then contain an oily and a saline part; and if they stay long before they are gathered, their salts become more active and hurtful: Another species of agaric, which now begins to attrad the attention of the luxurious, is the a. orcades of Bol- ton ; that kind which produces the circular appearanceh infields, styled fairy rings. Its substance is tough, and consequently it is used only to make catchup, or in powder. It greatly resembles another species, the 7nuceron of the French, employed in ragouts. There are several other species of agaric used, particularly a large one found in Cornwall, near the coast, but we need not enlarge further on the subject. The truffle belongs to that family of fungi whose seeds are internal. The tuber cibarium of Bulliard is, we believe, the only species generally eaten; though the musk, the white, the American truffle, and some others, specifically distinct, are mentioned among deli- cacies. It is firm and fleshy, and its surface covered with prismatic tubercles ; when at its full growth blackish, with white veins. It is buried about four or five inches deep in the earth, and discovered by hogs, or dogs trained for the purpose, as these animals are very fond of this fungus. De Bosch, who has written at some length on the truffles of Piedmont, informs us, that numerous tipulae may be found over the place where truffles abound; and the larvae of little flies, with red eyes, which likewise feed on truffles, lead to the spot. With respect to truffles, Bulliard gives up h's seminal system, and calls them viviparous; as he finds the young fungus attached to the parent by a cord re- sembling the umbilical. As a food, truffles are stimu- lant and difficult of digestion. M. Bouillon la Grange has engaged at great length in their analysis ; of which we find an abstract in some late volumes of the Critical Review. It differs little from the chemical analysis of other fungi; but we may remark, that truffles contain magnesia and some portion of albuminous matter. r rom the truffle the most odoriferous and pleasing li- queur is prepared. The morille is a mushroom whose stalk is hollow, and whose head is irregularly indented and wrinkled. It belongs to the family whose seeds are on the superior part of the mushroom, or, more strictly, which adhere to the surface of the cavities of the hat. It is of the genus phallus, and two sections have been distinguish- ed ; of which the p. esculentus and impudicus are ex- amples. Ventenat, however, has shewn that this dis- tinction is not strictly accurate, (Mem. de l'lnstitut, vol. i.). Yet on the whole, in a general review, it mav AMA 87 AMA be adopted. The morille, in its early stages, is of a greyish brown, but becomes afterwards black. In the first period it is preferred on account of its odour and flavour; for at last it becomes insipid. It should be cut off, not torn up, because the water, which rises in the cellular substance, conveys some earth with it; and, if collected while the dew is on the ground, it soon becomes mouldy. When strung on cord, they will keep in a good state a- long time, but should be mois- tened with warm water before they are used. Some other species of phallus are esculent; but it is useless to enlarge on them. If we recollect rightly, 13 species are described by Ventenat in the Memoirs of the Insti- tute, and three other American species have been since added. To various causes are attributed the disagreeable effects which some persons experience after eating them. The deleterious effects of these vegetables have been attributed to little worms, to their being too old, too long kept, &c. We cannot deny the effect of the worms ; but as they are seldom, if ever, observed in the esculent kind, it is not probable that any injury can arise from them. The other causes are certainly inad- missible ; since mushrooms are generally eaten at every period of their growth with impunity. We suspect that the mischief rather arises from mistaking the species, which, from the similarity of the poisonous to the es- culent kinds, is easy. Bosch, however, informs us, that steeping the mushroom in water, or, what is prefer- able, vinegar, for a short time, will take away every probable inconvenience. The poison of the deleterious kinds, which differ in their chemical analysis from the others only in being more watery, is not of a volatile nature, and does not rise in distillation. Mushrooms raised from seed in hot-beds are never, we believe, poi- sonous. They are said to contain a larger proportion of oil; but they are less sapid, and more firm in their substance. It is the agai'icus esculentus, or campestris of Linnaeus, the amanita esculenta of La Marck, that sub- mits most readily to this artificial mode of propagation. When offended by eating them, some of the follow- ing symptoms are produced; a qualmishness first af- fects the patient, which increases to a considerable de- gree of sickness, swelling of the stomach or of the belly, restlessness, giddiness, a palpitation of the heart, heart- burn, colic, hiccough, diarrhoea, accompanied with a tenesmus, flushing heat in the skin, with more or less of redness there, and swelling in the face, and some- times a sensation all over the body, which resembles what is felt from a general swelling; the patient stares in an unusual manner, all objects appear different from what they did before; a difficulty of breathing comes on, and the mind is strangely confused ; delirium, trembling, watching, fainting, cold sweats, apoplexies, and convulsions, have followed the eating of this sort of fungus. For the relief of persons under these circumstances, as speedily as possible, from gr. x. to ►) i. of white vi- triol, dissolved in a draught of warm water, should be given; and if the sickness is still urgent, the same quantity repeated two or three times, that the stomach may be well emptied. After this a large spoonful of vinegar in a glass of water should be frequently tnken. The,poison is not of the acrid kind, so that fat broths and oily medicines are useless. After evacuations up- wards, a passage downwards by purgatives or clysters must be procured. After due evacuations of each kind, and besides the vinegar, cyder and perry, that are brisk and sparkling, may be now and then given. If any pa- ralytic symptoms appear, sinapisms or blisters are ne- cessary. AMA'RA. (Marar, to grow bitter. Heb.) Bit- ters. Bitterness is a simple perception which cannot be defined, but must be referred to experience. What is the nature of the substances possessed of it, in a che- mical view, we cannot determine, and consequently cannot explain. The bitter is so often united with the astringent, the tonic, or the aromatic principle, that it has not been usual, in therapeutical authors, to distinguish the effects of the pure bitter. In this place, it must be considered as unconnected with either; and examples of a truly pure bitter we may find in the camomile flowers, the quassia, the gentian, and the columba. These, it is said, are tonic: we can scarcely think so. They are antiseptic, and most probably antacid; and from these qualities they correct the morbid state of the fluids in the stomach, thus giving strength by destroying the causes of weakness. The bile of animals appears to be a pure bitter; yet it is probably not so, since it occa- sions in the stomach sickness and faintness. Dr. Cullen seems to suspect that bitters are narcotic ; but his chief argument arises from their effects in gout, when, in the form of the duke of Portland's powder, they have been long continued. Various collateral cir- cumstances have, however, convinced us that bitters should not be long continued without some intermission. Bitters have been used as resolvents; a term not strictly defined, but intended to convey the idea of their resolving obstructions of the liver or other viscera.. When joined with fixed alkalis or neutral salts, they seem to have this effect; and, in this union, they are also1 febrifuge. They formed the mild febrifuge of Boerhaave, who, with little chemical accuracy, styled them saponaceous. In this form, at least, pure bitters are not injurious to the robust or inflammatory habits; and we suspect that without the union of the salts they would not be hurtful in such constitutions ; yet they are seldom, if ever, indicated in persons of this description, and the disquisition would tend to no useful purpose. Bitters, we have said, are stomachic; they are also slightly laxative ; but we have never found them, as some authors have alleged, diaphoretic. There is another class of bitters unconnected with those above mentioned; viz. the narcotic. Of this kind we have examples in the hop, the cocculus Indi- cus, the lactuca virosa, opium, perhaps the bitter of the myrrh, and of the Iceland liverwort. These are never employed, except in very small doses, for the purposes before mentioned. They will be more fully considered under their proper heads. We mention them in this place merely to connect the subjects, and to suggest a suspicion that these two kinds are very nearly related; to enforce also a due attention to the supposed narco- tic power of common bitters. With this perhaps their anthelmintic power may be connected ; but though the greater number of anthelmintics are bitter, yet it is in a very slight degree, if at all, a property of bitters in general. An additional proof of the connexion of the narcotic with other bitters, is their febrifuge power. A M A 88 A M A The faba St. Ignatii, a bitter of the narcotic class, is highly celebrated for the cure of intermittents; and a considerable febrifuge power seems to reside in the greater number. Bitters yield their virtues both to*watery and spiritu- ous menstrua: they yield very little of their taste by distillation, either to water or spirit; nay, the bitterness is so tenaciously detained, as to be improved in many extracts. Cold water extracts the pure bitter without any mixture of unpleasant roughness. Even the cold infusion of the carduus benedictus is pleasant. AMA'RA DU'LCIS. See Solanum lignosum. Ama'ra Indica. See Memordica. Ama'ra, Tinct. > SppGfvtivx* AMA'RUM SIMPLEX, Infus.5 bee ^ENTIANA- AMARA'CUS, (from «, non, and n-xpxtva, to decay, because it keeps its virtues a long time,) SAMPSU- CHUS. See Majorana majori folio. AMARA'NTHUS, (from the same). LUTjE'US. Goldilocks. See Elichrysum. AM ARE'LLA, (from amara, bitter). See Polygala. A name also of Gentian. AMA'RUS, du'lcis orienta'lis. See Costus. Ama'rus sal. See Catharticus sal. AMATO'RIA FEBRIS, (from c/«o, to love). See Chlorosis. In Vogel's Nosology, amatoria is defined to be a fever of a few hours' continuance, beginning with a great degree of coldness, and arising from ex- pectation of marriage. Amato'ria veni'fi'cia, (from amo, and venificium, witchcraft). See Philtron. AMATO'RIUS. The obliquus superior, or troch- lear is, and the obliquus inferior oculi, are thus named, as ogling is performed by these muscles. AMATZQUI'TL, (Indian) : vel UNEDO PAPY- RACEA. Arbutus unedo Lin. Sp. PI. 566. The wood is of a light texture, the leaves resemble those of the lemon tree, but are hairy and more pointed ; the fruits are large as Pontic nuts, divided into white grains of the same shape and nature with those of a fig. It is met with in warm countries only. A decoction of the bark of its root is commended in fevers. AMAUROSIS, (from xp.xvpou, obscure). It is a de- cay or loss of sight, when no fault is observed in the eye, except that the pupil is somewhat enlarged and motionless. This disorder is styled a gutta serena; cataracta nigra ; offuscatio; cecitas 771'mor; mydriasis. Some call it Amblyopoeia ; q. v. M. de St. Yves distinguishes this disease into the per- fect and imperfect kinds. The perfect consists in total blindness; in the imperfect, there is at least a power of distinguishing light from darkness. There is a species which comes on instantaneously, continues for some hours, or days, returning often periodically in hysteria, &c. In another species, the pupil is always contracted, whether the-unaffected eye is open or shut. Ininfants, the pupil is sometimes, though seldom, of its natural size,, but no movement is observed in it, however ex- posed to the light. The nyctyalops is supposed to be a species of this complaint. The causes are, a palsy in the retina, a tumour, or a plethora in the adjacent vessels; a translation of either a venereal or other poison. Suppressed periodical evacuations, vapours, hysteric and other nervous symp- toms, sedative poisons, external injuries, or whatever intercepts the nervous influence in the eye, may pro- duce this disease. In the middle of the optic nerve runs that branch of the carotid artery which enters into the eye; this artery, when distended, may press the nerve ; render it paralytic, and cause the periodical species. Dr. Cullen ranks this genus of disease in the class locales and order dysesthesie; and enumerates the spe- cies from the following causes, viz. compression, debi- lity and its causes, spasm, and the applications or the swallowing of poisons. The application of the bela- donna produces this disease. On dissection, the optic nerve is sometimes found flaccid, and by far too small; in others it is compressed. by extravasated blood, by a tumour, or by aturgescency of the artery which passes through it. The phlegmatic, cachectic, aged, those with weak nerves, or that have been subjected to severities or ex- cesses, and persons labouring under irregular or sup- pressed periodical discharges, are the principal subjects of this disorder. The signs that indicate the presence of amaurosis are generally the blackness of the pupil of the eye, its size being larger or less than usual, and its not contract- ing nor dilating when exposed to a great degree of light. Its approach is generally attended with pain in the head; and as the pain decreases this disorder increases, though sometimes an absolute blindness comes on without any previous complaint. When it comes on without pain, and one eye only is diseased, no defect is discovered until the sound eye is closed ; then the pupil of the dis- eased eye dilates, though exposed to a strong light; and when the other eye is opened it contracts to its natural size again. When it gradually comes on also, little specks appear on an object, or small flies seem to float before the eye, in the language of pathologists, musce volitantes. In infants the pupil is sometimes of a natu- ral size, though it hath no movement; and thus they continue during many months, before they can see. When pregnancy, suppressed periodical discharges, nervous disorders, or. vapours, are the cause, a head- ach, vertigo, drowsiness, noise in the ears, &c. often usher in this disorder: in these cases it frequently re- turns, but soon spontaneously passes away. The prognostics are generally unfavourable: if this blindness succeeds a fever, comes on in the aged or very infirm, a cure is not to be expected; if one eye fails, the other soon follows; but if the case is slight, the habit of body robust, if it happens after the measles or the small-pox, or about the age of puberty, it is sometimes cured. The treatment of amaurosis is not often successful. It is easy to draw indications from the causes; but when it proceeds from plethora, sanguine or serous, bleeding or purgatives have equally failed. In this exquisitely tender organ, palsy is apparently induced before the evacuations can relieve the oppression. Of internal remedies, valerian, castor, and the whole tribe of anti- spasmodics, have been most successful; but these should probably be confined to cases where it is connected with hysteria, and in these the disease often sponta- neously disappears. The internal use of mercury has been recommended, but we have never found it effica- cious. Active emetics have often succeeded, apparently from the general shock given to the svstem; and we • AMB 89 A MB know not from what cause the vitriolated mercury (turbith mineral) seems most salutary. If the resolution or the constitution can bear these severe shocks twice a week, amaurosis may frequently be removed. Setons and blisters to the neck do no service; but when the blisters have been applied to the temples they seem to have been occasionally useful. Sternutatories have been employed, but, in our hands, with little success. The best is the turbith mineral, with about ten times the quantity of any mild powder. Electrical sparks drawn from the eye twice a day have proved highly be- neficial ; and the Galvanic influence, if rescued from the hands of quacks, promises considerable relief. See Heister's Surgery, Hoffman's Med. Rat. Syst. St. Yves on the Diseases of the Eyes. Mead's Cau- tions and Precepts. London Med. Journal, ii. 10. Wallis's Sauvages' Nosology of the Eyes, p. 151, See. 271. Amaurosis a Sy'nchysi. ? 0 „ a.,. ,„~ » t\/t / r See Caligo pupillje. Amaurosis a My osi. ^ AMAZO'NUM PASTI'LLUS, usually given to chlorotic maids. The Amazons' troch. These troches were formerly prepared of the seeds of smallage and anise, the tops of worm-wood, of myrrh, pepper, 8cc. A'MBA. (Indian). See Manga. AMBAI'BA. (Indian). It is a tall tree growing in Brasil, with but few branches at the top ; the trunk is hollow its whole length, except that its cavity is divid- ed by a transverse membrane at every two or three inches distance', in the middle of which is a small hole. The root is very hard, even so as, by a gentle friction, to afford fire enough to burn cotton. The buds afford a juice that is cooling, if miked with gruel. This the Indians call tapioca. See Raii Hist. Plant. It is the cecropia peltata Lin. Sp. PI. 1449. A tree which pro- duces a milky juice similar to the caoutchouc. A'MBALAM, an Indian tree; also called manga. It resembles very nearly the cat-abolam. The root, used as a pessary, is said to promote the menses; the bark and the juices are used in dysenteries ; and a de- coction of the wood is commended in gonorrhoea. See Raii Hist. Plant. It is the mangifera iTidica Lin. Sp. PI. 290, the tree which produces the mango. A'MBAR. See Ambra. A'MBARUM. (Abara, Arabic). Ambergrise. See Ambra cineracea. AMBARVA'LLIS, Flos, (from the Latin word a7nbire). See Polygala. A'MBE, 1 ,c r \ A'MTU \ ('rom *A*»*» a LIP> edge, or border). An instrument used in dislocations of the humerus, called Hippocrates' a7nbe, from his having noticed it. Galen explains the word ambe by x^pvu^ e7rxvxe-rxtris, an eminence like a border ; and says, that the whole ma- chine takes that name because its extremity runs out with an edge, like the lip or brim of a pot, .towards the interior cavity. When the head of the humerus rests in the axilla, this instrument is sometimes of service, but in no other case: and even here it is rarely used; for when gentle methods fail, violence seldom succeeds. A'MBEGU. See Myrobalani emblici. A'MBIA MO'NARD. A yellow liquid petroleum, VOL. I. smelling like tacamahaca. - It flows from a fountain near the Indian Sea; and is used for the cure of itch AMBIDE'XTER. AMPHIDEXIOS. (From x^,. both, andh^tx, the right hand)* A man equally active with both hands. AMBLO'SIS, (from xy&Xoa, to .cause abortion). See Abortus. AMBLO'TICA, (from the same). Medicines which occasion abortion. AMBLYO'GMOS, AMBLYOSMOS,(from«,*^?, dull). Dimness of sight. Hippocrates observes, that dimness of sight and cor- ruscations of light are among the symptoms of an ap- proaching haemorrhage, in continual fevers and genuine tertians. Galen improperly explains this word by- abortus. AMBLYO'PIA, (from ut&Avs, dull, and a-^, the eye). Visus debilis. This is a debility of sight, absolute or relative, without any apparent opacity of the cornea or interior part of the eye. See Amaurosis. Hippocrates means by this word, in his Aph. xxxi. sect. 3. the dimness of sight to which old people arc subject. Paulus and Actuarius use it to express a gutta serena, and the latter considers it as arising from a defect of the nervous influence. De Meth. Med. lib. ii. cap. 7. The amblyopia comprehends, 1st, Myopia, Or short- sightedness : 2dly, Presbytia, or seeing only at a great distance: 3dly and 4thly, Amblyopia tenebraru7n and luminis. It is the dysopia of Cullen ; and the amblyopia of some writers is the amaurosis of Cullen. The re- medy for this complaint is not easily assigned. The eyes of the myopes and presbytae are said to be defec- tive in their form, either too convex or too 'flat; so that the pencil of rays terminates before or beyond the re- tina, and distinct vision is of course impossible. The latter is more generally true than the former; for it must be obvious, that a deeper orbit, and consequently a more distant retina, or a stronger refracting power of the lens, may equally produce short-sightedness. In either case, there is no remedy but using glasses, about one number less than that which renders the vision perfectly distinct, or using the eyes to examine distant objects. Age however alone brings relief, and this at no long period before blindness ensues; yet it is more common for short-sightedness to continue to extreme old age, than for the short-sighted to be blind. The presbytae can scarcely, in any instance, procure strong or perfect sight. The weakness of vision may be relieved by cold bathing; cold applications to the eye; frequent ablutions with water, to which about l-4th or l-6th of good brandy has been added, by draw- ing sparks, or by Galvanism. The amblyopia tenebra- rum arises from imperfect perception, and may be re- lieved, if relieved, by the same means. The opposite complaint, on the contrary, the seeing only by night, arises from too great sensibility, which renders com- mon light excessive in its powers; and the disease is truly " tenebrae per tantum lumen obortae." Age may lessen it, but medicines will have little effect. See Wallis's Sauvages' Nosology of the Eyes, p. 151, Sec. AMBLYO'PIA, Hydrophtha'lmica, i. e. Caligo humorum. See Caligo. It sometimes means also Amaurosis. N AMB 90 AMB A'MBOX, (from «pS*• superior to mortal aliment). The name of a sweet shrub, anciently used for making garlands. Ambrosia maritima Lin. Sp. PI. 1401. The modern ambrosia is the botrys, q. \. The an- cients seem to have given this name to various plants, as the lily, the greater house-leek, 8cc. Gerrard. In chemistry, it implies a highly rectified tincture ; and it is applied as a title of peculiar reverence to some ancient antidotes. AMBULA'TIO, (from ambulo, to walk,) walking. See jEora. AMBULA'TIVA, (from the same). See Herpes. A'MBULO,(from«/tt?«AA«, to cast forth). The name of a disease called also furiosus,fiatulentus, flatus fu- riosus. It is a distention or inflammation attended with pain, and variously periodical. See D. D. Joh. Michael. Prax. Clin. Special. Cas. 19. AMBU'STA»(from a7nburo, to burn). Burns, or scalds; called also causis, ambustio, ambustura. Dr. Cullen places this case as a variety of the phlogosis erythema. A burn is from solid substances; a scald from any hot fluid, or solid when in a fluid state. Their danger is according to the degree, the part injured^ the pecu- liarity of the constitution, and consequent symptoms. Wounds from burns are more liable to form a cicatrix than from other causes. Burns differ in degree only. The slighter kinds re- semble inflammation; those where much substance is destroyed, mortification. In the slighter kinds, medicines that neither heat nor cool in a great degree are to be preferred. Cold water may be used, by means of linen rags dipped into it, and the application repeated as often as they become either dry or warm. In the same manner brandy and rectified spirit of wine may be applied, repeating the dressings until the pain abates, and then the camphorated spirit of wine is to be preferred. Vinous and volatile spirits, if applied before the blisters rise, generally prevent them, and always mo- derate the inflammation; but if the injury is on a membranous or tendinous part, it is best to mix oil with the spirit, otherwise it will too much contract it. To the same purpose as the above, and in want of them, any of the following may be used :—The white of eggs beat thin; vinegar, in a quart of which one handful of common salt is dissolved; the pickle from olives; the brine from cabbage; oil of turpentine ; any cooling oil or liniment; vinegar; lintseed or olive oil; apples or potatoes scraped, and applied as a cataplasm. If the blisters are considerable they may be punctured and dressed with any cooling ointment; and if diges- tion is necessary, a proportion of ung. resinae flavae be added. Should fever follow, the appropriate remedies must be employed. In the severer kinds, if a crust is formed, the cure is effected by emollients and suppurants, as in the case of gun-shot wounds. See Sclopetoplaga. If the accident hath happened in the face, or, in fe- males, in the neck, whatever can tend to increase the cicatrix must be avoided: emollients folded in linen cloths are the best applications; an emollient fomenta- tion, with about two ounces of the camphorated spirit to a pint, may be used at the renewal of the other dress- ings, during the first three or four days, or until the crust is separated; after which the procedure will be as in any common wound. If the crust remain firm above three days, make in- cisions through it, to discharge the matter underneath. To prevent a cicatrix, as the skin forms, let it be often exposed to the stream of hot water, and apply a cerate of wax and the oil of eggs. Where all is destroyed even to the bone, Heister says, that the only method is amputation; but the me- thods here recommended will often succeed, and save the limb. A violent head-ach in one, and pain in the limbs of another person, were removed by the parts affected being accidentally burnt, and that only slightly. Hom- berg thinks that burning with moxa, and with caute- ries, cure by quickening the motion of the humours, by thinning them, and by destroying the ends of the vessels, by which the fluids flow less that way. On the whole burns can only be judiciously treated by con- sidering them as high inflammations, of the erythema- tous kind, and the treatment must accord, by evacuants if necessary, and by bark; attending in each to the material benefit arising from removing pain by proper opiates, without which but little advantage will be gained, whatever other means are used. For burns, or scalds, the following preparations are esteemed as highly useful. Linimentum oleosum—oily liniment. R. Olei oli- varum § i. ss. aquae calcis ^ iij. This is more particularly adapted to burns, especially where the skin is scorched, or destroyed, from its softening qualities: repeated affusion of, or continual immersion in, cold water, more conveniently relieves scalds. Cremor lithargyri acetati. See Plumbum. Lotio lithargyri acetati camphorati—campho- rated lotion of acetated litharge. R. Sp. camphorati 3 ij. aq. lithargyri. acetati 3 i» gradatim commisceantur et paulatim adde aq. distillatae f^ i. In topical inflam- mations, having a tendency to become erysipelatous, this possesses much efficacy. Lotio spirituosa—spirituous lotion. R. Spt. vini rectificat. ^ iv. aq. calcis lb ss. This acts as a sedativef and alleviates the pain of the parts inflamed. N 2 AME 92 A 31 M Mr. Cockburn recommends a plan, which we have found very successful. The part burnt is to be bathed with vinegar, till the pain is no longer felt; and this ap- plication is not contraindicated by even a loss of sub- stance. Afterwards, a common poultice, covered with finely powdered chalk, is to be applied, and repeated at first every four hours, and after a day or two every six or eight hours. In a few days the cure is completed. The effect of this plan is the coagulation of the fluid in the blisters, and their immediate healing. Mr. Kentish, of Newcastle, recommends the use of the aqua ammonie, oil of turpentine, or alcohol, as the first applications ; and afterwards a dressing of the unguentum resinae flavae, softened with oil of turpen- tine, with a cordial diet and the use of opiates, from which he has been very successful in his practice in some extremely desperate cases; and in cases of cos- tiveness he has recourse to calomel to keep the body moderately open. He has given to the public several cases, with the modes of treatment he made use of; and as they must vary according to particular circumstances occurring, and differences of the constitutions in individuals to whom such accidents have happened, we refer the reader to the perusal of his work, as the nature of our publication will not permit us to descend too minutely unto such particulars as may be necessary to be known by the practitioner. Bell's Surgery, vol. v. 357. Pearson's Elements of Sur- gery,parti. 159. White's Surgery, 24. Kentish on Burns. AMBU'STIO, ambustion, (from amburo, burning, or scalding). See Ambustio and Calcinatio. AMBU'TUA. (Indian). See Pareira brava. AME'A, a plant used on the coast of Africa in bleed- ings of tfie nose; its powder is used as snuff. AMENDA'NUS. See Alnus. AME'LI, a tree growing on the coast of Malabar, described by Reed too imperfectly to be classed in sys- tems. A decoction of its leaves is useful in oolics, and its roots infused in oil are said to be good resolvents. AME'LPODI. See Bellutta tsjampacam. AME'NE. See Gemm.s sal. AMENORRHCE'A ,(from «, neg. w, mens, and pea, fluo). A defect or want of the menses, or monthly flux. See Menses deficientes. AMENE'NOS, (from x, negative, and /neves, strength). Weak, feeble. In this sense Hippocrates often uses "this word. AME'NTIA, (from «, privat. and mens, the mind). Madness, idiotic insanity ; also anoia, fatuitas, oblivio ; foolishness, idiotism, Sec. Some use amnesia as a synonirrie. Dr. Cullen defines it to be the weakness of the mind in judging, from either not per- ceiving or not remembering the relations of things. He ranks this genus of disease in the class neuroses, and the order vesaniae. His species are, 1. Amentia congenita, natural stupidity, f. e. from the birth. 2. Amentia senilis, dotage, or childishness, from the infirmities of age» 3. Amentia acquisita, when from accidental injuries a person becomes stupid or foolish. In the last of these only can we afford any relief; and this species arises from the powers of the .constitution being greatly debilitated by preceding complaints, where the nervous system has been long and severely affected, and the mind equally debilitated: cheerful company, gentle exercise m a pure clear air, a generout mode of living, properly regulated, and cor- dial medicines, if necessary, bid the fairest for per- forming a cure. See Mania, Morosis, and Melan- CHOLIA. AMENTUM; a loop or bond, (from x^x, a thong). It is also a name "for scissile alum. See Alumen plumosum. AME'RI. (Indian.) See Indicum. AMERICA'NUM, Bals. See.PERUv. Balsa- mum. America'num tubero'sum. American potato, having a tuberous root. See Battatas Cana- densis. AMETHY'STA PHA'RMACA, (from x, neg. and t*,e6v, wine). Medicines which either prevent or re- move the inebriating effects of wine. AMIA'NTHUS,? (from «, priv. and (uxiva, to pol- AMIA'NTUS, 5 lute,) so called from its white or silvery gloss, which is not easily defiled. Also called asbestus, asbestinum, cinum fossile, asbestinum vivum, Indicum, corpasium, caristum, and Cypricum ; alumen officinarum, Sparta polia, salamandra, earth flax and salamander's wool. It is a magnesian earth composed of small silvery filaments ; met with in many of the islands of the Medi- terranean Sea, and in Italy. It is worked either into linen or paper, both which resist the most violent flame, and are cleaned by calcining. It is dug up also in the island of Anglesey, and in Oxfordshire. AMI'CULUM. A covering for the pubes. It is also used in the same sense as the word amnios. A'MIDUM. See Amylum. AMIN^E'A. A gum so called from Amin^ea^ place where it is produced. See Anime. AMINjE'UM VINUM. Wine of Aminala ; called afterwards Falernum, in Italy. It is a strong kind of wine. Amin^'um acetum. Vinegar of A"minaean wine, or any very strong wine vinegar. AMISA'DU. See Ammoniacus sal. A'MMA, (from xirlu, to bind). See Bracherium. AMMAN. CHAR. PLANT. The abbreviation for Ammani, Characteres Plantarum. A'MMI, (from apt?, an urinal; because it provokes urme. Sison ammi Lin. Sp. PI. 363,) or A'MMI VE'RUM; called also ammi creticum, ammi par- vum foliis foeniculi, ammi semine tenuissimo et odoratissimo,«mmzm JEthiopicum,fceniculum annuum origani odore, royal cummin, and true bishop's weed. Ammi veterum is the lagecia cuminoides Lin. Sp. PI. 294. The seeds of these plants only are used in medicine. the common sort is a native in the southern parts of Lurope; and the seeds of this species are larger, paler, and very different in flavour, as well as in medical power, from the true, which is a native of Egypt; and theseeds are of a reddish brown colour, small, and flat on one side, convex and furrowed on the other. We very rarely meet with them; the seeds of the amomum, and of parsley, being often sold for them. 1 he seedsof the true bishop weed are an agreeable carminative, of a moderately warm taste, resembling origanum m their smell. By distillation with water, they yield much oil of a yellowish colour, and contain- A MM 9; ing their wnolc flavour; spirit of wine also conveys their odour. These seeds have been recommended as emmenagogues and diuretics, but are only moderate- ly warm stomachics. A'MMION. See Cinnabaris. AMMOCHO'SIA, (from x&ims, sand, and %tu, to' pour). A remedy for drying the body, by covering it with hot sand, or salt, which is preferable. AMMONIA MURIA'TA. See Ammoni'acus sal. Ammo'nia pr^epara'ta, olim sal vola'tilis salis ammonia'ci. Ammo'nia aqua, olim sps. salis ammoniaci. Ammo'nia aqua pu'rje, olim sps. vola'tilis cau'sticus. See A'lcali volatile. There are several preparations wherein ammonia is considered the principal ingredient, and upon which, in many cases, practitioners fix their chief dependence. Linime'ntum AMMo'NiiE; volatile lini7nent.— R. Olei olivar. 5 i. ss. aq. ammon. 5 ss. m.—if re- quired stronger, loz. of ammonia is added to 2 oz. of the oil. This is an excellent, though not very power- ful, application in rheumatic affections and sore throats. Linime'ntum ammo'nia opia'tum; opiated liniment of ammonie. R. Aquae ammon. purae f ij. opii puri- ficati, 3 i- ss. sp. vini tenuioris lb i. digerantur simil donee opium omnino solvatur.—In rigid and painful swellings of the joints, this is considered as possessed of much efficacy. Linime'ntum petro'lei barbade'nsis ammoni'atum, ammoniated liniment of Barbadoes tar. R. Petrolei •Barbadensis ^ i. ss. aquae ammoniae purae § ss. m. In diseases of the hip, and other joints, this remedy is strongly recommended by Dr. Kirkland. Linime'ntum ca'mphor* ammoni'atum, ammoniated liniment of camphor. R. Aq. ammon. purge ^ iij. olei olivarum 5i. camphorae 5 ij- In °leo solvatur cam- phora, deinde adjiciatur gradatim aquae ammoniae pura. This is employed by some practitioners in deep seated inflammations, or to parts that suppurate imper- fectly, in order to quicken their action. Lo'tio ammo'nije aceta't.. 5 iij. olei sulphurati p. 5i. vel quod satis fit. Rub the quicksilver with the sul- phurated oil, until the globules disappear, then add gradually the ammoniacum in a liquid state, and mix. Five ounces of this plaster contain an ounce of quick- silver; and it is applied to indurated glandular tu- mours, in order to disperse or bring them to suppura- tion. AMMONI'ACUM. Gum. Called also armoniacum, but improperly; ha7nmoniaci lachryma, assac, azac: and in English, gum ammoniac. It is a concrete gummi-resinous juice, produced in the East Indies, and brought in masses from Ammonia, consisting of little lumps, which inwardly are very white, but outwardly yellowish or brownish; its whitest parts become yellow on being exposed to the air. From A M M what plant it is obtained we know not; but, according to Dioscorides, it is from a shrub called argasyllis. It has been supposed with great probability to be an exudation from a species of ferula; another species of which produces asafoetida. It hath a strong smell, somewhat like that of galbanum, but not so disagree- able ; a nauseous sweetish. taste mixed with a bitter- ness. Such pieces as are white, clear, dry, and large, should be preferred for internal use. Thrown on live coals, it burns away in flames; it is soluble both in water and vinegar into a kind of milk; but the resinous part, which is nearly one half of the whole, subsides on standing: spirit of wine dissolves near one half of it, taking up all its active parts. Dr. Dedier says, that lb i. of this gum, afforded by distillation of phlegm 5 vi. volatile spirit %i). a volatile fetid oil 5; vi. But other skilful chemists have failed to obtain any oil from it by this process. Water is very slightly impregnated with it by distillation. This drug has been esteemed a deobstruent, and an useful medicine in hysteric complaints; but modern practice confines its internal use to its expectorant powers in asthma, and difficult breathing: it gently moves'the belly, and externally applied with squills, it has been recommended for resolving indurated tu- mours. See Ammoniaci emplastrum cum hy- drargyro. The dose may be from gr. x. to 3 ss. three times a day, dissolved in water, when it is called lac ammoniaci; or in pills, which is the most agreeable form. It is adulterated with common resin, and the method of purifying it is, by softening it in a bladder, which is immersed in boiling water; and straining it while fluid-: but for inward use, the best is the largest and most un- adulterated pieces. AMMONI'ACUS, SAL; AMMONIA MURI- ATA; called also cyreniacus sal, ammoniac salt and armoniac, but improperly; likewise alem- zadar, ale7nzadad, adarige, aquila, alfol, alacab, alaza- let, alcob, alfatide, aliocab, alisteles, almisadar, anota- sier, hasacium, musadi. Many writers speak of the natural and artificial. The natural sort, spoken of by the ancients, accord- ing to Dioscorides, is only the sal gem, and is reckoned! by them among the alimentary salts; but others say that it was made from the urine of camels, and was de- posited in the sands near the temple of Jupiter Ammon.. We have no evidence of native sal ammoniac of this sort being found. Tournefort observes, that out of the simple native salts other compounded salts are naturally produced, viz. the essential salts, which naturally are concreted from the juices of plants, among which are native ammoniacai salts. The artificial is the only sort known and used in the shops. It is a neutral, composed of a volatile alkaline salt and the acid of sea-salt; hence the term ammonia muriata. Sal ammoniac is brought to us generally in round cakes, convex on one side, and concave on the other, from the shape of the vessels into which they are sub- limed. When these cakes are broken, the salt^appears of a needled texture, or composed of stria:, running transversely and parallel to one another: the internal A M M 94 AMM part is generally pure, and of an almost transparent whiteness ; the outside, for the most part, is foul, and of a yellowish green or black hue. j In England, this salt is obtained from burnt cows dung; it is obtainable from every species of soot by sublimation or solution. At Newcastle, it is made from the bittern, which remains after making common salt, and old urine ; from one hundred pound weight of the bitter cathartic salt, and three hogsheads of urine, fifty- six pounds of sal ammoniac are obtained. In Egypt it is made from the burnt dung of quadrupeds that feed exclusively on vegetables. This dung is collected only in the first four months in the year, when the cattle feed on spring grass, which is a sort of clover: at other seasons, and when the cattle eat other sort of food, it is unfit for this purpose. As to the camel, its excrements are not preferable to those of any other cattle which feed on grass, nor is their urine ever used. Mr. Hasselquist says, that the salt-workers in Egypt pretend, that the excrements from men, goats, and sheep, are preferable to all others; and he further tells us, that March and April are the only times in which they make this salt. See the account in his voyages. It may also be produced from A'cidum muRia'ti cum Tinct ria'ti FE RRI Ml'' IIydra'rgyrus ^-with< Sal. C. C. Ammonia, pp. Sal. fuliginis. Sp. Ammon. composi- tus. Sps. Ammoniae comp. feti- dus. Liquor C. C. Aq. Ammonia. J l_Ammonia acetata. Consequently the tine, ferri muriati, and the,hydrar- gyrus muriatus, will be decomposed by either of the preparations in the second column. The a7nmoniac salt is soluble in water and in spirit of wine, and in the air alone. It renders water extreme- ly cold during solution; and when dissolved and mixed with a vitriolic acid effervesces violently, producing a sense of cold. Its crystals resemble feathers, or long shining spicula. Mixed with a fixed alkaline salt, and then sublimed, it affords a dry volatile salt; but mixed with quick- lime, its volatile parts are only to be obtained in a liquid form. When unmixed, it may be sublimed with a con- siderable degree of heat, without the least change in its nature or properties; but if the fire is hastily raised dur- ing its sublimation, it volatilises many kinds of bodies mixed with it. On account of its sea-salt, it turns diluted nitrous acid into aqua regia, but does not curdle milk, nor alter the colour of an infusion of roses. Rubbed with quick-lime, or with a fixed alkaline salt, it emits an urinous smell, though dry. If a little hydrarg.mur. be added to its solution in lime water, the mixture becomes of a yellow colour. In soldering, tinning, and casting shot, the crude salt is much used. It becomes volatile in a heat somewhat greater than that of boiling water. Boerhaave says, thatitpreserves all animal substances from putrefaction; that its brine penetrates deeply; that it is one of the most efficacious, aperient, attenuant, and resolvent medicines, a good sternutatory, diapho- retic, sudorific, and diuretic. . When used externally as a discutient, or detersive, it is mixed with some proper fomentation, in the propor- tion of 3 vi. or 5 i to lb ij. of the liquid. It is more pungent to the taste than common salt, but is less antiseptic; it is a more powerful sudorific, and a less active purgative. In large doses, as 3 ij. it opens the belly, and in yet larger it proves emetic; it is a good febrifuge, and peculiarly assistant to the bark. In many instances, where the bark and emetics failed in agues, the crude salt given to $ i. every four hours, with an infusion of camomile flowers, for some days, then every six, and at least every eight hours, hath succeeded: it is used both as an antiseptic and a repellent in gargles; when the throat is inflamed, it powerfully dissolves viscid mucus in the mouth and fauces. In violent hypochondriac cases it hath been of singular efficacy, by a daily use of it in doses just within what are required to render the bowels lax, or perhaps in such as produce a slight looseness; after taking it six, eight, and twelve months, the cold bath hath com- pleted the cure. From 3 i. to 3 ij. dissolved in ^ viij. of any simple water, is a good substitute for the common saline mixture, and may be given, as to quantity and time, in the same manner. Dr. Cullen, however, doubts of these powers. He does not admit of its attenuating or dissolving the fluids; but, like other saline matters, in passing by the excretories it may be suited to pro- mote their discharge. With the Peruvian bark, it may be of some use as a diaphoretic ; but he doubts that in obviating the consequences apprehended from the use of the bark it can be of any service: nor does he allow that, externally applied, it has the power of discussing tumours, otherwise than by giving a moderate stimu- lus to the vessels on the surface; not by entering the pores, and by that means attenuating the viscid fluids. Materia Medica, vol. ii. Truth, as usual, perhaps lies between. Like other neu- trals, it seems to assist the febrifuge power of the bark, and prevent the latter producing the stricture on the sur- face, which sometimes occasions great inconvenience. Yet we have not been aware that it is more useful than any- other neutral. It does not act as a laxative, but in a dose that is not agreeable to the stomach, and that few will persist in. As a gargle and a discutient, however, it may act; we have found it highly useful. Mr. Jus- tamond strongly recommend the following in the cure of the milk abscess. R. Ammoniae muriatae 5 i. sps. ro- ris marini ft, i. m. Linen rags should bed ipped into this, and kept continually moist on the part affected. Am- moniae muriatae 5 ss. aceti. sps. vinosi rectificati, aa lb i. m. is also an useful application. The impurities of this salt will not dissolve in com- mon water; and the purification is consequently ef- fected by the solution and filtration. The very last crystals seldom betray any mixture of any other salt. Preparations of this drug are the ammonia prepared. Flos sa'lis ammoni'aci, which is only the salt sub- limed; and hath been called aquila albaphilosophonan, and aquila Ganymedia. Ammoni'aci vegetabilis, Sal. See Sp. Mindereri, under Alcali. AMO 95 AMP A.MMO'NIjE ACETA'TiE LINIME'NTUM. Sec Ammonia. AMMONI'TRUM,(from«wtes, sand,and vtrpot, ni- tre). In our glass-houses called frit. See Fritta. AMMO'NII COLLY'RIUM, (from aw^s, sand). A collyrium which removes sand or gravel from the eyes ; called also hygidion. It is a mere farrago. AMNE'SIA, or AMNE'STIA, xwrnx, (from x, priv. and (mvpis, meinoria). Forgetfulness. See Amentia. A'MNION, or A'MNIOS, (from x^m, a lamb, or lamb's skin). Martinus thinks it hath its name in allu- sion to xfMtov, a vessel, used for the reception of blood in sacrifice. It is also called ar7natura,agnina 77iembrana, and pellicula, charta virginea, galea, indusium, arnicu- lum. The internal membrane which surrounds the foetus. It is a fine, thin, transparent membrane, soft, but tough, smooth on its inside, but rough on the outer. Dr. Hunter says, that it runs over the internal surface of the placenta, and that this membrane, which seems not vascular in the human subject, makes the ex- ternal covering of the navel string, to which it is most firmly united ; and that viewed in a microscope, it ap- pears to have blood vessels, but they are lymphatics. It is found in all animals, both viviparous and oviparous. The fluid contained in the amnios is of a dilute white colour, transparent by filtration, with a faint smell: it contains ah albumen similar to that of the blood, muri- ated soda, and an uncombined alkali, with a small pro- portion of animal matter. In the liquor amnii of the cow there seems to be a peculiar acid, styled the amni- otic acid. Annales de Chimie, xxiii. 269. AMOGA'BRIEL. See Cinnabaris. AMO'MI. See Piper Jamascense. AMO'MUM, (from- human, Arabic, a pigeon,) whose foot it was thought to resemble. Stone pars- ley. Botanists enumerate three species, viz. the true, the bastard, and as a third sort, the tree nightshade is in- cluded. The amomum verum is also called amomum racemo- sum, caropi, elettari primum, Hort. Malab. True AMOMUM, Or TRUE STONE PARSLEY. The seed is the only part that is considered as medi- cinal, bvit it is not known whether the true amo7iium of the ancients exists or not ; the most probable account is that of P. G. Gamelli, in the Philos. Trans, which is, that the tugus, called by some birao, and by others caropi, is the genuine amomum of Dioscorides. See Dr. James's Diet, article Amomum. Many confound the amomum with great cardamom.— It is a native of China. The college of Edinburgh supply the place of the a7nomum verum with the caryo- phylli aromatici. The college of London have reject- ed it. The a7nomum vulgare is the sison amomum Lin. Sp. PI. 362, also called sinon, amomum Germanicum, sl- um aromaticu7n, bastard stone parsley. Its seeds, the only part used in medicine, are ripe in August; have a light agreeable smell, a warm, bitter- ish, aromatic taste ; and are esteemed as carminative and diuretic. They are not so hot and pungent as, by the best accounts, the true amomum seeds are, nor is their flavour of the same kind. All their virtue rises with water in distillation ; but by boiling in an open vessel, it is soon lost in the air; they yield their virtue also to spirit of wine. The third sort resembles the common nightshade. See Dale and Miller. It is also a name of the cassia caryophyllata, and piper Jamaicensis. Amo'mum cardamomum. See Cardamomum. Amo'mum scapo nudo. See Zedoaria. Amo'mum granum paradisi. See Cardamomum MAJUS. AMOXGA'BRIEL, or AMOGA'BRIEL. See Cin- nabaris. A'MOR, love, (from hamah, Hebrew, to bur7i ; or am, a 7nother ; because love is the natural passion of mothers to their children). Though not itself a dis- ease, it produces diseases. The symptoms produced by love are as follow : the eye-lids often twinkle, the eyes are hollow, and yet appear as if full with pleasure; the pulse is not peculiar to the passion, but the same with that which attends so- licitude and care ; when the object of this affection is thought of, particularly if the idea is sudden, the spirits are confused, the pulse changes, and its force and cele- rity are very variable: in some instances the person is sad and watchful; in others, not conscious of his state, he pines away, is slothful, and regardless of food ; though the wiser, when they find themselves in love, seek pleasant company and active entertainments. As the force of love prevails, sighs grow deeper, a tre- mor affects the heart and pulse, the countenance is al- ternately pale and red, the voice is suppressed in the fauces, the eyes grow dim, cold sweats break out, sleep absents itself, at least until the morning, the secretions become disturbed, and a loss of appetite, a hectic fever, melancholy, or perhaps madness, if not death, consti- tute the sad catastrophe. .Eginet. lib. iii. cap. 17. Oribas. Synop. lib. vii. cap. 9. or a treatise professedly written on love, as it is a dis- temper, by James Ferrard, Oxford, printed 1640. AMO'RIS PO'MA; also called lycopersicon, sola- rium pomiferum, 7nala aurea ; love apple. Solanum lycopersicum, Lin. Sp. PI. 265. It is a species of so- lanum about the size of a cherry, green at the first, and of a yellowish red colour; the flowers resemble those of nightshade ; the fruit is fleshy and soft; it contains many flat whitish seeds in a juicy pulp. The plant flowers in July, and the fruit ripens in Sep- tember. Their quality is cooling. In Italy they are eaten with oil and vinegar. See Miller Bot. Off. AMORGE, (from x^tpyu, to press out). See Amurca. AMO'STEUS. See Osteocolla. AMO'TES. See Battatas Hispanica. AMPE'LIOX, (from x^-xtXoi, a vine). Vine LEAVES, Or THE TENDRILS OF VINES. HippOd'ateS commends them for making pessaries to promote the menses. AMPELI'TIS, (from the same). Cannel coal. Named also terra or lapis ampelites,pharmacitis, obsidi- anus lapis, carbos. This species of coal is a bituminous earth, black as jet, and so hard that it takes a good polish, and is made into boxes, basins, and various other utensils. It con- tains much sulphur and salt, is divided into sca.es and AMP 96 AMP easily powdered ; when old, that is, when long kept after taking it out of the mines, it falls into powder, and then yields a quantity of saltpetre. It burns more bright than any other kind of coal: powdered and strewed upon vine trees it destroys the worms that injure them, hence its name: it is rarely used in medicine, but is commended as being more dry- ing than terra Samia, or than many of the earths that have been employed with credit in medicine. AMPELOCA'RPUS, (from x^eXo?, a vine, and xxpx-os, fruit,) so called, because its seeds resemble the young fruit of the vine. See Aparine. A'MPELOS. See Bryonia. AMPHARI'STEROS, (from «jk?«, both, and xptT- repoi, the left hand). It is the reverse of ambidexter, that is, not having a proper use of either hand. Figu- ratively it signifies unlucky or unfortunate. AMPHEMERI'NOS, AMPHEMERINA. It is the continued fever of Linnaeus and Vogel, (from xy., necto. Blanchard says that they are medicines which, being tied about the neck, are believed to expel diseases, especially the plague. The royal touch was ridiculously said to cure the king's evil.- Charms seem to have imposed a belief, that those who were exercising them were particularly favoured by some superior being. This gave the world a vener- able idea of the practitioner; and as the mind affects the body, the persuasion of the patient might some- times contribute to a cure. Yet it has happened that this supposed amulet may have some virtue. We mean not to allude to quills of quicksilver and arsenic worn about the neck, the eel- skin tied about the legs to prevent cramp, or the stones worn against haemorrhages; but the essence vessels hung round the neck, the xxphotyvXxxx of the Greeks, if filled with any very volatile aroma, may have been useful in guarding against contagion. Even the camphor, if not too closely confined, may have - some-effect; and we remember being told by a former recorder of London, that he found it imparted some warmth. The aromatic vinegar and the attar of roses diffuse a very sensible perfume, however closely shut up ; and M. Morveau's antipestilential box, which con- tain ingredients that, on the access of the atmosphere, act on each other, producing a copious exhalation of pure air, though as an external appendage it may rank with amulets, must have a certain and powerful effect. AMU'RCA (from afupY't t0press out). Amorge and bysma arc probably the same. It is the sediment from olive oil, found after the newly pressed oil hath deposited its gross contents. A'MYCHE, (from x^vrro, to scratch). A superfi- cial exulceration, or scarification of the skin. AMY'CTICA. Stimulating, vellicating. See Amuctica. AMY'GDALiE, (xtcvyS'xXev, almond,) almonds. The fruit of the amygdalus, almond tree. A C07n- munis and 7iana Lin. Sp. PI. 677. Amy'gdalje ama'rje. Bitter almonds. Amy'gdalje du'lces. Sweet almonds. The leaves and flowers of the almond tree resemble those of the peach tree, a species of the same genus, a. persica Lin. Sp. PI. 676. It is a native of Africa, and flowers earlier in the spring than most other trees, though its fruit is not quite ripe until autumn. Of the fruit we have two sorts, the sweet and the bitter; which are varieties, only changing these quali- ties with the soil. It is the a7nygdalus cormnunis Lin. Sp. PI. 677. The almonds from Barbary, where the tree is indigenous, are bitter, while those cultivated in Europe are sweet. The bitter matter resides in the mucilage, and dis- solves with a little heat in water and in spirit of wine : a part arises with both in distillation; but spirit seems to extract, and water to elevate, the greatest quantity. A simple water may be distilled from them after the oil is pressed out, possessing the same qualities as that drawn from cherry stones. It is not, however, at pre- sent employed. The flavour, when required, is obtain- ed from peach or laurel leaves. The distilled water of bitter almonds is strongly im- pregnated with the noxious matter which gives them their bitterness and flavour. It seems by some late ex- periments to consist of the Prussic acid, and may prove a poison, as is the case with the common laurel, to which it appears extremely analogous. Four or five bitter almonds are commended as anthelmintic, taken in a morning fasting: they are said to be diuretic, but occasion sickness and vomiting; to dogs, foxes, fowls, storks, horses, especially while very young, to pigeons, cats, and some other animals, they are poisonous. The sweet kind should be chosen free from ranci- dity ; and, if in the shells, from all appearance of in- sects, a species of which penetrates them, and destroys the kernel. They digest with difficulty, and afford very little nourishment, unless extremely well comminuted. As a medicine they obtund acrimony in the primze viae, are softening, and relaxant. They are a good interme- dium for uniting with water several substances, which of themselves are not miscible with it: camphor, and many resinous substances, triturated with almonds, easily dissolve into a milky liquor. For this purpose the almonds must be freed from their skin, but it should not be by infusing them in hot water, as this separates the oil. A longer infusion in cold water is preferable. Six or eight sweet almonds peeled sometimes cure the heart-burn; and one or two almonds at most will-mix five or six grains of camphor or resin. Sweet almonds are usually blanched, i. e. freed from their skin, by steeping them in hot water until it easily slips off: then triturated with water, their oil unites therewith, by the mutation of their mucilaginous and farinaceous matter, into an emulsion or milky liquor. AMY 103 ANA The pure oil of almonds, triturated with a thick mu- cilage of gum arabic, forms a more permanent emul- sion than the milk of almonds of the dispensatories ; from which the oil does not separate either on standing two or three days, or on the addition of a moderate quantity of acid. One part of gum, made into muci- lage, is enough for four parts of oil. The white of egg, or syrup, with a little spirituous water, will form an emulsion, but less perfect than the gum. R. Gum arab. pulv. 3 ss. aq. distillatae 3 i- f mu- cilago per trituram, et adde ol. a7nygd. 3 i. ss. sacch. alb. ^ ss. postea paulatim adde aq. distillatae Jfe i. f. emuls. If to this emulsion half an ounce of gum arabic be added, it is .called arabic emulsion; if half an ounce of chalk, it is named the absorbent emulsion ; if half a drachm of camphor, it is called the camphor- ated emulsion. The emulsions partake of the quality of the oil, and are prescribed with the same intentions, particularly relieving heat of urine and the strangury, whether from spontaneous acrimony, or irritating food or medi- cines. These emulsions, on standing, throw up a cream, and the whey beneath turns sour. Acids joined to them form curd and whey, as in milk. The milky solution of almonds in water, though con- taining oil, may be given in acute and inflammatory fevers, without danger of the ill effects which the oil by itself may produce, since emulsions do not become rancid, or acrid by heat; and in most cases the aces- cency is rather an advantage in the emulsion. The expressed oil of almonds is obtained from the sweet or the bitter sorts equally. The oil of bitter al- monds was called metopium, because the Egyptians used to make an oil in which bitter almonds and galbanum were ingredients ; and they named their compound, oil of metopium, from the plant that affords the galbanum : others give the same name to the simple expressed oil of this fruit. By bruising and pressing the almonds, they afford nearly one half of their weight in oil: by boiling them in water, part of their oil separates, and is collected on the surface; but that obtained by pressure, without heat, is the most agreeable. As a medicine, this oil is useful externally; like that of the olives and linseed, it is used to soften and relax the skin; internally, to sheathe acrimonious bile, or other fluids, to relieve a tickling cough, hoarseness, costive- ness, or nephritic pains. Oils are given in the form of emulsion, the proportion of two ounces to half a pint of water, and sweetened with half an ounce of some agree- able syrup. Draughts of manna and oil of almonds, at the same time using the common emulsion as the usual drink, are of service in the gravel, and in dysuries. The tenesmus, to which some pregnant women are subject, and which endangers abortion, is most speedily relieved by clysters of it, with a few drops of laudanum. The- besius thought that he found good effects from almonds in hydrophobia, and Bergius speaks of the emulsion of bitter almonds curing obstinate intermittents after the bark had proved unsuccessful. AMY'GDALiE, and Amygdalia. See Tonsill.e. AMYGDALA'TUM. The emulsion of almonds. AMYGDALOI'DES, (from xpvyfxXov, almond, and ufoz, forma,) also COMETES. Thus Oribasius caUs the species of tithymalus, which is named tithymalus masticus. It is a name for the white species of the gum ben- zoin, and of a stone resembling the kernel of an almond in figure, which is the petrified spine of the echinus ma- rinus, or.sea urchin. It is also a name for the gobius or gudgeon. AMYGDALO-PE'RSICUM, (from xpvyfxXov, and Triprixov, the peach). The Almond peach. AMYGDA'LUS SI'MILIS, GUATIMALE'XSIS. See Cacao. AMY'LA. Anv sort of chemical faecula. A'MYLI TROCHI'SCI. See Bechica. AMY'LUM. AMY'LEON. AMY'LIOX. (From x, neg. and /k.uAjj, a mill, because it is made of corn with- out a mill, or without grinding). It is the faecula of wheat, and with us called starch ; named also amidum. It is the purest farina of the wheat, but deprived of its gluten; and made also from potatoes. It was invent- ed in the isle of Chios, and is valued according to its lightness, newness, and smoothness. Starch is often very useful as a mild glutinous astrin- gent, and, mixed with milk, an excellent aliment in fluxes and catarrhs ; 3 i- of starch dissolved and boiled in ^ iij. of water, with a little sugar, forms an elegant jelly, of which a table 'spoonful.may be taken every hour. If dissolved in thin gruel, it is lenient, incrassat- ing, and of service against sharp defluxions, hoarseness, a dry cough, spitting of blood, diarrhoea, dysentery, in- ternal ulcers, heat of urine, gonorrhoea, Sec. In diarrhoeas and dysenteries, when the stools are bloody, and the intestines relaxed, the following far ex- cels astringents, or any other kind of clysters : R. Gelatin ex. amylo.J^ iv. extract, thebaic gr. iij. Sp. vini. Gallic, opt. 3 fi vel. 5 i. m. enem. pro re nata injiciendum. In spasmodic affections of the neck of the bladder, and in that distressing sense of weight and uneasiness, when, in gonorrhoea, the prostate gland is affected, the former clyster of starch, with opium, is an useful re- medy, omitting the spirit. A'MYON, (froma, priv. and y-'-s, a iriuscle). A limb so emaciated that the muscles scarcely appear. AMY'RIS OPOBA'LSAMUM, and its variety. Bal- samea Gileadensis Wildenow, 334, vol. ii. Amy'ris Gileade'nsis. See Balsamum. AMY'RIS elemi'fera, Lin. Sp. PI. Ed. Wildenow, 495. See Elemi. Amy'ris Zeylo'nica, (gum. elemi orientalis,) Wilde- now, 33 4. Amy'ris ambros'iaca, (see Ambergrise,) Wild. 335. This species yields an odoriferous balsam from its wounded trunk or branches, a dram of which is taken in red wine, it is said, with advantage in the dysentery. The a. balsa7nifera Wilden. is- full of aromatic par- ticles, and the berries have the taste of balsam copaiba. It is a tree found in the island of Jamaica. AMYTHA'ONIS, Empl. Amythaon's plaster. . R. Gum ammon. cer. flav. gum bdel. aa3 viij. tereb. rad. irid. illyr. gum. galb. aa. 3 xx. m. A'XA, signifies of each. Thus take of aloes, frank- incense, myrrh, a. or a.3. (that is, of each) 3 i. ANA'BASES, (from xwSxtw, to ascaid). See Ac masticos. ANA 10+ ANA AXAB ATICA, (from the same,) applied to con- tinual fever, when it increases in malignity. See Sy- nochus. ANA'BOLE,(from xvxtxXXa, to cast up). The dis- charging anv thing bv vomit. ANABROCHI'SMOS, (from xm, -sursum, and PpoXe$> a noose). An operation performed on the hair of the eye-lids, when they are offensive to the eye. ANABRO'SIS, (from auaGputrxat, to devour). A cor- rosion of the solid parts by sharp humours, or any me- dicine. The same as diabrosis; it occasions a discharge of blood, and often happens in the lungs. ANACA'MPSEROS, (from xvx%x[*.7r]a, to bring back; and tpu to purge upwards). Under this title the effects of emetics, masticatories, sternutatories, &c. are included. ANACATHA'RTICA. Medicines producing ana- catharsis. ANACHRE'MPSIS, (from «v«, upwards, and %pt- pefiLTOfMci, to hawk). The hawking up any thing from the lungs. ANA'CHRON. See Anatron. ANA'CLISIS, (from xvxxXtva, to recline). Hippo- crates uses this word to express the reclining posture of the sick. It also means a couch or sick-bed. ANACL'ISMOS, (from the same). That part of a chair on which the back of a sick person leans. ANACCELIA'SMUS,(from*v«, and xotXtx, venter). A remedy used by Diodes, which seems to have been gentle purging, with a view to relieve the lungs. ANA-COLUPA. An Indian plant mentioned in the Hortus Malabaricus, whose genus is not determined. Its juice is said to be useful in epilepsies, and to cure the bite of the naja. ANACOLLE'MA, (from xixxoXxu, to agglutinate). It is the same as frontale, only that it is always made of agglutinants or drying powders. Junker describes an anacollema frontale for stopping bleeding of the nose. See Cataplasma. ANACOMI'DE, (from xixxoftigu, to repair,) to re- cover a person after sickness. ANACTO'RIUM. See Gladiolus. AXACY'CLEI, (from xvxXoa, to wander about). Circulatores, mountebanks. See Agyrt-e. ANACYRIO'SIS, (from «»*, and xvpos, authority). Hippocrates, in his treatise on decency, advises physi- cians to keep up their authority, and the dignity of their profession, which he expresseth by this word. ANADENDROMA'LACHE, (from taufnS'p*, a tree, and fixXxy?,, the mallow). See Althea. ANADIPLO'SIS, (from «v«JWa, strength). Weak, effeminate. Hippocrates uses this word as an epithet for the Asiatic nations. ANAL'DES, (from x, neg. and «A&«, to increase). Not increasing. Hippocrates applies this word to Iruits growing about the river Phasis. ANALE'NTIA. A species of epilepsy mentioned amTt £U*' A corruPtion of the word analepsia. ANALE'PSIA. Johannes Anglicus and Riverius give this name to the species of epilepsy which pro- ceeds Irom a disorder of the stomach. It is sometimes SyANTT°F'^we?rilepSyin g^eral- See Epilepsia. rviN all rata, ^irom xvxXxp&xvu, to recover and re- gain vigour after sickness). Hence, ANALE'PTICA. ANALEPTICS. Such remedies ANA 105 ANA as exhilarate the spirits, and restore flesh and strength. See Cardi'ca and Restaura'ntia. Dr. Cullen says, they are medicines suited to restore the force of the body when lost, and are sometimes stimulants; but more commonly nutrients. The term he considers as attended with ambiguity, and thinks that it should be rejected. Besides the nutritious quality of restoratives, they are supposed to have a fragrant, subtile, oleous principle, which immediately affects the nerves, warms and sti- mulates the whole system. No such principle, how- ever, exists; at least no such has been discovered. In diseases, the speediest way to restore strength is to remove the causes of debility; but this is not to be done by medicines, which increase only the vital heat; for in convulsions and fevers the motions are very strong, and yet the natural strength is languid. True strength, however, depends rather upon proper-aliments, turned into wholesome blood; the only source of firmness and vigour. Cordial flowers and herbs, musk, ambergrise, oil of cinnamon made into olea sacchara, chocolate, shell-fish, &c. are the supposed analeptics; but they are only such as stimulating nutrients. ANALGE'SIA, (from x, neg. and xXyos, pain). Indolence, or absence of pain or grief. A state of ease. ANALO'GIA, (from xvx, per, by, and Xoyos, ratio, reason). Analogy. It is the mode of reasoning of things not perfectly known, by comparison with others which are better understood, and drawing conclusions from their similitude. See Botanical analogy. ANA'LTHES, (from «, neg. and xX6ea, to cure). Incurable. ANA'LTOS, (from x, neg. and xX$, salt). U.\- SALTED. ANA'LYSIS, (from xvxXvu, to resolve). In chemis- try it is the term used for decompounding any mixed body, and reducing it into its constituent parts. The chemists make use of two modes of analysis: 1. by fire; 2. by menstrua. Indeed the modes of decompounding bodies are all founded on the difference of the proper- ties belonging to the various principles of the body to be analysed. Suppose, for instance, a body to be com- posed of several principles, possessed of different degrees of volatility, the volatile parts will rise in proportion to the degrees of volatility which they possess on the ap- plication of heat; and if any are fixed, they will remain in the retort of crucible. This is called analysis by fire. But when a body is compounded of several sub- stances, one of which, for instance, is soluble only in spirits of wine, a second in water, and a third in aether, these substances may be very easily separated from each other, by submitting successively the compound to the action of these menstrua. This is called the analysis by menstrua. See, on this subject, Macquer's Che- mical Dictionary; Memoirs of the*Royal Academy of Sciences, for the years 1719, 1720, 1721 ; Elements and Principles of Chemistry, by Lavoisier, Fourcroy, Chaptal, and Thomson. In anatomy, the dissection of the human body is call- ed analysis. ANAMNE'STICA, (from xvx, and f*.vxo/*xi, record- er, to remember). Medicines supposed to improve the VOL. I. memory, or restore it when lost. We need not add, that the power of such medicines is imaginary. Anamne'stica signa. Commemorative signs; signs which discover the preceding state of the body : as demonstrative signs shew the present state; and prognostics shew the future state. ANA'NAS. The Brasilians call it yayanna. The pine apple. The bromelia ananas Lin. Sp. PI. 408: called also carduus Brasilianus. Mons. Le Cour, of Leyden, was the first Avho raised this fruit in Europe: they were brought from the East Indies to the West, and from thence into Europe. It resembles the cone or fruit of a pine tree, and from thence takes its name; the richness and the flavour of the fruit are well known. It is, however, cold, watery, and indigestible. See Aliment. Ana'nas, wild. See Karatas. Bromelia karatus Lin. Sp. PI. 408. ANA'NDROI, (from «, non, and xn%, vir). Hip- pocrates applies this word to women who have never known men. ANA'PALIN, (from uvx, and irxXiv, rursus). On the contrary side; as if nature endeavoured to free her- self from some disease, by her exertions on the side op- posite to that wherein the affection arose. It is opposed to Cati'xis, which see. ANAPHALANTI'ASIS, (from xvxQxXxvt<&, a bald person). Baldness of the eye-brows. ANAPHONE'SIS, (from xvx, and , vox). A species of exercise which consisted in vociferation. It is supposed to increase the natural heat, improve the appetite and digestion, and to be useful to the phleg- matic and cachectic. Singing is a gentler exercise. See Hieron Mercurialis De Arte Gymnastica.. ANA'PHORA, (from xvxtpepa, to bring up, or up- wards). Hippocrates uses it for thanks due to an obli- gation. Any discharge from the mouth. ANAPHO'RICOI, (from the same). Those who spit blood; or, according to Actuarius, those who spit .with difficulty. ANA'PHRA, (from x neg. and xtpgo?,froth). Hip- pocrates uses it as an epithet for stools that are not frothy. ANAPHRODI'SIA, (from x, neg. and x?poh,ta wash out). When faulty humours rot the bone so that it falls out of its joint, as happens sometimes in the jaw, this tenn is em- ployed by Hippocrates. In Vogel it implies the scaling or separation of the carious parts of a bone. ANAPNEU'SIS, (from xvx7rvea>, to respire). Res- piration, perspiration. Aretaeus uses it to express a truce from pain. ANAPODOPHYL'LON, (of anas, a duck, vovs, a foot, and QvXXov, a leaf). Duck's foot; so called from its resemblance; or pomum Maiale, May apple: called also podophyHumpeltatum,aconiti folia, Lin. Sp. PI. 723. The Americans call it black snake root. It bears the hardest winter in an open ground, and is increased by parting the root in August. ANAPSY'XIS, (from xvx^v%a, to make cold). Re- frigeration, i. e. cooling. ANARAPHE, (from xvx, and pxxpov, an eye-lid). A disease of the eye which closes the eye-lids. Sometimes the eye-lids grow together, and also to the tunica albuginea of the eye, from carelessness when there is an ulcer in these parts. Both these cases were called ancyloblepharon by the Greeks. This disorder derives its origin from glutinous dis- charges, such as attend most ophthalmies; chiefly in ulcerated eye-lids, and is prevented by warm milk, and absorbent or abstringent powders. If the coalition is a perfect concretion of the palpebrae with each other, or with the eye, there is sometimes a small aperture, which is generally in the great angle of the eye; if there should not be any, a perforation must be made in either angle, a probe with a groove then introduced, and with a fine edged knife let the parts be separated. If the eye-lids adhere to the globe, they must be care- fully divided from each other; being more sparing of the eye-lid in the operation than sclerotica. If the ad- hesion is only to the conjunctiva, blindness is not the consequence; if on the cornea, the sight is generally lost. This may be supposed to happen when the disease has arisen from a cause that affects the whole eye, as a violent burn, hot lime, or any other acrid fluid in the eye. In this case the cornea adheres to the eye-lid, and the ball of the eye feels collapsed; a strong light cannot be perceived through the lid, and the motion of the ball of the eye cannot be distinguished. This kind of adhesion is sometimes called symblepharon, and it is often firm and fleshy. If the adhesion is not to the cornea, it may be separated by the knife; but the greatest caution is necessary not to injure the sight. No directions can assist the operator, who must be left to his own judgment and dexterity. If the adhesions are chiefly membranous, a blunt knife only will easily sepa- rate them, with little danger. Hildanus attempted the separation by passing a silk, with the assistance of a probe, into the eye at the external canthus, and out of it at the internal; the ends were joined, and a small bit of lead suspended, whose weight gradually, and with little inconvenience, separated the agglutinated parts. This method however is chiefly useful in the slighter cases, and would have little effect when the adhesions were general to the ball of the eye. The re-union is better prevented by injection, or lint placed between the eye-lid and ball of the eye, after dipping it in some mild liniment, than by a plate of lead, as recommended by Sauvages; as that might, from its hardness, bring on inflammation. When the eye-lids adhere slightly, and the complaint has not been of long duration, they may be separated, according to Mr. Bell, by the end of a blunt probe in- sinuated behind them, so as to tear them asunder; but when they adhere firmly, or to the eye-ball, he advises slow dissection of every adhering fibre, and then the eye only to be covered with a piece of soft lint spread over with Goulard's cerate, or any other cooling emol- lient ointment; and after the first dressing, a small por- tion of the same to be daily insinuated between the eye- lids. Perhaps, in preference to all others, one part of mercurial ointment, with four parts of axunge, may be introduced twice a day : the parts may be bathed twice a day, also, with a weak solution of the zincum vitriola- tum purificatum, or cerussa acetata. When the whole eye-lid is closed, a slight opening may be made at either canthus to introduce the probe and divide the eye-lid through its whole course, and the divided edges should be dressed with Goulard's cerate, or any other cooling application. The eyes should not be kept long shut; and, even after the first nap, they should be opened and the dressing renewed. See Wallis's Nosologia Methodica Oculorum, p. 51. Bell's Surgery, vol. iii. p. 297. Cullen's First Lines, vol. i. p. 271. edit. 4. ANCYLOGLO'SSUM, (from xyxvXes, crooked, and yXurex, the tongue). A contraction of the ligaments ol the tonge : tongue-tied. Vogel defines it to be an adhesion of the tongue to the adjacent parts, so as to hinder sucking, swallowing, and speaking. Some have this imperfection from their birth, others from some disease. In the first case, the membrane which supports the tongue is too short or too hard; in the latter, an ulcer under the tongue, healing and form- ing a cicatrix, will occasion it; these speak with some difficulty, and are called by the Greeks f*.oytXxXot. See MOGILATIA. AND ill AND The ancyloglossi by nature are late before they speak, but when they begin they soon speak properly ; these we call tongue-tied, and the membrane which confines the tongue may be cut with scissors, being careful not to extend the points of the scissors so far as the fraenu- lum. When the child's tongue is tied, he does not suck freely, he loses the nipple very frequently, and whilst sucking he makes a chucking kind of a noise. The instances rarely occur which require any kind of assist- ance ; for if the child can thrust the tip of its tongue to the outer edge of its lip, this disease does not exist; and if the tongue is not greatly restrained, the fraenulum will stretch by the child's sucking and crying. Besides, without an absolute necessity, which scarcely ever ex- ists, an operation should not be admitted; for without great circumspection, by cutting the fraenulum, the nerves passing there may be also cut, and a loss of speech be the consequence. Sometimes the tongue is bound down with a fleshy substance, which should never be cut through, because a dangerous haemorrhage might follow, without any attending advantage. It is advisable only to direct the nurse, now and then, to stretch it gently by a light pressure on it with her finger. When, in consequence of delivering a child by the feet, a swelling is observed under the tongue, nothing is required, for the tumour will soon subside. See Hildanus in Cent. iii. Obs. 28, where he gives an accurate account of the nature, cure, and bad effects that may follow on improper methods being used for the cure of this disorder. He never cuts more of the fraenum than appears ligamentous, and then orders it to be gently rubbed two or three times a day with honey of roses. Bell's Surgery, vol. iv. p. 336. If the tongue is too loose, by the fraenum being too long, or not car- ried sufficiently near the apex, no remedy can be em- ployed. The only inconvenience arises from the child, in attempting to suck on waking, inverting the tongue, - the point of which suffocates him. This must be cau- tiously guarded against, or the tongue bandage of Petit may be employed. ANCHYLOME'LE, (from xyxvXos, crooked, and wXy, a probe). A crooked probe, or a probe with a hook. ANCYLO'TOMUS, (from xyxvXv,a hook, and re^va, to cut). Any crooked knife used in surgery. ANCYROI'DES, a process of the scapula, so called from xyxvpx, uncus, a beak or hook, and eifos, form. See Coracoides processus. A'NDA, probably the same with Andira, q. v. ANDE'NA. Steel which melts in the fire, and may be cast into any form. ANDHU'RA. See Andira acu. ANDI'RA, called also ange/yn et arbor nucifera. It does not occur in the system of Linnaeus. It is a tree which grows in Brasil, whose wood is proper for building. The fruit is a yellow kernel; it is bitter, astringent, and, if taken inwardly, it destroys worms; 9 i. of it in powder is a dose. ANDRA'CHNE, (from xvnp, a rnan, and *#»*, froth,) so called because it was supposed to increase the semi- nal fluids. See Portulaca. ANDRANOTOMIA, (from xvnp, a man, and rcfcva), to cut). The dissection of a male subject. A'NDRAPHAX,orANDRAPHA'XIS,(from«ty»«, quickly, and xv%u, to i7icrease,) so called from its quick growth. See Atriplex fcetida. A'NDRIA, (from xvr.p, a man). See Hermaphro- ditus. A'NDRIUS, manly, (from xv*,p, a man,—strong). It is metaphorically applied to strong wine, or wine from the island of Andros. ANDROGENI'A, (from xv»p, a man, and ytivxa, to generate). A succession of males. ANDRO'GYNE, > (from xvtjp, a man, and ywn, a ANDRO'GYNI, 5 woman). Effeminate men, and HERMAPHRODITES. See GYNANTHROPUS. ANDRO'MACHI THERI'ACA. This medicine of Andromachus hath above sixty ingredients in it. It is needless to repeat the universal good ascribed to this composition by its author; or its high reputation in consequence of its being considered as an antidote to all poisons. See Alexipharmica. So many drugs were crowded into one medicine, that a concurrence of similar ingredients might be more effectual; but, according to Pliny, it was only to make people more confident in their favour. An idea indeed seems to have prevailed in the middle ages, that numerous ingredients rendered a formula better adapt- ed to a variety of diseases. From the number of poison- ous plants sometimes used in such remedies, it seems to have been also an object to accustom the constitu- tion to their effects, so that, at other times, they may be harmless. The treacle of Andromachus is called Venice trea-- cle, because great quantities of it were made there, and conveyed to other countries. It is now disused. ANDRO'NION ; i. e. Andronis pastilli, the troches of Andron. They are made with alum, balaus- tines, &c. ' ANDROPHAGE, (from xvtip, a man, and pxyeiv, to eat). Man-eaters, cannibals. A few nations of this savage disposition still exist; - and the inhabitants of New Zealand, our antipodes, are certainly such. ANDROPO'GON NA'RDUS. See Nardus Ita- LICA. Andropo'gon sch.ena'nthus. See Juncus odo- RATUS. ANDROS A'CE, tubulana acetabulum, and also called umbilicus marin. cochlea ctzlata, acetabulum marinum minus, fungus petreus marinus, cotyledon 7narina, and sea navel-wort. It is a sub-marine production, found on the rocks and shells of fishes about the coasts of the Mediterranean. It consists of numerous, slender, short filaments, more or less bent or arched, of a whitish or gray colour, hard and brittle, bearing each upon the top a stria- ted concave body, nearly of the figure of an inverted cone. In powder it is given as a vermifuge and diuretic. It does not differ from coralline. In the flame of a can- dle, when dry, it yields a dazzling brightness, and the coralline does the same. ANDROSACES, summer navel-wort. A plant on the sea coasts of Syria. It is called an- drosace, (from xvrp, man, and xko$, a cure.) Two drams of this herb, or of its seed, taken in wine, powerfully promote urine. The species is un- certain. ANDROSjE'MUM, or ANDROS.fi'MOM.7/^- ri*um, androsemum, Lin. Sp. PI. 1102. Also called Siciliana, cly7nenum Italorum, ascyrus, ascyos, hyperi- A N E 112 A N E cum, ciciliana, dionysias. In English it is named tut- san, or all-heal, park-leaves, and st. Peter's wort. It grows in hedges and thickets. Two drams are mo- derately purgative, but it is rarely used. The name androsamum is from xvrip, a man, and xtf^x, blood, for it makes the fingers red if they rub it. Tut- san is a corruption of the French words, tout-sain, which signifies all-heal. ANDRO'TOME. See Andranatomia. ANDRUM, an endemic disease on the coast of Malabar. It is called in the language of the country the popular water rupture, and is in reality Hydro- cele, q. v. The disease is supposed to arise from the brackish water, and is preceded by an erysipelas of the scrotum. It is prevented by putting at the bottom of the wells some pure sand, through which the water fil- ters, and is rendered more pure. The partial remedy of tapping is the only one employed, and this is fre- quently repeated. ANDSJUDjEN. See Asafoetida. ANE'BION, (from xvxQxivu, to ascend,) so called from its, quick growth. See Anchusa. ANECPY'ETUS, (from «,neg. and txmtlty suppu- rated,) not admitting of suppuration. ANEILE'MA, or ANEILE'SIS, (from xveiXea, to roll up, or involve). An involution of the bowels from flatulence or gripes. ANE'MIA, (from xvtp.os, wind). The name of a dis- order which Hippocrates mentions, but does not de- scribe; probably flatulence. ANEMO'NE,(from xvtimvo$, wind,) so called because it will not open its flowers till blown upon by the wind. Wind flower, or corn rose. Called also phenion. A. hepatica Lin. Sp. PI. 758. The root of the scarlet anemonies is detersive if bruised while fresh, and ap- plied to ulcers, and on the skin it raises blisters. The her,b hath been used in collyriums and errhines. See Hepatica nobilis. Anemo'ne Pulsatilla. See Pulsatilla nigri- cans. ANEMONOTDES, (from xvepAvv, the wind flower, and ftfos, forma,) also called memorosa, ranunculus, phragmitis albus vernus. The wood anemone; resem- bling in virtues the garden anemone. ANENCE'PHALOS,(from x, neg. and tyxt Q ANE 114 ANE muscles of the shoulder and arm, constituting the dif- fused aneurism: in this case the arm becomes livid from the ecchymosis, and the blood coagulating, ob- scures any sensible pulsation. In the false kinds of aneurism, the cyst is probably formed of a portion of the aponeurosis that runs over the vessel, which, from extravasated blood underneath, is thickened and expanded: that this membrane is the cyst, seems to be confirmed by our so readily discover- ing the puncture in the artery upon opening the tumour; or it may be formed of the cellular membrane, which admits both of thickening and expansion. In the varicose aneurism, the vein that was punctured will become varicous, and will have a pulsatile jarring jnotion, on account of the stream from the artery; there will be a hissing noise, which will be found to corre- spond with the pulse ; and the blood in the tumour will be almost entirely fluid, because it is kept in constant motion : it is soon formed to its largest size, and so re- mains, if not disturbed by imprudent management: no considerable inconveniences arise from it. This sort of aneurism may be further known by placing a finger over the orifice in the artery, where the stream of blood pro- pelled into the vein at every pulsation is felt: by apply- ing the ear to the tumefied vein, a tremulous motion and noise are perceived; by pressing the corresponding artery, this motion and noise cease; and on the removal of this pressure, the motions, &c. return; the artery becomes larger in the arm and smaller in the wrist; the vein being emptied by pressure, instantly fills again on taking the pressure off; the pulse at the wrist grows weaker as the artery above enlarges. The beginning aneii7'is?n in the aorta should be dis- tinguished from a palpitation of the heart; from hyste- rics, in which symptoms of suffocation sometimes at- tend; from fever with fainting, both which are some- times the consequence of false aneuris7n; from varices of the_veins and their effects; from an emphysema; from an ecchymosis; from encysted swellings in the neck, in which is often perceived a strong pulsation from the stroke of the adjacent artery; and from tumour formed in consequence of ruptured veins. The aneuris7n of the aorta may prove fatal by injuring the general health, as it continues to increase in its size; it may be supported during many years, but no cure can be attempted, nor other palliatives used than what consist in composure of mind and quietude of the body. All aneuris7ns are incurable that lie too low for the operation; and, if unadvisedly opened, the patient's life is in immediate danger; for bandages, which are the only palliatives in such cases, are but uncertain aids. The diffused aneurism is not only subject to haemorr- hages, but also to mortification. The method of cure is the same in the true, the false, and the mixed aneurisms : the varicous needs but little, if any assistance: if it is enlarged by exercise and be- comes painful, indulge a little rest, and moderate the future labour; perhaps bathing the part with a little spirit may afford some relief, but bandages and all other pressure must be avoided. To palliate, when the operation is impracticable, bleed as often as is required to keep the force of the circulation moderate; let the diet be temperate, and the exercise very gentle; keep the bowels constantly free; where pressure is used, it must be such as only lessens the force of the blood, but does not resist it; flannel bandages, or knit stockings, &c. are the most proper for this purpose. But all pressure should be avoided when the aorta is the seat of the aneurism, however the tumour may appear externally : it is true that, if the integuments give way, and the coagulum formed on the inside of the tumour hath lost its support, the assistance of a bandage is immediately necessary, as it is the only means to prevent a fatal haemorrhage; in this dilemma, if the substitutes to the integuments are judiciously applied, and accompanied with such topical medicines as resist both suppuration and putre- faction, the life of the patient may be preserved for some time. In one instance, recorded in some of the Medical Observations, where several aneurisms occurred in the lower extremities, the blood lost by the bursting of one cured the rest. This circumstance might lead us to try active bleeding in true aneurisms. When the operation can be admitted, it is advisable first to attempt the cure by compression, because it sometimes proves effectual; is always a good prepara- tory step to the operation, by its enlarging the collateral anastomosing branches, and disposing the part to have a more free circulation after the division of the artery: but when the tumour is large, the palliative method should not be long continued, because it injures the neighbouring parts, and will occasion more inflamma- tion and sloughing when the operation is performed. The pressure, whether before or after the operation, should be confined as much as possible to the affected part, that the passage of the blood through the anasto- mosing vessels may be free; by which we may prevent the mortification that sometimes ensues from a want of a free circulation. Some few instances of small aneuris7ns, and punctures of the artery from bleeding, have succeeded by the use of a bandage, but they almost all require the operation at last, which is performed nearly in the same manner in every part; but larger aneuris7ns cannot receive any advantage from the pressure; therefore, when used long enough as a preparative to the operation, the latter should not be delayed. Plenck's apparatus is well adapted to close the wound instead of the common bandage ; and the German surgeons have introduced several refinements in the management, which are perhaps unnecessary. Yet where the aneurism has been cured by compression, it is more probable that the canal of the artery is obliterated, than that the wound is so firmly healed as to resist the arterial current. If, however, the cure be attempted in this way, the pledget should be very carefully laid on the wounded artery, so as to close the wound accurately without pressing on the veins or any anastomosing artery ; the limb should be kept at rest, blood taken from the other arm, and every part of the antiphlogistic plan rigorously adopted. When it is probable that the wound of the artery is firm, the bandage and pledget should be re- moved ; and gently loosening the tourniquet, we should observe whether any ,tumour appears on the part. If there should not, a more moderate pressure must be still for a time continued. In the event of having wounded an artery, M. The- den advises us to let the blood flow for a time, and while the proper bandages are preparing, to keep a strong general pressure on the cavity of the elbow. A ANE 115 ANE spiral bandage must then be applied, inclosing a cylin- drical compress along the artery. The whole must be wetted with his own aqua traumatica, q. v.; but as wetting contracts the linen, the bandage should not at first be drawn too tight. In three or foUr days the bandages grow slack, and they must be again applied, and every precaution taken against any of the folds slipping. Mr. Bell observes, that in diffused or false aneurisms, pressure cannot be applied to the artery alone, without at the same time affecting the refluent veins; and as this circumstance, by producing an increased resist- ance to the arterial pulsations, must undoubtedly force an additional quantity of blood to the orifice in the ar- tery, there is reason to suppose it hath been productive of mischief. But though pressure "ought never to be attempted in any period of the diffused aneurism, yet in some stages of the other species it may be often em- ployed with advantage. In their early stages, while the blood can be yet pressed entirely oufr-of the sac into the artery, by the use of a bandage of soft and some- what elastic materials, properly fitted to the part, much may be done in preventing any considerable increase of the swelling: indeed, by this continued support, complete cures have been at last obtained. Yet, though pressure to a certain degree hath sometimes proved useful, it ought never to be carried to a great length: tight bandages, in these cases, always counteract the intention. The greatest length to which pressure ought to go, should be to serve only as an easy support to the parts affected. With compression, other means should at the same time be used; such as low diet, occasional bleeding, a lax state of the bowels, freedom from strong exercise, &c. • The Operation for the Aneurism in the Humeral Artery. Having taken away some blood, and promoted such other discharges as seem needful, apply the tourniquet near the shoulder, tighten it so that the pulse cannot easily be perceived ; lay the arm in a convenient situa- tion; then make an incision on the inside-of the biceps muscle, above and below the elbow, a considerable length, which, being in the course of the artery, will discover it as soon as the coagulated blood is removed. Be careful not to cut the larger veins, nor the bag; the same attention is necessary in cutting the apo- neurosis of the biceps; for this aponeurosis, the capsula, the bag, and the skin, are all united by the pressure. If the orifice does not readily appear, let the tourni- quet be loosened, and the effusion of blood will direct you to it; then carry.a crooked needle armed under it, tie the vessel just above the orifice, and when you have secured the upper part, slacken the tourniquet a little; for if on slackening it there is any haemorrhage from the inferior parts of the artery, it plainly appears that the collateral branches are open, and that there is a free circulation. The first ligature secured, make a second a little below the orifice, and leave the intermediate space of the artery to slough away without divid- ing it. Avoid taking up the nerve with the ligature if you conveniently can; the readiest method to do this is, as it lies on the inside, at a little distance from the artery, to relax that vessel by bending the arm mo- derately, and to raise the artery from its bed by a probe introduced into its orifice, or by pinching it up with the finger and the thumb : the nerve is easily distinguished from the artery by feeling; and thus the artery may be drawn from the nerve.. If the nerve should be taken up, and a portion of the adjacent flesh being taken up with it, no inconvenience need be feared. After the operation, the limb is generally some little time without pulsation, which, if it does not recover in twenty-four hours, amputation is not to be deferred. This operation is indeed often necessary; but warm spirituous applications, and dry heat from warm sand and ashes should be first tried, and continued so long as the operation can be safely deferred. In the London Med. Obs. and Inq. vol. ii. page 360o is an instance of an aneurism in the arm being cured by the operation ; but, instead of the ligatures, a steel pin was passed through the lips of the orifice in the ar- tery, and secured by twisting thread about it, as in the hare-lip; after a few days the pin came away with the dressings. Under some particular circumstances, taking up the femoral artery in popliteal aneuris?ns may be perform- ed with success, and the leg preserved, where the mis- fortune occurs from falls, bruises, or punctures, in sound, healthy constitutions ; but if the aneurism arises gradually in habits -where there is reason to suspect a diseased state of the arteries, amputating the limb is certainly the least dangerous mode, and should be pre- ferred. The advantages of Mr. Hunter's operation for the popliteal a7ieurism, viz. tying the artery far above the aneurismal sac, are owing to the wound being small; for the true aneurismal sac is untouched, and disappears from absorption; as well as from^the greater proba- bility of the artery in a distant part being sound. Mr. Lambert's method of stitching the wound of the ar- tery by the hare-lip suture (Med. Obs. and Inq. vol. ii. p. 360), and M. Descham's (Medecine Eclairee par les Sciences, iii. 67), have been seldom followed, or gene- rally approved. See instances of aneurisms of the femoral artery be- ing cured in the Lond. Med. Obs. and Inq. vol. iii. p. 106. And in the Edinb. Medical Commentaries, vol. ii. p. 176. Also in Warner's Cases of Surgery. See Aetius Tetrabib. 7. serm. iii. cap. 10. P. ^gi- neta, lib. vi. cap. 37. Marcus Aur. Severinus de Efficaci Medicina. Morgagni de Sedibus et Causis Morborum. Mem. de 1'Acad. Roy. an 1712, 1733. Philos. Trans. Abr. vol. iii. viii. De Haen de Aneurismatib. Rat. Medendi. Mem. de 1'Acad. Roy. de Chirurgie. Scrip- tores de Aneurismatibus cura. Lauth. Monro's Re- marks on the Formation of Aneurisms, in the -Edinb. Med. Ess. vol. ii. and iv. L«e Dran's Operations in Surgery. Sharpe's Operations of Surgery. Dr. Hun- ter's, and others', Observations on Aneurisms, in the Lond. Med. Obs. and Inq. vol. i- ii- iii. and iv. Lond. Med. Journal, vol. vii. Transactions for promoting Medical and Chirurgical Knowledge, vol. i. Bell's Surgery, vol. i. White's Surgery, p. 115; and Home on the same subject. Aneuri'sma pr^cordio'rum. Called also car- diogmus, cardionchus; aneurism in the heart, or in Q 2 ANG 116 ANG the aorta near the heart, which occasions pain in the praecordia. ANFRACTUO'SUS, (from an, and frango, to break). Anfractuous. Full of windings: called anfractuosities. ANG. ET ANGUIL. The abbreviation of Sim- plici del cxcellente m. luigi Anguillara. Venet. 1561, 'vo. ANGEIOTO'MIA, (from xyfuov, a vessel, and n^vu, to cut). An opening of the vessels, as in arteriotomy and phlebotomy. It also signifies a particular dissec- tion of the vessels for anatomical purposes. ANGEIOTOMI'STA. An angeiotomist. A per- son skilled in the course of the blood vessels, or who can dissect them readily. ANGE'LICA ARCHANGE'LICA. So called? Ange'lica sati'va. [from its angelic virtues. 5 Called also i7nperatoria sativa, pectoraria herba. It is the angelica archangelica Lin. Sp. PI. 360. It is found by the sides of rivulets, on the mountains of Lapland, and is cultivated in gardens all over Europe; the best is said to be produced in Bohemia and Spain : but Lin- naeus thinks that the best is that which grows on the mountains in northern countries. The roots are in the greatest perfection in the second spring; they should be well dried and kept in a dry place, and frequently- aired, or they grow mouldy, and are the prey of worms. The whole plant is used; and hath been so much esteemed as to have obtained the name of princeps alexipharmicorum. Some physicians think that the English angelica differs from the Spanish only in the latter having been long kept, by which the disagreeable flavour of the fresh root is lost. Though all the parts of this plant possess the same virtues in a great de- gree, yet the root is the strongest. It resembles zedoary as a- medicine, but is milder, and a good carminative. Externally applied^it discusses inflammatory tumours in cold habits. By some authors it has been highly praised as a carminative, a stomachic, sudorific, and emmenagogue; and considered as a specific against some poisons and malignant fevers: in present practice it is seldom employed. In Lapland it is employed in coughs, and hoarseness. The stalks are roasted in hot ashes, and the flowers boiled in milk till they form a soft extract. The seeds come nearest to the roots in medical vir- tue, but scarcely retain either their vegetative or me- dicinal power until the following spring. The leaves lose nearly all their virtue in drying. A strong water is obtained from either the leaves or seeds by distilla- tion ; but,spirit of wine best extracts the oil in which the virtues of the dried roots reside. The stalks and the roots are candied by the confec- tioners; and the stalks were formerly blanched and eaten as celery. In Norway the roots are sometimes made into bread. • All the species of angelica have similar virtues, chiefly differing in the degree, but the a. archangelica is the best. The wild sort, in use, is the angelica syl- vestris Lin. Sp. 361. See Levisticum. Ange'lica pratensis apii folio. See Oreoseli- num. Also a name of the saxifraga anglica. Ange'lica grana, a name of Dr. Anderson's pills. ANGE'LICUS PU'LVIS. See Mercurius vitas. ANGELOCA'LOS. The true name of the twenty- fourth appellation of Myrepsus, and not, as is com- monly writ, alcancali. A'NGELYN. See Andira. A'NGI. Buboes in the groin, (from angor, an* guish). See Bubo. ANGIGLO'SSI, (from xyxvXv, a hook, and yXutrrx, the tongue). Stammerers. ANGI'NA, (from xyy,u, to strangle,) also called cynanche, kynanche, lycanche. Quinsy ; thus named, from an abbreviation of the French word squinancie. It is an inflammation in the parts of the {hroat sub- servient to respiration, speech, and deglutition; it is called a strangulation of the fauces ; more pro- perly, an INFLAMMATION OF THE INTERNAL FAUCES. Aretaeus supposes that it is named cynanche, from dogs being subject to it; or else, because in this spe- " cies of quinsy it has been said the tongue is inflamed and so swelled, that it hangs out beyond the teeth like a dog's. Coelius Aurelianus says, that the voice of the patient in- the quinsy resembles that of a dog, or a wolf; hence called lycanche: or, perhaps, the word cynanche is derived from xvov, canis, and xy%a, strqn- gulo ; because a set of symptoms affect the patient in a species of quinsy, not unlike the appearances ob- servable in hanging dogs. If the disorder is epidemic, it is so usually between the spring and summer, and after long continuance of cold and rainy weather. The true quinsy, the cynanche tonsillaris of Cullen, is an acute inflammatory disorder. The bastard quinsy is a milder catarrhal one; and its fever chronical, of the catarrhal kind. The Greeks give different names to the true quinsy, according to the respective part^on which this disorder falls: the Latins, considering the disorder as one, wherever its violence might have more peculiarly been manifest, included them all under the name a?igina; as we under that of quinsy. The curious may see the various appellations given to the different circumstances of this disorder in the writings of Aretaeus, Coelius Aurelianus, Hildanus, and Alexander Trallian. The cynanche of Dr. Cullen is placed in the class pyrexie, and order phlegmasie: and defined a fever, sometimes of the typhoid kind; redness and pain of the fauces; deglutition and breathing difficult, with a sense of straitness in the throat. This genus contains five species: 1. Cynanche tonsillaris, when the inflammation begins in the tonsils, and affects only the mucous mem- brane of the fauces with redness and tumour, having an inflammatory fever attending. 2. Cynanche maligna, also ulcerosa gangrenosa, and ulcerosa when it affects the tonsils and mucous membrane of the fauces, with tumour, redness, and mucous sloughs of a white or ash colour, spreading and covering ulcers; attended with a typhoid fever, and eruptions. 3. Cynanche trachealis, when it is attended with difficult respiration, shrill inspiration, hoarse voice, harsh sounding cough, scarcely any tumefaction ap- pearing in the fauces, little or no difficulty of swal- lowing, and the fever inflammatory. This among the Scotch is called the croup. See Suffocatio STRIDULA. 4. Cynanche pharyngjea cesophagea, when ANG 117 ANG there appears a redness, particularly at the lower part of the fauces, and swallowing becomes extremely diffi- cult and painful; the respiration sufficiently free, and the fever inflammatory. 5. Cynanche parotid^a, when the external pa- rotid and maxillary glands are tumefied, respiration and deglutition slightly affected, and the fever a mild inflammatory one. This species^ is called the mumps amongst the English; in Scotland, the branks; with the French, ourles. There is also a species of quin- sy to which children are subject, called pcedan- chone. The seat of the cynanche tonsillaris is properly in the mucous membrane of the upper part of the throat, and all the surrounding parts of the muscles which move the jaws. The young, the sanguine, and those of an inflammatory diathesis, are most disposed to the true quinsy ; and a disposition to it is often acquired by a few repetitions. The causes are the same as are pro- ductive of inflammation in general; particular consti- tutions and former habits determine the inflammation to particular parts. If all or most of these parts are inflamed, the case is desperate; for the return of the blood through the compressed jugulars being intei^pted, the fauces, lips, tongue, and face swell; the tongue is inflamed, and hangs from the mouth; the eyes are red, prominent, and ghastly; the brain is filled with blood; and delirium, yawning, stertor, strangulation on lying down, with a manifest redness, tumour, pain, and pulsation in the breast and neck, supervene. , The proper symptom of a quinsy is, the difficulty of swallowing solids or fluids; for if a large tumour af- fects the top of the oesophagus, and contracts it, li- quids, but not solids, may pass through it; but if the tumour be seated in the top of the larynx, where it is covered with the epiglottis, solid substances, by pressing the tumid epiglottis, find a way to the oesophagus; while liquids, not pressing with equal force, slide through the gaping space, by the tumour, into the as- peria arteria, and cause great uneasiness. The complaint is generally obvious to the senses, and can but in few instances be mistaken. Shivering, and other symptoms of inflammatory fever, often precede; but very frequently the difficulty of swallowing is the first inconvenience felt. The florid redness round the fauces, and on every part of the throat, at once points out the disease; and this, with a flow of saliva, often constitutes the whole. When however more violent, the upper part of the larynx, the muscles of the neck, and the oesophagus itself, in a great portion of its track, suffer. The soreness externally is very acute; the breathing difficult, with a wheezing noise; the pain violent, extending to the ear; and deglutition,from the swelling, almost wholly obstructed. The different parts affected are known from the inconvenience at- tending the performance of their different functions; but we need not distinguish them, as the practice will not differ. It is not, we have said, difficult to distinguish the inflammatory sore throat, when we reflect that it con- sists in, a difficulty of swallowing, with fever, and a florid redness of the fauces. Scirrhi, spasms, tumours, and venereal swellings, can never be mistaken for this disease; for though there is often an attending redness, yet it is not of the florid kind, nor is inflammatory fever present. The inflammation sometimes affects the muscles of the larynx, and is in some cases dan- gerous; yet the easy access that may be obtained to the neighbourhood of the diseased parts, gives us a power of relieving quickly. The greatest danger arises from gangrene, and suffocation from the swelling of the parts, particularly the tonsils. In common sore throat, however, gangrene is a very unusual conse- quence; and we have more often seen an inflammatory cynanche arise from the active stimulants employed in the malignant species, than gangrene from the present disease. When the tonsils suppurate, the previous swelling often threatens suffocation; and it has been thought necessary to open a passage for the access of the air to the lungs through the rings of the trachea; see Bronchotomy. We have seen this more than once employed with success, but it has never appeared necessary in our practice. Active gargles to hasten the maturation, bathing the feet often in warm water, or inhaling warm vapours from the mouth of a funnel, sometimes with the addition of camphor, have gene- rally ripened the abscess without danger. If the symp- toms are more urgent, the swelled tonsil may be punc- tured with the point of a scalpel. The treatment of inflammatory angina is not very difficult. When it is ascertained to be the true cy- nanche tonsillaris—and for the distinction of the great- est importance we must refer to a following article where we treat of the malignant kind—-every part of the antiphlogistic regimen should be employed in all its rigour. Diluting liquors, abstinence from animal food, and even animal broths, and cooling purgatives, are highly proper. Gargles should be almost incessantly employed, and a great error prevails in using gargles occasionally only. Two or three times a day will in- deed be sufficiently often; but they should never be employed for a less period than from an hour to an hour and a half. The syringe is chiefly useful in chil- dren, and in the malignant kind. Bleeding is seldom necessary, except when the swelling of the fauces is ra- pid and considerable, in healthy strong constitutions: it should then be actively employed, and not less than sixteen or eighteen ounces taken at once, and repeated after eight or ten hours. Such an emergency will, however, seldom occur: it has not at least occurred to us in a practice of above thirty years. Topical bleeding with leeches is sometimes employed, but seldom neces- sary ; and this remedy is inconvenient, as it is difficult to stop the blood, when there is no bone against which a pressure can be made. As a purgative the salts per- haps with senna are preferable. Vomiting early is often highly beneficial; and gven in a more advanced state, if it can be practised without much pain, it is particularly advantageous, from the dis- charge it procures from the affected glands. We have heard of its being employed to burst an abscess formed on the tonsils; but it is, undoubtedly, at this period, precarious, if not highly dangerous. Blistering is a remedy of peculiar importance. The plaster has been applied to the back or to the throat. Where the muscles of the trachea are greatly affected, the latter may be proper; and the former is, in no in- stance, improper The most useful application of blis- ters is, however, from behind the ear, extending under the lower jaw to the trachea. The ammonia, either in its mild or pure state, joined with oil, and mustard cata- ANG 118 ANG plasms have, at times, supplied the place of blisters; and, when the external fauces have been very sore, a common poultice is an useful application. We have not found the addition of camphor cither to the lini- ments or poultices useful. The kinds of gargle have occasioned some little dis- cussion. In the early stages they have been emollient and discutient; in the latter astringent ami antiseptic. A pint of barley water, with two drams of crude sal am- moniac, is a gargle of the former kind. We have not found a cold gargle of water with a portion of brandy recommended; and it has never before occurred to us, but we think it merits a trial. Acids have been repro- bated in the early stages: but the disadvantages enu- merated are those of the mineral acids. The acetous is, at any period, useful; and the sharper it can be borne, without pain, the more useful. This kind of gargle generally consists of an infusion of baum* or sage, with a portion of honey, sharpened with vinegar to such a degree as the inflamed fauces can bear. The raspberry vinegar however, alone, swallowed slowly, is perhaps equally efficacious with any gargle; and, as it is pleasant, it will be more steadily pursued than a less agreeable medicine. In the same way, a small bit of crude sal ammoniac, or of salt prunella, held in the mouth till it gradually dissolves, has been highly use- ful. Figs, as they are supposed to have a peculiar efficacy in ripening abscesses, have been often used in decoctions employed for gargles. The addition of squills to the gargle, as recommended by Dr. Fordyce, is seldom of peculiar service. The mineral acids and astringent gargles are scarcely in any instance required in inflammatory angina, though recommended in the more advanced stages. They are of great service in those inflammations which arise from relaxation; and when angina often recurs, the inflammation is of a less active kind. Decoctions of the oak bark with the vitriolic or muriatic acid, are more effectual than any form of the Peruvian bark. The myrrh we have never found necessary or useful. Gangrene, we have said, scarcely ever follows in- flammation of the throat; and scirrhi of the tonsils, though mentioned as a consequence, are certainly rare. The tonsils we have seen often scirrhous, but never cancerous; and they have remained in the scirrhous state through a long life. See Aretaeus,' Coelius Aurelianus, Hildanus, Trallia- nus, Hoffman, Boerhaave, Le Dran's Operations, Wal- lis's Sydenham, and Fordyce's Elements, part. ii. Cul- len's First Lines, i. 279. edit. 4. Angi'na aqu'osa cedemato'sa. Boerhaavii Aphor. 791* This is a species of dropsy, arranged by Dr. Cullen under anasarca, the second species, which arises from obstruction, occasioned by compression of the veins; see Anasarca oppilata. It is called Lowe- riana, being produced upon a dog by Lower's tying up the jugular veins, which brought on the angina aquosa that occasioned suffocation; see Sauvages' Nos. Meth. vol. i. p. 678. Angi'na gangrenosa, called also garotillo, angina maligna, epidemica gangrenosa, ulcerosa, ulcusculosa, suffocativa, erysipelatous, ulcerated, malignant, or putrid sore throat; cynanche maligna of Dr. Cullen. This is a disease of great danger and importance. It is probably not a new one; but its nature and proper treatment were seemingly obscured by the too com- mon term of pestilential, and the farrago of remedies adapted to a name. The history is very accurately detailed in Dr. Cullen's Synopsis, where a chronolo- gical list of the authors who have treated of it is in- sertcd. It attacks like a slight inflammatory sore throat, though sometimes onjy a languor insidiously creeps on, with a little difficulty of swallowing; and, in the worst cases, even this is absent. The strength, how- ever, rapidly sinks, the features fall, a ghastly pale- ness comes on, and death quickly follows. In slighter kinds, the course is not very different from that of the inflammatory species, though seemingly slight, with al- ternate chills and heats, pain in the head/Sec. till the debility appears, when every other bad symptom imme- diately follows. Every sore throat, should, therefore. be carefully examined. In the most active inflammations of the throat, white specks will sometimes appear on the velum pen- dulum or tonsils. If the inflammation is florid, the constitution robust, and the pulse firm, these spots may be disregarded.' On the contrary, in some in- stances of the most malignant kind, no sloughs can be observed. The distflfction must be taken from the co- lour of the inflammation. In the true malignant sore throat, the colour approaches rather to the crimson and the pink than the red; and sometimes a shade of brown, not far distant from the cinnamon, is mixed. The pain in swallowing is slight in proportion to the degree of inflammation; languor, listlessness, and indiffer- ence, are very conspicuous; and the features display the same want of fulness and tone: the eyes are red and watery. At this time the pulse will be sometimes apparently strong, but a slight attention shows that the strength of the stroke is apparent only: it throbs with a kind of convulsive weakness, rather than beats with a steady firmness. The tongue grows brown, the breath offensive, and delirium, at night, comes on: by day, a wandering is only observable. WThen there are sloughs on the throat, the edges are of a dark pink red; they are observed to cover, and sometimes they conceal a con- siderable loss of substance; they enlarge, become deeper, and the edges black. An ichor, or a thin acrid matter, is discharged from the nose or ears; the stools are thin and highly offensive. The fever is said to re- mit in the morning, but the remission is inconsiderable, and will never assist in the distinction, though it will sometimes lead to an insidious security. Sometimes, from the beginning, exanthemata ap- pear; and the putrid sore throat is frequently, if not constantly, an attendant on scarlatina: these soon as- sume a darker hue, and appear livid. The breath in the earlier periods is not affected, but a wheezing noise su- pervenes if neglected; and this, in the worst kinds, is succeeded by the shrill barking sound which has occa- sioned the Spaniards to give it the name of garotillo. It evidently arises from the erysipelatous inflamma- tion extending to the larynx, and is generally a fatal symptom. The eruptions have been described as fa- vourable and critical: we have generally found them accidental, and only of use as an index of amendment, or of the disease increasing in violence and malignancy. In a disease which runs its course generally in less than five, always in seven days, no prognostic is to be depended on but a more florid appearance in the ANG 119 ANG throat, and a more healthy aspect of the edges of the sores. The disease is epidemic, and attacks the active and robust as well as the infirm. We have not found the number of its victims greatly disproportioned in any period of life, in any situation or time of year. It is cer- tainly infectious, though the infection is not active, or its influence very extended. All evacuations are highly injurious; and an emetic, with which we are often directed to begin, sometimes operates with such violence as to debilitate greatly. If a stool or two be necessary, a clyster, or a very mild, quickly operating laxative, is alone admissible. After this the bark is to be given in active doses, with aroma- tics. Half a dram of the bark, with ten grains of aromatic species, should be exhibited every two hours. If it seems to produce strictures on the skin, and rigor, five or six grains of camphor, and three or four of true James's powder, (guarded by a little opium,) should be added to each dose. These may be washed down with a strong decoction of bark, sharply acidulated with either . of the mineral acids. We may, however, remark, that in this disease the bark seldom disagrees. The action of these remedies is greatly assisted by diet and gargles. Port wine should be given freely : it should indeed enter into every part of the food, and be drunk alone, cold. Even sleep is less necessary than bark and port wine ; and should it continue above three hours, the patient must be awakened, for the loss of time cannot be regained. The quantity of the medi- cine and the wine must be regulated by the effect. If we gain nothing in the first thirty-s^x hours, we may depend on a fatal event: if we lose ground in twenty- four, our hopes will be inconsiderable. We have known women unaccustomed to wine drink two bottles within twenty-four hours, for more than a fortnight. The gargles should be of a strong decoction of bark, very sharply acidulated with mineral acids or with the strongest Cayenne vinegar, or some Cayenne in substance should be added; and they should be fre- quently used, or, as the' patient is languid, injected with a syringe. Pepper-corns constantly bitten, and the saliva swallowed, we have often found highly useful. These are the appearances, and such the practice in the more violent attacks of the complaint; and we have never seen an instance of it, when taken early and treated in this manner, in a constitution moderately strong, proving fatal. The same plan, less actively pur- sued, is adapted to the milder kinds. But even the mildest should not be treated with indifference. In the worst cases, a palsy of the muscles of the throat has come on, and nothing could be swallowed. We must then inject nourishing clysters and port wine, alternately, every three or "four hours, with a little opium: use a semicupium of a strong decoction of bark; and let wine and jellies be kept in the mouth as long and as frequently as possible. This plan has suc- ceeded, in more than one case, in our hands; and in one of these the patient swallowed nothing for six-days. We have not mentioned, among the remedies, blis- ters, for authors are much divided respecting their-ef- fccts; and many idle theoretical discussions have been indulged on the subject. They certainly have never been injurious, but we dare not say that they have ever been advantageous. On a candid and dispassionate re- view of what we have seen, we can scarcely recom- mend them. The myrrh, also, we have not men- tioned internally, or in gargle, because we think it too weak a minister to be trusted in emergencies, and it is unnecessary in slighter cases. Yeast, efferves- cing mixtures, and clysters, have not been sufficient- ly tried in circumstances so desperate; and, as the other remedies seldom fail, these are at least unneces- sary. See Aretaeus de Causis et Signis Morborum, lib. i. cap. 9. Dr. Fothergill's Treatise on the Putrid Sore Throat. Dr. Huxham. Le Cat, Johnson, and Cho- mel on this disease. Northcote's Treatise on the Ul- cerated Sore Throat. Dr. Percival's Essays. Dr. Fordyce's Elements^ part. ii. Cullen's First Lines, i. 284. edit. 4. Angi'na trachealis. In compliance with Dr. Johnson, and consonantly with our observations in a former article, we mention this species as a separate one, and distinct from that sometimes comprehended under this title by other authors. The croup we shall next consider under the appellation of angina stridula, and confine the present term to the malignant angina, extending to the trachea, or to that species of the dis- ease in which the larynx and trachea are originally at- tacked. To this complaint authors have not, perhaps, paid due attention: it is indeed seldom an original disease; yet, within our own observation, it has ap- peared to be so. It is truly an erysipelatous inflamma- tion, in contradistinction to the phlegmonic; nor does it materially differ in its treatment from putrid pneu- monia, or angina maligna. We need not, in such in- stances, dread the* power of the bark in inducing dysp- noea, but employ it freely with cordials. The only question is, whether blisters are more admissible or more effectual? From our own experience we cannot encourage, their application; but they certainly do no harm. Angi'na stridula. This is the cynanche tra- chealis of Cullen; a disease that, for its singularity and fatality, has fixed the attention of pathologists and prac- titioners. We wish we could solve the difficulties, or direct a more scientific or successful method of cure than has hitherto been adopted. The cynanche was the boast of Dr. Cullen, as a natu- ral well established genus, under which the species were scientifically arranged. The subject of nosology we must, at a future period, consider; but we may now add, that self-complacency had never so baseless a foundation. The species agree in no one principle but affections of the parts connected with the neck. Is it a group of complaints in which the breath is affected ? No: in the gangrenous sore throat, and the mumps, the breathing is free.—The swallowing? This is not affected in the malignant angina or the croup.—In- flammation? Scarcely any inflammation occurs in the mumps. Yet we mean not to undervalue nosology, or its great advocate. We think highly of both; and if there ever was a man to whom medicine was pe- culiarly indebted as a science, who, by enlarged «and comprehensive views, has added to its value, its utility, and importance, that man was Dr. Cullen. Our pages will be an ample commentary on this text; but our eulogium is not the rash, hasty effusion of a young theo- A N G 120 ANG : ist, but of a person who has for a long series of years brought his opinions to the test of practice. Near fif- teen years have passed since his death, and no friendly hand has scattered flowers over his tomb, appreciated his genius, his- talents, and his virtues. We have some reason to accuse his family of insensibility, or his pupils of ingratitude, did we not know that attempts had been made, in vain, to procure the honourable office of his biographer. But this is from our present purpose. The angina stridula, (from stridere, to make a noise,) is called also angi7ia, 7ne7nbranacea, interna,per- 7iiciosa, polyposa, catarrhus suffocativus, a7id morbus s'trangulatorius. It is chiefly a disease of children, and is distinguished by a difficult inspiration sounding as through a brass tube, harsh cough, with seldom any tu- mour in the throat, and no difficulty in swallowing. This definition differs from that of Dr. Cullen, who is a little warped by his adherence to system. A cold and a short cough precedes for some days, when the harsh breathing comes on, with little or no fever; sometimes suddenly, at others more gradually, increasing by de- grees, till suffocation closes the scene. The other functions are scarcely disturbed. The pulse, at first a little harsh, or slightly quickened, in the progress be- comes very rapid and low. The- face, at first flushed, is in the latter stages livid, though sometimes full. The stomach and bowels are not apparently affected. The cough is dry, flaky substances are spit up, and the patient struggles with an attempt to discharge some- thing solid from the trachea. The internal fauces are, in a very few cases, swelled and red. It is sometimes epidemic; seems more frequent in low, marshy situa- tions than in more elevated spots; and peculiar to children, at least scarcely ever attacking those above twelve years of age. The disease consists in a membranous substance, lin- ing not only the trachea above its divarication, but also its minutest branches, though the larger parts of the lube are first affected. It has been considered as a spasmodic disease by some, as it attacks suddenly, and is relieved by the warm bath and asafoetida; and as in- flammatory by others, who rest, with equal security, on the cough preceding, and the utility of bleeding. In the early period it is undoubtedly inflammatory, but this stage is short and transitory; the exudation soon commences, and the remedies for inflammation lose their efficacy. It may be perhaps asked, in what, then, does the disease in its progress consist ? Certainly not in spasm, but in this peculiar exudation, of which we have scarcely any other example : and the more gene- ral ideas of spasm and inflammation have, we fear, mis- led practitioners in the treatment of the disease. The exudations, which are usually the consequence of in- flammation, agglutinate contiguous parts, not in the form of a membrane, but of cellular texture. It is thus in the lungs when united to the pleura, and in every instance of adhesive inflammation. A preterna- tural quantity of mucus hardens in masses, but not in membranes; for the mucus of the bronchial glands in catarrhs and asthmas, never assumes a membranous form. In fact, the inflammatory effusion consists of ;he gluten of the blood diluted with the serosity : the croupy membrane is a peculiar secretion. The labours of physiologists have discovered lately a new ingredient in the blood, which they have called fibrin; which concretes in a fibrous substance, sometimes membram ous, and has even been suspected of possessing a por- tion of irritability. It is undoubtedly this substance which is effused; but why inflammation, at this-parti- cular period, should occasion the exudation of fibrin rather than of gluten; why this should occur at an age when fibrin is not peculiarly abundant; and why a portion of the blood, which contains the largest share of azote, should be separated at a time of life when this principle is in a small proportion; are difficulties that we cannot surmount. The chemistry of the animal fluids is in its infancy. We know not the effects of the " play of affinities" in the fluid parts of the system; and, by some unexpected combinations, azote may be separated in constitutions that appear to contain the smallest share of it. Thus we cannot detect sulphur in the animal system ; yet we find it separated in the in- testinal canal, and making a large proportion of the fluids of some malignant ulcers and cancers. The whole is at present involved in obscurity. To detail the progress of a disease which generally goes on from bad to worse, or to estimate the period when nature can no longer bear up against the accu- mulations that obstruct respiration, would be useless: the distinction it is of more consequence to consider. The peculiar breathing is not the criterion of the com- plaint, for it occurs often in children without any bad consequence, and in persons of every age. Experience can see a distinction in the appearances which lan- guage cannot convey; but, in general, it may be con- sidered as true, that the clangous inspiration if not re- lieved within twenty-four hours, or, if relieved, recur- ring within twelve, is of the croupy kind, especially in children under four years. The asthma of infants has undoubtedly been mistaken for croup; but in those we think the respiration is attended with some rattling noise, while in croup it is clear and shrill. See Asthma spasmodicum. Many cures have been re- ported of croup, which were certainly cases of this kind; for those who have been able to distinguish the dis- ease, have repeatedly failed with the same remedies. It is not infectious, but it seems to prevail in particular situations; and in families it has affected all the chil- dren about a certain age. • We have said that it is for a short period inflamma- tory, and this we judge from the effects of active, de- cisive bleeding. If there be any truth in medical ob- servation, a large bleeding, immediately on the attack, has cured the disease. At a future period scarcely any thing has succeeded, though a few victims have been rescued. Emetics, topical bleeding with leeches, blisters, and purgatives, have been repeatedly tried, scarcely in any instance with success. We had long since determined to neglect these and to pursue an opposite method, viz. by a cordial and sudorific plan to endeavour to direct the morbid fluids to the surface, led by some relief ap- parently obtained by a quack medicine, which certainly had no other powers. This method would have been attempted, had not bold empiricism introduced another, viz. large and repeated doses of calomel. Even to very young children five or six grains are given every two or three hours, till a discharge of a green bilious matter comes on; and the relief, it is said, soon follows. We have some confidence in the reports we have received ANG 121 ANG of the success of this medicine, though in our hands it has failed; and the rapidity with which mercurials of all kinds break down the denser parts of the blood, renders it, in cur opinion, a remedy of great apparent utility. The thin green bilious discharge seems an evidence of this effect. Strong mercurial frictions might perhaps be at the same time employed. Angi'na erysipelatosa, mucosa, epidemica, angi- nosa, exanthematica. . Mucous quinsy. See Scar- latina ANGINOSA. Angi'na parotid^a. The cynanche parotidea of C,ullen ; catarrhus bellinsulanus, ourles, and orcillons, of other authors. After a slight inflammatory fever, the parotid and maxillary glands swell sometimes rapidly, and to a considerable size; but they seldom suppurate, and the disease requires no particular remedy. The fever is decisive in its attack, and appears of a specific nature. What leads more strongly to this opinion is, that the swelling sometimes ceases suddenly, and is transferred to the testes in the male, and to the mammae in females. We have, however, seen it twice pretty generally epidemic among children, without observing either metastasis. Twice in adults we have seen an instance of the former, and the swelling yielded to the common remedies. In the neck, it has been usual to keep the part warm; to give nitre and purgatives, and to rub in mercurial ointment. Nothing is, however, necessary; and those who have been most neglected, have been soonest restored to health. Keeping the swelled neck warm is always improper; nor does there seem the slightest reason to suspect a translation to the brain. Gooche's Cases and Remarks, p. 74—76, and Appendix, p. 13. Cullen's First Lines, edit. 4, vol. i. p. 303. Angi'nv pharynga;\. This species is particularly Tare. It is described by Eller, De Cog7ioscendis et Cu- randis Morbis ; and a case of it occurs in the third vo- lume of the Medical Commentaries. The pain is felt behind the sternum, in swallowing only, and the breath is not affected. The cure is easy, and consists in swal- lowing slowly nitrous and mucilaginous medicines. The complaint is uncommon and trifling. Angi'na spasmodica. See Asthma. Angi'na pectoris. For the first account of this disease, the world is indebted to Dr. Wm. Heberden of London. The patient is seized whilst walking, and more par- ticularly if he walks soon after eating, with a painful sensation in his breast, extending to his arms; at first no further than the insertion of the deltoid muscle, but in succession to the elbows, wrists, and fingers' ends; the moment he stands still, this uneasiness vanishes : but, after this complaint hath continued some months, it does not cease-so suddenly after resting; it will now rome on even while the person is in bed, obliging him to rise every night for several months together. In some inveterate cases it hath been brought on by very trivial.accidents, such as coughing, going to stool, by swallowing, speaking, or from any slight disturbance of mind. Sometimes, though rarely, it attacks while the patient stands or sits still. In some persons it is the worst in winter, in others during the summer season. When a fit approaches whilst the patient is walking, its duration is short; but if it comes on in the night, it will continue an hour or more. Sometimes, though VOL. I. rarely, there are several days before any remission is manifest; and, during this time, the danger is immi- nent. The pulse is, at least sometimes, not disturbed With the pain, consequently the heart is not affected by it. Persons of fifty years of age and upwards, of gouty- habits, with short necks, and who arc inclined to be corpulent, are the most subject to this disease ; it is; though rarely, met with in those who are younger. The fatal event is generally sudden: yet some con- tinue affected with it for twenty years ; and in some it almost spontaneously disappears. The seat seems to be in or about the sternum, but always more to its left side than to any other part; and the pain is more common in the left arm. The cause is most probably a spasm, or convulsion, as appears from its sudden attack and speedy departure, the long intervals of ease, the relief afforded by wine and spirituous cordials, its generally bearing the motion of a horse or carriage well, and its coming oh in the night after the first sleep ; at which time asthmas, the nightmare, convulsions, and other disorders attributed to the disturbed functions of the nerves, are peculiarly apt to return, or to be aggravated. Dr. Parry has lately endeavoured to show, that the disease arises from an ossification of the coronary ar- teries of the heart; but, in general, it may be remarked, that it attends persons of advanced life, where such os- sifications are not uncommon ; and that we can per- ceive no connexion between the effect and the cause. If the functions of the coronaries were impaired, we may expect only a mortification, or a washing of that organ. In his dissections also, it has been observed, that, in the only case where ossifications were found, the disease was obscurely marked; while the others, more certainly cases of angina pectoris, offered no such appearance. In general, ossifications have been found near the valves, and in almost every portion of the heart or larger vessels; yet these are evidently effects only. With regard to the cure, evacuations have been tried, but to no purpose; though wine and other cardials, taken at bed-time, will prevent or weaken the night fits, yet nothing does this so effectually as opium; ten, fif- teen, or twenty drops of the tincture of opium taken at bed-time, will enable those patients to keep their bed until the morning, who have been forced to rise and sit up two or three hours every night for many months. A blister applied to the sternum, and kept open with nervous medicines, particularly the bark and valerian ; and sometimes the preparations of copper seem to be most effectual; and, unless the disease be supposed to have vanished spontaneously, have cured it. Dr. Macbride advises issues in the thighs, with small doses of calomel; but this plan has either not been tried, or been unsuccessful. This quantity of opium, or more, may safely be continued as long as it is required. Dr. Bergius, a Swedish physician, says, that this disorder is a kind of spasmodic asthma,-and that it is relieved by a solution of gum. ammon. 3 ss. in aq. puleg. vel hyssop. tk ss. two spoonfuls to be taken two or three times a day. See the Lond. Med. Trans, vol. ii. p. 59. iii. 1 37. Medical Obs. and Inq. v. 233. 252. London Med. Journal, v. 162. Memoirs of the Medical Society of London, 238. 306. R AN G i22 A N H ANGIOLO GIA, ANGEILOGIA, (from xyyuov, vas, and Xeycs, sermo). Anchology. It treats of the glands, lacteals, lymphaeducts, nerves, arteries, veins, and other vessels; including their structure and dis- tribution. AN GO'LAM. It belongs to a new genus, not yet to be found in the systems^ the alangium. It belongs , to strangle). A nervous sort of quinsy. Vogel defines it to be an acute stop- ping up of the fauces, without inflammation. The con- vulsive quinsy, and hysteric suffocation, are enumerated among its species. A'NGOR, (from an go, to trouble). A concentration of the natural heat of the body, causing a palpitation of the heart and anxiety. In the beginning of a fever it is a bad prognostic. A'NGOS, a vessel ; a receptacle of humours. See Vas. ANGSA'NA, vel ANSAVA, (Indian,) called also draco arbor. It grows in the East Indies. The liquor which distils from a wound made in this tree is used as a medicine, when it is condensed into a gummy consistence. It is of a red colour, astringent, and is sold for dragon's blood. Raii Hist. Plant. Dale. It has not yet been reduced to its place in the vegetable system. A'NGU. See Cassada. ANGUI'LLA, (from tv, and xsop.xi, to involve, be- cause it rolls itself in the mud). The eel. Eels that are met with in rivers, or other clear run- ning waters, are the best; the liver and the gall are extremely acrid. Boerhaave says, that no fish has a more acrid gall; and that with a mixture of the galls of the eel and the pike, made into pills, he hath cured many rickety children with hard and swelled bellies. The torpedo, or torporific eel, found in Guiana, in South America, if caught by a hook, violently shocks the person who holds the line; and the shock is com- municated in a circle like the electrical. Hence it is called the electric eel. No shock is perceived by holding the hand in the water near the fish when it is neither displeased nor touched; but if it is angry, it can give a shock to a person at five or six inches distance. This shock is produced by an emission of electric or Galvanic energy, which the fish discharges at pleasure. On the death of the animal no such property remains, and then the Indians eat it. A'NGUIS. Serpens anguis, anguis coluber natrix torquata, the snake. Our snakes in England, and those in other cold coun- tries, the viper excepted, do not injure us with their bites. Their fat is as good as that of the viper. ANGUI'UM SENE'CTjE. The exuvie, or skins of serpents that are cast in spring; the slough or cast skin of a snake is as good. A decoction of it boiled m wine is said to cure deafness, pain in the ears, &c. ANGULA'RIS ARTE'RIA, (from angulus, an an- gle). See MAXILLARIiE ARTERIA. Angula'ris musculus. See Levator scapulae et PATI ENTIRE. A'NGULI O'CULI, (from angulus, an angle). See Canthi. ANGULUS ACU'TUS TI'BIiE. The spine of the tibia, or the shin. ANGU'RIA, (from xyyos, a vessel,) so called because it resembles a cup. See Citrullus. ANGUSTA'TIO,? (from angustus, strait). Anxi- ANGU'STIA, 5 ETY' restlessness in distempers. They also signify a narrowness of the vessels. ANGUSTIFO'LIA PLANTA'GO, (from angus- tum, narrow, and folium, a leaf). See Plantago MINOR. ANGUSTU'R.E CORTEX, Angustura bark. This bark, at first imported in the year 1788, was sup- posed to be the production of a tree on the coast of Africa; but it is now found to come from the Spanish main. Mr. Bruce pronounced it to be the bark of a tree called wooginos, by which he was cured of the dysentery in Abyssinia; and having brought over some seeds, and planted them in Kew gardens, their product he calls Brucea antidysenterica, vel ferruginea; but, in the Medical Commentaries of Edinburgh, 1790, they are, on comparison, proved to be very dif- ferent. This bark is imported in pieces of six inches long, and one inch and a half in breadth. The epider- mis is whitish, the substance compact, and the colour, when powdered, not unlike that of rhubarb. It is a powerful bitter, joined with an aroma, not much more pungent than cascarilla, having a portion of pure oil, which approaches in its nature to camphor. It seems ateo to possess a narcotic principle ; and has been con- sidered more powerful than the Peruvian bark, both as a tonic and antiseptic : the virtues reside more in its gummy than resinous extract; but both are extracted by warm water, together with the oily portion. The diseases in which this medicine has been employed are those in which the Peruvian bark has been useful. In intermittents it is generally inferior in efficacy; in low fevers, and those of the putrid kind, it has seemed su- perior. In head-achs, attended with fever, but aris- ing from the stomach ; in dysentery, and dyspepsia; it has been of great service. From various experiments, the Angustura bark se.ems to claim the highest rank as an antiseptic. An extract is made in the following manner : Take four ounces of the Angustura bark, put it into a flannel bag of a conical shape, pour upon this boiling water, and repeat it till the filtering liquor has but little taste or colour. Let the infusion be evaporated by a gentle heat, and thirteen drams and twenty grains of extract, of the full flavour of the bark, containing two drams of resinous matter, will remain. See Brande's Experiments and Observations on Angustura Bark. ANHA'LDINUM. An epithet of a corrosive, de- scribed by Hartman. ANHALTI'NAREMEDIA,(from anhelo,to breathe with difficulty). Medicines which facilitate respiration. AN I 12; AN I ANHALTFNA A'QUA. Ajjhalt water of the Brandenburg Dispensatory. Sp. vini rect. is distilled from turpentine, and twelve or thirteen other ingre^ dients of the aromatic kind added; but a more elegant spirit of a similar nature may be obtained by mixing a proper quantity of the essential oils of rosemary, laven- der, or sage, with the common oil of turpentine, and then distilling them from spirit of wine. This water is an excellent cordial. ANHELA'TIO, A'NHELO, ANHELI'TUS,(from anhelo, to breathe short,) panting. A shortness of breath after strong exercise. In fevers, dropsies, asth- mas, pleurisies, &c. there is always an anhelitus. To express this Hippocrates often uses the word pneuma ; but the same term amongst the chemists signifies smoke, and also horse dung ; this last is called, when hot, cancinpericon. An aquatic bird of prey in Its horn is esteemed an an- ANHI'MA. (Indian). Brasil, larger than a swan tidote against poison. ANHUI'BA. (Indian). See Sassafras. ANICE'TON, (from x, privat. and vixxu, to con- quer,) invincible. An epithet for a plaster ascribed to Crito; an infallible remedy for the acbres. ANICE'TUM. See Anisum. ANI'DROS, 1 f, , .* _, ANIDROSIS, I g™™ -» neS- *nd '*>••» t0 s™ea*>- ANIDROTI, J Without sweat. A'NIL. See Indicum. A'NIMA MUNDI, (from xvc^os, wind, spirit). The soul of the.wolrd. The ubiquitarian principle of Plato, like Des Cartes' aether, pervading and influencing all parts and places, and the archaeus of Van Helmont and Paracelsus. In the works of the elder chemists and pharmaceutists, it means a concentration of the virtues of bodies, by any means that can be supposed to deve- lop their powers, as solution, distillation, &c. Thus we have animajaspidis, aloes, and rhubarbari. A'nima pulmonum. A name given to saffron on ac- count of its supposed use in asthmas. See Crocus. A'nima hepatis. The name of sal martis. A'nima orticulorum. A term for hermodac- tylls, Sec. A'NIM.fi. The vesicles of herrings; are thus called because they are light and full of wind. They are supposed to he diuretic. A'NIMAL, (from an-'una, life). All bodies endowed With life, and with a power of spontaneous motion ne- cessary to support life, are called animals. Animals are thus distinguished in general from vegetables. But perhaps a more correct and scientific definition is the following:—An animal is an otganized body, sensible, capable of voluntary motion, provided with a central organ of digestion. They are all capable of reproduc- ing their like: some, by the union of the two sexes, produce small living creatures, and are called vivipa- rous ; others lay eggs, which require a due temperature to produce young, styled oviparous; some multiply without conjunction of sexes, hermaphrodites ; and others are reproduced when cut in pieces, like the roots of plants, ani7nal plants. After man, all other animals have been divided into eight classes, in the following manner : DAUBENTON'S Division and Characters of the Eight Classes of Animals. Having a head. The most part having no head. With nostrils. Without nostrils. With ears. Without ears. Two ventricles in the j heart. One ventricle in the heart. The heart variously form-ed, or unknown. Warm blood. Blood nearly cold. A whitish fluid instead of blood. Inspiring and expiring air frequently. Inspiring and expiring air at long intervals by lungs. Admitting the air by gills. Admitting the air by spiracula. No apparent entrance or aperture to admit air. Viviparous. Oviparous. With teats. Without teats. 1st Ord. Quadru-peds. 2d Ord. Cetaceous Animals. 3d Ord. Birds. 4th Ord. Oviparous Quadrupds. 5th Ord. Serpents. 6th Ord. Fishes. 7th Ord. Insects. 8th Ord. Worms. Four feet and hairy skin. Fins and no hair. Feathered. Four feet and no hair. Scaly with-out feet or fins. Scaly with fins. Having antennae. Having neither feet nor scales. R2 A N JL 1*4 v N I We shall add the Arrangement of CUVIER, which is in general preferred Apimals with vertebrae. . C Viviparous with mammae. ,Blood hot: heart with two ventricles, j Oviparous without mammae Animals without ver tebrae. i • i S L.ungs soineuiucs wi 'Blood cold: heart with one ventricle. ^ GiUs without lungs. With blood vessels Mammalia Aves. Reptiles. Fish. C Lungs sometimes with gills I Gills without lungs. A simple spinal marrow without articulated limbs. Molluscae. without articulated lim1- - with articulated limbs \ A knotty spinal marrow without articulated limbs. Vermes Crustacea?. C A knotty spinal marrow with articulated limbs. Insects, Without blood vessels. | Nq gpmal marrow . no articulated limbs. Zoophytes We may subjoin for its curiosity, perhaps from its scientific accuracy, that of M. VIREY ; premising only, that he understands, by the great sympathic or intercostal, a nervous system, not immediately and directly issuing from a brain, but, like the intercostal in the human body, composed of nerves from different sources. With two nervous systems, the cerebral and sympathic: ■ • With a nervous system surround- \nimals. -^ ing the oesophagus, the sym- pathic : With nervous molecules; zoo- phytes. Animal substances differ from vegetable in their che- mical nature and changes they spontaneously undergo. Though not peculiar to the animal system, yet azote and phosphoric acid are their most distinguishing in- gredients. The acid gives the distinguishing appear- ances to the earth which forms their basis, and the azote is the chief principle of the volatile alkali, formed during their spontaneous decomposition by putrefaction. Vo- latile alkali is contained in animal substances when en- tire, particularly in the blood, where it exists in an am- moniacal salt; but its proximate principles, azote and hydrogen, are more frequently found, and the alkali is formed during the decomposition. The same princi- ples are found, also, in the gluten of farinaceous seeds, in mushrooms, and many other vegetable substances, par- ticularly in the whole family of the cruciferae ; and a vo- latile alkali is separated from vegetables in various che- mical processes. Hydrogen, its other principle, is more generally diffused through the vegetable and mineral kingdoms, and can scarcely be* considered as an animal substance. Carbone, oxygen, and lime, the other ani- mal radicals, are found in almost every substance. There seems to be no peculiar animal acid. The zoonic and sebaeic are probably the acetous: the acid of ants and of silk, the formic and bombic, are acetous. The Prussic acid is still little known; and if any merit the appellation of animal acids, they are the phosphoric and the uric : of which the latter is only peculiar to the animal kingdom, and perhaps may at last appear to be the oxalic disguised by azote, as Proust supposes the bombic acid to be. The other animal productions are fibrin, albumen, gelatine, mucilage, oils, sugar, resins, sulphur, and iron occasionally, perhaps accidentally, occurring. Gelatine and mucilage connect animal with v-.y-etable substances, as they admit of the acetous fer- With hot blood C Mammalia. I Birds. With cold blood J J*ePtlles- ? rish. With a heart Without a heart Solitary United C Molluscae. I Shell-fish. C Insects. I Worms. C Echinodermes. £ Hydri and infusory animals. C Corals and ceratophytes. £ Madrepores and sponges. mentation. With oxygen, mucilages form resins, of which there are few examples in the animal system, and the proportions are small. If we recollect rightly, the bile, the cerumen of the ear, and the urine, are the only instances in the human body. The oils and fats of animals, like the gross oil of ve- getables, are soluble either in water or in spirit of wine, by the intervention of a third body only, as mucilage or gum. The oils of animals differ from those of vegeta- bles.—1. The finer animal oils are not, like the vegeta- ble, procured by a moist, but almost always by a dry distillation, that is, by combustion; and hence all ani- mal oils have an empyreumatic smell. 2. Though an acid is found in the fat of animals, yet in the distilled oils of animal matter a volatile alkaline property is found; but in those of vegetables there is always an acid. The volatile alkaline salts, therefore, contained in the oils of animals, render them more penetrating and stimulating than the distilled oils of vegetables. One drop of the ol. c. c. intimately mixed with the sp. vini. rectif. 3ij. is powerfully stimulant and sudorific. Independent of the oil collected in the cells of the adipose membrane, or that obtained by distillation, the decom- position of animal substances, by means of the nitrous acid, procures it in considerable purity. The odorous matter of some animal substances, as musk, castor, &c. is, like the essential oils or resins of vegetables, soluble in sp. vini rectificati, and volatile in the heat of boiling water. The gelatinous principle of animals, like the gum of vegetables, dissolves in water, but not in spirit or in oil. Like the gums, also, it renders oils and fats mis- cible with water. However, many animal juices differ greatly even in these general properties from the corresponding ones of vegetables. Thus animal A MI 125 A M J serum, which appears similar to vegetable gummy juices, and mingles with cold or warm water, concretes by heat into a solid mass: the heat necessary is about one hundred and fifty of Fahrenheit. Animal substances become putrid much sooner than vegetable ones, and when corrupted are much more of- fensive. See Putredo. Animal matter, burnt in the open air, is resolved, like vegetables, into soot and Ushes, but with this dif- ference, that no fixed alkaline salt can be obtained from the ashes, and no acid vapour accompanies the smoke. Exposed to the fire in close vessels, after the watery moisture, a volatile alkaline salt is obtained, together with an empyreumatic oil that is more fetid than that from vegetables. Animal bezoa-'rdicum occidentals. The lesser American deer. Animal bezoa'rdicum orienta'le. The bezoar GOAT. Animal moschi'ferum. The musk animal. See Mo'schus. Animal zibe'tkicum. See Zibe'thum. Animal kingdom. It is not our object to ascertain with precision the limits of this kingdom of nature, or to mark the various shades of distinction between ani- mals and vegetables. It occurs in this place chiefly to notice the various medicines which it affords. The mam7nalia chiefly furnish aliment; yet artificial teeth are formed from those of the trichecus 7nanatus: castor and civet from the viverra zibetha and castor fi- ber; musk from the moschus moschiferus. The various species of cervus afford a nutrient jelly from their horns, and formerly the volatile alkali was also prepared from them, though now supplied by bones. The milk of the cow, the goat, the mare, and ewe, are well known; and the suet of the sheep, and the lard of the hog, need scarcely to be noticed. The morbid concretions,, the bezoars, are not at present employed; the elk's hoof is disregarded; the bile of the ox and sheep seldom prescribed; and the gastric juices chiefly used as an external application. Thephyseter macrocephalus, from the cetaceous tribe, furnishes the spermaceti, now styled adipocire; and the different species of sturgeon, from their air bladders, the isinglass. The oil which spontaneously separates from the liver of the pike (esox lucius) is used in ob- fuscation of the eyes; the oil from the liver of the cod- "Tish in rheumatism. Among the amphibia, the rana esculenta is nutri- tious; and the rana bufo, it is said, has been used in cancers, by sucking the venom. Several of the lizards are supposed to possess medicinal powers. The /. agi- lis has been used as a remedy for cancers; the I. scin- cus as an aphrodisiac: and the flesh of the /. iguana, like that of some of tne whales, has been suspected of exciting to action the latent venereal poison. Of insects we shall on a future occasion treat more at length. See Insecta. The vermes intestina furnish the lumbricus terrestris and the leeches; of the 7nollusce, we employ only the sepia officinalis, and the Umax maxi- mus terrestris; of the testacea, the ostrea edulis and maxima, and the helix pomatia ; of the lythophites the madrepore, the coralline, the corals, and the sponges. ANIMALCULE. A diminutive of the word ani- mal; that is, they are such little creatures as require to be viewed through glassesHo discern them distinctly. Rain, snow, and dew, contain them in great numbers. In boiled Water they sometimes revive. The animalculae in a fluid are generally collected in a mass; if disturbed, they separate, as fish in a pond, and continue for a time distant from each other. They fol- low the fluid to the last drop, and then seem to struggle and die; after their apparent death, on adding water, they revive. When seemingly dead, they are very flat; but soon recover their plumpness when revived. They are destroyed by the slightest atom of oil of vi- triol ;_of solutions of common salt, salt of tartar, and sugar: urine and blood are equally fatal. In short,, animal life abounds so copiously, that wherever a nidus occurs, its peculiar animals are found; but in this place we must consider them only as con- nected with medicine. The animalcules discovered by Lewenhoeck in male semen, encouraged physiologists to suppose that they had unravelled the mysterious subject of generation. More mature reflection and repeated observation have, however, dissipated the phantom, as we shall see under that article. Animal- cules have also been considered as the causes of various diseases. Linnaeus's Dissertation on the fifth volume of the Amcenitates Academicae, entitled Exanthemata Viva, contains almost all the facts dispersed in various authors on this subject; and Langius has with equal anxiety reduced almost every disease to this cause. The complaints enumerated by Linnaeus as owing to animal- . cules are, itch, dysentery, hooping-cough, small-pox, measles, plague, and syphilis. With respect to dysen- tery the argument is curious: in dysenteric stools, ani- malcules were found, and these animalcules were only , killed by an infusion of rhubarb. Unfortunately, rhu- barb will not cure dysentery. At present it is doubted whether even the itch is owing to animalcules. A later idea of a disease from animals is that of Mr. Adams, who derives cancer from a species of tenia. His arguments are at least specious, and they will be considered in their proper place. See T^nia and Cancer. See Philos. Trans. Abr. vol. iii. Dr. Hook's Micro- graphia. ANIMA'LE DIPPE'LII, O'leum. Dippel's ani- mal oil. This is a common animal oil highly rectified: the number of rectifications required is in proportion to the former state of the oil: seldom less than six are neces- sary. 11 must be closely kept from the access of the air. Animal oils thus rectified are thin, limpid, and of a subtile, penetrating, not disagreeable smell and taste. They are antispasmodic, sedative, and diaphoretic, in doses, from five to thirty drops. Hoffman speaks highly in their favour, observing, that one dose excites sweat, and supports it for twenty-four hours without languor or debility; and that if twenty or more drops are given on an empty stomach, six hours before the accession of an intermittent fever, they frequently remove the disorder: in chronical epilepsies and other convulsive symptoms, especially if given before the usual time of the an. ck, and preceded by proper evacuations, they are cnectual. They lose much of their quality by keeping. All onpyreumatic oils dissolve in sp. vini rect. • and the more they are rectified, the easier is their solution, a circumstance in which they differ from essential oils, ANi 126 A N J which, by repeated distillations, become more difficult to dissolve. ANIMA'LIS FACU'LTAS. See Facultas and Actio. Anim.v'lis mo'tus. Animal motion. This is the same with muscular motion, and is di- vided into two species sufficiently known, voluntary and involuntary. See Musculus. Anima'lis spiritus. Animal spirits. See Cali- DUM INNATUM. ANIMA'TIO,{from ammo, to give life, to animate). Animation. The particular effect produced by the vis vitae in all animated bodies, by which life is begun and supported. A'NIME, so called from its refreshing odour. The Portuguese corrupted the word anime into ani7ne. The gum anime is also called resina anime, and courbaril rezina, aminea, animum. By Piso the tree from whence it is obtained is called jetaiba, by the In- dians courbaril. Hymenea courbaril Lin. Sp. PI. 537. The gum anime is a transparent, yellowish white, resinous gum, obtained from a large tree in Brasil, New Spain, and the East. 1 he latter Dioscorides calls by the names myrrha and minea; but in our shops we have no other than the American kind. The small tears are the purest. It hath but little taste, though to the smell it is very agreeable. It easily breaks between the teeth; but if chewed for some time, it softens and becomes adhesive. If it is laid on a red-hot iron it im- mediately melts, inflames, and burns quickly away, leav- ing only very little white ashes. It dissolves in sp. vini R. but is very little affected by water, except in distillation, when a part of its flavour and a small quantity of oil rise. The Brasilians are said to use it in fumigations for pains and achs from cold; for palsy and contractions. With us it is esteem- ed diuretic. The dose is 9 i. The gum copal is often sold for it. ANIMELLjE. The glandules under the ears, and under the lower jaw, called lactidnia. ANIMI, et ANIMJE DELIQUIUM. .See Lipo- THYMIA. ANIMI'FERA A'RBOR BRASILIA'NA. See Courbaril. ANIMUM. See Anime. A'NIMUS, (from xvi/ms, wi7id or spirit). The mind. The body and the mind reciprocally affect each other; whatever invigorates the body, renders the faculties of the soul proportionably active and strong: what de- presses the strength lessens the spirit, the resolution, and the more active intellectual faculties. The circulation of the blood not only unites the soul with the body, but also governs and directs its opera- tions ; with the circulation of the blood, the animal and vital functions continue: they vary, and cease to be, ac- cording as the circulation varies or ceases. To preserve, then, the faculties of each, we must attend to the health of both. The regulation of the mind is consequently a subject of the highest importance, and must be considered at some length; both as it affects individuals adapted for different employments, as necessary to the preserva- tion of health, and as a means of alleviating disease, and assisting the powers of medicine. The medicina mentis has not, perhaps, obtained a sufficient share of attention; and the few dissertations by Hoffman, Boerhaave, aha Gaubius, have scarcely elucidated so intricate a subject. It has been long since observed, that the most furious and courageous animals possessed strong fibres, a rich glutinous blood, and solids remarkably firm. The bones of the lion are said to be capable of striking fire with steel. These corresponding states of mind and body- are supported by large supplies of animal food; and we animate the spirit of cocks fed for combat, of horses for speed, and of pugilists, by food of a nourishing power beyond the usual standard, which will afford strength, without overfilling the vessels. A more calm and steady exertion of mind, a collect- ed coolness, and an accurate discrimination of circum- stances, in general similar, are connected with a very different state of body. The fever, excited by high diet, will not fit a person for duties of this kind. The sleep must be calm and undisturbed; the stomach not oppressed with crudities; the vessels not overfilled; the secretions neither obstructed nor preternaturally pro- pelled. It is the state in which the student will best succeed; it is that to which the gamester, with unre- mitted attention, brings his constitution; and it is that perhaps most consistent with the best state of the intel- lectual faculties. Yet a habit of study cannot be long indulged with perfect impunity. This regular co-opera- tion of body and mind is disturbed by the late hours which sometimes study demands; by the inactivity which persevering attention occasions. To the regular, calm performance of the functions succeeds from these causes a mind agitated and irritable; a stomach loaded with flatulence; bowels oppressed by accumula- tions. The powers of the mind are heightened to un- usual quickness, and the body seems to want the activi- ty thus diverted to other purposes. Yet the mind is a considerable gainer by the exchange. Fancy is more alive; analogies, remote and in general unperceived, become obvious; the imagination active, embodies airy nothings, and gives form, shape, and semblance, with hues more vivid than nature would own. The body, however, sinks under the exertion; and the irritable, sleepless, jaundiced, student, is the prey to the natural ills in consequence of his own irregularities, and to those which his imagination, thus exalted, portrays; happy to lose them in insensibility, or to exhibit an ex- ample how low human intellect can sink, as well as to what a height it can soar. Indolence, combined with free luxurious living, gives another turn to the intellectual faculties. The vessels overloaded, produce languor, an incapacity for exertion, and at last a real, unconquerable debility. In this state, too, the mind equally suffers. Listlessness, inactivity, and lethargy, come on; the mind and body, equally tor- pid, sink together, and no cause §f debility produces ef- fects so difficultly subdued. Abstinence, even conducted with caution, occasions fainting; exercise is attended with the most distressing fatigue; and the abridgment of the long protracted slumbers induces even a worse languor than it was intended to relieve. An entire loss of sleep and of appetite, as well as of memory, and some- times of reason, are the consequences. Great exertions of mind and body are not attended with effects so fatal. If united, they seem scarcely in- jurious. Exertions of body alone, if regular occasional sleep is allowed, do little harm; and exertions of mind, A NI 127 A N I though strong and long continued, with moderate at- tention to hours of relaxation and rest, are not very in- jurious. The sailor and the mathematician are, perhaps, the persons who afford the strongest examples of each, and both have been remarkable for longevity. The indulgence of passions, in every instance, un- dermines the constitution. The present subject con- fines us to mental passions. Anger, in excess, is a short madness, and unfits every man for careful enquiry and examination. Fear deprives us of our resources, and grief depresses every bodily function. Even joy, by extreme animation, has been fatal; and love, ab- sorbing every other feeling, has, even when successful, been little less injurious. In short, every passion should be kept in due subordination, and regulated by reason and judgment. We are thus brought to the next part of our enquiry— the regulation of the mind, as necessary to the preserva- tion of health. The Almighty, when he gave us pas- sions, bestowed also reason and judgment. By the due subordination of the former to the latter we obtain the chief good, mens sana in corpore sano. Yet it is with passions as with other causes of disease ; they are hurt- ful only in excess. They are given to vary the dull uniformity which, without them, would ensue; to agi- tate the stagnant lake, which might otherwise become putrid and injurious. Our hopes, our fears, our joys, and sorrows, become useful stimuli to the intellectual system, as wine, and sometimes high foods, to the ma- terial. The torpid misanthrope, and the most strictly temperate men, are seldom healthy .or long lived. The principle within us, which regulates our systems, which corrects our deviations, and urges us to the supply of our wants, languishes for want of action, as the muscle no longer exercised loses its power. In short, our frame is adapted for action : let the causes of activity cease, and we can no longer exist. Let not this be considered as the language of Brunoniasm, or the apology for ex- cess. We disapprove of each : but a man may vary his habits without becoming a glutton or a drunkard; and may speak the language of common observation, with- out being wedded to a sect. The regulation of the mind is of great importance in a studious man. The hour of sleep should not ap- proach, while the mind is irritated by study. A calm serenity should be allowed to steal on, by light conversa- tion, or by works which engage the attention, with- out mental exertion, before the time of retiring, and that time should not be protracted beyond eleven. Dur- ing the times of study, the mind should never be forced to labour. It is sometimes less fitted than at others; and it often happens that the period of the best health is not that of successful study. The mind is then seemingly too much alive for confinement to a single subject, and will bend with greater ease when a little bodily fatigue has checked its too soaring flights. The studies also should be varied: few men studied more than Lord Kaimes; yet few preserved the mental powers so little weakened to extreme old age. This he owed to the variety of his studies, and to mixing them with the af- fairs of common life. A student was supposed to be above these; but he will gain little in the estima- tion of those " whose praise is fame;" he will gain little in mental or corporeal vigour for being so. Per- haps a student should be abstemious : this is,-indeed, ne- cessary, unless he combines bodily exercise with study; but he should certainly avoid studying soon after his meals, however slight they may be. An important regulation of mind, particularly to the student, is the power of turning to a different subject, from that which engages his attention, without confu- sion or difficulty. This power few possess, but it is not difficult of attainment. It chiefly consists in having clear ideas on every subject, and declining any, until reflection has given that clearness, which enables us to see at once the whole of it with its various bearings. W hen this is attained, it is only necessary to avoid hurry. If a new subject is started, a few minutes' delay will pre- vent confusion; and, before custom has made a change common, the time allowed for the mind to resign one, and resume the other, should be enlarged. By habit, as usual, great facility in the process will be acquired, and it will seem intuitive. A very convenient power which may perhaps also be easily acquired is, that of employ- ing the mind at once on two subjects of unequal im- portance ; to talk, for instance, on common topics in general company, while the mind pursues some abstruse and intricate reasoning in its own recesses. This, we believe, is attained only by exercise and experience. The regulation of the mind is of great importance in alleviating disease, and assisting the power of medicine. The effects of diseases purely corporeal, on the mind, are singular. In hectics, for instance, confidence of returning health constantly prevails, notwithstanding the hasty approaches of debility in every form. In syphilis, where there is no real danger, the mind is in as great a degree depressed, with an equal confidence of not surviving. In some fevers, the depression is so great, and the certainty of dying so strongly fixed, that the patient looks on the person as his worst enemy. who Ibretels a different event. We might pursue this connection between the mind and body in a great va- riety of diseases. We mention them as instances only, to render the directions for the management more easy. Of the confident state of mind little need be said; yet this confidence must be sometimes lessened, when the arrangement of worldly affairs is necessary. When the mind is unreasonably depressed, ridicule and argument are equally cruel and misapplied. To reason with a madman is ridiculous ; and the mind is partially derang- ed, which admits such unreasonable fears. The best method is to admit the danger, but to magnify the power of medicine; and, if any instance of recovery can be found in similar circumstances, ostentatiously to point it out. Mental impressions, except in very particular complaints, are by no means very permanent. - They will in time lose their power; but, unfortunately, in many instances this power is retained till the constitu- tion has received irretrievable injury. The operation of medicines is sometimes assisted in chronic cases by exciting hope, and placing the com- pletion of the expectations at a distance. If, by the relief of a troublesome symptom, one step can be gain- ed, it will give a confidence which will materially assist the future progress. Cheerful conversation,where the strength will permit, is of great importance in amusing the mind. The com- plaints, however, should not form the subject, nor should it be unkindly disregarded. When it unavoidably re- curs, the conversation should be dexterously shifted; AN I 128 ANN not, as if that topic was forbidden, but as if it was not of importance, or because something more interesting offered. In general, patients should have sufficient power over their minds to prevent irritation from little inconveniences or disappointments, that must occasion- ally happen from the failure of their medicines. The calm, well-regulated mind possesses considerable ad- vantages over the hasty, the fretful, and impatient. The one will recover in the most apparently desperate circumstances; the other will yield to diseases, scarcely in themselves dangerous. ANl'NGA'IBA, (Indian,) Brasil. arbor aquatica. The genus has not been ascertained. It seems to .be- long to the families of the balisiers and aroids. The bulbous roots of the aquatic species are used for fomentations against inflations of the hypochondria. Of that species which is found in the woods, the leaves are bruised and applied as a general remedy for healing ulcers. Raii Hist. PI. ANISA'TUM, (from xvio-ev, aniseseed). A wine in which aniseseeds are infused. ANISCA'LPTOR,(fromcwws, the breech, andscalpo, to scratch). See Latissimus dorsi. ANI'SUM, A'NESUM, ANICE'TUM, A'NISE. It is the piinpinella anisum Lin. Sp. PI. 379. Anisum herbarioru7n. Common anise. The common anise is a native of Egypt, Crete, and Syria: cultivated in the southern parts of Europe, and grows in our gardens in England; but it does not arrive at any great degree of perfection with us. The seeds only are used in medicine: those which are produced in Spain are smaller than those collected in other coun- tries, and are generally the most esteemed. A-niseseeds have an agreeable aromatic odour, and to the taste they are gratefully warm, with a degree Of sweetness ; they are much used in flatulent complaints, and a scruple of the powder has been given for a dose, and in spasms of the bowels: they are also moderately anodyne, diaphoretic, diuretic, and discutient; an in- fusion of them in water moderates the thirst in "a dropsy, and abates the diarrhoea; the fume received through the nostrils is said to abate head-ach; they promote an ap- petite, and check convulsive coughs, when a flatus and coldness in the stomach are the causes. They are sup- posed to increase the milk in nurses. Geoffroy says the odour isperceptible in that fluid. Cullen's Mat. Med. -Those who are offended with the seeds may employ the tincture, for the spirit in some measure covers their flavour. Water and spirit of wine both completely extract the virtues of aniseseeds; but in distillation very little of the seeds are carried over with the spirit; however, after its evaporation, a powerful and agreeable extract re- mains. Angelica seeds are added to improve the flavour of those of the anise, in the compound water of aniseseeds. This water is apt to be milky if drawn so low as direct- ed in the dispensatory: it has been considered an elegant cordial stomachic medicine; a glass of it assists diges- tion after full meals, and when vegetables have been too freely eaten. Along with the water in distillation, their essential oil, called by Van Helmont intestinorum solamen, arises to the quantity of ^ i. from ffe iii.; it possesses the taste, smell, and all the virtues of the seeds in the highest perfection: it congeals when the air is not sen- sibly cold into a butyraceous consistence: so that the water in the refrigeratory should rather be warm, par- ticularly towards the end of the process. The dose is from ten to thirty drops. This oil is also obtained from aniseseeds by expression; it is of a greenish colour, grateful to the taste, and strong of the seeds, of which, if sixteen ounces are lightly moistened by exposure to the steam of boiling water, about an ounce of oil may be obtained from them. This oil is gross, insipid, and inodorous, similar to the common expressed ones, with a part of the essential oil of the seed, on which its flavour depends. If this ex- pressed oil is digested in rectified spirit of wine, the essential oil is extracted from it; or if it is distilled in water, the essential oil rises and leaves the other behind. The gross oil seems to reside in the kernel of the seed, the essential in the cortical part. Ani'sum I'ndicum, Stellatum; Sinense; Phillipense; . Badian Semen; .F"aniculum Sinense; Cardamomum Siberiense; Zingi. Indian or stellated anise. It is the produce of a small tree which grows in Tartary, China, and the Philippine islands. The husks contain the chief of the flavour, which is the same as that of the common a7iiseseed, but not so fiery: if they are digested in spirit of wine, they yield a most acrid resinous extract. The seeds afford "much essential oil by distillation in water, which is thinner, more limpid, and more fragrant than that from the common sort. The seeds of this species of aniseseed are not yet common in the shops, though they are deserving of a preference to those in use. To the virtues of the com- mon aniseseeds they are supposed to add an expectorant power, and to be useful in atonic diseases of the lungs. ' Added to tea they make it more grateful and less in- jurious. The dose of the powder is 3 ss. In infusion 3 i. is added to a pint of water. Ani'sum fructico'sum Galbani'ferum ;—Africanum fructicescens, folio, et cdule vere ceruleo tinctis. See Galbanum. . ANNETE'STES. So Paracelsus call's the Galenists, because he thought them ignorant of the causes and principles of things. ANNO'RA. See Ovorum testje et calx. ANNOTA'TIO, (from annoto, to mark). The very beginning of a febrile paroxysm, called also the attack of the paroxysm. There is another annotatio or episma- sia, proper to hectic fevers soon after eating: in this there is no previous shivering. ANNUE'NTES MUSCULI,(from annuo, to nod,) so called, because they perform the office of nodding or bending the head downwards. See Rectus internus minor. ANNULA'RIS CARTILAGO; is thus named from its shape, annulus, a ring. See Cricoides. Annula'ris digitus. The ring-finger, or that next to the little one. Annula'ris vena. The vein betwixt the ring and little finger. Annula'res ligaments, the name of those liga- ments which confine the tendons of the carpus and tansus. Annula'ris muscle. Sphincter ani. Annula'ris process. A protuberance of the me- dulla oblongata. A N O 129 A N 0 A'XNI'TEMPORA CONSTA'NTIA, vel IN- CONSTA'NTIA. Consistent seasons, such as keep their usual temperature. Or inconsistent seasons, when the weather is unsettled. A'NNUS A'MADIN. Long life. A'NO, xva, upwards. Anothen. The superior parts. Emetics are thus called, as purging medicines are called xxru, downwards. • ANOCATHA'RTICA, (from xv» upwards, and xxixipu, purgo). Medicines which purge upwards, as emetics. ANOCHEI'LON, (from xva, and ^£/a©^ a lip). The upper lip. ANOCCE'LIA. See Ccelia. ANO'CHUS, (from «v£?^<», to retain). A stoppage of the intestinal discharge. ANO'DMON, (from x, neg. and■ ofoa, a S7nell). Without smell. It stands opposed to fetid. ANO'DUS. A word used by chemists for what is separated from the nourishment by the kidneys. The Greek word xvoo^as, anodus, (from x, neg. and o$xs, a tooth,) signifies toothless'. ANO'DYNA, (from x, neg. and S^wy, pai7i). Anodynes are medicines which ease pain and procure sleep. They are usually divided into three sorts, viz. 1. Paregorica. Uxpy,yopiu, mitigo, called also anetica. Paregorics, or such as assuage pain. 2. Hypnotica, hypnop^eos. Hypnotics, or such as relieve by procuring sleep ; t5?rv«s, so7nnus. 3. Narcotica. Narcotic, or such as ease the pa- tient by stupifying him; vxpxou, stupefacio. These divisions are not hoAvever correct, as there is no distinction between paregorics and hypnotics, except in degree; nor is there any evidence of the stupefa- cients acting differently from the latter: it would, at least, be a difficult task to ascertain where the one order begins, and the other ends. We would suggest a'more natural and convenient division, viz. narcotics and in- irritants; the first to "be again divided into opiates and stupefacients; the second into medicines which excite new motions, or those which remove sources of irrita- tion. We thus include anodynes of every kind. Though we cannot accurately discriminate between the opiates and stupefacients in their respective lists, where they approach near to each other, we can distin- guish them in their extremes; and may instance, as examples, opium and hemlock. The opium, we know, is taken from the poppy; but its natural order, the rheades, affords no other medicine. The umbellate contain the hemlock and the dropwort; and the solanacee plants of the strongest carcotic powers, solanum, digi- talis, hyoscyamus, datura, and many others. From other classes of plants we find the wolf's bane, (aconi- tum napellus,) flammula Jovis, lactuca virosa, lauroce- rasus, (prunus lauroccrasis,) camphire, laurus cam- phora,) agaricus muscarius, coculus Indicus, lolium temulentum, (l.spicis aristatis,) and the Indian hemp, cannabis sativa. Chemistry gives us the oil of wine, nitrous aether, wine, and ardent spirits. All these seem to act in a way somewhat similar; viz. on the nervous system through the medium of the stomach, and perhaps differ only in degree; for the hemlock and the henbane, in moderate doses, seem to produce easy'and quiet rest. What change is produced in the nervous system by VOL. i. these medicines, or the opposite class of stimulants, we cannot in this place determine, because it would anticipate the subject. We may however observe, that in animals styled cerebral by Virey, (sec Animal,) the whole nervous system communicates with the head, and that the stomach is the organ by whose nerves the head is most readily affected. A small sedative power, applied to a nerve, has little influence beyond the nerve itself, and the organ to which it is sent; but the same degree of activity exerted on the stomach, produces effects more extensive, which are soon communicated to the brain and the whole system. Of the change in .the nerves from these medicines we know little. It is highly probable, that an active fluid, analogous to the electrical or Galvanic, gives them their peculiar power; that its activity is confined to the nervous fibril, which, in its minuter ramifications, is accompa- nied by a non-conducting sheath or coat. At the. ex- tremities only is the nervous fibril free from this impe- diment, and in the stomach are these extremities chiefly- accessible. The power, then, whatever it be, in seda- tive substances, which occasions this diminished action, most powerfully affects those nerves, and is from their constitution immediately communicated to the brain, diminishing or destroying its functions. The system of Dr. Brown has occasioned a consider- able change in the language of pathology and thera- peutics, by the distinction which he introduced be- tween direct and indirect stimulants. In this place it is sufficient to hint at the difference of language, be- cause it is apparently supported by stimulant powers, which, in the greater number of anodynes, are at first obvious. It has been supposed by sounder physiolo- gists, and more accurate observers, that these sub- stances contain a stimulant with the sedative power, and that the former is more quickly exerted than the latter. This idea is not however very probable, both from the great dissimilarity of the two principles, and that the previous stimulant effects are disproportioned to the sedative, while many sedatives seem to produce no previous stimulus. Both in the arterial and nervous systems we have found great reason to suspect, that irregular action has been mistaken for increased ac- tion ; and from the effects of sedatives, we very ge- nerally see irregular action only. This principle we shall have occasion to develop in explaining many parts of the animal economy. In the question before us we may instance the most common sedative, when in excess, because it is preceded by the most violent sti- mulating effects—we mean ardent spirits. While every -artery in the body seems to act with increased energy; while the more violent passions are animated to phren- sy, the voluntary muscles are certainly weakened dur- ing its action. The other intellectual functions are no longer exercised. The mind and body, even in the moments of fury, lose in many respects their power. If we are rightly informed of the effects of the Indian intoxicating powers, even in themoments of phrensy, partial debility is apparent, and, in the action of opium, we find very quickly irregular wanderings of the mind, though sometimes accompanied with a quicker or somewhat fuller pulse; and, in general, it will be very difficult to discover in this latter medicine a real stimulating power. When we consider its use A N U 130 V N O in inflammatory diseases, Ave shall show that it is sel- dom dangerous from its stimulus. The foxglove, and some others of the sola7iacee, seem to have no stimu- lating effect: they are purely sedative, and act as such on the arterial and nervous system; but it is doubtful whether they are truly anodyne or hypnotic. A tendency to sleep is constantly produced in situa- tions where we cannot readily trace the cause; viz. after a full meal. Whether, in the process of digestion, some gas of a sedative nature is evolved; or whether, as former physiologists have supposed, the pressure of the stomach on the descending vessels occasions a greater flow of blood to the head, is uncertain. Each cause may have some influence. For this reason it is needless to observe, that anodynes should not be given after a full meal: they «re at least unnecessary; yet custom has long established the innocence, if not the utility, of the fumes of tobacco in such circumstances. The inirritants, the second class of sedatives, are as various as the causes of irritation they are designed to remove. Extraordinary action, in any part, is relieved by blisters and friction; and, in some instances, well managed conversation, by inspiring hope, confidence, or cheerfulness, will produce sleep. Mental irritation is also soothed by exciting a less distressing series of thoughts; by melodious strains; by light narratives; by repeating verses or numbers; by watching, in ima- gination, corn waving in the wind ; or roving, in fancy, through well known streets and roads. All these pro- duce new motions, and less active ones, so that natural sleep soon follows. The regular movement of a coach, and, not to speak indecorously, the drawling voice of a dull preacher, will have the same effect. We remove irritation of the nerves by the use of the pediluvium; but for this purpose it should be long con- tinued, and the water not very warm; at about 98° of Fahrenheit it may be continued for more than half an hour. Irritation of the stomach may be removed by drinking cold or warm water. The irritation of too pure an air may be avoided by sleeping in a lower or more marshy situation, abounding more with hydro- gen : thus asthmatics sleep better in a less elevated spot; and hectic patients have certainly slept sounder in the neighbourhood of a stable. Vapours of nitrous aether, and of hops, scarcely belong to this head; but perhaps their powers have been greatly exaggerated. Cold has been considered as a cause of sleep: it is certainly a cause of death, beginning with torpor; but slight de- grees of cold are highly inimical to rest. Nitre, which cools the system and checks inordinate circulation, seems sometimes to occasion sleep by this operation; and camphor, in a way less obvious, seems, in febrile cases, to act as an hypnotic. A great inconvenience resulting from opiates is a languor and dizziness on the following morning, similar to what results from taking ardent spirits or wine in ex- cess. In some cases the cicuta seems to act as an anodyne, without the same consequences; and a pre- paration of opium by a surgeon of Lancaster, appears to affect the head very slightly after its operation. This is partly owing to its being a watery, rather than a spi- - rituous, solution; and a tincture from wine or weak spirit is scarcely inferior. The correctors of opium we must consider under that article. See Opium. ANO'DYNA. Indolence, or absence from pain. Synonymous with Anesthesia. ANO'DYNUM. Also ANTIPODA'GRICUM, bals. The Anodyne balsam. Bates's anodyne balsam consists of linim. sapon. ft i. tinct. theb. g iv. m. Bateman's drops are made in the same way, only with a Avcaker spirit, and tinctur- ed with aniseseeds. Bals. Anodyn. Guidonts, contains tacamahacae pul- veris terebinthinae Venet. aa p. aeq. A retort is filled to nearly two-thirds of its capacity, and the oil distilled with a fire gradually increased: The red oil swims on the water, and must be separated, but differs little from other empyreumatic oils. If two parts of opium and eight of soap are digested in 48 parts of spirit of wine, adding to the strained liquor four parts of camphor and one part oL oil of rosemary, an excellent anodyne balsam will be obtained. Ano'dynum minera'le. See Nitrum, and Nitrum stibiatum. ANO'DYNUS FOTUS. Anodyne fomenta- tion. R. Capit. papav. contus. 3* ij. Flor. sambuc. et flor. chamom. al § i. coq. in aq. font, ad Jfe ij. et colantur, adde acet. accerrim. | vi. aq. ammoniae 3 i. m. ANCE'A, ANOI'A, (from x, neg. and voos, the mind). Stupidity. See Amentia. ANOMA'LA, anomalous, (from x neg. and o^xXos, equal or smooth). Unequal, irregular. ANOMCE'OS, (<*, non, and x^oios, like). Dissimi-. lar or heterogene. Hippocrates uses this word for vis- cid or unnatural humours. ANOMPHALOS, (from x, neg. and o^pxX(^, a na- vel). Without a navel. ANO'NIS, (from x, priv. and ovy/M, to assist,) so called, because it hinders the plough; called also ononis, resta, or aresta bovis, re7nora aratri, petty-whin, cam- mock, and rest harrow. Ononis spinosa of Linnaeus, Sp*. PI. 1006. The cortical parts of the roots have a faint smell, and a sweetish bitter taste. In a dose of 3 i. they are diuretic and aperient. ANO'NYMOS, (from x, neg. and ovo^x, a name). Nameless. It was formerly a name of the cricoid cartilage; and many exotic trees and shrubs are ranked now under this name. Ano'nymos America'na. A sort of wild madder. See Rubia sylvatica l^vis. A'NORA. See OvoRum testae et calx. ANO'RCHIDES,(from x, neg. and op%is, a testicle). Such as are born without testicles. ANORE'XIA, anorexy, (from «, neg. and opt%i$, appetite): also apositia, asitia. A want of appe- tite, without loathing of food. The Greeks call such as take no food, or have no appetite, anorecti and asiti; but those who have an aversion to food, they call apositoi. This disorder, when original, is caused by bad diet, and excess in eating or drinking. In old age it may proceed from weakness. But it is more frequently a symptom Of some other disorder, particularly of fevers, and the cure depends on the removal of the original one. Dr. Cullen ranks this genus of disease in the A N S 131 A N T class locales, and order dysorexie. He seems to think it always symptomatic; yet points out two species, viz. 1. Anorex'ia humoralis, when the stomach is offended with mucous, bilious, or other humours. 2. Anorex'ia atonica, when the fibres of the stomacli have lost their tone. He uses this word ano- rexia as synonymous with dyspepsia. In the first species an emetic is highly necessary, and must be occasionally repeated, lengthening if possible the intervals; and during the interval, warm tonics apd aromatics should be employed. From the emetics a large quantity of very viscid mucus is sometimes thrown up; and it has be en an object to dissolve this substance, but no solvent has yet been found. We have tried lime water, pure kali, and ammonia, with little success. It must be occasionally discharged, and its accumulation prevented by aromatics and tonics. The whole tribe of astringents and stomachics have been employed, but scarcely any one merits a preference. Bile in the stomach produces anorexia and nausea, with a putrid taste, sensible on the back part of the tongue : this also must be discharged; but it may be corrected with lemon juice, though, in weak stomachs, a considerable commotion follows. If excess in drinking is the cause,besides temperance and a light but cordial nourishing diet, with daily ex- ercise, the dilute acid of vitriol with the bark, and, when circumstances admit, the waters of Bath, Buxton, Llandrindod, Pyrmont, and other chalybeates, will be serviceable. If acids prevail in the primae viae, vegetables should be avoided, and the diet be chiefly of the animal kind. The drink may then be Seltzer water, or any of the cha- lybeate kind; magnesia, warmed with the oil of carui, is useful; or any of the warmer bitters with the pure kali. If there are a nausea and aversion to food, the same remedies in general succeed as in a simple loss of appe- tite ; the difference of the cases consisting only in the degree. Hoffman particularly commends mint and its preparations. See Apepsia. ANO'SIA, (from x, neg. and ve«-«s,a disease). The absence of a disease. ANO'SMIA, («, non. and os-^u, odour). A dimi- nution or loss of smelling. This function may be de- stroyed in various ways, from a dryness of the pituitary membrane; its too great mucosity, as in a coryza; its infarction, as in ozaena; and from an obstruction of the nostrils, as in a polypus. According to Dr. Cullen the species may be reduced to, 1. Ano'sMia organica, when there is some evi- dent fault in the membrane that lines the nostrils, as a catarrh, a polypus, a venereal infection, &x. 2. Ano'smia atonica, when the membrane of the nostrils has no perceptible imperfection, as in pa- ralysis. In these different instances, an attention to the cause will lead to the means for relief. ANOTA'SIER. See Ammoniacus sal. ANO'THEN. See Ano. A'NPATER. See Sulphur. A'NSER. (Syriac word, auza.) The^osE. See Aliment. The fat of geese is penetrating and discutient beyond that of any other animal. A NSJUDEN. See Asaf(etida. ANTA'CIDA,(from xvn,agaiiui, and acida, acids). Antacids. Such remedies as resist or destroy acids. See Alterants. The best antacid is pure kali; but it is not suffi- cient that we destroy the present acidity in the stomach: its digestive power must be increased in such a degree as to prevent future disturbance from this cause; for Avhich purpose, see Anorexia, and Apepsia. ANTAGONI'STA, (from xvn, against, and xyuvt^oi. to strive). One acting in opposition to another. This word is applied to muscles which counteract each other. ANTA'LE. SeeANTALiuM. ANTA'LGICUS, (from xvn, against, and xXyos, pain). Such remedies as ease pain. ANTALIUM, (from xvrx, before, and aXs, the sea,) also called antale, and tubulus 7narinus. It is a shell like a pipe, of the thickness of a-small quill, and about an inch and a half in length; it is hollow, and hath hol- low lines running from one end to the other: its colour is white, or a greenish white. A kind of worm is the natural inhabitant of this shell, and its medical uses are the same with the shells of oysters, Sec- ANTALKALI'NA, (from xvn, against, and xXxxXt, alkali). Such medicines as resist or destroy acids. See Alterants and Anorexia. Bile is the most com- mon alkaline acrimony found in the stomach. ANTAPHRODISI'ACOS, ANTAPHRODI'TI- CA, (from xvn, against, and Afipoo'iT?!, Venus). Anti- venereal, or such means as extinguish amorous desires. Such are violent fatigue, especially if combined with low diet, whatever draws the attention from venereal sub- jects, active stimulant diuretics, and sometimes, ap- parently, nitre and camphor. ANTAPODO'SIES, (from xvtxkoS'iS'up.i to recipro- cate). Returns of the paroxysms of fevers. ANTARTHRI'TICUM, ANTI-ARTHRITI- CUM, (from xvrt, against, and xp6pms, the gout). Medicines against the gout. ANTASTHMA'TICA, anti-asthmatic,(from xvn, against, and xfS^x, an asthma). Remedies against an asthma. ANTATRO'PHON, (from xvn, against,andxrpopix, a consumption). Medicines against consumptions. ANTECE'DENS CAUSA, (from antecedo, to go before). See Proegumene. ANTECEDE'NTIA SIGNA, antecedent signs. Such signs as precede the disease. ANTELA'BIA, {ante, before, and labium, a lip). The extremities of the lips. ANTELIX, or ANTIHELIX, (from xvn, opposite, and tXi\, the helix). It is that part of the ear which is opposite to the helix. ANTEMBALLO'MENOS, ANTIBALLO'ME- NA,(from xvn, instead of, and tp£xXXu, to contribute). Substituted. Called also succedanea, succeda- neous. ANTE'MBASIS, (from xvrt, mutually, and xpGxiva, to enter). A mutual insertion or ingress, applied by Galen to the bones. ANTEME'TICA, (from xvn, against, and t^ttrixes, vomiting). Remedies against vomiting. These are all neutral salts, particularly the citras potassae (the saline draught); and its power in this respect is increased if S 2 A X T 132 ANT given in an effervescing state; opiates, and, in cases of debility, a glass of wine, or even brandy. ANTENDE'IXIS, (horn xvn,against, and xvfoixvvftt, to indicate). Contra-indicatio. A contra-indication. When one symptom requires a remedy which an- other symptom forbids. Prohibens is used in the same sense. ANTENEA'SMUS, (from xvn, against, and m- vxtrw, implacable,) ANTENEA'SINUM. The same with enthusiasmus. A particular kind of madness: in it the patient is furiously irritated, and endeavours to lay violent hands on himself. Those people are apt to be seized with sudden convulsive startings of the hands and feet; and therefore the disease is thought to coin- cide with the chorea sancti viti in some degree. ANTEPHIA'LTICS, (from xvn, against, and efc«, afiower). Properly rose- mary ; but, transferred to metals, it signifies the fifth essence, or elixir of gold. ANTHRA'CIA, ANTHRACOSIA, (from xv8px%, or a'nthrax). A burning coal. A hard, painful, burning swelling, which attends the plague. SeeCAR- BUNCULUS. ANTHRACO'SIS 0'CULI,«»ty«|. A scaly corro- sive ulcer of the eye, attended with a defluxion. A'NTHRAX. See Cinnabaris, and Carbuncu- lus. ANTHRFSCUS, (from xv6pirxx, fiowers). See Caucalis. ANTHROPE'A, (from «»fy«sr@-, a man). See Cu- tis. ANTHROPOLO'GIA, (from xv6pa7cos, a 77ian, and Xoy<&>, a discourse). The science of anatomy. ANTHROPOMO'RPHOS, (from *»ty«sr«s, a 7nan, and t*opKoy,ov$pix, the hypochondria). Medicines against the disorders of the hypochondria. ANTHYPOCHONDRFACUM, ANTHYSTE'- RICUM, Sal. It is the residuum remaining after the distillation of the water, and sublimation of the sal ammon. which consists of the marine acid and the fixed alkaline salt, or the alkaline earth, according as one or the other was used in the process. The same term is applied to this salt when refined. ANTHYSTE'RICA, (from xvn, against, and vrrepx, the uterus). "Medicines against hysteric affections. ANTI, («vt<, contra, against). This Greek preposi- tion is generally used in a compound term. See the preceding articles. ANTI'ADES. See Tonsil. It sometimes signifies the tonsils, when inflamed. From xvnxu, to be opposite; because they answer one another. ANTIA'GRI, (from xvnxhs, the tonsils, and xypx, a prey). Tumours of the tonsils. ANTIBALLO'MENA. See Antemballome- NOS. ANTICACHE'CTICA, (from xvn, against, and xxx,t%ix, a cachexy). Medicines against a cachexy. ANTICA'DMIA. A third kind of fossil cadmia, also called pseudocadmia. Anti is here joined to ex- press its being substituted for the true cadmia. A'NTICAR. See Borax. ANTICA'RDIUM. The hollow at the bottom of the breast. (From xvn, against, and xxphx, the upper orifice and the pit of the st07nach). Called also scrobicu- lus cordis. ANTICATARRHA'LIS, (from xvn, against, and xxrxppos, a catarrh). A remedy against a catarrh. See Catarrh. ANTICAUSO'TICUS,(from xvn, against, and xxv- i, are appella- tions of a similar inert calx. The cerussa antimonii So- laris, diaphoreticum miner ale solare, stomachicum pote- rii, are pompous names for the highly oxidised and use- less calx made from the solar regulus, and employed to attract the particles of quicksilver, which, after a long mercurial course, were supposed to be fixed in the fluids. A similar cerusse was prepared from the lunar regulus. The antimonium diaphoreticum joviale (antihecticmn poterii) is a white calx, prepared from the jovial regulus, deflagrated Avith three parts of nitre. It is neglected as a remedy; and if it retain any poAvers, they are certainly not adapted to the complaint in its common form. We have used it Avithout apparent injury; and in cases Avhere the bronchial vessels were greatly relaxed we thought it useful as a tonic. The antimonium diaphoreticum mar- tiale is the pulvis anticachecticus of Ludovici; the stoma- cichum of Poterius; the pulvis vitalis of Hall; and use- less as an antimonial: but it contains some iron in an active state, though the martial regulus is deflagrated with three parts of nitre. The mercurius vite correc- tus of Sylvius, bezoardicum minerale, is prepared from the mercurius vitae, deflagrated with three parts of nitre, and consequently inert. The calx antimonii sine sul- phure consists chiefly of lime water, to which 0.11 of calx of antimony, and 0.02 of calx of iron, are added. The flores antimonii nitrosi are only the inert Avhite oxide sublimed. The cinnabar of antimony differs in no respect from common cinnabar. We shall add a list of other preparations in which antimony has been employed, and to which it has given a name; but they contain only a small portion, if any, of the metal, and certainly owe no part of their virtue to it. These are, 1. Lilium paracelsi, called by Stahl tinctura antimonii aeris et alkalinus, tinctura antimonii spuria of Cartheuser. 2. T. anti/nonii rubra of Roger Bacon. 3. T. vitri antimonii of Lemery, and his T. an- timonii diaphoretici. 4. T. ex regulo a7itimonii martiali ; the antidotospantagogos of Schroeder. 5. T. anti7tionii Brixii. 6. T. antimonii nigri (mineralis amara) of Ur- biger. 7. T. Antimonii saponata Schulzii. 8. T. anti- monii Thedenii. 9. Oleum vitri antimonii, quinta essen- tia ant'anoniioi Basil Valentine. 10. Antimonii febrifu- giun, magisterium antimonii, arcanum, elixir, balsamum, oleu7n sulphuris, et clyssus, antimonii, of the same au- thor. 11. Acetumphilosophorum ex antimonio. 12. Aqua stimmi tartarea of Schroeder. 13. Spiritus antimonii compositus of the same author; Sp. bezoardicus Bussii; Sp. vitrioli philosophicus of Lemery. 14. Sp. salis antimoniaci of Basil Valentine. 15. Sal verum, and flores antimonii of the same; and, 16. the chevalier's powder. This enumeration is nearly complete. Some of the most insignificant and ridiculous forms only are omitted. Antimo'nii sulph. reg. succ. See Antimonium. Antimo'nii spi'ritus. See Clyssus. Antimo'nii rubicu'nda magne'sia. See Magnesia opalina. Antimonta'le cau'sticum. See Antimonium. Antimo'nii esse'ntia. See Antimoni'ale vinum. Antimo'nii oleum. Antimo'nium muriaticum. See Antimonium. Antimo'nium diaphore'ticum jovia'le. See Anti- he'cticum pote'rii. Antimo'nii m tartarisa'tum. See Antimonium. ANTFMORIS, (from xv\i, against, and tv>p»s, death or disease). A medicine to prolong life. Also the A N T 142 ANT name of an antidote which Myrepsus improperly calls diatamaron. ANTINEPHRI'TICA, (from xvn, and vtppms, a pain in the kidneys). Remedies against disorders of the kidneys. See Nephritis. AMTPARALY'TICA, (from xvn, against, and •rxpxXvG-ts, the palsy), Medicines against the palsy. See Paralysis. ANTI'PATHES. A black coral. See Coralli- um nigrum. ANTIPATIIEI'A, (from xvn, against, and -srxQos, an affection). Antipathy. An aversion to particular objects. It is doubtful Avhether there is any real foun- dation for feelings of this kind; yet, when we reflect that some animals, as toads pv serpents, are generally objects of antipathy, we cannot Avholly attribute the aversion to fancy, though Ave cannot explain it. Form, colour, but, above all, disproportion, excite it. ANTIPERFSTASIS, (from xvn, and vrepirwi, to surround). A compressing on all sides as the air presses. ANTIPHA'RMICUM, (from xvn, against, and Qxpfixxov, poison). An antidote, or preservative against poison. See Alexipharmica. ANTIPHLOGI'STICA, (from xvn, against, and (pxiym, to burn). Antiphlogistics. Medicines or re- medies suited to resist, diminish, or cure inflammation, or an inflammatory diathesis of the constitution. Un- der this head may be classed all watery diluents, cool- ing saline diaphoretics, and diuretics, particularly nitre; antimonials in small doses ; and bleeding, ge?ieral and topical. See Phleboto'mia, Cucurbi'tula, and Hiru'- dines. Besides, living on watery, cooling vegetables, drinking copiously of simple watery liquids, and abstain- ing totally from all animal food and stimulating diet, may be classed not amongst the weakest of the mate- rials proper for promoting the desired intent, under circumstances where antiphlogistics are required. ANTIPHTIU'SICA, (from xvn, against, and to ■strangle). Strangled, or suffocated. APANTHI'SMUS, (from xkxv&u, to grow thin). A scarcely perceptible line in painting, to Avhich Galen resembles the small capillary veins. APANTHRO'PIA, (of xtto, from, and m6f«ir&; a man). An aversion to company, or love of solitude; generally a symptom of melancholy. APARACHY'TUM VINUM, (from *, neg. and 7rxpx%a>, to pour upon). Wine not mixed Avith sea Avater. APAREGORE'TOS, (from x, neg. and rrxpyyopsa, to comfort, mitigate). What affords no comfort or re- lief. APARI'NE, (from pm,afile; because its bark is rough, and rasps like a file). Called also philanthropus, ampelocarpus, omphalocarpus, ixus, asparine, asperula, goose-grass, and cleaver's bees. Cleavers, goose- share. Hayriff. It is the galium aparine Lin. Sp. PI. 157. This plant has been tried in scrofula, but Avithout success; and in some cancerous cases, the juice given internally, and the herb applied in a cataplasm externally, has been supposed to mitigate the severity of the pain. An extract made of its juice is possessed of a pungent saline bitterness. The fresh juice, in doses of two or three ounces, is slightly diuretic. It is best if gathered when half grown. The whole plant is hoAvever inert, and scarcely ever employed. Apari'ne latifolia. See Asperula. APARTHRO'SIS, (from xtto, ab, and xpOpov, a joint). See Articulatio. A'PATHES, (from x, neg. and ■srpt6os, a7i affection, or passion). Those who seem to be void of human pas- sions, instanced in Diogenes the Cynic, and Timon. APATHI'A, (from x, neg. and txo-^oj, to suffer). Apathy expresses the quality of not feeling, a freedom from the impulses of passion and mental perturbation. APECHE'MA, (from xtto, and «#«?, a sound, apocho- phema). Properly a repercussion of sound ; but in me- dical sense it signifies a contra-fissure, or frac- ture. APEIROF, (from x, neg. and zretpx, an experiment). Unexperienced, unaccustomed. APE'LLA, (from x, priv. and pellis, skin). Short- ness of the prepuce. Galen gives this name to all whose prepuce, either through disease, section, or othenvise, will not cover the glands. A'PEN, (Indian). A sort of bread made with the Juice of the ambalam tree and rice in India. APE'NSALUS. A vessel with a narrow neck to hold oil. APE'PSIA, (from x, neg. and vrtirlu, to digest; also dyspepsia). Indigestion. That genus of disease which Dr. Cullen names dyspepsia, he arranges in the class neuroses, and order adynamics. The symptoms are, a want of appetite, a sickness, sometimes vomiting, sudden and transient distentions of the stomach, eructa- tions, heartburn, pain in the region of the stomach. These symptoms, or the greater number of them, are attended most commonly with costiveness, Avithout any other disorder either in the stomach itself, or any other part of the body. In this case, when what ought to be digested and form materials for good chyle becomes acid, or putrid, a variety of other symptoms occurs, according to the nature of the materials thus morbidly changed. But indigestion is very frequently a second- ary and sympathetic affection, though the just mention- ed symptoms are essential to this disease, as idiopathic. All these may arise from one cause, viz. Aveakness, or loss of tone in the muscular fibres of the stomach: and this Aveakness is the proximate cause of the disorder, when an original one. The remote causes are various, as tumour, in the stomach itself; or some disorder of other parts communicated to the stomach, as in the gout; in these cases the indigestion is sympto- matic. In most instances of indigestion, as an original dis- ease, the weaker action of the muscular fibres of the stomach is the chief cause; a depravity or defect of the gastric juice has been supposed to occasion it; but even here, perhaps, Aveakness is the only cause to which we can attend usefully in practice. To succeed in the cure, Ave must avoid the occasional causes, re- move such symptoms as tend to aggravate or to continue the disease, and invigorate the tone of the stomach. For this purpose the patient must be informed of the ne- cessary changes in his conduct; for though he has often pursued such a practice without sensibly suffering, ex- cept he conforms to a contrary one, the present com- plaints will not be removed. Crudities, acidity, and costiveness, must be obviated at least in their excess, as they tend both to aggravate and continue indigestion. When these ends are accomplished, the restoration of the tone of the stomach alone remains for perfecting relief. Abstemiousness and excess, but chiefly the latter, are causes of indigestion. An over-distention of the sto- mach may in some measure injure its proper tone; and frequent long fasting, render it feeble. Hard drinking, and any of the causes of an anorexy, also injure diges- tion. Fasting, however, must be long continued, and frequently repeated, to have any bad effect. When it produces dyspepsia, improper food has been occasion- ally taken. Anxiety and uneasiness of mind are often remote causes of dyspepsia, and when these are removed, the. effects often continue. Intense study, not properlv al- ternated with cheerful conversation or exercise, has' the same effect; but no remote cause is more frequent or powerful than late hours, and indulgence in spirituous liquors. In these cases the management of diet is of considerable importance; and they form one of the very few exceptions to the general rule of suffering the sto- mach to be occasionally empty. When it is so in dys- pepsia, all the symptoms are aggravated; and persons labouring under this, complaint should frequently swallow some food. A bit of ship biscuit, as bread not subject to fermentation, is one of the best substances to be frequently taken, and a little beef tea may be also occasionally added. The food should in general be of the light animal kind, and the more flatulent vegetables and fruits avoided. The drink should be porter, or strong, not SAveet, cyder; and the wine, Madeira or sherry. If these cannot be obtained, a slight addition of good brandy to cold water, Avithout sugar, may be allowed. Tea should be at once abandoned; and an A P E 147 a. p h infusion of our own Avarmer herbs, as pennyroyal, pep- permint, or rosemary, substituted. In some Aveak stomachs a singular aggravation of the symptoms comes on, in about an hour or two after a tolerably full meal, attended with a sense of sinking or Aveakness. This seems to be OAving to a digestion un- usually rapid, and consequently imperfect. In such cases, aliment of more difficult digestion, as eggs boiled hard, or the addition of condiments which retard di- gestion, may be allowed ; but, in general, a bit of bis- cuit and a glass of Avine will remove the sense of Aveak- ness, which is owing to the sudden emptying of the stomach before too much distended. Little need be added in order to the cure; for the treatment is the same as is required in Anorexia, q. v. The columbo root, not mentioned in the article Anorexia, is particularly useful Avhen the stomach is languid, the appetite defective, digestion Avith difficulty carried on, or Avhen a nausea Avith flatulence attends. It may be given in substance Avith any grateful aromatic, or infused in Madeira Avine, now and then interposing gentle doses of the tincture of rhubarb. A mixture of mustard seed Avith the columbo root is of considerable utility in complaints of this kind; par- ticularly where acidity and flatulence prevail much in the primae viae; and the aqua kali purae ahvays assists its action : a warm plaster, with the addition of some opium, Avorn at the pit of the stomach, is occasionally of great service. The Bath waters, assisted Avith warm nervous medi- cines and corroborants, are not to be omitted Avhen cir- cumstances admit of their use. See Percival's Essays in the Reflections on Exper. 4, 5, and 6. Cullen's First Lines, v. iii. p. 217. edit. iv. APE'PTON, (x, priv. and ttcttJu, to digest). Crude or indigested. A'PER. The avild boar. See Porcus, and Ali- ment. APE'RIENS PALPEBRA'RUM RECTUS. See Leaator palpebr.e supf.rioris. APERIE'NTIA, aperients, (from aperio, to open). These are medicines supposed to have the poAver of opening the mouths of vessels, and clearing vascular or glandular obstructions. In this sense they are synony- mous Avith the anastomatica, deobstruentes, and deop- pilativa. But those medicines which render the boAvels gently laxative are noAv generally called aperients; the removal of other obstructions is more confined to the term deobstruents. In the Avritings of the ancient physicians, particularly the practitioners of the Boerhaavian school, aperients were considered as medicines of peculiar importance, and many vegetable substances of little real powers Avere arranged under this head, and supposed to act in consequence of a saponaceous principle. These are now disregarded; yet modern practice still adheres to some of these in jaundice and hepatic obstructions, though they seem to have little effect, except as gentle laxatives. APERI'STATON, (from x, neg. and vepirxns, afflic- tion and danger). An epithet in Galen for an ulcer that is neither troublesome nor dangerous. APERI'TTOS, (from x, neg. and ■sripirlos, redun- dant). Such aliment as generates but little excrement. The opposite quality is called perittomaticos. APE'RTUS, (from aperio, to open). It is used foi exulceratus, as in saying an open cancer, &c. in Avhich cases the tumour is ulcerated. A'PES, (perhaps from apio, necto, to join together; because, connected together by the feet, they hang down from the entrance of the hive). Bees ; called by the ancients Bugones, q. v. If they are dried and poAvdered, they are somewhat" diuretic; but their chief use is for the preparing of honey and wax. APEUTHY'SMENOS, (from*™, and tv6vs, strait). See Rectum intestinum. APHiE'REMA. See Alica. APHjE'RESIS, (from xtpxipia, to take away). To take away any superfluous part, medicinally or chirur- gically. APHASSIO'MENOS, (from xQxce-tw, to handle). To reduce any thing to a pulp or powder by rubbing it between the fingers. Hippocrates often applies this word to the touch of the pudenda, in order to discover disorders of these parts. It is the same as tactus. APHE'BRIOC. Sulphur. APHELICESTEROS, (of xtto, from, and vXiks* youth). One past the floAver of age. APHEPSE'MA, (from xvo, and tyw, to boil). Sec COCTIO. APHE'SIS, (from xtpivfu, to re7nit). Hippocrates generally signifies the remission or solution of a disease by this Avord. APHILANTHRO'PIA, (from x, neg. and QiXxv- 6pu7nx, the love of mankind). The first degree of me- lancholy, Avhen a person hates society, and delights in solitude. APHLEGMA'NTON,(from x, neg. and , to taste.) See Agheustia. APOLE'PSIS, (from x7roXxfiGxvof*,xt, to be suppress- ed, retained, Sec.); also diulepsis interceptio. A sup- pression or retention of urine, or any other natural evacuation. Hippocrates means by the term dialepsis the space left in a baiuh.gc for a fracture, in which the dressings are applied to wounds. The same term is applied to the extinction of the heat, and is sometimes used for catalepsy. APOLE'XIS, (from x-xoXaya, to cease or end.) A decaying time of life, and opposed to the floAver of age. APOLINO'SIS, (from xtto, and Xivov, flax). See Omolinon. APOLLINA'RIS, (from xn-oXXvpt, to destroy). See HYOSCIAMUS NIGER. APO'LYSIS, (from xvoXvu, to release). A solution, or release. Such as the exclusion of a child, the so- lution of a-disease, or untying of a bandage. APOMA'GMA, (from xxo/nxrlu, abstergo). Any thing used to Avipe away sordes or filth from sores, as a handkerchief, or a sponge, 8cc. APOMATHE'MA, (from xto, neg. and f^xvixvu, to learn). Hippocrates expresses by it a forgetfulness of all that hath been learnt. APOME'LI, (from xto, and /mXi, honey). A sAveet liquor made Avith honey combs, diluted and boiled Avith water. Galen says, that Hippocrates, and others, called apomeli by the names of oxyglici, and oxyglicum, and that some were made with and others without vinegar : ■some being sweet, and others sour and SAveet. It is simple oxymel. APONENCE'MENOS, (from xxovoeu, to be negli- gent or averse). An adjective importing an utter aver- sion to any particular thing. APONEUROSIS, {p{xiro,fro7n, and vevpov, a nerve). The word vevpov, from Avhence comes the term nerve, used in its more extensive sense, means tendons and ligaments. Hippocrates, and other Greek writers, ap- ply it in this way. The moderns use it to describe a very different substance. See Nervi. Any tendinous expansion. The tendon of a muscle, called by Hip- pocrates, T£, jugulo). According 'to Galen's interpretation of the sense in Avhich Hippocrates used the term, it means the faeces ready for straining, or after they have been strained: and, according to Pliny, it is applicable to an animal Avhose blood, when its throat is cut, flows into a vessel placed underneath, and by different processes is formed into food. APOSPONGI'SMUS, (from xtto, and o-royyifr, to cleanse with a sponge). It is the using of a sponge either dry or moist for cleaning the skin, alleviating pains and itching, or for other purposes. APOSTA'GMA, APOSTALA'GMA, (from x*o- o-tx^u, to distil)^ The SAveet liquor that distils from grapes before they are pressed. APO'STASIS, (from «£> vinegar, &c. -*\ru ittLblb, (from mrenin/u, to reposit, or from APP 155 APY «*-», and Ti6iifA.i, to place). The reduction of a dislo- cated bone. APOTHLI'MMA, (from xxoi and S-Xt€a>, to press from). The dregs, or the expressed juice of a plant. APO'TOCOS, (from«5r», and nxru,to bring forth). Abortive. APOTROPCE'A or APOTROPAI'A, (from xxo- rpevu, to avert). See Amuleta. APOZE'MA,(from«7ra^ej, sound, from the noise it makes in running. Natural philosophers define water to be an insipid, ponderous, transparent, colourless, uninflammable, and highly fluid body, susceptible of the different states of aggregation from solidity to that of elastic vapour. It owes its fluidi- ty to a certain degree of heat, since Avith a heat two- thirds less than that of our blood it congeals; and Avith someAvhat more than twice the heat of our blood it boils, beyond which it cannot be made hotter. Water is more compressible in winter than in sum- mer, contrary to most, if not all other fluids; it is also clastic. See Philos. Trans, vol. iii. p. 640. It .is found in almost every natural body; and nature unites it with many bodies Avhich art in vain attempts to imitate. It exists in the hardest and most compact calcareous stones, and forms the greater part of the' fluids, and a considerable proportion of the solid parts, of animal bodies. It is contained in bodies either in a state of simple mixture or of combination ; in the first case it renders bodies humid, is perceptible to the eye, and may be disengaged Avith the greatest facility ; in the second its own characters disappear. In this form it exists in crystals, salts, plants, animals, &c.: Avater imparts to many forms of bodies hardness and trans- parency, particularly to salts and many stony crystals. Some bodies are indebted co Avater for their fixity : the acids, for instance, are supposed to acquire fixity only by combining with water. It is noAv however proved to be a compound body, formed by the union of oxygen and hydrogen. On this subject our renders may consult the works of modern chemists, particularly Cavendish, Lavoisier, Fourcroy, Thompson, and Chap- tal, as Ave must consider it only in a dietetic and medical point of view. Water, as it is the most ancient, so it is the best and most common fluid for drink, and ought to be esteemed the most commodious for the preservation of life and health; for not only all kinds of animals, but the great- est part of mankind, preserve life by drinking water alone. If moderately drunk it assists digestion, quenches thirst, cools the habit, dilutes the fluids, opens ob- structions, dissolves viscidities, corrects acrimony, pro- motes the fluid secretions, and is an universal vehicle for solid food. It is superior to all other liquids, be- cause it is purer, more simple, and more fluid than other drinks. The more pure the water the better; and that is certainly the best which falls in rain, collect- ed from high situations' in the country, then boiled a little, and afterwards distilled, the half which comes over first only to be used. This, from its purity, is also recommended to all chemists where water is to be employed; but, indeed, such as nature affords is a proper drink for mankind, if there is no impregnation to the taste or smell of a person of common sensibility. The softer and purer waters, however, are to be pre- ferred for use; though the harder waters, or such at are impregnated with selenites, or rather earthy mat- ters, have not been discovered by any decisive clear evidence to have produced the bad effects ascribed to them. In the pharmaceutical use of water we must however be more cautious. Even the purest rain Avater was found by Margraaf to contain a small portion of a mu- riated salt, and in large cities it generally contains some vitriolated salt. Distilled Avater should therefore be particularly employed in dissolving the pure kali, the pure ammonia, sal acetosellae, terra ponderosa salita, argentum nitratum, mercurius nitratus, mercu- rius sublimatus corrosivus, and acetatus, tartarum emeticum, hepar sulphuris, and antimonii. Water dissolves salts; and an ounce of Avater at a mean temperature, that of 60 degrees of Fahrenheit, Avill dissolve of 1. Alkalis. oz. dr. gr. Dry volatile alkali - 0 5 0 Pure salt of tartar - 0 6 0 " Soda depurata - - 0 5 0 Lapis causticus - - 0 6 o " 2. Neutrals. Phosphorated mineral alkali 0 3 0 Pure nitre ... 0 1 30 Rhomboidal - - 0 2 0 Sal ammoniac - - 0 2 0 — Glauberi - - - 0 3 30 Muriated kali - - 0 2 0 Natron tartarisatum - 0 3 0 Kali tartarisatum - 0 3 0 ---vitriolatum - 0 0 24 Borax ... 0 0 24 3. Earthy salts. Crude alum - . - 0 0 30 Epsom salt - - 0 5 0 Terra ponderosa salita - 0 1 10 Calx salita ... 100 \. Metallic. Mercurius acetatus - 0 0 20 ---------sublimatus cor- rosivus ... 0 o 30 ---------nitrosus - 0 2 0 ---------tartarisatus - 0 18 20 Sal martis - - - - 0 7 0 Saccharum saturni - 0 4 0 Salis ammon. floris martiales 0 4 0 Tartarus emeticus - 0 0 10 Vitriolum caeruleum and martis 0 2 0 --------zinci - - 0 2 30 Good water is known by readily mixing with soap without curdling, and by quickly boiling pease, and pulse, soft and tender; and it keeps best in large ves- sels, in cold places, and in earthen or glass jars. Muddy water may be cleared by adding two or three grains of alum to each pint, and thus the water is not injured. If hard it may be rendered soft by adding a few grains of the salt of tartar to each pint, in propor- tion to its hardness, but it leaves a neutral scarcely less inconvenient. River Avater is the best for short voyages; but the spring water is longer before it putrifies, and answers better for long ones. Stagnant Avaters; water in which is much melted shoav, ice, or dew; Avater from mines; such as rises in low flat lands, and particularly from springs Avhich contain an unctuous or bituminous matter at the bottom; are-' bad: but good Avaters are obtained from springs which are on high lands consistingof gravel; from the clouds, by rain falling at a distance from great towns; from AQU 157 AQU. rivers and rivulets : but the distilled is the most pure, and a regular drinking of it would perhaps in some cases be as beneficial as some of the most celebrated mineral waters. See Dr. F. Clifton's Translation of Hippocrates, on Air, Water, and Situation. Cullcn's Materia Medica. Hoffman's Systema Rationale. Chaptal's Chemistry. A'qua mu'lsa. See Hydromeli. A'qua sulphura'ta. See Gas sulphuris. A'qua sa'lis. See Circulatum. AQU.E MEDICINA'LES, vel MINERA'LES. Medicinal, or Mineral avaters. Waters Avhich Contain minerals in solution are distin- guished by the name mineral Avaters; but as there is no water found in nature, even among the purest, unim- pregnated by some of these substances, the name of mineral waters ought to be confined to such as are suffi- ciently impregnated to produce a sensible effect on the animal economy, so as to cure or prevent the disorders to Avhich it is liable; hence the term medicinal is more applicable. They participate more or less of the matters over which they run in their subterraneous passages, and from some prevailing ingredient they receive their names. The substances which are contained in waters are cither held by suspension or solution; by the first are meant clay, silex, (quartzose, verifiable earth,) in a state of division; calcareous earth; and magnesia. By the second, air of different kinds; the carbonic acid; pure, or compound alkalis; lime, magnesia, the sul- phates, muriates, the extractive matters' of plants, he- patic gas, isfc. Silex, however, is often contained in Avaters, apparently dissolved by means which Ave cannot understand or imitate. Though the most ancient, the ' most general, and the most simple division of mineral Avaters is into cold, hot, or thermal waters, accordingly as their temperature is the same with, or exceeds that of common water. Modern chemists of allowed abilities have arrang- ed all mineral waters into four classes; called gase- ous, saline, sulphureous, and ferruginous wa- ters. The acidulous are the most common and best knoAvn of the gaseous Avaters, and are those in which the carbonic acid air abounds; knoAvn by their sharp penetrating taste, the facility with which they - afford bubbles by simple agitation, or even by mere standing, the property of turning the tincture of turn- sole red, and precipitating lime water and liver of sul- phur. These are divisible into two orders, cold and hot; the first comprehending cold, acidulous, and alka- line waters, such as Seltzer, St. Myon, Bard, &c; in England, Tilbury and Clifton. The second, hot or thermal, acidulous, alkaline waters, as those of Mount d'Or. This ingredient in mineral waters Avas first discover- ed in the Pyrmont Avaters by Dr. Brownrigg. There are few waters without it; but unless at least six inches of this air are found in 100 of the water, it is scarcely medicinal. The Pyrmont water contains from about 150 to 187 inches in 100. In general, water at the temperature of 60° can take little more than its own bulk, unless when pure alkalis, with Avhich it can combine, be present. It is incompatible only Avith al- kaline air. Azote was first discovered in the Buxton waters by Dr. Pearson, and it has been suspected in the Bathwa- ters. Dr. Garnet found it in those of Ilarrowgate; and Mr. Lambe (Manchester Mem. vol. v.) in those of Lemington Priors. Common air was discovered by Mr. Boyle in waters of every kind, but this does not render them medicinal. Oxygen air was first discovered in water by Scheele, but has not since been found in any other instance. In- deed the medicinal waters, whose obvious qualities force them on our notice, can scarcely ever contain oxygen, since it cannot unite Avith Avater containing hepatic air or ferruginous salts. We knoAV not that this is ever medicinal, for oxygenous air in the stomach is injurious. Hydrogenous air seems never to exist alone in Avater, though it may be suspected in the waters of marshes ; but it is a solvent of sulphur, and, with it, forms a common ingredient in sulphureous waters. When combined to saturation it is styled by Berthollet, the sulphurated hydrogen; and, when united to a ba- sis, hydrosulphuret. When the sulphur is in excess, it is hydrogenated sulphur of Berthollet; and, with a basis, hydrogenated sulphure; more conveniently, the supersnilphurated hydrosulphuret. Mr. Kirwan calls these combinations, respectively, hepatic air, or super- sulphurated hydrogen, hepatules, and hepars. Of the hepatic air, Avater takes up about two-thirds or three- fourths of its bulk; by agitation, or heating the water, a greater quantity is absorbed. Heavy inflammable air, or carbonated hydrogen, exists seemingly ,in some volcanic waters, but has not been ascertained by direct experiment. Sulphureous, or vitriolic air, is also con- tained in the hot Avaters of Italy connected with volca- noes. It is apparently the excess of the vitriolic acid in the ferrugineous waters, and has been usually refer- red to that head. The saline waters consist of a numerous group of the acid, alkaline, earthy, and neutral saline springs. As we have just seen the excess of vitriolic acid form- ing its peculiar air, so the excess of the acid itself is sometimes found in the vitriolated and aluminous waters. The muriatic acid has not yet been found except in a state of combination, unless Dr. Wethering's suspicion of its existing in the waters of Nevil Holt should be realized; (Translation of Bergman's Sciagraphia). The boracic acid has, as we shall show, been found in some Italian lakes : in a combined state we have ahvays received it as a natural production from the lakes of Persia and Thibet, under the name of tinkal. The nitrous acid exists only in a combined state, and Ave re- collect of this only one instance, viz. at Bihor in Hun- gary. See Annales de Chimie, vol. i. p. 224. Of the alkalis, the natron is most abundant in mine- ral Avaters, and it is found in an aerated state. The quantity of this salt in almost every region of the earth is considerable; and it forms a striking and con- vincing proof, that theAvaters of the ocean once covered the face of the earth; for the natron is, in almost every situation, evidently the fixed residuum of decomposed sea salt. In the natron lakes of Egypt it is accompa- nied with the sea salt, and the same admixture occurs in many mineral Avaters. Sea Avater has not been usu- ally reckoned among mineral waters; it is hoAvever highly deserving of this distinction: and we cannot avoid noticing in this place a curious fact lately AQU 158 A Q U. published, which, if confirmed, will greatly illustrate our subject, viz. that the Galvanic spark passed through water produces an impregnation of sea salt. In the progress of our publication we shall again advert to the fact, should further experiments cither confirm or oppose it. In the interval between Avriting and printing this paragraph, it has received additional confirmation. The vegetable alkali is rarely found in mineral waters; yet as it has been discovered in some granites Ave may expect to meet Avith it. The solitary instances in which it has yet occurred, scarcely however support the ex- pectation. The Avater at DoAvay in France is the only uncontroverted one which occurs to us; for Mon- net's discovery of it in the Avaters of Aix la Chapelle has not been supported by subsequent experiments. The volatile alkali, which Ave should with less reason expect to find, has been discovered by Mr. Cavendish in the waters of Rathbone place in London, ~and by M. Malouin in France. If the kali might occur from burnt woods, the ammonia Avould riot be a less probable impregnation from decayed animal sub- stances. Lime is a very common ingredient, seldom hoAvever, if ever, uncombined. Aerated lime frequently occure, and the air in these instances acts as a solvent, and is not combined Avith the earth. Bergman supposes, that about 100 cubic inches of water, saturated Avith its oavii bulk of fixed air at the temperature of 50°, will dissolve nearly 29 grains of aerated lime; and about 1504 parts of fully aerated water, dissolve about one of aerated lime. Mr. Cavendish however found that this proportion Avas too Ioav, and that a quarter of a grain at least might be added (Phil. Transactions, for 1767); and Berthollet has even advanced the quantity of lime dissolved in water to nearly 3 to 1500. This ques- tion is rather a chemical than a medical one, and we need not pursue it fu rther. Magnesia, as an ingredient in sea water, will of course appear a frequent impregnation of mineral waters. Magnesia, fully aerated, is soluble in 900 parts of water; but fully aerated water takes up a l&rger proportion of this earth at the period of it's precipitation by a mild alkali. Of common magnesia about -^^ is dis- solved in aerated Avater, and by management a larger proportion. Even pure water, we are told, will dissolve -g\7 of its weight of the common earth. It is remark- able, that the impregnation of water with vitriolated kali, common salt, and Epsom salt, will render it a better menstruum of magnesia. Argil is rather suspended than dissolved in Avater; but if Westrumb found nine grains in five quarts of Pyrmont Avater, it must have been really dissolved. We are not now speaking of aluminous waters, but of argillaceous ones, where the earth is suspended by fixed air: Avith its assistance, magnesia is very much more soluble than argil. Aerated iron is very common, and 1Q0 cubic inches of fixed air may dissolve four of iron. If in the Avaters of Medevi, analysed by Bergman in the first volume of his Opuscula, four grains of iron are suspended Avith only six cubic inches of this air, we may suspect the intervention of some other solvent. Of all the impregnations of mineral waters, the neutral salts are the most frequent: they occur in all their va- rieties, and in every possible combination. The sele- nite is a very common impregnation; and in Mon- ro's system, compiled when chemistry had scarcely assumed a scientific form, it is called calcareous glauber. The Epsom and Glauber's salts are more rare, but frequent. Vitriolated ammonia, and vitriol of iron, are the production chiefly of volcanos. The latter occurs in tlie Avaters of Mulino near Latera (Lavoisier, Mem. de Paris, 1777); in those of Horsley Green (Garnet); and in Denmark.(Bergman, vol. i. p. 176). Vitriol of copper is contained only in waters issuing from the copper mines. We have mentioned the acid of nitre seldom occurring in a combined state ; but Margraaf found some traces of - nitre in the wells of Berlin, and Bergman in the waters of Nidda, near Altendorf. Nitrat of lime and magnesia occasionally occur, but these" springs are not medicinal. Of the muriats, Ave find muriated natron, lime, and magnesia, in many mineral springs. Muriated ammo- nia has occurred in some of the Italian lakes, and in Siberia (Herman, vol. ii. p. 346). Muriated barytes has been found in water by Bergman and Schoeffer; mu- riated argil by Withering (Translation of Bergman's Sciagraphia, p. 31); and muriated manganese by Berg- man; and, iii our own country, by Mr. Lambe in the water of Lemington Priors. The sulphureous waters owe their peculiar properties to the union of alkalis or lime; but Mr. Kirwan remarks that the sulphur is never in the form of hepars, since these are ahvays coloured, or, Avhen diluted, become so on standing; then ceasing to have any effect on ni- trated silver, lead, or any other test. Bituminated alkali occurs only in one or two solitary, perhaps doubtful instances. Petroleum was found floating on the waters of Dri- burg, and in some of those of Pyrmont, by Westrumb. Vegetable and animal extractive matters are accidental, and never medicinal impregnations. The ferruginous waters we have already mention- ed: the iron is held by the sulphuric and the car- bonic acid, or mechanically suspended. Of the first Ave have already spoken: the carbonate of iron oc- curs chiefly in the acidulous waters, and the mechani- cal suspension occurs in the forge Avaters sometimes used as topical astringents, to be afterwards noticed. The medicinal are, in some measure, ascertained by the sensible qualities of waters. To the sight, pure water is clear, like crystal: when less so, some hete- rogeneous matters are certainly present. Water that has run through a gravelly soil is generally very pure: that which has passed through argillaceous or muddv land much less so. Though good water is Avithout colour, it does not follow that every colourless water is good. An obscure muddiness verging to yellow or red is found in stagnant waters, and may arise from the ex- tractive vegetable matter found in marshes, or from fatty substances. A blue colour points out copper; a green, vitriol of iron. The aerial acid, when uncom- bined, becomes obvious by the bubbles separated on standing, or on agitation. The purest water, however, when standing in the sun, will discharge numerous air bubbles. To the sense of smelling, good water is free from odour. When saturated with the aerial acid, it exhales a suffocating, subtile vapour. Hepatic waters resem- ble in smell a stale e^, or the scourings of afoul gun: AUL 159 a av those impregnated with putrid extractive matter are distinguished by their fcetor. Waters may be considered as pure, in proportion to their want of taste: even in the purest, hoAvever, the experienced Avater drinker will discover a difference. The aerial acid gives an agreeable pungency. Bitter- ness shows an impregnation of Glauber's salt, nitre, vitriolated, nitrated, or muriated magnesia, nitrated or muriated lime. Lime and selenite are distinguished by a slight austerity; alum by a little stypticity; com- mon salt by its saline taste; alkali by its urinous fla- vour; copper and iron by tastes peculiarly their OAvn, and sufficiently known. The quantity of foreign matter in medicinal Avaters is ascertained by their specific gravity, compared with that of water at the same temperature. The compari- son should be made with distilled Avater, not in small quantities, for the difference is not easily ascertained; nor in large ones, as the-greater weights are not mi- nutely exact. Vessels which hold a quart or three pints form the proper mean. The specific gravity is, hoAvever, only a test of the quantity of matter in vvaters without smell, for the hepatic waters are lighter than distilled. The Avater of Limmer and Rensdorf are in- stances of this kind, examined by Andria and Brock- man. The lightest Avater is that of Envie, near Turin, eight pounds of which contain about half a grain of lime: the heaviest, that of the Dead Sea, which, ac- cording to Lavoisier, contains 44.4 per cent, of common salt, muriated lime, and magnesia, so that it is evident- ly a salt lake, Avhose fluid contents are decreasing. These extremes are 1.0000 and 1.2403. If waters abound with aerial acid, their specific gravities do not give the proportion of solid matter with any accuracy at a temperature above 50°. A convenient rule, suffi- ciently accurate, is given by Mr. Kirwan to ascertain the solid contents by the specific gravity, which we shall transcribe. It consists in subtracting 1000 from the given specific gravity expressed in whole numbers, and multiplying the product by 1.4. This gives the weight of the salts in their most desiccated state, but that of fixed air is also included. The fixed air should of course be previously separated, and the water of crystallisation allowed for. We shall therefore add at the end a very convenient table from Kirwan, to which Ave shall often have occasion to refer. Another method of estimating the medicinal from the sensible qualities of waters, is, an examination of their temperature. For this purpose, it will be of use to enquire Avhether the temperature is the same at all •seasons, whether it follows the variations of the atmo- sphere, or the water freezes in winter; if warm waters deposit any sediment in cooling; of what this sediment consists; and whether their sensible qualities are di- minished or destroyed after the deposition. The situation of the waters must not be neglected. The character and elevation of the neighbouring coun- try ; the quantity of the water, and the occasional varia- tions in this respect; its current; the number of its springs, and the quantity they furnish; the quantity and nature of their depositions; what sublimations are observable in their channels; Avhether they flow tran- quilly or with ebullition; what vegetables and animals they support; are circumstances of real importance in ascertaining the nature of mineral waters. r It cannot form a part of our present object to engage in details of the various methods employed in the ana- lysis of mineral waters; yet, as the medical practitioner is sometimes called on to determine on the propriety of using any water which has not been hitherto analysed, a few short rules may not be improper or misplaced; they are not designed to obtain an accurate analysis, but to form a general idea of the nature of any water.offer- ed to observation. The description of the sensible pro- perties of the different kinds of mineral Avaters will lead to a general knowledge of their contents. The acidu- lous waters will tinge the juice of litmus red, but the colour will disappear by exposure to the air : they will also precipitate lime from lime water, which will be again dissolved if a small quantity only is added, or if the air be in excess. If a flaccid bladder be tied round the mouth of a bottle containing the Avater, and heat applied, the quantity of uncombined air may be mea- sured by the quantity in the bladder. The hydrogenated sulphur Avill tarnish silver, or, more readily, lead. A mark made on paper with acetite of lead or tartrite of bismuth is instantly blackened, Avithout producing any turbidness. A sulphuret of either fixed alkali will indeed produce the same effect, but a decomposition ensues. When the sulphur is combined with the Avater by means of an alkali, it may be precipitated by the sulphuric or muriatic acid, and Aveighed ; but some sulphur will still remain suspended. Either the sulphureous acid, or the strong red nitric acid, Avill precipitate what is left. Oxides of lead, quicksilver, and arsenic, by uniting with the hydrogen of the gas which keeps the remaining sulphur suspend- ed, will have the same effect. By these means we can also separate the sulphur, dissolved by means of hydro- genous gas in,water. Alkalis, when uncombined or aerated only, are dis- covered by changing the colour of syrup of violets green. . To ascertain whether this change is OAving to the fixed or volatile alkali, some muriat of quicksilver must be added. The volatile attracts a large portion of the acid, and the rest is precipitated with the metal in the form of mercurius dulcis. Acids are more easily discovered. The muriated barytes is decomposed by the sulphuric acid, forming an almost insoluble compound, and all its salts are thus at once discovered: an almost imperceptible par- ticle of either forming a precipitate. The muriatic acid can be as certainly discovered by a solution of nitrated silver with an excess of acid. Having ascer- tained the nature of the acid, if in the first instance an alkali is added, the lime, if the water contain a calca- reous earth, is deposited; or argil, or magnesia, if these be its ingredients. If the precipitate be soluble in distilled vinegar, it is not argil; if, when dissolved, and sulphuric acid be added, no precipitation ensues, it is not calcareous, and consequently must be magnesia. The acid of sugar will at once show the existence of calcareous earth, for its attraction is very powerful and the compound insoluble. If aerial acid be the means of the solution of the. earth, it will separate in boiling; but more certainly by acetite of lead. The metal is precipitated, and the earth suspended by the acetous acid. As the lead would also be precipitated by a sulphat, a little more acid should be added, Avhich will redissolve the lead if an A Q U 160 A Q U earth has occasioned the separation. The nature of the saline neutrals can only be Avith certainty ascertain- ed by evaporation and the form of their crystals. If nitre be contained in Avater, after a considerable evapo- ration, the smell of the acid may be detected on the addition of some sulphuric acid. As copper can be discovered by the taste, we need only notice the means of distinguishing iron; though this also shoAvs strong marks of its presence by the ochery depositions on the banks of its streams and the astringency of its taste. A ready and convenient test is, hoAvever, the calcareous prussiat, prepared by boil- ing lime water a little while on Prussian blue": it must be kept in well stopped phials from the light. The tincture and infusion of galls are equally useful; but a little alkali must be previously added, as an excess of acid, should there be such, will prevent the change of colour. Mr. Kirwan, in his excellent treatise on mi- neral waters, has added a list of ' associated,' and ano- ther of * incompatible' salts, chiefly, he remarks, for the assistance of geologists. We think a short abstract of this part of his work will be equally useful to the medical chemist. Aerated lime and selenite most fre- quently accompany each other; and aerated magnesia is always accompanied Avith aerated lime, but not vice versa. Aerated soda is generally accompanied with Glauber and common salt, but not vice versa. Epsom salt is commonly accompanied by Glauber or selenite, or both, but not vice versa. Vitriol of alum and iron are commonly associated. Common salt, unless with soda, is always attended with selenite; and the latter, very generally diffused, accompanies all salts except soda when in any remarkable proportion. Muriated magnesia is most commonly found with sea salt, but not vice versa, often with Epsom salt. Muriated lime is almost always accompanied with common salt. Ep- so7n and common salt decompose each other when some degrees beloAv the freezing point, producing Glauber and muriated magnesia; but in a higher temperature they react on each other. Many salts found in mineral waters are incompatible, capable of decomposing each other; or, if simple, of decomposing some of the compound salts. This how- ever appears to be prevented by the large proportion-of the menstruum. Aerated alkalis are--incompatible with earthy or metallic salts; uncombined vitriolic acid with earthy nitrats, or muriats, or aerated earths; alkaline sulphats with earthy nitrats or muriats; Glauber with sylvian ; vitriolated tartar with nitrated soda; vitriolated ammo- nia with nitre and sylvian; Epsom salt with nitrated or muriated lime; alum with nitrated or muriated lime, or magnesia; nitrated lime with sylvian, sal ammoniac, muriated barytes, or magnesia ^nitrated magnesia with sylvian and muriated barytes; muriated magnesia with nitrated soda and lime. From these few hints the nature of any mineral wa- ter may be ascertained with sufficient accuracy, and we shall now proceed with some account of the impregna- tions of mineral waters, and their medicinal powers. In this place it is unnecessary to be minute in giving the contents of each; it is the object of the chemist, rather than the physician. In a medical view we shall class the most noted mineral waters under their proper heads, and then consider the virtues of each class. I. Waters with very inconsiderable or no impregnation. Cold. Malvern; Holywell; Plombieres. Warm. Bristol; Matlock ; Buxton. II. Aerial, acidulous, sparkling. 1. United with alkali: Seltzer; Clifton and Til- bury in England ; Carolina in Bohemia; Mont d'Or and Bourbon L'Archambaultin France. 2. United with steel: Tunbridge, Spa, Pyrmont, Boussan, and Pougue in France. 3. ----------Steel, hot: Bath. 4. ----------Steel and salts: Cheltenham and Scarborough. 5.---------------------------Hot : Vichy, Carlsbad. III. Saline, simply Avith one or more neutral salts. Sea-water; Sedlitz and Seidschutz in Bohemia: Epsom; Balaruc and Bagnere in France. IV. Sulphureous. 1. Cold: HarroAvgate; Moffat. 2. Hot : Aix ; Borset; Bareges and Dax in France; Baden in Germany. V. Bituminous: Driburg, and some of the springs of Pyrmont. VI. Metallic. 1. Vitriolated chalybeate : Hartfel. It forms a problem of no little difficulty to explain, Avhy waters Avith impregnations so slight and inconsi- derable should ever have become famous as medicinal. It has furnished arguments for the sceptic, and refined considerations for the pathologist. If water so pure be ever useful, might we not attribute the Avhole to the element alone ? and, having obtained this ' vantage ground,' may Ave not suppose that all the advantages of mineral waters are derived from dilution, added to changes of air and scene, absence from the distrac- tions of business, or what would revive the recollec- tion of distressing scenes or events ? The argument has been draAvn out with much care, decked with delu- sive colourings, and supported by facts, which might at least occasion hesitation. Those who have indulged in excess of every kind, in indulgences the most ex- hausting, would certainly be benefited by a water diet, accompanied Avith regular hours, with exercise in free air, with tranquillity and cheerful conversation: men, whose midnight hours have been irritated by study and anxiety, would find the surest balm in calm repose; those who have never sought rest, but in fevers from wine, and ' rude wasseling,' must feel peculiar com- fort in the calm of temperance and cheerfulness: men Avho have burnt under the torrid zone, and whose fluids are highly animalized by scorching heat, will find the cooling streams soothing and salutary. These repre- sentations may be allowed, yet they will not prove all that they are designed to show. CroAvds of hectic pa- tients seek, and often seek in vain, relief in the pure springs of Bristol; yet, had they not been advanta- geous, crowds would never have resorted to them. Pathology steps in to our aid, and attempts to show that medicines in a form highly attenuated may pro- duce effects to which in a grosser state they were un- equal ; that the peculiar appropriate effects of every medicine are attained only in a suitable dose ; and that, beyond this, each is indiscriminately stimulant. To reasonings of this kind, on either side,, we need no re- ply ; but we must have recourse to experience, which A Q C 161 * AQU tells us, in language not to be misunderstood, that Avatersof a given-class are highly efficacious in their ap- propriate diseases, let the immediate cause be Avhat it may. If Ave were to give our own opinion, it would be limited and discriminated. We see striking effects of acidulous, of sulphurated, of saline, and chalybeate waters; but for this reason, must we deny them to the purer kinds ? We know that the effects we perceive are not in proportion to the doses of the active ingre- dient SAvallowed; may we not then suppose, that ingre- dients apparently less active may have effect in the same form ? In reality, we would not give them all the merit assigned, or deny wholly their powers. We belieA'e the purest waters have been useful ; and are convinced that those which possess the more active in- gredients, have been highly salutary. This disquisition we have been led into from the first class of waters; and Ave may noAv add, that chemistry may probably detect ingredients not yet suspected in some of these, as azotic gas appears to have been found in those of Buxton; and perhaps oxygen may occur in others, as it has been suspected in the waters of Plombieres. The second class, the acidulous waters, stimulate the stomach and improve the appetite. They are certainly refrigerant and antiseptic: refrigerants Ave shall find to be deobstruent, and, in some constitutions, diuretic. Perhaps the acidulous waters are adapted to those who have injured the stomach by excess in drink- ing: when joined with chalybeates, this advantage is more strikingly conspicuous. If ever these waters prove peculiarly useful as deobstruents, it is Avhen they are united with neutral salts; but to folloAV this subject would be ro anticipate Avhat more naturally occurs under the next head. The saline waters are certainly cathartic and diuretic: they have the credit of being alterants and deobstruents. Of the supposed acrimonies of the fluids Ave have al- ready spoken, (see Alterants,) and have remarked, that though what appears in excrementitious fluids must have existed in the blood, yet it never formally appears in that fluid. We may iioav add, that such is the connection between the secretory organs, that a derivation from one of these will prevent a deposition on some others. Thus the discharge of the more fluid secretions from the bowels will check similar ones of the saliva and of the skin ; and to cure, or certainly to prevent, the recurrence of cutaneous eruptions, there is no more certain remedy than the saline mineral waters, particularly sea water. Obstructions of greater conse- quence occur in the chylopoietic viscera and the con- globate glands. Dissection shows us that the liver, the pancreas, and other organs of the abdomen, may be obstructed, enlarged, become scirrhous, or otherwise diseased. For these complaints the saline mineral waters are recommended with advantage. To explain their effects Ave must first notice the general principle pretiously alluded to, that the chief and first effect of all deobstruents is refrigerant or sedative. When ob- struction, exists, if the circulation is accelerated and the obstacle is not conquered, the matter must be more firmly impacted; and at a distance from the source of power, the action of the vessels must be comparatively weak and inconsiderable. To this Ave knoAV but of one exception, viz. the action of mercurials, whose stimu- lant power is chiefly felt in the extreme vessels. In- vol. t. dependent, however, of the refrigerant effect of saline medicinal Avaters, they generally increase the discharge from the excretory ducts of the obstructed part, and of course relieve the over distended vessels; not only pre- venting further impaction, but taking away the impedi- ments to the action of arteries already obstructed. The action of these waters on obstructions of the lymphatic glands we have also already glanced at. It was the language of Dr. Cullen "that saline waters, par- ticularly sea water,' washed out' the lymphatic system. We know not, however, by what channels they could reach glands Avhose disease consisted in refusing a pass- age to every absorbed fluid ; and when Ave before noticed this effect, and was willing to attribute it to the power Avhich salts possess of rendering the gluten more fluid,. Ave were obliged to allow that the matter of scrofulous glands was not gluten. Saline Avaters are, hoAvever, very valuable remedies in these complaints; and they seem useful by increasing the action of the lymphatic system, which is probably in this disease defective. Ob- structions of the mesenteric glands are very often re- lieved by saline Avaters ; and from what we have observ- ed of their poAvers, it will be easy to see on what prin- ciple their good effects depend. In some late authors, the physconia abdominalis is mentioned among the dis- eases to Avhich these Avaters are adapted. The com- plaint consists in hardened tumours in the abdomen, apparently not connected with glands of either system ; and if the remedy is useful, Ave must confess our ignor- ance of its manner of acting. Some of these saline waters are recommended in cases where Ave hesitate respecting their poAver, or the means, if their efficacy be admitted, by which they re- lieve. We allude to those cases of exhausted constitu- tions Avhich are supposed to find relief from Chelten- ham. It is said that the chalybeate impregnation obviates the debilitating power of the cathartic salts. In fact, we strongly suspect that in all such cases an ob- struction of the liver has occasioned or coincided with the other complaints, and that the relief obtained has followed from the effects of the waters formerly men- tioned. It is contended, however, that they arc useful in other circumstances, and we cannot deny that they have appeared to be so ; but with the little experience Ave at a distance can possess, it would be the height of arrogance to contend against the enlarged field of ob- servation a residence on the spot affords. Melancholy and dfopsy, two diseases, for Avhich the saline waters are recommended, need not detain us: in each there are generally obstructions in the viscera, and in each gentle laxatives are useful. Theaerated alkaline waters are now peculiarly fashion- able, and the artificial soda water, which we shall men- tion in another article, is frequently drunk: it is re- commended as a stimulant, a tonic, a solvent, and a stomachic. In weak digestions, in gouty apepsia, in stomachs abounding with acid, it is highly commended, and is not without its merit, though the popularis aura seem to have extolled it beyond its bearing. In nephri- tic and calculous complaints it is recommended as a solvent; but it is doubtful whether its power is obvious in any other organ except the stomach. The acid evolved in the urea, in the perspiration and calculi of arthritic patients, is apparently generated in the sto- mach, and is there counteracted by antacids. If, how- Y AQU 162 AQl ever the alkali can be conveyed without change to the bladder, it may certainly be useful as a solvent. In in- flammatory fevers it acts as a cooling laxative, and in some cases of hectic appears beneficial; but, as a re- medy in putrid fevers, this gas is too trifling as an anti- soptic to detain us a moment. The sulphureous waters are very poAverful and active remedies; as the sulphur, in the attenuated form Avhich it assumes in its combination with inflammable air, is conveyed to the smallest vessels. These Avaters have been long employed in diseases of the skin; and, as they are used both externally and internally, they pro- duce very considerable effects. In gouty SAvellings and diseased joints from this and other causes, the Avarm sulphureous Avaters are highly useful; in the chronic pains from gout, rheumatism, contractions, or indeed any cause, they afford considerable relief. They are supposed particularly effectual in diseases produced by arsenic, lead, or mercury: but Ave suspect that this opinion rather arises from the power of sulphur on metals out of the body, than from actual observation. In such diseases, the metal seems to be soon discharged out of the system, and the effects only remain. Modern refinement, perhaps modern theory, has added another group of complaints to those which are likely to be benefited by^sulphureous waters, viz. the diseases aris- ing from too great a proportion of oxygen in the system. Pathologists have not traced this cause very extensively; but it has been supposed to occasion the diabetes melli- tus, and in hectics the florid blood seems to sIioav that the fluids are highly oxygenated. In the former, Dr. Rollo advised the hepatised ammonia; and other authors have thought that the same object might be more con- veniently attained by these Avaters. We know not that they have been employed in hectic, but air of a loAver quality than that of the atmosphere seems occasionally useful; and Ave strongly suspect that the credit of the Bristol waters has been lessened, since it has been fashionable to reside nearer the summit of the hill. Of the bituminous waters we have had little expe- rience, and need not enlarge. We perceive in some authors, that water impregnated with what is called •fossil oil occur in this kingdom and in different parts of the continent. In our oAvn country the Avaters of Brosely, Pitchford, and Wigan, are enumerated; in France, those of Gabian and Plombieres ; in Germany, that of Waldsborn. In fact, the accuracy of modern chemistry has not yet sufficiently illustrated the nature of several mineral springs; nor are the medical reports wholly free from suspicion of superstitious, prejudiced, or interested exaggeration. We have, consequently, pre- ferred giving the general outlines of the analysis, with the knoAvledge to be draAvn from the sensible qualities of the water respecting its ingredients, to the list of mineral Avaters, Avith which Ave had purposed to con- clude the present article. The metallic impregnations only remain, and under •this head Ave purpose to speak more particularly of the Bath Avaters. These springs have been long and highly esteemed; but the chemist has been disappointed in finding so little foundation from his analysis for the character they have for so many centuries enjoyed. This water consequently furnishes a strong argument in fa- Arour of those Avho consider the attenuated form of the impregnation as the chief source of the benefit arising from it. Simple warm water has indeed been substi- tuted, and manv are the virtues attributed to it in assist- ing digestion. ' Such it may possess; but till it pro- duces all the varied effects of the Bath waters, we shall have little confidence in the refinement. Every physi- cian, Avho Avishes to distinguish himself at Bath, writes on its waters, and endeavours to add to the stock; yet Ave are still little acquainted with the volatile ingredients Avhich occasionally produce giddiness, and, when im- properly used, fever. It is not very unreasonable to presume that it is inflammable or azotic gas. The iron is in a small proportion; and a late author, who has plumed himself on the discovery of silex in this water, has advanced very little in the discovery of the cause of its powerful effects. Bath waters are certainly warrn and tonic : in the arthritic weakness of the stomach they are highly useful; in palsy, if the effects of the stimulating, inebriating principle be avoided, they are very serviceable; in topical weaknesses of the joints they excel almost every other remedy. In the relaxa- tion of the hip joint, Ave perceive, from the records of the Bath hospital, they have given important relief: in chronic obstructions of the viscera they are equally valuable. The waters impregnated with vitriolated iron only are more simply'tonic; and the forge water, where the iron seems only mechanically mixed, is chiefly useful as a topical application. The other metallic impregnations of water are cop- per, arsenic, and tin: of the two latter however Ave have no proofs, and Ave think they have never been dis- covered. Copper in water chiefly occurs near mines; but we perceive in Ireland the mineral waters at Balle- murtoch and Cronebaum accounted cupreous; and those of Altenburgh, Cement, Goslar, Herengrunde, Neusol, and Schmelnitze, in Germany, are supposed to be of a similar nature. They are used only as topical applications to old ulcers, and sometimes in chronic ophthalmy. We may perhaps be accused of neglect, for not more particularly noticing the cretaceous waters and the sea Avater. Of the former, Bristol waters are a striking and an almost solitary example; nor are Ave ignorant of different effects supposed to result from its demulcent properties, particularly in hectics and diseases of the bladder. It is sufficient to mention them in this place for the use of those who have more credulity on these subjects than ourselves. We see no other effects from these waters than from a mild pure fluid, Avhich is cer- tainly useful, though not the only source of the advan- tages Avhich mineral waters impart. The Bristol springs have been thought serviceable in diabetes: a fact that requires a more ample consideration of the disease than can be admitted in this place. Sea water has been supposed to possess peculiar poAver; Jmt if more eminently useful than other saline purgative waters, the advantages chiefly result from its being more easily procured and longer continued. Yet Ave must remark that common salt is a necessary con- diment to many tribes of animals. To man it is equally of importance, since it furnishes the most common and salutary stimulus, so that we may suppose it pecu- liarly advantageous in diseases. In fact, Ave find it so; and, where the constitution can bear its action, which is not always mild, it is highly useful. Physicians have supposed that it owes some of its advantages to the bittern, the oHv matter which it contains. This cannot A Q U 163 A Q L be denied, though it is not probable. Yet Avhen\ve re- flect that the 6alts of marine plants and of other marine productions areoften particularly useful as deobstruents, more so than even the salt itself, Ave must not deny some peculiar advantages to their pabulum. The administration of these remedies requires but little particular attention; the doses of the saline Avaters must be regulated by their effects. They should be drunk till they produce a slight evacuation from the bowels; and, of course, the Aveaker unpregnations are of little importance. If al pint, or from a pint to a pint and half daily, does not produce some sensible effect, the quantity of fluid will be more injurious as a load, than useful as a medicine. The chalybeate waters, if also saline, should produce some sensible effect in the same way; and, it is said, that the tonic poAver of the metal prevents their debilitating effects as cathartics. The sulphureous waters have, in general, their appro- priate doses regulated by their other impregnations. Those wholly chalybeate must never be drunk in large quantities at once, or without some preparation. Th»_ quantities of the Bath waters necessary for different diseases are taught on the spot: it is a sacred science which the uninitiated must not aspire to know : juvat integros accedere fontes, atque haurire. The others re- quire no particular advice, except not to distend the sto- mach so far as to produce inconvenience. This caution is peculiarly necessary in the use of the acidulous wa- ters. In general, it is better to begin with small quanti- -iies, and repeat them often. If sea water is too nauseous, or excites too much thirst, a portion of milk added to it will greatly diminish the inconveniences. See Kirwan and Sanders on Mineral Waters, Monro on Mineral Waters, Falconer on Bath Waters, Mon- nett's Hydrologia, Annales de Chimie; Fourcroy's Connoissances Chimiques. A'qu.s: minerales artificiales. The preparation of artificial mineral waters has iioav almost become a science. Since the idea is in a great measure aban- doned, that in the vast laboratory of nature they can be only with advantage prepared, many have attempted to imitate them by impregnating common Avater Avith their contents. We have just now admitted that the ingre- dients are of consequence as medicines, but have at the . same time allowed that many of the effects are OAving to a change of scene, of air, and of habits. We cannot therefore expect from these creatures of art what we find from the natural waters, assisted as they are by the other advantages ; at the same time, it is of importance to consider the progress and state of this very useful art, which will supply in part the advantages derived from visiting the springs. It has been common to at- tribute the invention to Dr. Priestley. In fact, Ave are indebted for it to a French physician of Montpelier, who, in 1755, presented to the Academy of Sciences an account of his method of imitating the Seltzer waters. Bergman, in 1774, followed these steps; and, in his successive dissertations, published in 1774, 1775, and 1778, taught us to prepare the waters of Seidchutz, Seltzer, Spa, and Pyrmont; the cold and warm hepatic waters. In this interval, Dr. Priestley gave us the form of preparing the acidulous waters; and Mr. Lane taught us that water thus impregnated was a men- struum of iron. In 1779, M. Duchanoy, a French chemist, reduced the scattered facts to a systematic form, but added little to them. He Avas folloAvcd h\ numerous other instructors, till M. Paul of Geneva, and M. Schweppe in this country, have rendered the art an. almost perfect imitation of nature. Imitation! it is more, for all the noted waters are prepared with an ac- curacy Avhich prevents their being distinguished from those Avhich nature offers in stronger or Aveaker states, and Avith additions adapted to the disease. M. Paul, it is said, has sold 40,000 bottles of artificial Seltzer Avater in one year. Of M. Schweppe's manufacture Ave have received no information, so that our account of this list must be collected from the report of the French acade- micians appointed to examine M. Paul's apparatus and management. The general doctrines Ave have antici- pated in the article of mineral avaters, and the im- pregnations are those which the most accurate analysis has detected in the natural mineral waters. When the acidulous Avaters are prepared by the separation of the carbonic aeid gas from chalk or marble, some of the vitriolic acid escapes with the air, and gives a harshness not found in the natural acidulous Avaters. M. Paul prepares it Avith carbonic acid gas, separated by com- bustion, and all the airs are united to water by com- pression. His alkaline water is prepared Avith potash, in compliance with the directions of Mr. Home and others, Avho have recommended it in calculous cases. In the natural Avaters, however, the alkali is the soda; and this is the salt in the Vichy Avaters, and many of those of Puy de Dome, and Mont d'Or. In many of his aerial waters, the quantity of air is greater than in the natural Avaters: experience must determine whether this is an advantage, for Ave knoAv that Ave lose the peculiar qualities of a medicine by excess m the dose. It is evident, however, that the unavoidable loss in keeping, in uncorking, and pouring out the water,'is thus compensated. The sulphureous Avaters contain half their bulk of pure hydrogenated gas, Avith -j1^, or, in the stronger kind, one-fourth of the sulphureous hy- drogenated gas. According to Bergman, the propor- tion of the latter ingredient is larger. An alkali with an excess of carbone has been lately offered to sale, to prepare the aerial water extemporaneously. Air ra- pidly escapes in solution; but, to make the salt effica- cious, it should be dissolved in a close vessel, or drunk during the solution. The oxygenated Avater is a neAv remedy, yet it seems rather pressed into the water than united Avith it, and very readily escapes. It should certainly be drunk from a siphon, furnished with an accurately ground stop cock. Of this remedy we have no experience; yet, in the Bibliotheque Britannique, a Avork of charac- ter and credit, Ave find many facts in its favour. It seems from this work that the oxygenated Avater may supply the use of acids, and of various oxygenating re- medies; but Ave AArould recommend its being used with caution, as oxygen in the stomach appears to be occa- sionally injurious. The oxygenated water has no taste, while the oxygenated wine, a quack medicine recom- mended in fevers, is slightly acid, and certainly consists only of wine with a small proportion of one of the mine- ral acids. The hydrogenated and hydrocarbonated Avaters con- tain, respectively, half their bulk of air. Of these little use seems to have been made, and the trials hitherto have spoken little in their favour. Y2 XQV 164 A Q U As the artificial mineral waters are becoming fashion- able, Ave shall add a table of the solubility of the differ- ent gases in one hundred parts of Avater. Muriatic acid......100 Alkaline air......34 Sulphureous acid gas . . . 3.96 Xiirous oxide ..... 0.27 Carbonic acid ..... 0.17 Nitric oxide...... 0.16 A'qt'iE thermales. The Avarm mineral waters dis- tinguished by this title Ave have in general noticed in a preceding article; and it is now only necessary to con- sider the peculiar advantages derived from their heat. Were our present object chemistry in general, we might examine at some length the cause of this heat, which has been hastily and indiscriminately said to be subterraneous fire. The problem was thus quickly dis- missed ; and little enquiry into the probability of vol- canic fires existing in the spot where these warm waters were found was thought necessary, and less investiga- tion into the cause of these fires continuing to burn for ages with a temperature neither increased nor dimin- ished. There is little doubt of the heat being derived from decomposition, and in general of martial pyrites. These contain a large proportion of caloric ; are found in vast extensive beds; and, when decomposed, may for ages continue to give out and communicate heat of a steady temperature. In general, they add greatly to the effects of the sulphureous waters, and often to the chalybeate. For external use they are in general pre- ferable ; and when percussion is added by pumping or pouring the water from a height, their stimulant and tonic effects are greatly increased. In these ways the Avaters of Bath are so singularly useful. This subject must, hoAvever, be resumed, when we consider the im- portance of bathing in general; and Ave shall then add what seems to render the Bath Avaters in this form so frequently of peculiar value as a remedy. The heat of thermal waters differs from 92° to 212 of Fahrenheit. See Balneum, and Bathing. We shall add the table formerly alluded to. Of the Proportion of Ingredients in the folloAving Saline Compounds. 100 parts Carbonic. Aerated Tartarin ------ Common Salt of Tartarin or Pearl ash Aerated Soda....... Do.......... Aerated Barytes ------ Aerated Strontian - - - - - Aerated Lime - -..... Aerated Mngnesia ------ Common Magnesia..... Aerated Vol-alkali ..... Basis. Vitriolic. Vitriolated Tartarin Glauber - - - - Do..... Vitriolated Vol-alkali Baroselenite - - - Vitriolated Strontian Selenite - - - - Do. - - - - Do. - - - - Do. - - - - Epsom - - - - Do. .--- Alum..... Do. - - - - - Vitriols. Of Iron - Do. - Lead - Copper Zinc - 41, • - - - 60, - - - - 21,58 - - - 59,86 - - - 78, - - - - 69,5 - - - 55, - - - - 25, - - - - 45, - - - - In the ratio of 6 of Salt to 13 fixed Air 54,8 - - 18,48 - - 44, - . - 14,24 - - 66,66 - - 58, - - - 32, - - - 35,23 - - 38,81 - - 41, - - •- 17, - - • 36,63 - . - 12, ignited 63,75 - - 28, •* of I = 12, Metal - - - 45, - - - - - 75,Calx=71 Metal 40,Calx=30 Metal 40,Calx=30 Metal Acid. 43, 30, 14,42 40,05 22, 30, 45, . 50, 34, 45,2 23,52 56, 54,66 23,33 42, 46, 50,39 55,84 59, 29,35 63,32 17,66 36,25 26, 41,93 23,37 31, 20,5 Water. 16, 6, 64, 2*5, 21, 58,.....- - - . 31,1 ........ 22,.......- - 14,38......- - 5,35 -.-.-.-.. 53,65 -....... 51,of Crystal+19,24 in the Earth 38,-|-8 of Composition 13,07 -..... 1,63 -.--.. 29, ---.-. . 39,....... State. Crystallized. Dry. Fully crystallized. Desiccated. Natural or ignited. Natural or ignited. Nat. if pure, or artificial ignited. Crystallized. Dried at 80°. Dry. Fully crystallized. Desiccated at 700°. Nat. and pure, artificial ignited. Nat. and pure, artificial ignited. Dried at 66°. Dried at 170°. Ignited. Incandescent. Fully crystallized. Desiccated. Crystallized. Desiccated at 700°. Crystallized. Calcined to Redness. AQU 165 AQU 100 Parts Nitrous. Nitre..... Nitrated Soda - - Do. - - - - Nitrated Vol-alkali Nitrated Barytes - Nitrated Strontian Nitrated Lime - - Nitrated Magnesia Muriatic. Muriated Tartarin Common Salt - - Sal Ammoniac - - Do. - - - - Muriated Barytes - Do. - - - - Muriated Strontian Do. - - - - Muriated Lime Muriated Magnesia Muriated Silver - Muriated Lead Do. - - - 51,8- 40,58 42,34 23, - 57, - 6,21 2, - 22, - Basis. 64, 53, 25, - - 64, - - 76,2- - 40, - - 69, - - 50, - - 31,07 - 75, - - 81, 77 •* 83, * of 44, 53,21 57,55 57, 32, 31,07 57,44 46, Acid. 4,2 of Composition 6,21 of Composition 20, 11, 32,72 10,56 22, 36, - - - - 47, aqueous, 38,£ real 42,75 - 20, - 23,8 - 18, - 31, - 42, - 34,59 - 16,54 - 18,23 - 17, - Water. 32,25 16, 42, 34,34 - 8,46 Oxygen In the Calx - Dried at 70°. Dried at 400°. Ignited. Crystallized. Crystallized. Well dried, that is in Air. Crystallized. State. Dried at 80°. Dried at 80°. Crystallized. Sublimed. Crystallized Desiccated. Crystallized. Desiccated. Red hot. Sensibly dry. Dried at 130?. Crystallized. Desiccated. A'qu.E pa'vor, (from paveo, to fear). See Hydro- phobia. A'qu-ffi stillati'ti-e si'mplices. The simple dis- tilled avaters, now called only aque; the word sim- plex is omitted. Distilled Avaters are only Avater impregnated with the essential oil of the subjects distilled Avith them. When more oil is brought over than the water can take up, it sAvims at the top, or sinks to the bottom, and is to be separated by a funnel. Cohobating may answer for ob- taining more essential oil, but it does not increase the strength of the water first distilled; and such plants as do not sufficiently impregnate the water at the first distilling are improper subjects for this operation: other methods are to be used to obtain their virtues. See Distillatio. Distilled waters are extemporaneously made Avith the oleo-sacchara, oils rendered miscible with water by rub- bing them with sugar, or Avith the essential salts. See Oleo saccharum. When simple waters are used alone, or as the prin- cipal medicine, they are not disagreeable; but Avhen used only as vehicles for other more powerful remedies, distilled water is by far more elegant; ,and as but feAv of the simple Avaters are of sufficient efficacy to be used alone, they are hardly worth the trouble of making. A'qu^E stillati'tije spirituo's.i, a spider, and eilos, a form). See Aranea, and Pia mater. A'RACON. See jEsecavum, under jEs. A'RACUS AROMATICUS. See Vanilla. A'RADOS, (from xpxhu, to be turbulent). Hippo- crates means by it the perturbation excited in the sto- mach by digestion. It also signifies any perturbation in the body. ARjE'QN, (from xpxios, rare). Thin, rare, sIoav. It is applied to breathing, as when we say the breathing is not frequent nor thick. The air is also said to be rare, when not too much condensed. ARiEO'TICA, (from xpxiou, to rarify). Things or medicines which rarify. ARA'LDA. See Digitalis. ARA'LIA, (from ara, a bank in the sea; so called because it grows upon banks near the sea). Berry- bearing ANGELICA, Or ANGELICA TREE. The floAvers consist of many leaves, which expand like a rose and are naked, growing on the top of an ovary. These flowers are succeeded by a globular fruit, Avhich is succulent and. full of oblong seeds. It is the aralia racemosa Lin. Sp. PI. 393. In its natural order it has been usually arranged among the umbcllifere, but Ven- tenat has separated it, and formed a new order from this genus, the araliacee. The a. undicdalis grows in. Canada, and is there called sarsaparilla, because its roots and virtues are nearly the same. See Miller's Diet, and Philos. Trans. Ab. vol. v. The a. octophylla and palmeta groAV in China, and their bark is supposed to be useful in dropsies. Ara'lia hu'milis. See Gensing. ARA'NEA, (from xpxu, to knit together,) called also arachne araneus, the catcher, the wolf, and SPIDER; Spiders are absurdly said to abound with volatile salt, in consequence of Avhich they are sometimes useful in agues, if taken inwardly. A scruple of the spider's web, it has been said, in many instances hath proved successful, given an hour before the fit of an ague, and an hour after it. They may perhaps contain an acrid oil, but their effect in agues is from the horror excited: they never cured, when the nature of the medicine Avas concealed. By this name are also called the coat and capsula of the crystalline humour of the eyes, named also speculum crystalloides tunica. It is furnished Avith vessels from the ciliary processes, and from an artery which enters the bottom of the retina and runs through the vitreous humour. Ara'nea is also the appellation of the coat of the vi- treous humour of the eye, from resembling a spider's web; called also arachnoides, a name added to it by Herophilus, according to Celsus. It is noAV called vi- trea tunica. Dr. Nicholls, and Albinus, on injecting it* say that the vessels run on it like rays from a centre. ARANEO'SA URI'NA. Urine, in Avhich is some- thing like spider Avebs, Avith an oiliness on the top. It indicates a colliquation. ARANEO'SUS PU'LSUS. A spider like pulse. According to Galen, a small pulse that moves as it* shaken by short puffs of air. ARANEUS. See Aranea; also Astcii.vchilos. ARA'NGIA, ARA'NTIA. See Auramia Hispa- lensis. ARA'RA FRU'CTUS SECU'NDUS, or A'RARA FRU'CTUS AMERICA'NUS. (Ararah, Arab). It is a tree of the juniper kind, groAving in Cayenne ; and Avhen bruised is applied to ulcers. Raii Hist. Its genus has not been ascertained. ARA'SCON. See Furor uterinus. ARA'XOS. See Fuligo. A'RBOR. A tree; defined to be a plant of the largest growth, whose trunk is perennial and single, divided into many large branches, which are again subdivided into small twigs, on which the leaves, flowers, and fruit are produced. A'reor AquA'ncA Brasilie'nsis, see Anixga ; Arbor camphorifera, see Laurus. A'rbor farini'fera. See Pa'lma Japo'nica. A'rbor febri'fcg.v Peruvia'na. See Co'rtex Peruvia'nls. A'rbor Ixca'na siLiquis toro'sis. See Ca'jan. A'rbor Indica fru'ctu conoi'de, Sec. See Ana- ca'rdium. A'rbor jucadi'ce. See Ca'ssia li'gnea ; Cane'lla a'lba. A'rbor lani'gera sprxosA. See Bo'mbax. A'rbor mala'barica lacte'scens, 8cc. See Co- ne'ssi. A'rbor mexica'na. Scc-Orlea'-va. A'rbor mci'fera. See Andi'ra. A'rbor St. Tho'jijE. See Manda'ra. A'rbor spino'sa. See Ly'cium. A'rbor spino'sa I'ndica, Sec. See Bo'nduch Indo'- rum. A'rbor pomi'fera, and prunife'ra I'ndica. See Acajai'ba. A'rbor vimfera coupon juglandi similis. See Cou'ton. Arbor Dian.£. Silver precipitated by the superior affinity of some other metal in an arborescent form. Lead and tin produce similar appearances, and are styled arbor plumbi, and arbor stan.nt ; but the method of forming these trees has no relation to medicine. ARBORE'SCENS, arborescent, (from arbor, a tree). See Dendroides. ARBU'SCULA CORA'LLII, orCORALLOI'DES, (a dim. of arbor). See Corallodendron. Arbv'scula gummifi.ha Brasiliensis. See C.wio- PIA. ARC 168 ARC ARBU'STIVA, (from arbor, a tree). An order of plants of the shrubby kind. ARBU'TUS PAPYRA'CEA, called alsopapyracea, fragaroides, ferentis, fragaria. The strawberry tree. The fruit of this tree, called unedo, comarus, and memacylon, is slightly cooling and relaxing, aperient, and a promoter of the urinary and alvine secretions: mixed with watery liquors the juice forms an useful drink in fevers. The jellies and inspissated juices are less flatulent than the raAv fruit. See Fraga. This strawberry is like a quince tree, and is common in the south of Europe. Arbu'tus u'va u'rsi. See Uva ursi. ARCiE'I, Bals. vel Linim. vel Ung. See Elemi. ARCA'NNE. See Ochra. ARCA'NUM, (from area, a chest). A secret, or a medicine whose preparation is kept from the world to enhance its value. - Arca'num coralli'num. See Mercurius coralli- NfUS. Arca'num du'plex, or duplica'tum. See Ni- trum. Arca'num jovia'le, is a preparation of tin and quick- silver amalgamated and digested in spirit of nitre, but iioav disused. - Arca'num materia'le. Among the chemists it is a specific extract, supposed to be allied to the matter of our bodies. Arca'num ta'rtari. Te'rra folia'ta tartari. See Diureticus sal. ARCEUTHOS, (from xpx, evil, and xevdtu, to drive away). So called, because the smell of its leaves keeps off noxious animals. See Juniperus. ARCHE'US,(from xp%y, the principal, chief, or first 7iiover). The supposed primum mobile of Helmont, which, in his opinion, superintended the animal econo- my, and preserved it. It resembles Plato's ani7na mundi. Hippocrates uses the words xp^xmi pvms, to signify the former healthy state before the attack of the disease. It is also a term coined by Paracelsus ; by it he would ex- press the sole active principle in the material Avorld. But hoAvever language has diversified the nature and operation of this principle, the existence of a poAver in the animal system, to correct accidental deviations from health, and to preserve the body in a sound state, is un- " deniable. When nature is said to act, such a prin- ciple must be intended, Van Helmont, Avho, among numerous fancies, possessed in many instances a sound judgment and extensive knoAvledge, placed hisarchseus in the stomach, and supposed it the grand regulator of the animal machine. Stahl adopted the principle, and extended its influence, without however fixing its throne in any one part. The system of Stahl Avas Avidely dif- fused in Germany, and for a long time obscured the humbler, but scarcely less industrious, labours of Hoff- man ; and to Stahl, Dr. Cullen has been more indebted than is generally supposed, or he Avas himself willing to acknowledge. The great point at issue between the disciples of Van Helmont and Stahl, and the more modern physiologists, is the action of this principle. Stahl contended, that nature acted from Avide exten- sive vieAvs, consulting Avith consummate Avisdom the good of the machine entrusted to her care. Dr. Cullen, Avhile he admitted the benefits produced by the ope- rations of nature, considered her action as the necessary consequence of immutable laws; and denied that Ave in any instance possessed a power of acting, directed by means; chiefly since these means Avere beyond our knowledge; nor were we in many instances conscious even of the end or object. We need not expand this article by the arguments on either side. In the Avorks of Stahl, particularly in his ' Theoria Medica Vera,' and in the theses, published by his pupils, the whole doc- trine is expanded with singular ingenuity, and support- ed with a logical precision, of which, in the annals of medicine, there is no example or imitation. It is more clearly explained in the works of Junker; for the lan- guage and the laboured precision of Stahl place him beyond the reach of many readers. As the principle i.s acknoAvledged, we ought to look to physiologists for its explanation: none has, hoAvever, been offered, except that hinted at above by Dr. Cullen. The power evi- dently does not reside in the immaterial- principle, but is the result of changes more purely material; and such is the constitution of the animal machine, that, by being repeated,, it obtains greater facility of action. Nature, then, often urged to supply deficiencies and correct de- viations, acts more readily, and performs her office more successfully. In a future part of this work Ave shall re- sume the subject; and Avhen the articles to which Ave must refer are before the reader, Ave may make some advances in the explanation. See Vires nature. ARCHANGE'LICA. See Angelica, and Lamium album. A'RCHE, xp%tj. The first attack of a disease; its first stage ; or that time of the disorder in Avhich the patient first takes to his bed, or in Avhich help might be effectual. ARCHE'GENUS MORBUS, (from xpw, the be- ginning, and yivopxs, to be). Holding the first rank in diseases. See Acu'tus mo'rbus. ARCHE'NDA. Corrupted from the Arabic alkenda, the ligustrum, or privet. A powder prepared of the Egyptian privet, to be applied to the feet to check their fetid odour. ARCHEZO'STIS, (from xpx*i, extrc7nity, and £»v- wa, to bind). Because its tops or tendrils are apt to bind round whatever is in its reach. See Bryonia alba. ARCHIA'TER, (from *pm, chief, and ixlpos, a phy- sicia7i). The principal physician at a court. ARCHI'MIA, (from xpy/i, chief, and xv/ux, chemis- . 'try). The art of changing imperfect into perfect metals. ARCHI'THOLUS, (from «pw, and SoXos, a chamber). See Archicolum. A'RCHOS, the anus. Also the intestinum rec- tum. ARCHOPTO'MA, (from xp%os, anus, and -xtxlu, to fall down). A bearing down of the rectum. Vogel. A'RCION. A'RCIUM. See Bardana. A'RCOS. ^ See JEs ustum. ARCTA'TA PARS. So Scribonius Largus calls a part compressed or closed by a fibula. ARCTA'TIO, vel ARCTI'TUDO, (from arcto, to make narrow). It is when the intestines are constipated from an inflammation or spasm. Also a preternatural straitness of the pudendum muliebre. A'RCTIQN, (from «f«7«s, a bear,) so called from i*s roughness. See-Bardana Arcticuv A R D 169 A R J) A'RCTICUM LAPPA, vel A'RCTIUM MAJOR. See Bardana major. ARCTOSCO'RDON, (from xpxlos, a bear, and c-xopfrov, garlic). Bear garlic ARCTOSTAPHYLOS, (from xpxlos, a bear, and tf\x>uns like oil, in which state it is cast in moulds. The caustic thus formea deliquesces in the air, and is inflammable ; the silver, during the com- bustion, separating in a pure state. For its mode of application see Cauteria under Escharotica. The nitrated solution of silver, previous to the eva- poration, should be transparent. It has been used, under the appellation of aqua graeca, to blacken the hair; but must be greatly diluted, and employed Avith caution. The lapis infemalis, under the name of nitrated silver, has been given internally by Boyle and Boer- haave. The latter thought highly of its virtues in dropsy when mixed Avith an equal quantity of nitre, and has told us that it occasioned the discharge of water in large quantities. Modern practice has recommended it in epilepsies, and angina pectoris. We have already had occasion to remark that all metals are apparently tonics or antispasmodics, and silver is probably of this number From its acrimony it may also prove ca- thartic, as has been said, but our oAvn experience has been too inconsiderable with this medicine to enable us to recommend it from observation. The dose should not exceed I of a grain: it is perhaps best to begin Avith f or -i. Angelus Sala recommended for similar diseases the CATHARTICUM LUNiE, MAGISTERIUM HYDRAGOGUM, Or dejectorium. This Avas a filtrated solution of nitrated silver crystallized. Of this salt he gave from six to eight grains, but found it so rough and uncertain that he soon disused it. Of his luna potabilis, recom- mended in delirium, he has given no formula: but his bezoardicum lunare consisted of equal parts of glass of antimony and calx of silver. Lemery's tinctura lux.e was made Avith the impure.metal, and oAved. AR G 171 ARG us chief virtue to the copper with which the silver Avas alloyed. Arge'ntum vi'vum; called also hydrargyrus; a term noAV used by the college of London, mercurius, liquor metallicus, metallumfluidu7n, argentum fusum, et mobile, mercurius, chemicorum-, vomica liquoris eterni; aludit; ahatris; alambic; alborca ant-erit; dedaius; al- carith, alecarith, alkaut, ebesmech; fans che7nie; gery- on; guma; ignis; ahnarkasita; alohar; alohoc; mus- ■salis; massariam; mater metallorum; ziback; alosat; altaris; quicxsiLVER. Hatty, vol. iii. p. 423. Its chemical character is $, Avhich denotes that the inside is pure gold, but the outer part is of the colour of silver* Avith a corrosive underneath. Its being a metal has been disputed; but it is hoav found that at about 40° beloAV 0 of Fahrenheit it be- comes solid and malleable. In the Venetian territories are the greatest quantity of mines producing quicksilver; the East Indies, Spain, and Hungary,, afford great quantities of it; in China, Japan, and about Montpelier in France, there are mines in which it is found. It is found in the earth in a fluid form, sometimes so pure as not to require refining, when it is called virgin quicksilver ; but most frequently it is mixed Avith other substances. The most general state in which it is met Avith in the mines is in sulphureous ores of a red colour, called cinnabar, whose colour is deeper Jin pro- portion to its richness. From the ore it is separated by Avashing in Avater, grinding with vinegar and a little salt, which dissolves the metalline impurities; and by distillation, either alone or with the addition of lime, potash, or iron filings. The people Avho work in the quicksilver mines soon die: when first affected they are seized with tremors, after which a salivation comes on, their teeth drop out, and pains of the whole body, particularly of the bones, seize them. Hippocrates does not seem to have been acquainted with this mineral; Aristotle and Dioscorides rank it amongst poisons; Galen says that it is corrosive ; Mes- sue, the Arabian, was the first who used it medicinally, and he only applied it in the form of an ointment in cu- taneous distempers. Avicenna observes that it maybe SAvalloAved crude, and that it passes through the body. About the end of the thirteenth century it was intro- duced into Europe as a medicine, but not esteemed a safe one until the venereal disease was found to yield to its efficacy- The first internal mercurial medicine which gained real credit was the pilul. Barbarossae,, which Avas ■composed of quicksilver, rhubarb, and musk. The term quack, originally quacksalber, was a name of this metal, and applied to the irregular indiscriminate use of it It is the heaviest of all bodies except gold. Mercury is to gold nearly as 3 to 4; and to Avater as 13.5681 to 1.0000. It is totally volatile in the fire by heat not much greater than that of boiling water, and by a far less heat it is calcined into a red powder. The fumes raised by fire are scarcely visible; and yet, by being received into cold water, may be reduced to the state of pure quicksilver. It rises also in vapour, in the vacuum of 'he Toricellian tube. It amalgamates most readily Avith gold, and in suc- cession with lead, silver, and tin; scarcely at all Avith iron or copper. By the assistance of trituration, or of heat, it dissolves all metallic bodies except iron. The vitriolic acid hath no effect upon it until concen- trated by heat; the nitrous acid acts quickly upon it; and the muriatic scarcely at all until it is oxidated: fixed salts, vegetable acids, and neutral salts, scarcely alter it in any Avay. It is allowed to be pure Avhen a little held over a fire, in an iron ladle, totally evaporates. It is often adulterated with lead; a large quantity of which may be incorporated with it by the intervention of bismuth in a moderate heat; and in this case the lead cannot be separated by pressure through leather. This abuse may be discovered by the mercury staining paper blackish; by its not running into round globules; by its leaving a poAvdery matter or a coloured spot on the bottom of the vessel; and by its producing a turbid milkiness during its solution in aqua fortis. As a medicine, it is used to promote the secretions in general, particularly the saliva. The more perfectly it is divided, the more poAverful and penetrating is its action, Avhich is chiefly exerted in the small vessels. Whether used internally or externally it affects all the vessels in our bodies, and may be so managed as to pro- mote excretions through all the emunctories. If not restrained, it is determined to the mouth, and cause* inflammation, tumours, ulcerations, and constantly an increased discharge of saliva. Mercury, like antimony, has been tortured in many different Avays, but the result of the chemists' and al- chemists' labours has been fortunate. We have obtain- ed by their means a considerable variety of active pre- parations, Avhich are of the greatest importance in the healing art. We shall, as in the article of Antimony, first examine the preparations retained by the colleges of these kingdoms, and then notice some of the more important formulae formerly recommended, or still valued. The mind will not in this Avay be distracted by a multitude of objects, and what the enquirer chiefly wants he will readily find. Mercury is employed I. Purified by distillation. Hydrargyrum purificatum (Dublin. London). II. Slightly oxidated x By precipitation of nitrated mercury by means of ammonia. Oxidum hydrargyri cinereum (Ed.). Pulvis hydrargyri cinereus (Dublin). /3 By trituration. 1. With unctuous substances. Unguentum hydrargyri (Ed.). --------------------fortius (Lond. Dublin;. ————-------------mitius, ibid. Emplastrum ammoniaci cum hydrargyro. ----------- lithargyri cum hydrargyro. ----------- hydrargyri (Ed.). 2. With saccharine substances. Pilulae hydrargyri (Lond. Dub. Ed.). 3. With aerated lime. , Pulvis hydrargyri cum creta (Lond.). 111. Considerably oxidated x By heat and air. Hydrargyrum calcinatum (Lond. Dublin' Z 2 ARG 172 ARG fi By nitrous acid. Oxidium hydrargyri rubrum per oxidum nitri- cum (Edin.). Hydrargyrum subnitratum (Dublin). Hydrargyrus nitratus ruber (Lond.). Unguentum oxidi hydrargyri rubri (Edin.). IV. Oxidated and combined Avith acids. }. More slightly. x With the nitrous acid. Unguentum hydrargyri nitrati (Lond. Dub. Edin.). p With sulphuric acid. Subsulphas hydrargyri (Edin.). Hydrargyrum subvitriolaturn (Dub.). Hydrargyrus vitriolatus (London). y With muriatic acid. 1. Sublimation. Submurias hydrargyri (Edin.). Hydrargyrum muriatum mite sublimatum (Dublin). Calomelas (London). 2. By precipitation. Submurias hydrargyri praecipitatus (Edin.). Hydrargyrum muriatum mite praecipitatum (Dublin). Hydrargyrus muriatus mitis (London). o With acetous acid. Acetis hydrargyri (Edin.). Hydrargyrum acetatum (Lond. Dub.). ,'. More completely. Muriats. Murias hydrargyri (Edin.). Hydrargyrum muriatus (London). Hydrargyrum muriatum corrosivum (Dub.). With ammonia. Calx hydrargyri alba (London). V. Combined Avith sulphur. 1. By trituration. Sulphuretum hydrargyri nigrum (Edin.). Hvdrargyruin sulphuratum nigrum (London. Dublin). :. By sublimation. Hydrargyrum sulphuratum rubrum (London. Dublin). Mercury differs from antimony in one important re- spect, viz. that its calces are not inert in proportion to their degree of oxidation: in fact, the more highly oxi- dated metallic salts and calces are among its more active preparations. In the first stage of oxidation Ave find mercury assume a grey colour; and in this state, as appears by the table, it exists in plasters and oint- ments, and formerly existed in,some other preparations noAV chiefly confined to private practice. The only re- maining preparations of this kind are, the pulvis hydrar- gyri cum cretd, and the pillule hydrargyri, of the three colleges. The latter differ only in the proportions; for one grain of mercury is contained in four grains of the Edinburgh pill, three in that of London, and tAvo and a half in the Dublin form. It has occasioned some anxiety to learn in these preparations the source of the acid, for an a6id Avas thought necessary. We noAvfind that oxygen is chiefly required; yet it has been dis- covered that electricity has, or possibly the Galvanic fluid, some share, since the preparation differs accord- ing to the nature of the vessels employed. A simiki. poAvder is the result of agitating pure quicksilver in Avater, but the source of the oxygen is there suffi- ciently obvious. The difficulty of obtaining a complete extinction of the quicksilver by trituration, induced the Edinburgh and Dublin colleges to precipitate the mercury from its solution in the nitrous acid by means of ammonia. The oxidum hydrargyri cinereum, and pulvis hydrargyri cinereus, are the results of this plan. The oxide is, hoAvever, not pure, for it contains the oxide of mercury with ammonia not saturated Avith nitric acid. Fourcroy has remarked, that a part of this salt is soluble in the acetous acid; and the remainder, a pure subnitrate of mercury and ammonia, crystallizes in brilliant polyhe- dral crystals, extremely styptic, and scarcely soluble in water; consisting of 68.2 of oxide, 16 of ammonia, and 15.8 of nitric acid. Though this be different from. the grey oxide, yet Ave think it deserves a trial. The black oxide may be prepared also by triturating the calomel (in modern language the sublimed submuriate of mercury) in lime water. The decomposition is said to be more complete if the precipitated submuriate is employed; the preparation generally knoAvn by the name of calomel in the humid way. A pure oxide of mercury with a larger proportion of oxygen occurs in the hydrargyrum calcination of the London and Dublin Dispensatories. The process" is sIoav and tedious; but the preparation, if carefully levigated, highly useful. Its acrimony must, hoAvever, be guarded by opium, or it will prove emetic and pur- gative. In a long practice, it is not uncommon to feel at different periods a predilection for different prepara- tions of mercury; and, perhaps, at this time Ave may be peculiarly fond of the present preparation. It seems, hoAvever, to perform every thing Avhich the most cele- brated mercurials have effected, and not to be more in- convenient. Yet, perhaps, in every instance, calomel Avill do as much. Mercury, oxidated by nitrous acid, has been much employed ; hydrargyrus nitratus ruber of the London Dispensatory; oxidum hydrargyri rubrum per oxidum 7iitricum of the Edinburgh; and hydrargyrum sub7ii- tratum of the Dublin: yet it scarcely differs from the mercurius calcinatus, except in-the convenience and the facility of the preparation. The metal is first united Avith the acid ; then the latter decomposed and separated by heat. In general, the acid exceeds fn a small proportion th@Aveight of the quicksilver; but the London college renders the proportions equal, adding a little muriatic acid, Avhich it is supposed increases the size and beauty of the red scales. This advantage is, hoAvever, equivocal; and the little difference in the pro- portion of the acid of scarcely any importance except in an economical vieAV. If too small, the continued heat compensates the inconvenience. The ointment contains one part of the oxide to eight of hogs' lard. The oxides of mercury, combined with acids, are preparations of great importance. In the old unguentum citrinum, unguentum hydrargyri nitrati, we find the only instance of its combination with the nitrous acid. With the vitriolic acid it forms the hydrargyrus vitrio- ARG 173 A R G latus of the London, and the subsulphas hydrargyrifia- vus of the Edinburgh. The very singular process by Avhich this medicine is prepared, M. Fourcroy has very industriously and ingeniously analysed. When the acid is added to the metal, no action takes place; but when heat is applied, a part of the acid is decomposed and the metal oxidated, uniting with the remainder of the acid. The salt thus formed is Avhite, but the acid is in excess. When the seperfluous acid is separated, this salt crystallizes in fine prismatic needles; is soluble in about five hundred parts of cold Avater, and in half that proportion of warm, Avithout decomposition. A little sulphuric acid increases its solubility. In this state Fourcroy found that it contained seventy-five of the metal, twelve of the acid, eight of oxygen, and five of water, in one hundred parts. In the processes of the colleges, the saline solution is boiled to dryness, so that more of the acid is decom- posed, and a larger proportion of sulphureous acid gas evolved. If then, as directed, it is throAvn into boil- • ing water, a yelloAV powder, the hydrargyrus vitriolatus, is formed. What is effected ,by this part of the process M. Fourcroy discovered by examining the different por- tions. The water contained a salt Avith more than its proportion of acid: of course, the poAvder had a di- minished proportion, and the affusion of the hot Avater dissolving as much of the salt as it could take up Avith its acid, left the powder deprived of it. It consisted, on analysis, of seventy-six parts of mercury, and eleven of oxygen. The taste is acrid; it is soluble in two thousand parts of cold Avater, decomposed by the nitrous and mu- riatic acids, oxidizes quicksilver, and is converted by trituration Avith it into a black poAvder. Such is the outline of this author's labour; and chemistry does not furnish an analysis at once so accurate, so elegant, and satisfactory. The muriatic acid furnishes preparations of the great- est use and importance in medicine. In the calomel of the London Pharmacopoeia, the siib7nurias hydrargyri of the London, and the hydrargyrum 7nuriatum 7nite sub- limatum of the Dublin, prepared by sublimation, the metal is oxidated more slightly. But before Ave can notice these Ave must step forward in the table to the muriats, and the three different titles express only the combination of the metal with the muriatic acid, ge- nerally known by the appellation of corrosive sublimate. In all the preparations the mercury is oxidated by sul- phuric acid, and then combined with the muriatic, by subliming it with a mixture of common salt. The taste is peculiarly acrid and styptic: it is soluble in twenty parts of cold, and in about two of boiling water; in nearly four parts of alcohol at 70°, and in an equal weight of alcohol in a boiling state. It is unaltered in the air, in sublimation, or by either of the mineral acids. Its solubility is increased by the addition of a small pro- portion of crude sal ammoniac. It is precipitated by .dl alkalis and earths; those not carbonated form a yellow precipitate; the others an orange yelloAV, chang- ing to a brick red. It consists of oxide of mercury 0.82, and of acid 0.18. The oxide itself containing 0.15 of oxygen. The calomel, and the synonymous formulae Avhich precede, are prepared from this muriat of mercury. The principle of the preparation is obvious, Avhen it is recollected that earths and metals, unlike alkalis, may be combined with different portions of acid, and still be in appearance neutral. In the muriat of mercury there is no apparent excess of acid; yet nearly an equal proportion of the metal may be combined Avith it, and partake not only of its acid but its oxygen. About nine ounces of the metal are added to a pound of the muriat, and united by trituration. The neAvly added metal shoAVs immediately appearances of oxygenation, but the combination is effected only by repeated sublimation and trituration. The London college orders this pro- cess to be repeated four times ; an extraordinary pre- caution, certainly not necessary. Generally twice is sufficient; but Ave have sometimes found the union not perfectly complete, and a third sublimation is occasion- ally necessary. From Mr. Chevenix's experiments also there seems to be an unnecessary Avaste of quicksilver, a less proportion, 0.54,for instance, appearing sufficient. He considers the excess,however,a necessary precaution. The -utility of calomel, which may be perhaps considered as an instar 07nnium Avith respect to the other mercurial preparations, for it is in every instance equally useful Avith any other, and in many cases greatly superior, has induced chemists to attempt Avith great diligence an easier and more certain mode of preparing it. The great object is to avoid the necessity of very long and careful trituration; for the calomel forming by subli- mation a very hard solid mass, consisting of a con- fused aggegration of tetraedral prisms, terminated by pyramids, the most careful attention is necessary lest any spiculae should remain. Calomel has, consequently, been prepared in the humid way ; first, if avc recollect rightly, by Schecle, and aftenvards more accurately 1 y Gottling. It is noAV found in the Dublin and Edinburgh Dispensatories Avith the epithet precipitatum ; and ul that of London, under the title of hydrargyrus muriatus mitis. The principle of the process consists in forming a nitrated solution of mercury Avith an excess of oxide, to which a dilute solution of common salt is added. It Avas supposed that the decomposition of the nitrate-.1 mercury immediately took place, and that the poAvder deposited Avas calomel. Mr. Chevenix, however, has given us some reason to doubt the justness of this con- clusion; and as water, the menstruum of the salt, will decompose nitrated quicksilver, the precipitate is pro- bably a subnitrate of quicksilver, together with the sub- muriate. He consequently proposes adding to the Avater a little muriatic acid, or to employ a nitrated quicksilver Avithout heat. To either proposal no reasonable objec- tion can be made: yet it has been suggested by good authority, that the quicksilver in the nitrated salt is too highly oxidaied—for, .if the preparation be made by boiling, the proportion oi oxygen is greater—and that the solution has been found to contain muriated quick- silver. We have repeated the process with this view without finding the same result; yet we think it should teach us to render our solution of common salt more concentrated, and the two fluids should be added at once, that the moment a particle qf water touches the metallic solution, the latter should be met also by a portion of the common salt. In the usual preparations there is always a little of the nitrated mercury ; for on rubbing the piccipitatesAvith lime water, the powder is grey and not black. When again sublimed, this niii .ted mercury is decomposed, and a sublimation is conse- quentry recommended. We find in our minutes a pro- ARG 174 ARG posal of again repeating the addition of a solution of common salt, and edulcorating the poAvder by Avashing; but do not recollect that the experiment Avas tried. Hermstaedt recommends a process of preparing ca- lomel from the sulphat of mercury, to which nearly the original quantity of mercury is to be united by tri- turation. The muriat of soda is then added, the Avhole mass sublimed, the trituration and sublimation a second time repeated. This preparation has not been che- mically examined, and Ave do not know its peculiar ad- vantages. On the Avhole, perhaps, the old method of preparing the calomel forms the most certain and best preparation, if the subordinate agents can be depended on in the trituration; and as their error can be detect- ed by a nice eye, inconveniences will not often occur: indeed, in the shops of the greater number of apothe- caries no such are found. Calomel, according to Mr. Chevenix, contains 88.5 of oxide of quicksilver, and 11.5 of muriatic acid: the oxide amounts to 0.107, Avhile the muriate contains 0.15 of oxygen. Fourcroy estimates the oxides differently: he makes three spe- cies, the black, the red, and one other still higher, not to be obtained separately; the black and red con- taining, respectively, 0.04 and 0.08 of oxygen. These different results have not been reconciled, and as the disquisition would be purely chemical Ave shall not at- tempt it. Chemists expected to form milder and more con- venient preparations of mercury with the acetous acid; and the reputation of Keyser's pills, Avhich Avere found to be a combination of this kind, seemed to confirm the opinion. In the preparations of the three colleges nitrate of mercury is first formed Avith a gentle heat, which neither occasions it to take up an excess of acid, nor, as in case of boiling, to absorb and oxidate a larger proportion of the metal. A solution of acetated pot- ash is then added, and the acetite of mercury crystal- lises, leaving the nitrate of potash, formed, in the pre- paration on account of its greater solubility in the fluid. It dries sloAvly, and should be compressed in bibulous paper. We have not found it to possess any advantages above the other mercurial preparations. Combined Avith sulphur, mercury is seldom employed internally. Of the medical effects of the iEthiops mi- neral Ave have already spoken ; but we must now con- sider shortly the chemical relations of this union, to complete the chemical history of the metal before us. The black sulphurated quicksilver is not merely a combination of the sulphur and the metal, as authors have supposed. Quicksilver never assumes the form a black powder, Avithout having absorbed some portion of oxygen. Others have suspected that hydrogen is also united, and think that the process is expedited by adding a little Avater,Avhose decomposition supplies both. It is dissolved by the aqua kali, but unaffected by ni- trous acid. From the solution of kali it is recovered unchanged by acids, and in the fire it suffers no altera- tion. When hot quicksilver is thro\\n into melted sulphur, and the Avhole stirred till cold, the same pre- paration in appearance results: the union is not how- ever so complete; it is not soluble in the solution of kali, and is changed by the air. Berthollet supports ihe idea of its containing hydrogen by this remark, that the ^Ethiops mineral may be prepared by agitating mev cury Avith sulphurated, hydrogenated ammonia. Thi. preparation also admits of change from the air. The hydrargyrum sulphuratum rubrum is the factiti- ous cinnabar, a medicine formerly used as a tonic, a stimulant, and a deobstruent; in short, for every object of which the prescriber had no distinct idea. It is noAV only employed as a fumigation in venereal complaints. It is not soluble in any acid; but the nitro-muriatic takes up the metal and leaves the sulphur. Alkalis, in a boiling heat, will not affect it; but, when melted, these and many of the metals decompose it. M. Proust supposes, that the quicksilver which it contains is not oxidated, but that it is in the proportion of 85 to 100, and that the remainder is sulphur. The variety of other preparations of mercury, em- ployed by physicians and surgeons of different countries. at different periods, Avould fill a volume. As Ave cannot enumerate every remedy of this kind, so preparations often celebrated must not be Avholly overlooked. Wt shall not immediately follow the same order; but first * divide the preparations according to their pharmaceutical forms, viz. ointments, plasters, pills, syrups, troches, drops. The mercurial ointments have been varied iii every possible way according to the objects for Avhich they Avere designed. Turpentine Avas formerly the ge- neral intermede to divide the crude mercury, and the additions were adapted to the disease for which it was employed. In the various unguenta ad pcdiculos Ave find the seeds of stavisacre, extract of tobacco, the roots of white hellebore, and oleum laurinum added. In Mynsicht's formula, the'quicksilver is divided by the saliva of a person fasting. When to cure the itch, sul- phur, alum, and' white hellebore, are united Avith the metal; against Avornis, the gall of an ox, and oil of bitter almonds; in cutaneous-diseases, by Stahl, pre- parations of lead and a' portion of camphor; and, in the unguentum ophthalmicum of Hecker, nitrated mer- cury is united Avith camphor. The mercurial plasters and cerates have not been greatly varied from those directed in the different British Pharmacopoeias. Plenck's cerate is made with mercury, divided by mucilage, as in his other prepara- tions. It has been doubted, whether in this form the mercury is absorbed. Mercurial plasters have often no effect; but after their application we sometimes have found pains in the stomach and boAvels, which are re- lieved by removing the plaster; and, in one or two in- stances, salivation has folloAved. The mercurial pills have been very various. Barbarossa's pills,named from the celebrated Algerine who gave the process to Francis I. consisted of mer- cury, Avith a small proportion of rhvrbarb and scam- mony, formed into a mass with lemon juice. Plenck's pilule ex mescurio gummosa, consisted each of a grain of mercury, extinguished by starch and gum arabic, with sometimes a small proportion of rhubarb; and, indeed, some of the forms used in this country contain a mixture of some active cathartics. It Avere endless to follow all the varieties directed indifferent Dispensa- tories, varying only by the mode of extinguishing the quicksilver, and the peculiar additions. The magnetic pills of Ostius are prepared with the mercurius cal- cinatus, with a large proportion of some vegetable ex-. ARG 175 ARG tract, which has not been accurately ascertained; and Keyser's pills, with the acetite of mercury. These last are noAv disused; and, Avhatevcr Avas once their credit, the testimony of Murray, Girtanner, Quarin, and Co- lumbier, seems to have destroyed it. Of the syrups Plenck's mercurial syrup is well known. Bellet asserts that his syrup contains no mineral acid. Girtanner, however, and SAvediaur, have ascertained that the mercury has been dissolved in the nitrous acid precipitated by the vegetable alkali, then dissolved in vitriolic aether, and sweetened. The precipitate of Avhich it is formed Avas found to retain no inconsider- able proportion of the acid. Girtanner also informs us, that Velno's syrup does not differ from Bellet's. The rob antisyphiliticum of L'Affecteur is nearly similar; but some authors contend that a small portion of corrosive sublimate is added. The various troches, particularly the anthelmintic rotule and tabelle of Morelli, ZAvelfer, and Le Mort, as Avell as the rotule infantiles laxative of Schroeder, OAve their virtue to calomel and some active cathartic. In these we may find the source of the various Avorm- cakes and lozenges, celebrated by names of high re- spectability in this country, who do not, however, rank among medical authorities. The secret remedy of Nicole is formed into little cakes, and supposed to contain cor- rosive sublimate, though denied by the author. The trochisci tonici mercuriales of Bru, are formed by an operose process Avhich Ave need not particularly describe, as the medicine is no longer employed : they consist of a mixture of turpeth mineral with Avhite precipitate, and are made into lozenges Avith honey, sugar, and meal. Each lozenge contains about two grains of mercury. The drops contain mercury so much concentrated as to be given in very small doses. Of Ward's drops Ave noAv knoAV the form. They consist of mercury preci- pitated from its solution in aqua fortis by the volatile alkali, and again dissolved in rose Avater. The anti- vencreal tincture, or quintessence of Mollet, contains mer- cury united with the muriated ammonia,, a subject on Avhich we shall soon again speak. The liquor mercurii secretus of Gmelin is given in drops, but it contains little or no mercury. Four ounces of the muriated mer- cury are dissolved in tAvelve ounces of vinegar: the fluid is drawn off, and the.residuum infused, repeatedly, in spirit of Avine, Avhich is drawn off by distillation after being for many days digested in a gentle heat. Libavius' tincture of quicksilver contains as little of the mercury. Nitrated quicksilver is digested Avith the brown oil of vitriol, which is repeatedly draAvn off till the residuum becomes red. From this, spirit of Avine is also repeatedly distilled and someAvhat inspissated. -The Thibet remedy, described by Mr. Saunders in the r9th volume of the Philosophical Transactions, merits also some notice. It consists of a portion of alum, nitre, vermilion, and quicksilver sublimed, and appears to be a nitrated mercury of a mild operation. The drops of General La Motte are of a beautiful red colour, and supposed to be preparations of red preci- pitate or cinnabar in an acrid fluid, of Avhich a feAv drops are taken in tea. The elixir antisyphiliticum of Bouez de Sigogne is, in the opinion of Astruc, similar; and the dose, as Avell as the mode of exhibition, the same. W'r shall next folloAV the less common preparations of mercury in a chemical order. In speaking of the sul- phurated preparations of mercury Ave need not enlarge on the iEthiops mineral, though its formula has been infinitely varied, and numerous discussions on its vir- tues and preparations lie before us. The iEthiops mi- neral forms the basis of the pilule JEthiopice of the Wiitemburg Dispensatory, in which this preparation supplies the place of calomel', in a formula not unlike Plummer's. The Mthiops narcoticus of Jacobi, described in the Acta Naturae Curiosorum, is more curious. Tavo ounces of quicksilver are dissolved in four ounces of smoking nitrous acid, and boiled with two pounds of a caustic lixivium, two ounces of potash, and four ounces of sulphur. The sediment is well Avashed, and is the pulvis narcoticus. This powder, triturated for three days with the ./Ethiops mineral, becomes, it is said, - an active antisyphilitic, Avithout producing salivation. Navier's 7nercurial, said to be particularly useful in scro- fulous and cutaneous complaints, is prepared by pre- cipitating mercury dissolved in hepar sulphuris by any chalybeate neutral. The panacea mercurialis nigra, the panacea of Schroeder, consists of mercury, sulphur, and sal ammoniac, united by sublimation. It differs little from cinnabar except in its darker colour. The pa- nacea Anwaldina is chiefly cinnabar, with some saffron and oyster shells. The cinnabaris cerulea of Wallerius, mercurius violaceus Parisie7isium of Triller, and the mer- curius violaceus diaphoreticus of Astruc, differ only in colour from cinnabar; a change occasioned by a com- bination of sal ammoniac. The mercurius diaphoreticus of Sir Kenelm Digby is prepared by subliming a pound of mercury Avith four ounces of sulphur auratum anti- monii. The union of mercury Avith other metals has been often attempted, and the compound supposed to be highly useful. With lead it has been employed in the iliac passion; Avith tin against Avorms; and with iron in chronic disorders. Corrosive sublimate dissolved in Avater, mixed with a solution of iron in vinegar, we are told by Navier, is void of acrimony, and useful in many chronic diseases. The mercurius dulcis martiatus of Hartmann, is a similar union of a martial calx Avith mercury. The 7nercurius diaphoreticus consists of the calces of mercury and antimony Avith a caJx of gold; for gold has been always considered as a cordial and a diaphore- tic. It is celebrated even by Hoffman, under the name of the solar precipitate, Hercules bovii, and auri vite Clossai. The panacea de la vigne contains mercury with gold and silver; the precipitatus Solaris, Avith gold only; and many similar ridiculous preparations are described by ZAvelfer, Hercules Saxonia, Schroeder, Hartmann, Jungken, and Lemery, under the titles 7ner- curius dulcis Solaris, manna 7nercurii, and arcanum co- rallinum. The mercurius precipitatus viridis, ovlacerta viridis, contains copper united with mercury. The calces of mercury next claim our attention. Dr. Priestley informed us, that mercury triturated Avith Avater might be changed into a black powder; but the fact Avas published by Homberg in the Memoirs of the Academy of Sciences for 1700. This prepara- tion, if it may be so called, has been highly celebrat- ed under the name of. JEthiops 7ni7ieralis per se; more properly, mercurius oxidatus niger: but its chief use has been to unite Avith the vegetable acid in V R G 176 ARG making Kcyser's pills; and, triturated Avith axunge, to prepare extemporaneously the mercurial ointment. The pulvis vigonis is only the 7nercurius calcinatus; and Schroeder's precipitatus dulcis is prepared by calcining quicksilver Avith the red precipitate which has been de- flagrated Avith spirit of wine. The red precipitate itself is the preparation Avhich distinguishes Girtanner's un- guentum rubrum; and forms, Avith burnt alum, eu- phorbium, dry leaves of savine, the roots of iris, and aristolochia rotunda, the pulvis catheriticus, for carious bones, of Schroeder. With minium and ceruse it forms the unguentwn piaccntinum of the hospital at Padua; and Avith tutty, nitre, and camphor, the celebrated ointment of Mursinna for restoring the transpa- rency of the cornea. The pracipitatum nobile of An- gelus Sala is only the red precipitate Avith a small por- tion of the muriatic acid; since it is prepared by cal- cining a solution of a calx of mercury in aqua regia. It is highly commended by its author in a malignant itch. The arcanum corallinum and 7nercurius corallinus are preparations of Crollius, described in LeAvis's Dis- pensatory ; and the laudanum 771'merale of Hartmann is the former, first digested with vinegar, Avhich is again separated by distillation, and aftenvards with spirit of Avine. It is supposed to be a gentle laxative, and then an anodyne and sudorific. The rosa vita 7ni- neralis is the red precipitate, digested four times Avith spirit of Avine. The panacea 7nercurialis rubra, praci- pitatus diaphoreticus excellens, turbith 77iinerale rubrum Zwelferi; pulvis p7'incipis, and 77iercurius antivenereus of Hartmann, are similar preparations, in Avhich the red precipitate is rendered milder by digesting it Avith spirit of Avine. In the two last it is previously elutriated with water, to Avhich an alkali is added in some of the latter Avashings. Various similar preparations of mer- cury are found in chemical authors; but Ave shall only notice Hahnemann's 7nercurius solubilus, Avhich, in his Chemical Annals for 1790, he mentions Avith the Avarmest commendations, as producing no inconve- nience in the stomach or boAvels, being soluble in vine- gar and in the animal fluids, and easily absorbed Avhen applied externally. It seems to be a calx of mercury, precipitated from a solution of the metal in pure aqua fortis by the caustic spirit of sal ammoniac. This pre- paration has been aho called turbith nigrum. The greater number of the calces of mercury have some remaining saline matter, and this is particularly the case Avith the 7nercurius precipitatus albus, the calx hydrargyri alba, Avhich avc again mention to introduce its numerous singular synonims. These are 77iercurius t0S7ncticus; lac mercuriale; calcinatU7n majus poterii; panacea mercurii albi; catharticum mercuriale; and, Avhen Avashed, 7nanna 7nercurii. It is chiefly used on the continent as an external application, and is highly commended in the itch. Authors of credit have, hoAV- ever, Ave perceive, given it internally, and speak highly in its favour: Avhen sublimed, dissolved in Avater, and again sublimed, it is styled aquila celestis. A modern preparation of mercury similar to Hahne- mann's mercurius solubilis, is the hydrai-gyrum nitra- tion cincreum of SAvediaur; pulvis 7nercurii cinereus of Girtanner; called, for a reason that we cannot develop, 7nercurius cinereus of Black. It is mercury, precipitated from its solution in aqua fortis by a mild volatile alkali, c'.nd Is of a lighter colour than the turbith nigrum. The precipitatus luteus of Hartmann is not greatly dif- ferent, as it is precipitated by a mild fixed alkali, and acquires its yelloAV colour by Avashing. The precipita- tus luteus diaphoreticus of the same author is a solu- tion of the corrosive sublimate, precipitated by the same alkali, and carefully washed. Mercurius dejecto- rius, or the flores argenti, is the precipitatus luteus of Hartmann, digested in the acetous acid, and then Avash- ed. The precipitatus correctus of Schroeder is pre- pared by dissolving the Avhite precipitate in vinegar, and again separating it by a fixed vegetable alkali. The improved chemistry has introduced some neAV preparations of mercury. The first that occurs to us is the mercurius phosplwatus, sal phosphoricum mercu- riale, and phosphoras mercurii, Avith some similar ap- pellations. It is a Avhite salt, unchanged in the air, and scarcely soluble in water, prepared by precipitating mercury from its solution in aqua fortis by the phos- phoric acid. This preparation is slightly mentioned by Girtanner and Swediaur, but chiefly introduced by a French quack, M. Mittie, folloAved by a German, J. Fr. Schmidt. It is highly praised in the Avorst stages of syphilis, particularly in the most inveterate kinds when the bones are affected, and is given Avith aromatics to prevent its exciting nausea, in the dose of half a grain, or a grain. We oavii that these assertions are to us suspicious: Ave knoAV that the use of phosphorus is dangerous, and have no reason, front the facts adduced by the admirers of the phosphorated mercury, to sup- pose that this is a safe or manageable preparation. We can add, that it is by no means neAV; for Ave observe in Angelus Sala a preparation styled pulvis rose vita, copied by Hartmann, who calls it mercurius incarnatus precipitatus, in which the nitrated mercury is precipi- tated by urine. We knoAV that this fluid contains the muriated ammonia and the oxalic acid, Avhich may alter in some measure the nature of the precipitate. It is certainly milder, since these authors admit that it may be given from six to ten grains, and is then a ca- thartic. The sal sedativus niercurialis is another modern pre- paration ; not, Ave suspect, of superior value, since its authors Avish to confine it to external use. The nitrated mercury is precipitated by a solution of borax ; and the salt, which is at first yelloAV, by the access of air be- comes greenish. It is scarcely soluble in Avatery fluids, and when sublimed is of an orange colour. Journal de Physique, ix. 343. x. 411. The union of mercury with the benzoic acid (mer- curius benzoinus) Avas first mentioned, we believe, by Tromsdorf in his Chemical Annals for 1790. The floAvers of Benjamin, dissolved in water, are employed to precipitate nitrated mercury. The salt is of a broAvn colour; but, carefully washed and dried, is Avhite and shining, unchanged in the air, with difficulty dissolved in Avater, somewhat more readily in spirit of Avine. It is with some regret Ave add, that, except its author* the only authority Ave can find for its having been ad- vantageously employed is the suspicious one of M. Mittie. The mercurial salts offer some facts and prepar- ations of curiosity, if not of importance. Lavoisier and Cornette, in the Memoirs of Medicine, have in- formed us that the mild alkalis will dissolve the calces of mercury; and Quercetanus long since de- A 11 G 177 A R G scribed the preparation of a spiritus tnercurialis, which consisted of an alkaline solution of mercury; and Rit- ter speaks Avith commendation of an essentia mercurii, which contained the metal, joined Avith a caustic alkali. The neutral salts, however, have a greater power, and the most active of these is the muriated ammonia. The mercurial tincture of Garaye is prepared by triturating the dry sal ammoniac Avith mercury, suffering it to de- liquesce, then again drying, and repeatedly triturating, deliquescing, and drying it. The process is shortened by triturating the brown or the red precipitate with the salt, and then subliming it. Monnet and Paecken long since informed us, that mercury triturated Avith cream of tartar Avould be com- pletely united with it; and if some syrup was added, the union Avould be so complete, that the addition of powders capable of absorbing the moisture Avould not affect it. Cream of tartar, though it does not dissolve the metal in its shining state, will dissolve its calces; and Ave once saw salivation induced, by digesting in cold water ^Ethiops mineral, sulphur, and cream of tar- tar, and giving the solution. If a little borax or seda- tive salt is added, the union will be more complete. This preparation, called mercurius, and sometimes JEthiops tartarisatus, and dissolved in water, the eau vegetable mercurielle, is considered as a very useful me- dicine, but it seems to have no claim to any extraordi- nary .powers. The pure acid of tartar, as we are in- formed by Meyer and De Morveau, dissolves the mer- cury more readily, and in a larger proportion. Rhenish wine, cyder, verjuice, and vinegar, have been employed, as solvents of mercury. The liqueur fondante of Diennert, the hydrargyru7n acetatmn, and the terra foliata 7nercurialis of DeFourcy, are prepara- tions of this kind; but the acid dissolves only the calces of mercury, and the preparations differ in activity ac- cording to the calx employed. We find, in the Avorks of foreign surgeons, very caus- tic topical remedies resulting from the union of mer- cury with the nitrous acid. Of this kind are the liquor exfoliatus Bellostii, liquor mercurii vivi of Mynsicht, and the aqua grisea of the Wirtemburg Pharmacopoeia. The mercurius nitrosus of Selle forms Avhite crystals, prepared by dissolving mercury in the nitrous acid. These are dissolved in four times their weight of water, and two drops of the solution are given morning and evening. The muriated mercury is the foundation of the dif- ferent mercurial Avaters employed externally. Ilor- stius's aqua mercurialis pro scabiosis contains equal parts of corrosive sublimate and euphorbium, Avith a larger proportion of arsenic than his menstruum will dissolve. Grunlingius's lihi/nentum ad serpiginem con- sists of sublimate and alum, of each half a dram, and an ounce of gum tragacanth, dissolved in plantain water. We may here remark that alum is often useful in itch, and is an active ingredient in many of the secret reme- dies Avhich profess to cure it in a very short time. ZAvelfer adds to his aqua mercurialis a portion of aloes for venereal ulcers and cutaneous eruptions ; and Jung- ken, in a similar water, adds ceruse, alum, nitre, sal ammoniac, Ainegar of litharge, 8cc. A preparation nearly of the same kind occurs in the Wirtemburg Pharmacopoeia, which was, for many years, the standard pharmaceutical work of Germany; but, more scientifi- VOL. I. cally combined, Vogler's liquor 7nundificans contains the sublimate, Avith dock root, brown floAvers, the leaves of juniper and savine, and the root of the acorus cala- mus. The most singular external preparation of this is the oil of mercury, for warts and corns, of Fausius; an equal quantity of candied sugar and of sublimate, with a very small proportion of filings of iron, are ex- posed first to a gentle and then a violent heat in close vessels. The iron, however, in part, decomposes the muriated mercury. Such are the most curious or important preparations of mercury, not admitted into our pharmacopoeias ; but we cannot conclude this account of external mercurial applications, without guarding the more inexperienced practitioner-from too free and indiscriminate employ- ment of them. The records of medicine are full of the most dreadful instances of death, in its most painful shape, following their use ; and, though the subject led us to enumerate and explain the principles of their several combinations, Ave have carefully avoided those particulars which would lead, on the one hand, to rash empiricism, or add to the already too numerous list of quack medicines. As a medicine, there is scarcely an indication that mercury cannot supply. There is no more certain and active emetic than the mercurius vitriolatus; a more poAverful laxative than the calomel; a more effectual and steady diaphoretic and stimulant than the mercu- rius muriatus; a more certain emmenagogue than ca- lomel ; a more effective errhine than the turpeth mi- neral ; a more infallible sialogogue than either of its preparations. If Ave look at the principle by Avhich these different changes are effected, we shall find it to be a steady and permanent stimulus. When applied to the extremities of the excretory ducts, it excites the action of the various glands ; Avhen, on the contrary, it is determined from the mass of blood to the first branches of the glandular system, it is equally powerful. When no glandular system intervenes, it excites the action of the extreme vessels over the whole body. We have had frequent occasion to remark, that all the metals possess a tonic power. We shall find that in this class of medicines there are many Avhich seem to act chiefly by lessening irritability: there are some that produce tonic effects by their stimulus on the ar- terial system : others that more imperceptibly increase the general powers of the Avhole body. In the second class mercury must be arranged, and iron seems to unite the second and third : copper, arsenic, and probably silver, belong exclusively to the third. While, then,jnercury acts as a general stimulus, it seems to unite the tonic power of the other metals; and, from these considerations, all its powers may be explained. We mean not to prejudge the question of its anti-venereal influence : when we consider this sub- ject we shall find some arguments in favour of its spe- cific poAver. Yet we may now remark, that the effects just mentioned will in a great measure explain the changes it produces; and, though a specific power ap- pears probable, it is scarcely necessary. We shall be- gin, however, Avith cutaneous diseases, as these are most nearly connected Avith the principle we are endea- vouring to lay down. We took an early opportunity of observing, that Aye oan seldom, in any instance, demonstrate any taint in A a ARG 178 V R G the general mass; yet Ave added, that Avhat appears in the secreted fluids must have been virtually, and per- haps formally, contained in it. The poAvers of nature separate these impure portions, and determine them to the most ready and extensive outlets, the urine and the okin; generally the latter. The constitutions most subject to chronic, cutaneous diseases, are distinguish- ed by a general languor in the circulation : those sub- ject to the acute kind, by an irregular determination to the surface. The former are our present subject; and Ave may add, that the obstructions appear on the skin, in the glandular system, or in the parts where, from the distance from the heart, its action has less poAver in consequence of this languor. If the circulation is properly supported, the matter is carried through the extreme vessels ; if irregularly hurried, the depositions v.vc more frequent and numerous. This position we shall have frequent opportunities of illustrating, parti- cularly in considering the eruptions of variola. By the steady, uniform, increased action, excited by mercu- rials, the vessels obstructed in lepra and some similar diseases, regain their poAvers and throAv off the ac- cumulated masses : the same increased action prevents their recurring. Nor is .this merely hypothetical; for one of the first effects of mercurials in these cases is to increase the eruption; in fact, to determine more co- piously to the skin to throAv off the offending matter. One difficulty indeed remains. If these humours pos- sessed an assimilating power, the cause of their increase Avould continue, perhaps, in proportion to their evacua- tion. The general causes of cutaneous eruptions are not, hoAvever, of this kind; and the subject of syphilitic eruptions we reserve. When mercury has removed the more common species, a return must be guarded against. The matter seems to accumulate in spite of the powers of nature; and, as the continuance of mercurials Avould .be inconvenient, less active medicines prevent a disease which they Avould not cure; and the saline or sulphu- reous mineral waters, sea water, or even laxative doses of salts, with a mild diet, will succeed. We need only add, that, though mercurials are alone sufficient, the addition of antimonials to assist their determination to the skin is eminently useful. This enquiry, though it has detained us, will facili- tate our future progress. Scrofula unites the cuta- neous complaints with the common obstructions ; and, in/this case also, mercurials joined with, or followed, by neutral salts, are particularly useful; and in our account of the effects of remedies, see Scrofula, we have hinted at the origin of > the disease: a languor and Avant of irritability in the vessels. Jn gutta serena, indolent tumours of the viscera, particularly of the liver, in jaundice, constipation, and many obstructions, it is obvious that mercury must be useful on the same principle. In chronic inflammations of the liver, its action is particularly elucidated by a singular fact, the disease seldom yielding till the gums are affected by the mercurial; in other Avords, till the irritability of the vascular system is excited. Its use in old quar- tans seems owing to its influence on infarctions of the viscera; and in various dropsies independent of its evacuating powers, it is probably salutary by the same effects. In amenorrhcea this action is peculiarly striking, since it is useful only in those languid inirri- table habits Avhich Ave have been used to call phlegma- tic and cachectic. In melancholy, the viscera arc com- monly affected, and support a disease which other causes originally produced ; and mercury is sometimes a very useful remedy. In chronic rheumatisms the inactive state of the vessels is sufficiently obvious, and mercurials are singularly useful. One other class of diseases remains, viz. the spas- modic, as trismus, tetanus, and hydrophobia. On these subjects Ave can scarcely at present speak, but must refer to what we have said on the subject of ' irregular action,' as the effect of debility. The whole will be illustrated under the articles Convulsions and Fe- vers, q. v. But, if this idea be for a time admitted, the utility of mercury will be obvious, and experience has already established the fact. If useful in the croup, it is on the same principle; and the proof is the same as that adduced in speaking of its advantages in in- farcted liver: the complaint does not yield till we find proofs of the irritability of the vascular system being restored. As an errhine and a sialogogue, (we now allude to the topical application of calomel,) it seems to act as a local stimulus only. As a sudorific and diuretic, it seldom acts without some assisting medicine more di- rectly pointing to the different organs, and seems only to support the general action Avhile the peculiar stimu- lus is supplied by the other ingredient of the formula. In general, its action in every disease is assisted by the medicines more peculiarly appropriated to it. It is improper in weak exhausted patients, and in erysipelatous ulcers, cancers, and some similar com- plaints. Among its bad effects may be mentioned, ex- cessive debility and irritability, decayed teeth, weaken- ed stomach and intestines ; but, above all, what is styled by Mr. Pearson, erythismus. It is a state of debility, Avith the poAvers of circulation exhausted, perhaps, by too long or constant exercise; a slight exertion proves fatal, seemingly from a defect of circulation in the brain. Of the choice of the preparations we have little to add. The most useful errhine and emetic is the mer- curius vitriolatus: the most effectual laxative, calomel: the most serviceable alterative, muriat of mercury. It is this preparation that gives efficacy to the popular alteratives styled vegetable; and the contrivers hope to elude detection by the density and the colour of the preparation. The metal may, however, be discovered by inspissating a large quantity, and adding ammonia. In this state the mercury will, by rubbing, Avhiten bright copper: in the minute proportion employed it eludes every other test. In venereal complaints, the mercurius calcinatus or calomel are the most effectual preparations; but per- haps the mercurial ointment, rubbed in externally, is still better. In internal visceral obstructions; and in external indolent tumours, (scrofulous ones excepted,) the ointment is the best remedy: in chronic rheuma- tisms the calomel has been preferred: in enlargements of the prostatae, and similar indurations internally, the corrosive sublimate. It hath been swallowed crude, as an universal re- medy. Dr. Dover and Dr. Cheney commend it in the fol- loAving disorders: " 1. Joined with the gum guaiacum and a little aloes, ARG 179 A RI it hath been successfully used in the erysipelas, gout, and defoedations of the skin. " 2. In hysteric complaints its advantages are con- siderable, if joined Avith the bark, valerian, aloetic, or the gum pills, as circumstances may require. "3. In conjunction Avith preparations of iron, it suc- ceeds in suppression of the menses. " 4. In intermittents it avails when joined Avith the bark and iron. "5. In ophthalmies it hath been effectual when ac- companied with millepedes and laxatives. " 6. The hydrargyrus cum creta., joined Avith gum guaiacum and the antimonial wine, does wonders in chronical rheumatisms. " 7. In the jaundice, sciatica, and anasarcous dropsy, the hydrargyrus cum creta is successful to admiration." And to these of Dr. Cheney may be added, that old foul ulcers are sometimes brought to digest by its use. " The hard bellies of children are relieved by it, if ac- companied Avith such other medicaments as the parti- cular case may require. " By boiling two or three ounces of quicksilver in four pints of water to tAvo pints, and using the clear liquor for common drink, it destroys worms. " And in the venereal disease it is by many considered as a specific. " The true secret of curing diseases Avith mercury is to cause it to circulate with the blood as long as possi- ble, Avithout producing any evacuation at all. " A long use of quicksilver weakens the habit, and so should be accompanied with mild antimonials, the bark, or.sarsaparilla, &c. as circumstances seem most to require." Quicksilver is divided by earthy powders, balsams, mucilages, &c.; but with nothing more advantage- ously than the mucilage of gum arabic. Mr. Plenck, of Vienna, directs a drachm of it to be mixed with two drachms of gum arabic in powder, by degrees to add a little water, and to continue the trituration of them together until the globules totally disappear. This is called mercurial mucilage; to which half an ounce of any syrup', and half a pint of water may be ' added, and two common spoonfuls of the mixture may be taken every night and morning in such cases as re- quire its use. Gum arabic is supposed to poAverfully restrain the mercury from running off by the salivary glands; and if a salivation is already excited, it may assist, like any other mucilaginous substance, in checking it. Crude quicksilver in general is of equal advantage Avith any of its preparations; yet, in particular con- stitutions, one or other of them may demand a pre- ference. Arge'ntum mo'bile, et fusum. See Argentum vivum. Arge'ntum ni'tratum. See Argentum. ARGILLA, one of the earths, the basis of alum; and, in the modern nomenclature, styled alumine. It is soft, mild, and insoluble; and is considered as possessing no medicinal powers; but the various earths, the terr^ sigillat.s of older authors, so called because they Avere impressed with a seal, seem to be only pure clay, and owe their demulcent, and apparently astringent, powers to this earth alone. See Bolvs. Argi'lla a'lba, Argi'lla can'dida, (from xpyos, white). See Cimolia alba terra. ARGISTA'TA, (from xpyos, white). Incorporated Avith wax. A'RGOL. See Tartarum. A'RGUS. The name of a sort of pheasant. Pha- sianus. ARGYRI'TIS, (from xpyvpos, silver). See Lythar- gyrum and Lythargyrus argenteus. ARGYROPCEIA, (from xpyvpos, silver, and zroieu, facio). The art of making silver out of more imper- fect metals. ARGY'RUS, (from xpyos, white). See Argen- tum. ARGYROLIBA'NUS, the avhite olibanum, q. v. ARGYROTROPHE'MA, (from xpyos, white, and Tpo7©", bread). Troches are thus called that are formed like a loaf. An ingredient in the famed theriaca Avas distinguished by this name, as it consisted of viper's flesh made into a troche by means of bread. Viper's powder was afterwards sub- stituted. ARTIYPO'CHROS COLOR, (from xpli-vxo, and ax,pt>Sy pale). A palish yelloAV colour which attends a disorder of the spleen, or chlorosis. ARTIZO'A, (from xplt, and £»?, life). Short- lived. ARTOCARPUS, the bread-fruit tree. A. incisa Lin. filii supplem. p. 61. Nat. order urtica. The leaves .exude a milky juice Avhen broken : the fruit about the size of a child's head, and the skin reticulated. The eatable part between the skin and the core is Avhite, farinaceous, and not unlike new bread. The taste is insipid, Avith a slight sweetness. See Aliment. Artocvrpus, integrifolia, sititodium 7nacrocarpum. Thumberg's Philosophical Transactions, Ixix. This is a native of Malabar, but inferior to the former, as more difficult of digestion. It contains a great number of nuts much larger than almonds, Avhich are roasted like ches- nuts, and in some measure resemble them. ARTOME'LI, (from *pl<&; bread, and (text, honey). A sort of cataplasm prepared of bread and honey. ARTOPTI'CIUS PANIS, (from xpros, bread, and o7t]xu, to toast). Toasted bread. A'RTOS, (from xpros, bread). See Panis. A'RTUS,(from xgOpev; perhaps from arto, for arcto, because thejimbs are joined one to another). A limb, a JOINT. A'RTYMA, (from xgrvv, to prepare). See Condi- mentum. A'RUBUS ARVINA, butter. See Adeps. A'RUM. It is derived from the Arabic term jaron, a dart, Avhich it exactly represents. Called also arum maculatum, aron, jarus, isaros, pes vituli, barba aronis, serpentaria 7nin. dracontia minor, alimwn. Lords and ladies, cuckoo pint, avake robin. Arum 7naculatum Lih. Sp. PI. 1370. Nat. order piperita. The root is irregularly round, tuberous, about an inch thick, sending off many long simple fibres ; and in the medicinal part of this plant it is broAvn on the outside, and Avhite Avithin. It is acrid and pungent to the taste; the sensation continuing for some hours, but it may soon be relieved AA~ith a little milk. The firm, hard roots should be chosen. They lose their acrimony by drying, and by heat they become a bland farinaceous aliment; but a syrup made Avith them Avould probably keep as well as the syrup made of gar- lic. They afford nothing by distillation nor infusion; yet if buried in fresh sand, and kept just moist only, their virtue is preserved unimpaired. Bergius consi- ders this root as stimulant, aperient, and diuretic; and indeed the more ancient writers speak highly of it, both as an internal and external remedy. Bergius considers it as useful in a pituitous colluvies, > loss of appetite, sympathetic headach, humoral asthma, and inter- mittent fever. Arum is certainly a very powerful and permanent stimulus; and by promoting the secretions may be advantageously employed in cachectic, chloro- tic, paralytic, and rheumatic affections, and in vari- ous other complaints of phlegmatic and torpid constitu- tions ; but more especially in a Aveakened relaxed state of the stomach. That it contributes to dissolve the viscid mucus, avc have no reason to think, though, as an active stimulant, it may prevent its accumulation. Its greatest utility seems to be in palsies, in chronic rheumatisms, and in atonic gout, where a permanent stimulus is wanted. In such cases, it has proved a re- medy of particular value. The conserve of arum, however, with three parts of sugar to one of the root, is too much inviscated. We have found equal parts sufficient to cover the acrimony ; and sometimes one almond rubbed down with each five grains has been suf- ficient. The dose is from ten grains to a scruple. A'rum moscha'tum. See Piper. AR Y 193 A S A A'rum polyphy'llum, dracu'nculus. See Dracon- tium. ARU'NDO, (from aresco, to grow dry). The reed. Aru'ndo fa'rcta I'ndl* Oriexta'lis. The dra- gon's blood cane. It grows in the East Indies. The juice of its fruit is called dragon's blood, in drops. Aru'ndo I'ndica. See Sagittaria alexiphar- mica. Aru'ndo major and minor. Names of the tibia and fibula. Aru'ndo sacchari'fera, and Viva Brasiliexsibus. See Saccharum. Aru'ndo Syri'aca. See Calamus aromaticus. Aru'ndo phragmites, Lin. Sp. PI. 120, has been recommended as an antisyphilitic; Aru'ndo bambos. Loureiro. Cochinchinens. 56. This reed is used for many medicinal purposes, though of little importance. The flint found in its cavities, styled tabashir, is a singular curiosity, to which we may have occasion, for purposes more strictly medicinal, to allude. ARVI'SIUM, so called from Arvisia, the promon- tory of the isle of Chios, Avhere it was made. See Malvasia. ARYTjE'NO-EPIGLO'TTICI. These are small fleshy fasciculi, each of Avhich is fixed by one end in the head of one of the arytaenoid cartilages, and the other in the nearest edge of the epiglottis. ARYTENOIDE'iE CARTILAGINES. See As- pera ARTERIA. ARYT^EXOI'DES, vel ARETjENOI'DES, (from xpvrxivx, a funnel, and eifos, shape). Hence from the shape it takes the name. The arytenoid, or eaver-like cartilage ; called also guttalis, and gutturiformis. An epithet of two cartilages, which, together with others, constitute the head of the larynx. ARYTjENOI'DEI MUSCUL. MINOR, vel ob- liquus, vel transversa'lis. They are situated on the back part of the arytaenoid cartilage. They are very small muscles Avhich run upon the surface of the greater arytaenoid muscles: they arise from that part of each of the cartilagines arytaenoideae, next the cricoides on the other sides, and terminating in that part of the other or adjoining the arytaenoidal cartilage that is fur- thest from the cricoides on the other sides. Their use is to assist the arytaenoidei majores in their action, which is much strengthened by the manifest decussa- tion of their fibres. Douglas. ArytjEnoi'dei majo'res. They are under the arytae- noidei minores. They have an insertion into the annu- lar cartilage, and help to close the glottis. They arise fleshy from the arytaenoid cartilages near their junction with the cricoid cartilages, and running transversely of an equal breadth, Avith straight fibres, they are inserted into the same side of the other cartilage. Their use is to shut the rimula, or chink called glottis, by bringing these two cartilages nearer one another. ARY'TIIMUS, ENRY'THMUS, (from «, neg. and ivS/ios, a modulation, or modification of time and sound in music, but used to express order and harmony in general). Galen applies it to the pulse not modulating according to nature. Every age hath its natural pulse, AA'hich, as long as it keeps in its due ry'thmus, or modulation of time and force, is called eu'rythmus; but if it deviates, vol. i. it is a pulsus arythmus. If it runs into a modulation proper to the next age, it is pulsus parary'thmus. If it changes to a pulse proper for any other age, it is called pulsus hetero-ry'thmus. If it passes into a modulation not proper to any age, it is then a pulsus ecry'thmus, disorderly or irregular. AS, was a weight and a measure amongst the Ro- mans, each of twelve ounces. See Cyathus. ASA, (from the Hebrew Avord asa, to heal, or per- haps lasar, the old name of asafetida). A'SADU'LCIS, A'SADU'LCIS ODORA'TA. See Benzoinum. A'SAFCE'TIDA, vel A'SSAFCE'TIDA. Andsju- dcen. The stinking healer. Also called hingisch, laser, laser-pitium, silphium, hing, cyrenaicus succus, hindisch, devil's dung. It is the fetid concrete juice of a plant Avhich groAvs in Persia, and other parts of the eastern countries. Kempfer says, that the plant resembles lovage, and that it is the root which yields the gummy juice. See Kempfer's Amoenitates Exoticae. It is the juice of the ferula asafetida Lin. Sp. Plant. 356. WildenoAV 539, Sp. 11. Nat. order umbellatce. Philoso- phical Transactions, vol. lxxv. The plant, however, greatly differs from that described by Kempfer. This juice is Avhitish at first, but it gradually becomes broAvner and harder. The best pieces that are brought into Europe are of a pale and yelloAV red colour, varie- gated Avith white masses or tears. This gum hath a strong fetid smell, like that of garlic, and a nauseous bitter biting taste, which it loses by keeping. Its smell and taste reside in the resinous part, which is \ of the whole; spirit is therefore its best menstruum, though water extracts the greatest part of it by the aid of the gummy matter, consisting of f. In distillation with water the impregnation is strong, and a pale coloured essential oil is received; the remaining decoction af- fords a bitter extract. In the East, as by the ancients, it was used as a condiment, and has been thought an aphrodisiac. As a medicine it is the strongest of all the deob- struent, fetid, Avarm gums ; some suppose it more dia- phoretic and expectorant than the gum ammoniacum, and more useful as a carminative and an emmenagogue. than any other of the fetid gums. When it disagrees, the milder gums of similar efficacy should be used in its stead. The next to it is the gum galbanum ; which, if too strong, must give Avay to the gum sagapenum, or to the still milder gum ammoniacum, or to myrrh, or to the wild valerian root, which is still milder. In flatulencies, and all the symptoms called nervous, it acts as an anodyne and antispasmodic; though some- times the addition of opium greatly improves its effi- cacy. It is by far more quick in its effects than any other of the fetid gums; and it is the speediest in re- lieving the anxieties and oppressions of the precordia, Avhich frequently attend nervous disorders, and nervous fevers : but in such cases its efficacy is also increased by joining it with opium, and sometimes, if not too nauseous, with valerian: one part of the first to two parts of the last may be a general proportion. Large doses of asafoetida, with a blister on the back, have relieved in epilepsies, and in palsies that succeed epi- lepsies. In the nervous asthma, joined Avith an equal quantity of the gum ammoniacum, it greatly relieves ; but it sometimes fails, ant1 then the bark is to be tried\ Cc ASA 194 A SB In hysteric complaints, fetids are only palliatiA-es; in hysteric suffocations, a plaster of asafoetida 3 vi. and camphor 3 ss. mixed, by far excels those made of the gum galbanum; for camphor softens all the resins, and renders them more soluble. In hooping-cough it has been highly commended; and may probably be very useful, for its expectorant powers are considera- ble, and it is an excellent antispasmodic. In croup it has been also employed. When it cannot be given by the mouth, it may be safely and advantageously admin- istered in clysters, from a scruple to the youngest children, to three drachms to adults, in from two to four ounces of water, and in this state it is an effectual destroyer of ascarides. We cannot find that it has been in any other respect useful as an anthelmintic. Exter- nally it has been reckoned an useful application in bubo and paronychia. In nervous cases it acts as an anodyne sometimes where opium fails, and without leaving any lowness on the spirits: and where neither succeeds separately, they often answer if joined. Cullen's Mat. Med. The dose of the powder is from ten to thirty grains. The officinal preparations are, the pil. e gummi, consisting of two parts of galbanum, opoponax, myrrh, and sagapenum (each), and one part of asafoetida. We have found however the asafoetida, with soap and a small portion of aloes, a better form. Dissolved in spirits, it is more usefui and quick in its operations. Of the fixed alkaline salt, a pound and a half is em- ployed in disengaging the alkali of a pound of sal am- moniac, and this mixture is distilled with four ounces of asafoetida from three quarts of proof spirits. This is the volatile, fetid spirit of the dispensatories. The tincture consists of four ounces of the gum to a quart of spirit of wine. A'SAB. See Borozail. A'SABA HE'RMES, (an Arabic term). It re- ceives its name from Hermes, its inventor. But azaba meaning tinctured with yellow, as well as a finger, it may have been named from its colour. See Hermo- •dactylus. A'SABON, {asaphon, Arab). See Sapo. A'SAGAR. See jErugo jeris. A'SAGEN. See Sanguis draconis. A'SAGI and A'SAMAZ. See Vitriolum. A'SAMAR. See jErugo jeris. A'SONON. Prepared sal ammoniac. See Al- kali. ASA'PHATUM, (from x, neg. and o-xtp^s, clear,). minute eruptions, hardly visible. A species of ser- pigo, or impetigo, seemingly generated in the pores like worms. When the skin is pressed, they come out like long threads, with black heads. It consists in a retention of the sebaceous substance, and forms threads by hardening in the ducts. ASA'PHEIS,(from the same). Patients who do not Utter their words distinctly. A'SAPHIA, ASAPHO'DES. It is the paraphonia palatina of Cullen. See Paraphonia. (It is derived from the same roots). Hippocrates uses this word to express a muffled hesitating tongue that hath no plain utterance; such a confused voice as proceeds from an indisposition of the organs of speech. Sometimes this word signifies a dubious kind of delirium not easy to be discovered. ASARABA'CCA. See Asarum. ASA'RCON, (from *, non. and wyg, caro). Voii> of FLESH. A'SARI PUT.VIS COMP. See Asarum. ASARI'TES. The wine of asarum, made with must, or sweet strong wine, fo vi. and asarum three ounces. A'SARON, A'SARUM, (from *, non. and l halation, or diminished absorption. This kind of dropsy is sometimes very rapid in its approach and advances, then continues many years without making any progress ; at others its advances are very slow, and a number of years elapse before it manifests itself in a confirmed state. One of the first signs is a languor and an aversion to motion, with pit- ting of the ankles towards the evening, and a shortness of breath; though it should be observed that the pitting of the ankles is not conclusive, since it often attends pregnant women, as well as old men with gross habits, when suddenly freed from an asthma under which they have laboured many years. If, after the swelling of the feet, the legs and thighs swell also, the case is plain, and these anasarcous SAvellings usually precede ascites. The palms of the hands are dry and hard; perspiration, is greatly diminished; the urine is less and less in quantity, appears turbid, high coloured, and deposits a large quantity of a lateritious sediment; the belly gra- dually swells; and, in proportion, the breathing be- comes short, the appetite for solid food fails, and thirst increases; a slow fever sometimes attends; the face and arms are emaciated; a paleness at first, and after- Avards a yelloAvish colour, is seen in the skin. These symptoms grow worse, and a dry cough comes on; the belly is greatly distended; and, except the water is contained in cysts, or hath rendered the integuments too tense, it may be felt to fluctuate by gently tapping one side of the belly Avith one hand, Avhile the other is placed on the opposite side. At length little watery vesicles arise on the feet, Avhich burst, and from them a quantity of water is discharged, which greatly relieves for a time, and has been known to remove the complaint. A mortification, however, frequently comes on; or, the strength gradually failing, the patient sinks from weak* ness, or is suffocated from accumulation of water. If a scirrhus in any of the viscera is the cause, a cure is scarcely to be expected; since the swelling presses on the lymphatics and retards absorption. If an ascites succeeds other diseases, in Avhich the viscera were in- jured, if the thirst is great, and other symptoms violent, there are but little hopes -of recovery. An haemorr- hage, or an erysipelas coming on, with an increase of the fever, is highly dangerous. It is a bad sign when diuretics in every form, and of every different kind, fail. If the fluctuation, when the hand is laid on one side of the belly and struck Avith the other on the oppo- site side, can be felt only partially, tapping will afford a temporary relief; though, in such a case, we cannot expect to empty the belly totally ; for this can only be the case when the fluctuation is felt by very distinctly striking on any point of the belly. But, on the other hand, if perspiration increases, or the discharge of urine becomes plentiful, these afford favourable prog- nostics. Indeed, without the urine continues to Aoav with tolerable freedom, or is compensated by other Avatery evacuations, there remains very little hope of a perfect recovery. The distinction of ascites is of great importance, especially the distinction between the disease and the pregnant state. In an unmarried person, there is no disease which will so effectually conceal the real situa- C c 2 ASC 196 ASC tion as dropsy; and, in a married womafr, where there is no pretence or wish for concealment, dropsy will sometimes be considered as the cause, while the swell- ing arises from pregnancy, or is combined Avith it. Dreadful to relate! the trocar has, more than once, Avithin our own observation, happily not by our direc- tion, been plunged into a pregnant uterus. When the unmarried libertine disguises her fault under the pretence of dropsy, we" cannot expect to gain any information from enquiry into the state of the menses; for she can invent circumstances, as well as the principal fact. We must draAV our conclusion, therefore, from the first appearance, the progress, and the state of the tumour. If a person of a phlegmatic, cachectic habit, finds a tumour gradually coming on, Avithout beginning at the bottom of the abdomen, and a fluctuation is observable in this tumour ; if, at the same time, the urine is scanty and the legs SAvell; we may conclude it to be dropsy. If, on the contrary, the tu- mour began to rise above the symphysis of the pubes; if there is no fluctuation; if the general health and ap- petite be good; we may suspect pregnancy. Yet, in the pregnant state, it sometimes happens that the uterus Avill rise on one side rather than the other; and in encysted dropsies the swelling is not general. Such circumstances occasion much doubt and uneasiness; for, in one case, the physician's character, in the other, the Avoman's, is at stake. In such situations we must rest in suspense, carefully watching the progress, and attending to the state of the breasts, and other symp- toms of pregnancy. When the swelling has reached near the umbilicus, the round circumscribed tumour of the uterus can be distinctly felt, and can rarely" be mis- taken. We have, however, a recent instance before us, to show that mistake is not impossible. If there is still any room for hesitation, Ave should wait longer, nor proceed to active measures till the tumour has con- tinued so long as to prevent any further doubt of its nature. It happens also, as we have said, that married Avomen Avho have no wish for concealment, or women of decidedly bad characters who cannot be injured by an illegal pregnancy, have sometimes equivocal com- plaints of this kind. Such doubtful cases chiefly occur at the change of life, when the cessation of the courses gives a colourable appearance to the suspicions of pregnancy. In this case, the general health, and the state or progress of the tumour, will enable us to de- cide ; but we would deprecate any hasty decision of its being dropsy, and any violent remedies, till a sufficient period has elapsed to destroy the slightest suspicion of a pregnant state. There is one other disagreeable situation for the practitioner; we mean, when dropsy and pregnancy are combined. If a married or an abandoned woman has dropsy, it is not impossible but that she may be also Avith child. The menstrual discharge will some- times continue during the whole of pregnancy; and, in such circumstances, all suspicion sleeps. Yet the state of the breasts, an areola round the nipple, the capricious appetite, or the morning sickness, will give the alarm. These circumstances should be always attended to, and. will suggest the necessity of caution. Every caution, however, has failed; and, in one instance, Avithin our own knoAvledge, during the operation of a drastic pur- gative, a premature delivery came on, though every possible attention had been paid to the diagnostic symptoms. Yet, again, a married couple anxiously wish for a child, and the lady begins to SAvell. Woe to the prac- titioner who shall announce that she is in a dropsy! Whatever the circumstances or his opinion be, he must be cautious of opposing openly the wish; he must Avatch with care till the continuation of the complaint will as- sist the discovery of the unpleasing truth; while, by safe but sufficiently active medicines, he can prevent the dropsy, should it be so, from gaining ground; and he will reflect that she may still be pregnant. In the worst circumstances of general health, also, a woman is sometimes with child; and, when dropsy would natu- rally occur, it is not an unpardonable error to consider any tumour in the abdomen as such. The physician, however, in every case of supposed ascites, should be guarded with the most unremitting caution. Tumours of the abdomen may sometimes be mis- taken for dropsy, but the hardness and irregularity will soon discover the nature of the complaint. Wind, either in the cavity of the peritonaeum or in the intestines, is distinguished by the elasticity of the tumour, the want of fluctuation, and, in the last instance, by its variable state, and the relief felt from the occasional discharge of flatus. The cure of ascites is a difficult task; and indeed the best concerted plans generally fail, as the disease is often a symptom of a decayed constitution, of the vis vitae no longer able to support the requisite equilibrium of discharges and absorptions. When dropsy folloAvs frequently occurring paroxysms of asthma, it is gene- rally found to arise from obstructions to the returning blood, in consequence of ossifications on the right side of the heart: where shall Ave find the solvents of these bony substances? When the disease proceeds from ob- structed liver, we must reflect, that the veins from al- most all the chylopoietic viscera center there, and that the whole venous system of the abdomen is conse- quently obstructed: where shall we find aperients and deobstruents of sufficient poAver to remove the ob- stacle ? When, from long continued excess, the Avhole system is weakened, Avhere shall we find the restorative to renew youth, to give fresh vigour, and new powers to the whole machine, to approach the art of conferring immortality ? Yet medical authors draw their indica- tions, and speak Avith confidence of their remedies: the inexperienced student believes, and is disappointed; is credulous, and soon becomes sceptical. It is our business to guard against each extreme; and to add, that, though the cure of dropsy is difficult, and often hopeless, yet that Ave can almost always alleviate, and' sometimes cure. If the indications to diminish exhalation and increase absorption could be followed, Ave might be more san- guine. The most frequent part of our duty, however, is to increase other evacuations, that nature may supply the defect, from the accumulated fluid of the cavities. If, however, Ave Avould diminish exhalation, we should employ cordials and tonics to support the action of the extreme vessels Avhich convey the blood back to the heart. In this way Ave may suppose mercurials of use; and, it has certainly happened, that, in cases where ASC 197 ASC there was no suspicion of obstructed liver, calomel and mercurial frictions have been of great service. Where such obstructions do occur, the use of mercurials is less equivocal. The employment of warm tonics is refer- able also to this head; and perhaps the oleum terebin- thinae and the mustard, may produce, in part, their ef- fect from their stimulus. The more modern French physicians usually combine tonics with their evacuants, perhaps Avith propriety, except in cases of hydrothorax. Dr. Magennis has published in our OAvn language an account of his practice, which induces us to mention his name; but various observations occur in the Me- moires de Medecine of the same tendency. Dr. Magen- nis gave the myrrh and ferrum vitriolatum Avith the squills; and Cornette and others give with the eva- cuants, bark and cordials. Bacher's tonic pills are re- ferable to this head. The basis was black hellebore, whose acrimony he attempted to correct by repeated affusions of spirit of wine, and afterwards by Rhenish wine. The latter was supplied in proportion as it Avas imbibed by the roots, so as to continue covered, nearly six fingers breadth above- them, for forty-eight hours. The whole was then boiled for half an hour, and the Avine pressed out. The process was repeated, and the fluids added, inspissated to the consistence of a syrup. One part of the extract is then mixed with two parts of boiling water, and the whole again inspissated. This preparation of the pills is, he thinks of great import- ance, as the substances combined to form a mass must be both inviscating and soluble in the stomach. For this purpose an ounce of the extract is united Avith an equal quantity of an inspissated solution of myrrh, and the whole made into a mass with three drachms and a scruple of powdered carduus benedictus. The pills contain a grain and a half each of this mass. He calls them evacuant and tonic; but they.seem to act chiefly as evacuants. In his hands, and in those of Dr. Daig- nan, they succeeded: Avith almost every other practi- tioner they have failed; and are now little used in this country, though they maintain their credit on some parts of the continent. In fact, therefore, as we have said, our chief object is to increase the serous evacuations, in order to assist absorption. This is most successfully performed by increasing the evacuations from the mouth and salivary glands; from the skin; from the stomach; from the intestines, and the kidneys. Some few solitary instances of spontaneous salivation proving a remedy for dropsy, have led to the use of mercury for this purpose. Yet as mercurial salivation is not only a severe remedy, but a frequent cause of dropsy, it has not been followed. When obstructed perspiration is a cause, sudorifics have been employed; yet these weaken the system, in general, too much, if persisted in for the time required in this disease. We have, however, before us a man Avho laboured under a dropsy twenty-five years since, from working in a river: all the remedies failed till he took Dover's sudorific powder, which succeeded, and he has had no return. In this long interval it is, hoAvever, a solitary case, though the same plan has been often tried. Some instances also of water having been evacuated from the stomach, have led to the use of emetics. These are indeed remedies of importance for promoting absorption, independent of the evacuation they pro- duce. In the general cases of dropsy, they are inad- missible from the debility of the patient, and from their preventing a proper supply of nourishment or cordials. We find few instances of their use, and fewer of their efficacy. The discharge from the intestines we consider as of the greatest service in dropsy; and, indeed, Ave cannot say that the cure has in any case properly succeeded where this discharge has not accompanied the others. Sydenham advised purgatives every day, unless too great weakness prevented their use. In the operation of purgatives, however, this distinction must be made. If accompanied by violent colics, and an inconsiderable or a disproportioned discharge, Aveakness is the conse- quence, and the remedy must be discontinued; but if they operate without pain and inconvenience, and,if the stools are watery, whatever the number may be, weak- ness does not follow. It should be the physician's busi- ness, then, to attain this end by his choice of the medi- cine. The saline purgatives are the most obvious ones; but in general the quantity necessary, and the large proportion of fluid to convey them, prevent their exhi- bition. The sal diureticus, the salt most generally em- ployed, has been perhaps preferred from its name, and indeed seldom acts without assistance as a purgative. The cremor tartari is more common, and has been highly commended; yet, alone, the necessary dose is too large, and we have been induced to join with it a proportion of jalap, a medicine preferred as, in small doses, sufficiently mild, and as supposed to combine diuretic poAvers. Yet, with many persons, this medicine must be still further quickened; and a convenient addi- tion is the gutta gamba. In the list of cathartics, we find the more acrid kinds distinguished by the name of hydragogues, expellers of water. This is, indeed, the characteristic of many of the resinous purgatives; so that Avhat we have said of the milder kinds is rather cautionary than strictly ne- cessary. Of those hydragogues, the elaterium (the in- spissated juice of the wild cucumber), the coldcynth, the gutta gamba, are the chief; and next in order are the scammony, the jalap, and the seneka. A formula of Dr. Dover is powerfully hydragogue; it consists of four parts of scammony; crude antimony, and sulphu- rated steel, of each one part: and from a scruple to half a drachm is a#powerful dose. Of these, the elaterium and the colocynth alone appear too stimulant. They have seldom succeeded in procuring Avatery stools with- sut greatly irritating and Aveakening the patient. Gutta gamba succeeds better; but this beyond a grain or two produces sickness, languor, and faintness: and it seems more useful in rendering other purgatives active than given alone. Scammony holds its rank as an ingredient in Dover's formula, and is not often employed alone. The seneka is highly recommended by Dr. Milman; but he proposes only half an ounce or six drachms of the root to a pint of the decoction, instead of an ounce for- merly directed by the Edinburgh college; and his pro- portion is, in the late edition, adopted. It is an active purgative, and said also to be diuretic. The jalap is the remedy most commonly employed. It is remarked by Lewis that the watery infusion is diuretic, and the spi- rituous tincture cathartic; and this has been repeated by every author, Avithout having tried the experiment. On trial Ave have found no such effect from the infu- ASC 198 ASC sion; and the tincture of jallap, or its resin; has ap- peared to us the best preparattion. Combined with soap, in pills, the resin has not appeared too virulent. One observation arises on an examination of the effects of purgatives, viz. that the more active ones, which excite languor and nausea, are the most useful; apparently the relaxation thus produced, assists their purgative poAver, as a small proportion of emetic tartar greatly increases the action of the resinous purgatives in general. The diuretics also, Avhich are most useful, possess a similar effect; and the squills seldom succeed in increasing the discharge of urine to any degree, till raised to a nauseating dose. Another remark.which Ave may suggest is, that, during the action of hydra- gogues, the secretion by the kidneys is scarcely in any instance increased; yet the patient recovers strength, appetite, and spirits: and indeed we have found, in the happiest recoveries, that the urinary discharge is not increased, till the load of water is in a great degree re- moved. A similar observation will recur when Ave speak of the operation of the paracentesis. Amidst these numerous advantages, it is with some surprise that Ave find a man of judgment and experience, Dr. Fordyce, so adverse to cathartics; and we suspect, that a little prejudice prevented him from using them with so much freedom as would show their utility. When we reflect also, that one of the most frequent causes of dropsy, obstructed liver, is greatly benefited by purga- tives, our temptation to employ them will be increased. As we pretend not to have enumerated all the purga- tives employed at different times, but only to appreciate the value of the more useful ones, so, in the enumera- tion of diuretics, we shall follow a similar plan. Of these, the principal is the squill, with the rest of the onion tribe. It is, alone, a host: and could we render it a purgative as often as we find it injuriously so, viz. in pneumonia, we should perhaps want no other medi- cine for all curable dropsies. In every form, dry or fresh, in vinegar or tincture, it succeeds in the greater number of cases; but its nauseous taste renders pills the most convenient mode of exhibiting it; and the dry powder, which retains all its activity in a moderate bulk, best adapted for the purpose. With cream of tartar, and a small portion of jalap, it is highly useful, as combining a diuretic and purgative effect; and, with the resin of jalap and gutta gamba, in pills, its utility is almost unrivalled. Of the other vegetables of the onion tribe we use only the juice of leeks, which, though nauseous, is said to be often successful. The colchicum autumnale is apparently the next in power: Ave have sometimes thought superior, for it has- suc- ceeded where squills seem to have failed. The broom is a very useful diuretic; and the broom ashes, as com- bining the alkaline salt Avith the essential oil of the ve- getable, have been highly commended. The alkaline salts themselves are useful in this Avay, though of weaker power. The broom seeds formed the secret re- medy of Lemery; but these are acrid, and in general unmanageable. The other diuretics are, the lactuca virosa, the juni- per berries, the taraxacum, the nicotiana, and the fox glove. The first rests on the authority of Dr. Colin of Vienna, for the medicine has been rarely given in this country. The juniper berries are well known, and the diuretic effects of gin (from Giunipero in Italian) suffi- ciently understood. The taraxacum is still more pow- erful ; and the tobacco, especially when its alkaline salt is employed, appears, from Dr. Fowler, to be a very active, useful medicine, meriting much more attention than it has received. The fox glove requires a longer discussion. It is arranged in a poisonous and suspicious order with the nicotiana, &c; and in many instances it seemingly shows a deleterious power. In dropsy, death often suddenly seizes the patient; but we have thought this sudden termination still more frequent when the fox glove has been taken. It is, however, a remedy of considerable power and utility. The weakness, the nausea, and the affection of the head, which often fol- lows its exhibition, would point it out as chiefly useful to the strong and active. On the contrary, hoAvever, the weak, languid, worn out constitution is chiefly be- nefited by the fox glove; and the discharge of urine, which it occasionally produces, is astonishing. Every part of the plant is equally effectual; but the leaves are generally employed, and the dry powder is the most use- ful and certain preparation. We fear, however, that the injuries resulting from it have greatly overbalanced the benefits. Diuretics from other sources have been numerous. From the animal kingdom we have received the can- tharides, Avhich, with some physicians, have been a fa- vourite remedy. We own, however, that in our hands they have not produced any diuretic effect, nor have we recognized their activity till they have reached the neck of the bladder. Some other species of the meloe have been supposed also diuretic, but experience has not de- cided on their virtues. The chief remedy of the mineral kingdom is nitre, whose poAvers are not considerable; and chemistry has furnished us with the sweet spirit of nitre, an aethe- rial fluid, which in slight cases is often successful. The turpentine also, formerly mentioned, is a preparation frequently and generally useful as a diuretic. Some other modes of relief remain. A powerful one is friction; and friction, with olive oil, has been em- ployed since the time of Celsus, though the oil, by general consent, is considered as useful only to prevent excoriation. Perhaps the friction with camphorated oil has no very different effect; and when the external ap- plication of mercurial ointment has been found useful, friction may have had some share in the success. Mus- tard and horse radish have been ordered without any determinate view, and have been attended with no very striking success. The mustard- seed unbruised, often swallowed in dropsical and paralytic complaints, acts only as a gentle laxative. Two important subjects remain: the first is the pro- priety of indulging diluted liquors, and the second the operation of the paracentesis. For nearly two hundred years it has been common to prohibit the use of fluids in dropsy; and the reason probably was, that as an ex- cess of diluents sometimes brought it on, so they might continue or increase it. We recollect a case in the Medical and Physical Essays of Edinburgh, Avhere a salt herring Avas ordered without any liquid: the thirst was burning and intolerable; but after a time it ceased, and a flow of urine came on. In such a violent agita- tion, nature might have exerted her powers to supply dilution; and the absorption, once commenced, might have continued. The experiment is, hoAvever, too ASC 199 ASC violent to be repeated; and, in a less degree, the ab- staining from drink would probably be useless. In fact, the prohibition is of a modern date: it was not the prac- tice of the ancients; it is not of the most experienced physicians of the present day. If a regular course of evacuants is pursued, the fluid taken in will not at least be injurious: it may be beneficial; for watery liquors verging to the kidneys may excite their action, and thus contribute to the absorption. It generally happens, that, during a course of purgatives and diure- tics in dropsy, occasionally refusing or supplying drinks, occasions little alteration in the progress of the com- plaint: if there is any change, the cure is accelerated; and Ave think Ave have seen, that cathartics and diuretics have not had their proper and appropriate effects till diluent drinks have been allowed. The prejudices of patients have sometimes occasioned their rigorously abstaining from drink, but we have never found the cure advance more rapidly. Dr. Milman has consider- ed the subject at length, and is of this opinion; and Ave formerly examined in a chronological series the opinions of the ancient physicians on this subject, and found them speaking the same language ; but this his- torical research would be too extensive for the present work. The operation of the paracentesis has been in general too long delayed. If there is a considerable accumula- tion of fluid in the abdomen, and the different evacu- ants have no decided or powerful effects, it should be attempted early. When the load is removed, medi- cines, which were unequal to the discharge of so large a quantity, may prevent its again accumulating; and, at all events, the removing the pressure from the kidneys appears to facilitate the action of their vessels: even a spontaneous discharge of urine has been the result; and diuretics certainly answer with greater certainty and effect after the former burden is taken off. Dr. Fother- gill recommends the operation so soon as the degree of distention removes all fear of wounding the intes- tines. Dr. Hunter leans to the same opinion ; and Dr. Baker urges it more confidently. .. Yet, in directing the operation, Ave should examine several questions with great care; and the neglect of this enquiry has contributed to its disrepute. The general contents of dropsical SAvellings are serum, not essentially different from the serum of the blood; but we sometimes find it lymph from a rupture of a lacteal; sometimes purulent matter from a supposed previous inflammation; sometimes the peculiar serosity of hyda- tids. The two former may perhaps be distinguished by a want of freedom in the fluctuation; yet this criterion is necessarily uncertain; and, in some of the less sen- sible viscera, suppuration proceeds with so little fever, that we have no reason for suspecting the existence of purulent matter. Added to this, it is by no means cer- tain that this peculiar fluid may not be secreted from a surface not previously inflamed. De Haen Avas of this opinion; and we have, we think, seen two instances of purulent matter in the abdomen, apparently secreted from its parietes without previous fever. When the fluid is the lymph effused, in consequence of a rupture of a lymphatic, there is no particular danger from the operation; but should the accumulation recur, perhaps some delay may be necessary, as the pressure of the ef- fused fluid may contribute to prevent further effusion, and heal the wound. Where the fluid is purulent, the Avorst consequences result from the operation, as the access of air soon occasions putrefaction; and, though some present relief is obtained, we have seldom seen such patients long survive the operation. It would hi- an object of importance, therefore, to be able to ascer- tain its existence; but there are no discriminating symptoms, except the fluctuation and the apparent causes. When the accumulation is from hydatids, there is no peculiarity in the symptoms, and indeed no danger from the operation. These may be suspected in drop- sies which attack the young, whose viscera are sound; and these are cases which often recur for a time, and then the disease disappears for long intervals, perhaps wholly. The cause is ascertained by some small pieces of apparent membrane passing through the trocar. See Hydatids. One other kind of dropsy, the encysted, requires pe- culiar attention with respect to the propriety of per- forming the operation. It is distinguished by the tu- mour appearing first locally; by the fluctuation feeling distinct only in some particular directions, or parts of the abdomen; and in the early stages, by some irregu- lar hardness on deep pressure. These accumulations of water generally begin in the ovaria, and Ave suspect are always occasioned by hydatids. We know not, Iioav- ever, that if the sac is pierced by the trocar that there is any peculiar danger; but in all these instances the relief is temporary only: a dropsy originating in the ovarium is seldom cured. After the operation, the existence of a cyst is ascertained by the abdomen not being completely emptied; for some Avater is always at the same time accumulated in the abdomen; and if the instrument has penetrated the cyst, the other water remains; if not, the cyst is still unemptied. In either case it may be felt on pressing the abdomen. In pass- ing the trocar, if there is a cyst, the resistance is un- usual, and the pain violent; but we have known a cyst penetrated, in repeated operations, Avithout danger. See Paracentesis. When the duplicature of the peritonaeum is the seat of the ascites, tapping is alone the remedy. For the relief of occasional symptoms see Hydrops. See Mil- man on the Dropsy. Leake's Medical Instructions, edit. 5. Cullen's First Lines, vol. iv. and White's Sur- gery, 304. Asci'tes uteri'nus. See Hydrops uteri. ASCI'TICUS, (from ascites). One who labours under an ascites. ASCLE'PIAS, (from Asclepius, its inventor; called also hirundinaria, contrayerva Germanorum, vi7icetoxi- cum). tame poison, silken cicily, and white saval- loav wort. A. vincetoxicum Lin. Sp. PI. 314. It resembles the apocynum, or dog's bane; and like it yields a milky juice. The roots, Avhen fresh gathered, smell like the root of valerian, but lose their odour by drying: chewed, they are sweetish at the first, then bitterish. In doses from 9 i. to 3 i- it is sudorific and diuretic. In tin. se characters it hath been so commonly used by the Ger- mans as to have obtained the name of contrayerva Ger- manorum. It is said to be useful as an emmenagogue; and lias been employed, though with little success, in dropsy: A S E 200 ASP from its connection with many poisonous plants, it is, however, suspicious, and to be used with caution. Ascle'pias asthmatica, Lin. Supplem. 171. Wil- denow, Sp. PI. v. i. p. 1270. This is a plant from the island of Ceylon, and is slightly emetic and cathartic. Its chief use, as the namev indicates, is in pituitous asthmas, and is given in decoction or syrup. ASCLE'PIOS, (from the same). The name of a dried smegma described by P. ^gineta; of a troche in the writings of ^Etius; and a collyrium in Galen; call- ed Atheniphium, from its author Athenippus. ASCLI'TES. See Ascites. ASCO'MA, (from xtxos, a bottle). . The eminence of the pubes at the years of maturity. A'SCOS, (from xe-xvros, leather). A bottle. They were formerly made of leather, and Hippocrates used to apply them, when filled..with hot wate*, to pained parts. ASCYROI'DES, (from xo-xvpov, and etfros, forma). A species of the ascyrum. A'scyros, A'scyrum, A'scyrus; probably from ~Z.xvpov, the city Scyrum, Avhere it abounds. See Andro- s^emum. ASDE'NIGI. See Hematites. A'SE, or As'se, (from «^*>, nauseo). Hippocrates by these words means a loathing of food, from accumu- lations in the stomach. A'SEB. See Alumen. A'SEF. See Hydroa. A'SEGEN. See Sang, draconis. ASE'LLI; also called millepedes, polypedes, cutio, cyamus; 77iultipede; cubaris; centipedes: slaters, HOG' LICE, CHURCH BUGS, SOAV BUGS, and AVOOD LICE. These are insects, according to Linnaeus, of the class aptera, and genus oniscus. It comprehendeth fifteen species. One species is the- wood louse, and the variety employed is of a bluish colour, which, if touched, rolls itself up in a rounded form. They are found under stones and logs of wood, in cold, moist places; and the pale brown, and the bluish black sorts are indiscriminately used. Those found in vaults are said to contain the largest proportion of salts, and most esteemed. The London college directs them to be dried by suspending them in a thin canvas bag, placed within a cohered vessel, and over the steam of hot proof spi- rits, that, being killed by the vapour, they may become friable. The taste of these insects is sharp and pungent, and they are supposed to possess an alkaline quality, and to be diuretic. They are prescribed, both fresh and dry, in hepatic, and other visceral obstructions; in pituitous diseases of the chest, and suppression of urine; the dose in poAvder, from 3 i- to 3 h; in an expressed vinous in- fusion, f ij. repeatedly. They have been swallowed alive in great numbers daily; and though reckoned diuretic, the effects usually attributed to them are doubtful. From fifty to one hundred are eaten alive; or infused in wine and pressed, half an ounce is taken for a dose. ASE'LLUS. The cod fish; it is called also ca- beliau, morhua, molva, and the keeling. This be- longs to the genus gadus Lin. and includes the whiting, the haddock, the Avhiting pout, the sea pike, and some similar fish. See*Aliment. A'SEMOS, from *, neg. and o-n/ut, a sign). An epithet applied to events that fall out contrary to all appearance, and without any manifest cause. A crisis happening beyond hope. A'SEPTA, (from x, neg. and f£-LEABANE. See CONYZA. A'ster perua'nus. Potatoes. See Battatas Cana- densis. A'ster thala'ssius, is named Stella marina. Sea star. A certain zoophyte or insect of the family of the vermes echinodermes. Hippocrates hath recommended it Avith brassica and sweet scented wine, against Avhat is called the accent of the uterus and hysteric pains; but it is wholly useless. ASTE'RIAS, (from xrrr.p, a star). Star stone. Telesia asterias of Hauy. Is a fossil gem, very hard, resembling half a globe, extremely full of black radiated appearances, resembling stars; from whence its name. In medicine it Avas considered as a charm against marks of the mother. Aste'rias. See Gentiana. ASTHENI'A, (from x, non. and rievos', robur). Ex- treme DEBILITY. Astheni'a ab Hydroce'phaeo. Apople'xia hydro- cepha'lica. See Apoplexia. Astheni'a panonica. See Amphimerina Hun- GARICA. Astheni'a. General Aveakness, sometimes from excessive evacuations, but generally connected with visceral obstructions. In these cases it is attended Avith fever. If Avithout fever, bark and other tonics are useful. A'STHMA, (from xu, or xi)fu, spiro, or rather xx^u, anhelo, to breathe short). This is an impeded and very laborious respiration, joined with inexpressible anxiety and straitness of the precordia, preventing a free circu- lation of blood through the lungs, arising from various causes, and threatening suffocation. The characteristic symptom of this disease is a chronical, and sometimes a periodical, difficulty of breathing; hence it differs from orthopnea, Avhich is acute; from dyspncea, because that is continued. This disease has generally been considered to be of two kinds; the humoral, pituitous, or moist; the spas- modic, dry, nervous, or convulsive. Both which are properly included in the subsequent definition. ' A difficulty of breathing, coming on at intervals, with a sense of straitness in the breast, and sibilating respira- tion ; at the beginning of the paroxysm, attended Avith an uneasy cough, or no cough at all; tOAvards the con- clusion, a free cough, often attended with a copious ex- pectoration of mucus. Dr. Cullen ranks this genus of disease in the class Neuroses, and order Spas7ni, divid- ing it into three species. 1st. Asthma spontaneum; to Avhich belong the orthopnea spasmodica, and hysterica, when there is no manifest cause, or any other disease attending. 2d. Asthma exanthematicum, when it arises from the retropulsion of some acrid humours from the sur- face of the body. 3d. Asthma plethoricum, Avhen it is the con- sequence of some accustomed sanguinary evacuation suppressed, or a spontaneous plethora.—The hypochon- driac, arthritic, and venereal species, are symptomatic only. The attack of the convulsive asthma is sudden, and at its first appearance the fit is short. The symptoms which usually precede it are languor, flatulency, head- ach, sickness, pale urine, disturbed sleep, a sense of straitness and fulness about the pit of the stomach. In some cases there is an uncommon stupor, droAvsiness, and heaviness. The fit is frequently observed to come on about one or two o'clock in the morning, or at any hour after the first sleep. The patient Avakes suddenly, and feels a great tightness and constriction around the chest, Avith a' difficulty of breathing, and an impedi- ment to the free admission of air into the lungs. Both inspiration and expiration are sIoav, laborious, and ac- companied with constant Avheezing, particularly the latter. Great bodily anxiety always attends this dis- order. As the lungs cannot be sufficiently dilated a\ ith air, the passage of the blood through the pulmonary vessels is not free. Hence the face, in full and pletho- ric habits, appears red and bloated, and the vessels of the eyes are unnaturally turgid. The action of the heart is greatly disturbed, as is evident by the weakness, ir- regularity, and increased quickness of the pulse. Dur- Dd2 A S T 204 A S T uig the fit, the patient has, generally a longing instinc- tive desire for cool fresh air, Avhich ahvays revives him. A small close room, Avith a fire in it, is extremely offen- sive, and all Avarm things, given internally, increase »he flatulency in the stomach and boAvels, Avhich is al- Avays the most troublesome after a full meal. When the fit has continued a feAV minutes, half an hour, or an hour, it leaves the patient; his respiration becomes free and natural, his pulse sIoav and regular, his com- plexion puts on its usual appearance, and the bodily anxiety goes off. The urine is generally pale, and the skin somc-Avhat dry before the fit, and during its pro- gress ; but at the termination of it, the urine for a day or two is high coloured, and deposits a sediment, and the skin feels soft and moist. This is the description of a first and moderate attack of the disorder. In some t ases it appears in a more violent form, even at its com- mencement, and continues for several days before the fit terminates. Sometimes the patient will have one fit, and then remain free for many months. At other times fits come on for several nights together, the patient appearing almost perfectly Avell during the day, with his appetite and pulse natural. When the asthma once attacks, it seldom or never fails to recur, though the intervals bctAvecn the fits are very uncertain; when rooted in the constitution, it often makes its attack in the spring and autumn. In many cases it attacks perio- dically once in ten days or a fortnight. Sometimes it occurs regularly at the full and change of the moon. lioyer mentions a case Avhere the fits occurred for seven Aveeks together, and the patient Avas obliged to sleep in a chair; and from the strictest observations it is found, that there is no certainty nor regularity ob- servable in the attacks of the asthma. The reason why the fits so often occur first in the night, is thought to be oAving to the heat of the bed, and the horizontal posture in Avhich the patient lies. Relapses are commonly attended Avith an increase of the symptoms, and the vigour of the constitution is gradually impaired, till, by length of time, general or chronic Aveakness is induced. The difficulty of breath- ing in the fit arises to a much higher degree in these relapses, and the sensation of tightness over the breast is so great and distressing, that the patient feels as if he \\ ere bound Avith cords. His anxiety at this period is inexpressible, and he labours in respiration as if every moment would be his last. Severe vomiting frequent- ly occurs, and the matter discharged is slimy and frothy, or of a greenish or yelloAV colour. The hands and feet are cold, and the patient is subject to palpitations and huntings. Cool fresh air becomes absolutely necessary. The eyes are prominent, the face is sometimes pale and sometimes high coloured, bloated, or livid; the pulse extremely Aveak, irregular, and even intermitting; there is a difficulty of SAvalloAving, the patient can scarcely speak, cough, or expectorate during the fit, and the stomach and boAvels are violently distended with wind. While thus labouring for breath, he is obliged to rise from his bed, he cannot bear even the weight of the bed clothes upon him. His shoulders are constantly elevated, to give the muscles of the chest their great- est poAver of action in raising the ribs in inspiration. At this time, too, the patient, though before costive, \ ill frequently have a loose stood. When the violence of the fit abates, and respiration becomes free, the cough returns, and the patient begins to expectorate phlegm, Avhich is sometimes intermixed Avith blood. As soon as an easy copious expectoration takes place, it affords great relief, for the evacuation is made im- mediately from the parts affected, from the vessels which have been obstructed. This expectoration is one of the most certain signs of the abatement of the complaint, as it denotes the solution of*the contraction of the bronchial air vessels; particularly if a moisture and softness of the skin, and a sedi- ment in the urine, make their appearance. The blood Avhich is spit up in this complaint proceeds generally from a rupture or dilatation of blood vessels in the lungs. In some cases, indeed, the quantity of blood which is spit up is in full habits very considerable, and at the same time accompanied Avith an abatement of the symptoms.' But all free discharges of blood from the lungs, though they afford relief, are unfavourable signs, as they denote greater violence of the disease; during the course of Avhich, the very efforts of nature to relieve are in themselves so alarming. The nose, too, will some- times gush out Avith blood during the severity of the fit, from the obstruction given to the return of the blood through the pulmonary vessels into the left auricle of the heart. Thus in a short time the fit of the convulsive asthma goes off. In a course of years one fit succeeds another, and the disorder increases in the violence and duration of the fits, as Avell as in the frequency of their returns. The expectoration from the mucous glands of the lungs, Avhich still continues to relieve at the ter- mination of the fits, becomes itself a very troublesome symptom. These glands are relaxed, and the discharge of mucus greater than natural. Hence the bronchial or air vessels are frequently obstructed with phlegm, and from this cause the freedom of respiration is disturbed: the patient breathes with unusual difficulty, although his convulsive fits be absent. When he first wakes in the morning he has generally a severe fit of coughing, which continues till he has discharged the phlegm that provoked the cough, by preventing the free admis- sion of air into the air vessels. Through the day, at different times, the cough still recurs, 'but with less violence ; and in the evening it is often very teasing and distressing, especially on any sudden motion of the body, or in cold, damp, foggy Aveather, Avhich obstructs the exhalation of the perspirable matter from the lungs. Thus the humoral asthma is united with the convulsive, and both together exist in the same patient. The humoral asthma is a disorder of the mucous glands of the lungs, in consequence of Avhich they are relaxed, and the discharge of mucus; being unnaturally copious, obstructs the freedom of respiration. This kind of asthma is more constant; the convulsive more violent, and of shorter duration. The humoral asthma is more severe both with respect to the cough and dif- ficulty of breathing in winter; but in summer, when the Aveather isAvarm, and perspiration free, it often dis- appears totally between the intervals of the fits of the convulsive asthma. The convulsive asthma, too, is some- times severer in Avinter than in summer, especially when combined Avith the humoral, or with a catarrh. But it often happens that the warm weather affords little or no relief; nay, even in many cases it is observed, that the AST 205 A ST irritability of the constitution and the rarefaction of the blood are so much increased by the warmth of the Aveather, that the frequency and severity of the fits are greater in the warm and sultry, than in the cold seasons of the year. In this case the humoral asth- ma is continued on during the summer months by the convulsive asthma, as a symptom of the natural and critical solution of the fits. After the convulsive asthmas there is often a great soreness in the breast, partly from the violent muscular exertion, and partly from the frequency and severity of the cough. Some- times, too, there are shooting pains in the sides, Avhich are extremely painful and alarming to the pa- tient; but the judicious practitioner will easily distin- guish them from internal affections of the breast, by the external soreness, and the acuteness of the pain in con- sequence of motion. The frequent returns of fits some- times cause obstructions in the lungs, Avhich, as the dis- section of dead bodies clearly ascertains, appear full of knots or tubercles. These tubercles are most liable to occur in those Avho have naturally a narroAv contracted chest, in which the lungs have not a free and easy mo- tion ; these render the disorder very obstinate, occa- sioning a long continuance of the cough after the asth- matic fit, frequently ending in small inflammations of the lungs, attended Avith internal pains, difficulty of breathing, and hectic fever. We have already observed, that the humoral asthma often supervenes on the con- vulsive. It is necessary also to observe, that the con- vulsive sometimes attacks those who have long been previously afflicted with the humoral asthma. Patients subject to catarrhs and Avinter coughs, during which they expectorate a considerable quantity of thick or frothy phlegm, are sometimes suddenly seized Avith violent difficulty of breathing, and great tightness over the breast, so as to dread even instant suffocation. This neAV complaint, after having tormented them for some hours, or perhaps a day or two, also leaves them sud- denly, and they look back Avith surprise at their happy deliverance from so formidable and unexpected an ene- my. Their old habitual cough and asthma, with sore- ness and stuffing in the breast, still remain ; but they bear it Avithout repining. In this manner they conti- nue for some time, till the convulsive asthma returns, perhaps, with additional violence. Thus, the convulsive asthma becomes habitual to the patient, and he has the misfortune to find himself labouring under a complica- tion of two diseases; the one aggravating the other, and both growing Avorse. The compulsive asthma sometimes attacks persons of a thin spare habit, Avhose constitutions have been great- ly emaciated by a long exposure to causes of general or chronic Aveakness. In some cases it seizes patients Avho are robust and full of blood, particularly if they have small vessels and strait chests. At other times it occurs in those who are gross, phlegmatic, corpulent, and in such habits it is often very distressing. In general,- the indolent and luxurious suffer in a very consi- derable 'degree, and the disease seems to be convey- ed to the children. It is frequently connected like- wise with hysterical and hypochondriacal complaints, in irritable and relaxed constitutions. The convulsive asthma, recurring for many years, is capable of re- ducing the strongest constitutions, and of bringing on the symptoms of general debility; but if it attacks a constitution already weakened and exhausted, it is ob- vious that it will necessarily weaken and exhaust it more. The stomach and boAvels are more particularly liable to be affected in the convulsive asthma; they are often seized with colic pains, distended Avith wind, tormented Avith burning heats, and agitated with tremulous mo- tions, which give a sensation to the patient of something moving and fluttering within him. Floyer, too, has ob- served, that slight fits of the asthma often affect the sto- mach and boAvels, not the lungs. The appetite is greatly- impaired, sleep is often prevented, or it is disturbed and unrefreshing. The menses are sometimes obstructed, and sometimes they are brought on before the usual pe- riod ; and when plethora prevails, that discharge is ac- companied with relief. The patient is generally costive, though sometimes he will have loose stools. The ex- tremities, particularly the arms, shoulders, and upper parts of the body, are often affected Avith great uneasi- ness. Symptoms of fever are not essential to the disease, though they frequently occur, especially Avhen the hu- moral asthma or a catarrh is complicated with the con- vulsive. A hectic fever, with a colliquative diarrhoea, faintings, palpitations, violent vomitings, coldnessof the extremities, SAvelled legs, and other dropsical symp- toms, arising from weakness, relaxation, and obstruction to the circulation of the blood through the lungs, is common in the last stage of the disease. Asthma may- attack at any age, but its general approach is after the prime of life. From the preceding account of the symptoms qf the convulsive asthma, it will appear obvious that the dis- tinction of it from every other disease cannot be difficult. The sudden attack of the fits, the short time of their duration, the violence of their symptoms, the state Of ease and good health between them and their returning at intervals, Avill sufficiently characterise the complaint. The convulsive asthma is sometimes combined with the humoral asthma, pleurisy, peripneumony, dropsy of the breast, catarrhal and consumptive disorders; but the distinctions will require an accurate study of the respec- tive histories of the different complaints Avhich bear any resemblance to it. In many instances in the practice of medicine, words can never convey those minute distinc- tions Avhich are very obvious to the eye and other senses. When this disorder is recent, and produced by a de- cided occasional cause, there may be hopes of a lasting recovery ; otherwise it is rarely, if ever, cured. An eruption of the menses, or of the haemorrhoids, during a paroxysm, alleviates it; improper management causes an asthma more readily to end in a dropsy; paroxysms of convulsive asthmas greatly endanger the life at every return, yet seldom prove fatal. If frequent and long con- tinued, should the patient escape with his life, a dropsy is the result, which is his destruction. If a slow fever comes on, an unequal intermittent pulse, a palsy of the arms, a continual palpitation of the heart, a preterna- tural small discharge by urine, or a syncope, death is at hand; as these symptoms show, that the heart or its connected vessels are organically injured, An asthma affecting old people usually attends them to the grave. Dr. Cullen observes, " That the asthma depends upon a particular constitution of the lungs: that the proximate cause is a preternatural, and, in some measure, a spasmodic constriction of the muscular fibres of the bronchiae, which not only prevents the dilatation of the AST 20G A S T bronchiae necessary to a free and full inspiration, but gives also a rigidity, which prevents a full and free ex- piration. This preternatural constriction," he adds, " like many other spasmodic and convulsive affections, is readily excited by a turgescence of the blood, and other causes of any unusual fulness and distention of the vessels of the lungs." When this spasm is removed, the patient, after the expectoration of a little phlegm, feels himself almost restored to perfect health ; for the cause being obviated, and there being no fixed obstruction in the lungs, the symptoms totally disappear. The proximate cause of the convulsive asthma, when complicated Avith the hu- moral, is a spasmodic contraction of the air vessels of the lungs, occasioned by an increased secretion of mu- cus, from a relaxation of the mucous glands. The chief predisposing causes of the convulsive asthma are, a narroAV contracted chest, morbid irrita- bility of the lungs, and pulmonary obstructions in con- sequence of tubercles, either scrofulous or formed by repeated catarrhs, winter coughs, pleurisies, and perip- neumonies. The occasional causes of the convulsive asthma are, cold, moisture, sudden changes of weather, dust, metallic fumes, smoke and other particular smells, me- phitic vapours, evacuations, great fatigue, neglect of exercise, shouting, and all strong exertions of the voice, certain disorders in the constitution, anger, joy, sur- prise, fear, grief, and other depressing passions, excess in venery, and intemperance in diet. When, however, we compare the action of these re- mote causes with the spasm supposed to occasion the disease, the connection is not very clear; and, indeed, while anatomy has not ascertained the existence of mus- cular fibres in the bronchial cells, or the branches of the trachea ultimately terminating in them, it is not easy to admit this cause. There are, indeed, some reasons for supposing the diaphragm alone affected, since respira- tion is chiefly carried on by its means, and the convulsive asthma is intimately connected Aviththe state of the sto- mach and boAvels. When the diaphragm is affected, by consent of parts usually acting together, the intercostal muscles are also spasmodically contracted. This idea is in some degree supported by the symptoms of pleurisy, Avhere the diaphragm gives little assistance in respira- tion, as the ribs cannot be raised Avithout pain. It cannot have escaped the attentive observer, that the remote causes and threatening symptoms of con- vulsive asthma and gout, are not very dissimilar; the period of attack, the firm health in the intervals, and the subjects most liable to these diseases, are still stronger marks of the connection; but our pathology is in too imperfect a state to explain the reason why a previous debility of the system, folloAved by irregular action, should, in one case, produce inflammation in the extremities; and in the other, spasm on the organs of respiration. We indeed see, in general, that those sub- ject to asthma have some imperfect conformation of the chest, or some obstruction in the organs which it contains; and we see, also, that an accumulation of mucus in the bronchial glands, or a suppression of the usual discharge, Avill often bring on fits of true con- vulsive asthma. A late author, Dr. Bree,Avho is himself an asthmatic, has endeaAOiired to bring us back to the humoral pa- thology, and to connect more intimately the convulsive and humoral asthma, though not with signal success. His chief argument consists in the appearances after death: but Ave have already remarked, that these arc effects only; and in general the quantity discharged at the termination of a fit is so inconsiderable, the relief is so often obtained previous to the discharge, and the marks of accumulation even when present are so trifling, that this opinion cannot be supported. The hopes of relief are to be estimated from the violence and duration of the symptoms, the age of the patient, the condition of his constitution, the nature of the predisposition, and the power of the exciting- causes. If the symptoms of the spasmodic affection in the lungs run high; if the disorder be of long standing, and, Avhen once excited, continues for several days; if the returns of it be frequent; if the lungs be greatly ob- structed with phlegm at the termination of the con- vulsive fits, and an obstinate cough remains during the intervals, with a laborious respiration, and a copious ex- pectoration of mucous matter ; the cure is difficult, te- dious, and uncertain. Tubercles and obstruction in the lungs are symptoms too unfavourable to admit of hope. If, on the contrary, the disorder be recent; if the patient's constitution be not greatly impaired; if there be no natural deformity in the chest; if respiration after the termination of the fit be free, and the cough, Avith expectoration of phlegm, not violent nor obstinate in its duration; if the occupation of the person be not in- jurious to the lungs, or, if so, can be easily relinquished; and if the lungs be not obstructed Avith tubercles, either in consequence of a scrofulous habit, or repeated in- flammatory affections, the case bears a favourable aspect, and may, in all human probability, be frequently treated with success. When infants are seized Avith the asthma, it often ends fatally, especially if poAverful means for the removal of it be not applied at its commencement. The cure of asthma must differ according to its na- ture, and the periods in which the remedies are em- ployed. The only disease properly distinguished by this appellation is the convulsive asthma ; but the humoral asthma is so often connected with it, at least as an ex- citing cause, that we shall consider it in this place. The treatment of convulsive asthma must differ, when considered with a vieAV of removing the fit, or of pre- venting its recurrence. It was formerly a constant prac- tice, in every case of difficult breathing, to bleed; and bleeding has been repeatedly employed to mitigate the urgent symptoms of the moment. We have great rea- son to think that this practice has been highly injurious; and repeated bleedings in repeated fits have undoubt- edly hastened the common termination of asthma, the dropsy. Yet so sudden is frequently the relief, that patients once accustomed to it are displeased if so ready a remedy is omitted, and it is often necessary to take a small quantity of blood to satisfy their minds: indeed it frequently happens that a slight bleeding will be equally useful with a large one. Such is theconnection established in the human system by concomitant effects, that Ave are told by Dr. Whytt, that a nervous paroxysm has been removed by the momentary puncture of the arm. . Vomits are considered by Dr. Akenside as highly useful in shortening the paroxysm, and he recommends them to be given early, indeed almost in the moment >>f A ST 207 A S T the attack. We own that Ave have followed this prac- tice Avith some hesitation, yet we have never found it inconvenient or dangerous. Physicians have usually Avaited till some expectoration has come on, but the remedy is then unnecessary. Dr. Akenside gave very small doses of ipecacuanha only; and remarks, that it is equally useful Avhen it nauseates, as when it vomits. The more rapid effects of the white vitriol have not,, we believe, been tried, though they may probably unite a tonic poAver Avith the usual effects of vomiting. Blisters require too long a period for their operation to be of great service during the fit; but, Avhen the pa- roxysm is unusually protracted, they may be of service. The chief benefit to be expected during the attack is from the volatile antispasmodics; and, as no incon- venience is likely to follow, expectorants have been combined Avith them. With the mixtura camphorata, have been united aether, aqua ammoniae, tinctura fcetida, lac ammoniac, and even opium. The quickest and most diffusive stimulants are undoubtedly the best; and these mentioned may be combined in any proportion the physician may prefer. Opium is however a medi- cine of equivocal utility. It is mentioned because it has been recommended; but in our hands it has been rather injurious than useful. Mixing the opium Avith squills, or any active expectorant, or with gentle laxatives, to avoid its constipating effects, are proper precautions. Bathing the feet in Avarm water has been sometimes useful; and in the very violent attacks, cataplasms, Avith garlic applied to the feet, have been of service. When a fit of true convulsive asthma is apparently connected Avith water in the chest, an active laxatiVe has given great relief. In such cases, ten grains of jalap, Avith as much calomel, have been given Avith advantage. The intervals between the fits are the periods Avhen medicine may be most usefully employed; for though Ave lessen debility, and prevent in some degree any organic derangement by shortening and mitigating the fit, yet it scarcely ever happens that a paroxysm proves fatal. The diet should, in general, be light and digestible; and every thing acescent and flatulent should be avoid- ed. As life advances it should be more generous; and Madeira, or Port, if it does not produce acidity, may be taken Avith freedom, regulated by former habits. The less perfectly fermented ale is injurious, but porter is an excellent liquor with the meals; and, if not too flatulent or too strong, agrees well with asthmatics. In some cases of asthma however these liquors are too stimulant; and water, or absolution of cream of tartar in water, is found more useful. Though acescents are injurious, the acids less susceptible of further change, as vinegar, or the pure acid of tartar, are supposed to be very beneficial. Tea should be avoided; but coffee is supposed to be highly useful: and the warmer plants of our own country, as peppermint, rosemary, and pennyroyal, may Avith advantage supersede those of foreign growth. Supper should always be light of digestion, and not flatulent or acescent. The ship bis- cuits, Avith porter, or brandy and water not SAveetened, or some beef tea, will fully supply this meal. The situation of asthmatic patients is of great im- portance. , In general, they cannot breathe with ease in an elevated spot; and too great a proportion of oxygen in the air, irritates their Aveak and susceptible lungs. In Avhat the lower quality of the air consistent Avith their case, consists, Ave knoAV not. It has been suspected to be azote or hydrogen; but, from a fact mentioned by Dr. Percival, that the asthmatics Avho have been disor- dered by the fumes of lead, find relief from Avorking in the Jime kilns, it may be fixed air, Avhich, from its greater specific gravity, falls into the lower strata of the atmosphere. Whatever may be the cause, the fact is well established. Asthmatics do not always find great advantage from a Avarmer climate. Such hoAvever is the variable nature of this disease, that some cannot breathe but in a less inclement atmosphere than this country affords. The other physical qualities of the air are probably of importance. A due degree of elasticity is apparently necessary; but this, too, may be in excess, and produce inconvenience. An easterly wind is always injurious; but to what all the disadvantages of this peculiar state of the air may be attributed, Ave are yet ignorant. The exercise should be steady and regular. Walking, for the reasons formerly assigned, is the most salutary ; and sailing, for a similar reason, has been found very advantageous. If exercise on horseback or in a carriage is necessary, the feet must be well covered to keep up an equable, steady perspiration. Moisture should be carefully avoided; and, if accidentally wetted, the clothes should be immediately changed. The cold damp air of the night should be shunned with equal anxiety. Flan- nel should be usually Avorn next the skin in winter, and a moderately thick calico in summer. Vomits frequently repeated have been found of consi- derable utility, and their advantages have been variously explained. Those who consider the source of the disease to be in the stomach, think the frequent evacuation use- ful; while others consider them chiefly as expectorants, or as determining very poAverfully to the skin. All, however, confess their utility, and we have known them given every other morning for a considerable length of time, Avithout appearing in the slightest degree to in- jure the stomach : on the contrary, they seemed to re- store its action. The emetic has generally in these cases been assisted by mustard Avhey, and sometimes by the volatile alkali added to camomile tea, and occasionally by the infusion of the seeds carduus benedictus. The steady action of the warmer purgatives is also of great importance in this disease. The connection of asthmatic paroxysms Avith flatulence and costiveness has been already pointed out; and obviating these has greatly contributed to extend the intervals of ease. The rhubarb and aloes appear to be the most useful; nor have Ave found any distinction in their merits, except that the former seems more applicable when the skin is dark and yelloAV, indicating an affection of the liver; and the latter, Avhen these appearances are absent. Those subject to piles find aloes inconvenient; but in asthma, haemorrhoidal inflammations are said to be ad- vantageous. We knoAV no subject in medicine less'un- derstood than the nature of haemorrhoids, and their con- nection with the general health; nor can we promise to elucidate, though we shall notice, the more important facts relative to it. In the case before us, if the asthma- tic feels advantage from these swellings, or the dis- charges of blood Avhich sometimes accompany them, such is the distressing nature of this complaint, that he may assist both by aloetic purgatives; yet so painful and disagreeable is the disease, that in scarcely any other, A ST 20* A S T apoplexy and palsy perhaps excepted, would the change be considered as advantageous. Some authors have pre- ferred the saline and the acid purgatives. In the earlier and more robust periods of life they may perhaps be more useful; but asthma is seldom the disease of youth and activity. The predisposition is, however, in some constitutions, so strong, that Ave have knoAvn its attacks commence so early as sixteen years of age. There is another circumstance Avhich renders the more cooling purgatives sometimes proper, Avhich is the alternation of mania with asthma. We have seen some cases of this kind, and suspect that they are more com- mon than authors have supposed ; and in these, unless the maniacal affection be of the melancholy kind, salts and acid purgatives are better adapted to the complaint. A remedy of peculiar importance is said to be a per- petual blister, or an issue; and Ave think that Ave have found a perpetual blister on the back, or on the breast, Tiighly useful in preventing the return of fits. Of issues we have less experience; nor can Ave confirm by our observation the remark, that this discharge is as useful from the arm or thigh, as from parts nearer the chest. In affections of the chest, it has not been uncommon to employ blisters on the thighs and legs; or, in the more chronic complaints of these organs, issues. This remaining scion of the old doctrine of revulsion is iioav decaying, yet the practice has been very lately recom- mended by physicians of eminence; and, with all our theoretical prejudices alive, we cannot help adding, that we have seen these applications apparently useful. Diuretics have been sometimes recommended; but as the principal remedy of this kind is the squill, it may- be of service as an expectorant. If the nitre and sal ammoniac be ever useful, they must chiefly act by pre- venting the accumulations of those salts, Avhich, pre- vious to a paroxysm, appear to be retained by the urine becoming colourless. Expectoiants might be supposed a very useful class of medicines; yet, if the view Ave have taken of the disease be correct, we shall find it not occasioned by any accumulation of mucus, and Ave shall soon perceive on what foundation they have been advantageous. The great object, in the interval, is to restore the tone of the system, and to support it. With occasional vomits, the steady and continued use of eccoprotics, sea bathing has been found highly useful, and it is strongly recommended by Dr. Ryan. The bark has been found of equal service; and, with the same view, Dr. Withers has recommended the flowers of zinc; and other authors, a mild alterative course of mercu- rials. Perhaps all the metallic tonics will be found use- ful, except perhaps the iron, which seems to combine too great a share of inflammatory stimulus. This idea may appear probably too hypothetical, and it is hinted only to suggest a little caution in its use. These are the principal remedies of convulsive asth- ma; and we shall next consider the humoral asthma, as the accumulation in the bronchial glands acts often as an exciting cause of a convulsive fit, and in the old asthmatic, they are often united. The symptoms are the usual ones of a laborious and oppressive breathing, but accompanied with a wheezing noise in the respira- tion, which indicates an accumulation of mucus in the bronchiae. The fit also, instead of lasting a feAv hours, is kept up many days, and at length terminates imper- fectly, leaving the patient for a long time Aveak and languid; and, after various attacks, usually occasioning hydrothorax. In this form of the disease the sputum is at first frothv, or of a gluey consistence, admitting of being draAvn out in threads; and little or no relief is obtained till it is expectorated in rounder masses, is of a yel- loAvish white, less tenacious, and more soft. Bleeding is here also employed to relieve symptoms, as suffoca- tion is more frequent than in the true asthma, yet its repetition soon produces all the bad effects attributed to it in the convulsive species; and if the necessary- quantity is at all exceeded, the Aveakness occasioned Avill render it difficult to bring on the proper expecto-. ration. Vomits are more useful, and the squills given in such doses as to vomit or nauseate, produce the best effects. If there is .much fever, they are assisted by antimonials, particularly the kermes mineral; if little or none, by the volatile alkali. In general, except in the very early stage, there is little fever; and the quick- ness and hardness of the pulse are the effects of the laborious breathing. Blisters are in this complaint singularly useful, and there is no doubt of the propriety of applying them very near the back. They must often be repeated, and as soon as one has begun to discharge, another may be applied, as the'stimulus of the cantharides appears to be chiefly useful. Cataplasms of garlic to the feet have been considered as very valuable assistants. Expectorants are also of great importance, and the chief of these are the squill, the gum ammoniac, and the volatile alkali. Equal parts of the oily emulsion and lac ammoniac, to which is added as much of the tincture of squills as the stomach can bear, is a medi- cine of peculiar utility, and often will bring on expec- toration in cases apparently desperate. The other ex- pectorants are not of equal power; the inula will some- times be useful Avhen continued, and is adapted rather for the intervals than the urgent emergency of a pa- roxysm ; and the asafoetida, whose poAvers as a carmi- native and antispasmodic have eclipsed its numerous other virtues, merits considerable commendation in the same view. Even in the convulsive kind it becomes an excellent vehicle for the constant laxative. The oliba- num, in many of its effects resembling the asafoetida, is highly useful, and seems to combine a tonic Avith its expectorant power. Respecting the propriety of purges in the humoral asthma, authors have differed. If given in any con- siderable dose, they induce debility, and retard the expectoration; but Ave have generally found, that to procure about two motions daily, has-been highly salu- tary. These must, however, be produced by the mildest laxatives. There are some cases where humoral asthma is combined with hydrothorax, or indeed where the lat- ter puts on the appearances of the former. In these circumstances- Ave have fortunately an active medi- cine, adapted to both diseases; viz. the squills. The distinction is, hoAvever, necessary, as- the hydrotho- rax requires more active laxatives. In this disease, the hydropic diathesis is more conspicuous. The urine is scanty; the breathing, though oppressed, is not so violently obstructed as in asthma; the dyspnoea con- tinues with less change; the lips are livid, and the AST 209 AST whole face more dark and sAvollen. The sleep is in- terrupted by sense of suffocation, and fainting recurs on the slightest motion. In such circumstances, diuretics and active laxatives are the only remedies. Of the diuretics, the squill is the most powerful; but some of the more stimulating kinds are frequently useful; and great advantages are often obtained by the oil of juniper, or the oil of turpentine. These seem also to act as expectorants; and the balsam Peru, both as an expectorant, a stimulant, and a tonic, Avhen the more violent urgent symptoms have disappeared, is an excellent medicine. In the intervals of this disease there is no room for the bark, as it is too astringent, except where the asthma is of the gouty kind. In other species, the cascarilla, the quassia, the cortex salicis latifoliae, the oak, or the angustura bark, may be given as a tonic. But, above all, it is necessary to keep up the determination to the surface, to avoid cold and damps of every kind, night air, and every cause of de- bility. The asthma, in some instances, ends in a partial palsy ; mothers, in some species of dropsy; sometimes, though not often, the patie'nt is suddenly suffocated. This accident, Avhen it happens, hath for its cause a polypus in the lungs; and instances have occurred of its ending in an inflammation of those organs. See Aretaeus. Dr. Dover. Sir John Floyer on the Asthma. Cullen's First Lines, edit. iv. vol. iii. Withers on the Asthma. Dr. Ryan on the History and Cure of Asthma. Hoffman on Convulsive Asthma. Bree on Disordered Respiration. Akehside in the London Me- dical Transactions, vol. i. Asthma spasmodicum infantum. The difficulty of breathing, which so often attacks during the period of infancy, is a disease of peculiar danger, and its different kinds are not easily discriminated. The suffocations from cold and teething are generally knoAvn by the fever attending, and the period of life, as well as the SAvelling of the gums. The difficulty of distinction chiefly lies between the spasmodic asthma, and cynan- che stridula. The inconvenience has been greater, since, from the resemblance of the symptoms, remedies have been celebrated as successful in croup, Avhich were never used in the disease; and the less experienced practitioner, trusting to them, has felt the severest disappointment. The distinction indeed is not easy, nor does it admit of explanation. The peculiar sound of the croupy breath- ing, which is knoAvn only from experience, decides the question. The sound of the asthmatic breathing is less shrill, and generally accompanied with some Avheezing. The remedies for the spasmodic asthma of children require the utmost activity in their administration. A blister must be immediately applied to the breast or back; an active emetic of tartarised antimony quickly given, in a dose that will secure its effects, and probably occasion also some discharge by stool. A warm bath will often prove advantageous; and the asafoetida, given Avith tinctura opii in a clyster, after some motions have been procured, either by the emetic tartar, an active clyster, or a dose of calomel, will relieve very effectually the spasm. To a child of tAvo years old, two scruples of asafoetida may be given in a clyster, dissolved in two ounces of warm Avater, Avith thirty or forty drops of the tincture of opium; and this may be repeated in four or six hours, according to the exigency of the complaint. VOL. I. Dr. Millar, in the spasmodic asthma of children and the hooping cough, advises the asafoetida internally;.and adds, that children are soon reconciled to the taste, and even grow fond of it. This may be true, but Ave have not been so fortunate as to meet Avith such admirers of the garlic flavour. Cataplasms of garlic, hoAvever, ap- plied to the feet, have been often advantageous. A'STITES GLANDULO'SI, (from ad, and sto, to stand nea7-). A name of the prostate glands, because they are situated near the bladder. See Parastat.<£. ASTRA'GALO, ASTRAGALOI'DES, (from o)?\pxyxXos, and eiS'os, likeness). See Orobus. ASTRA'GALUS, (from xy the corrugation and constriction of the whole mouth and fauces, from a small portion of astringents being applied to a small part of the tongue, astringents act upon the sentient nerves; and that, taken into the sto- mach, they show their effects in other parts of the body so quickly, that they can hardly be supposed to have passed the stomach itself: therefore, their sudden ef- fects in distant parts must be ascribed to an astringent poAver communicated from the stomach to those distant parts." The discovery of tannin is, however, of a later date, and its chemical effects seem to change the state of the question. These considerations, however, assist us but little in "explaining all the effects of astringents. While they render the simple solids more dense, they add also to the tone of the system, and give energy and activity to the vital. Muscular action is, at least, attended Avith increased density, and a stronger cohesion of the mus- cular fibres; and Ave can therefore perceive how astrin- gents can increase their energy. But the tone of the nervous system is apparently connected with a fluid confined to the nervous fibrils; and the little Ave knoAV of its nature shows no very striking connexion ketween increased density and increased nervous power. To avoid this difficulty, it has been supposed that astrin- gents unite a tonic power; and, as we certainly pos- sess tonics that are not astringent, so, on the contrary, some astringents may not be tonics, or the latter power may be combined without altering the sensible quali- ties of the former. The flowers of zinc and arsenic are certainly tonics Avithout astringency; and catechu, the most poAverful astringent, is not a tonic. It is not, therefore, improbable, that the tAvo qualities may be combined ; yet they are so often united in a body, that Ave are anxious to find a closer connexion. We may reflect, then, that though the astringents can have no effect on any fluid in the nerves, yet it seems probable that the state of this fluid, or poAver, differs according to the state of the simple solid, and to that of the nen-es as such. In a Avarm climate, and from warm confined air, Avhich relaxes the simple solid, the nervous energy is more mobile, but less strong. From cold, and in cold climates, the contrary takes place; and, in gene- ral, astringency and relaxation seem respectively to attend tone and irritability. Thus it happens that astringents lessen irritability ; and it is not improbable that the whole of their apparent tonic poAver is merely the diminution of irritability, by the condensation of the simple solid and the nervous system, so far as it is such. Astringents are of very different kinds; or rather me- dicines of different powers produce their effects. Those Avhich strictly deserve that title, make the. impression of astringency or acerbity on the tongue, for the latter is the effect of astringency joined with acidity. To these only - the explanations Ave have already entered into apply. The principle on which their power de- pends, we have said, is the tannin* in itself bitter, but probably uniting in the vegetable something Avhich adds to its power. The property of striking, a black with chalybeates, supposed to be the distinguishing quality of astringents, is now found to be characteristic of the gallic acid, which sometimes accompanies the tannin. The catechu, Avhicl^we have styled the strongest astrin- gent, produces no change of colour with vitriolated iron. The natural orders, stellatce, senticos , to perforate). Those of either sex are thus called, when their anus, or any other natural aperture, is closed. A'TRICES, (from x, non, and §pi%, hair). Small tubercles near the anus, about Avhich hairs will not grow; and Avhich recede and return, especially at the first. Valesius de Taranta reckoned them among con- dylomata et fici. A'TRICI. Small sinuses in the intestinum rectum, which do not reach so far as to perforate into its cavity. ATRI'PLEX. The Greek term is Atraphaxis, from whence some say the Avord is derived; q. v. O'rach, or o'rache; also called atriplex alba or rubra horten- sis, arrache, atraphraxis, chrysolachanon ; avhite, red, Or GARDEN ORACH. It is an annual plant rising from seeds, and chiefly employed in the kitchen. - Atri'plex fce'tida. Called also garosmum, andra- phex, vulvaria, chenopodium fetidum, chenopodium vulvarium, atriplex olida, blitum fetidum ; stinking orach: is the chenopodiu7n vulvaria Lin. Sp. PI. 321. It hath a strong disagreeable smell, someAvhat like that of salt fish. That found growing amongst old rubbish is weaker than that in moister ground. Wa- ter takes up all its virtue by infusion; but it loses its strength by keeping. It is a fetid anti-hysteric, an- tispasmodic, and acts without irritation. It can only be used in its recent state, as when dry it loses its sen - sible qualities. Therefore the best form is a conserve, of Avhich two or three drachms may be taken in a day. Dr. Cullen Avishes it Avas more often employed, Mat, Med. ATRI'PLEX. Mari'tima, and Portula'ca. See Halimus. Atri'plex odo'ra suave'olens. See Botrys. Atri'plex sylve'stris, avild orach. See Cheno- ■podium, Ambrosoides, and Rubrum. A'TROPA, belladona, (from AlpoTros, the goddess of destiny). See Solanum lethale. A'tropa mandragora. See Mandragora. . ATROPHI'A, (from x, and rpe, to dry). The Latins call it squalor. It is hot, dry, sultry Aveather. AUCUPA'LIS or AUCUPA'RIA, (from aucupor, to endeavour to catch,) so called because birds are taken by its berries. See Ornus, and Sorbus sylves- ,tris. AUDA'CIA, (from audax, bold). In a medical sense it is that sort of boldness which Ave meet with in delirium or madness. AUDITO'RIA ARTERIA, (from audio, to hear). The internal auditory artery goes off from each side of the arteria basilaris. to the organ of hearing, and accom- panies the auditory nerve, having first furnished several small tAvigs to the membrana arachnoides. AUDITO'RIUS MEATUS, (from the same). The passage that conveys the air to the auditory nerve. It leads from the lower anterior part of the concha to the tympanum, and is partly bony, partly cartilaginous; all within the temporal bone is the bony part, it is the longest, and forms the bottom; the rest is cartilaginous, and makes the external opening or orifice of the canal: these two parts make a canal of about three fourths of an inch long, a little tortuous, and wider in some parts than in others. On the membranous covering of* the cartilaginous part Ave observe the yellow bodies, sup- posed to be the glandule, ceruminis. The bony part of the meatus is nearly horizontal and straight; the carti- laginous part only is curved and Avinding, which should be observed when a syringe is used to inject any thing Avith into the ear. Audito'rius nervus. The auditory nerve. The seventh pair of nerves are called auditory nerves; so are the sympathetici 7ninores. This seventh pair of nerves run into the os petrosum, and are there divided into the portio mollis, Avhich is spent upon the labyrinth of the ear, and distributed to the meatus auditorius in- ternus, passing to the vestribulum cochleae; and portio dura, Avhich goes out by" the aqueduct, between the mastoid and styloid processus, passes through the pa- rotid, becomes a cutaneous nerve, and communicates with the upper maxillary. On these nerves, no cover- ing from the dura mater can be traced. AUDI'TUS, (from audio, to hear). The sense of hearing, also called acoe. By this sense we perceive the elastic tremors of the air; and to facilitate the func- tion, the organ of hearing is made up of hard bones, and of elastic cartilages and membranes. The elastic air only receives sonorous tremors, and transfers them, as Ave see Avater transfer any impulse given to it. The sound is increased in air that is condensed, and is lost in a vessel emptied of its air. The body, which pro* duces sound, ought to tremble or vibrate in the smallest of its particles. From such a tremor the contiguous air is beat into waves, whereby the parts of the air that lie outermost are compressed, and fly back.again as soon as their elasticity conquers the impulse. The air con- sequently flies again towards the sonorous body, where it is noAv more loose and rarefied, to be again compressed by the impulsive power; and in the same manner the anterior and outer portion of air surrounding that Avhich is impelled, is by the action of the latter compressed and removed further from the trembling body, yet so as to return again in its proper time by the force of elasti- city, driving its contents to the tremulous body for the exciting a neAV wave. These impulsions of the air are required to succeed each other with a certain velocity; and in order to render them audible, they must not be fewer than thirty in a second of time. As these sono- rous Avaves are more frequent in a given time, so much sharper is the sound heard, and the'more strongly does it affect us, till Ave come to the most acute of audible sounds, which have 7520 tremors in a second. Acute sounds are in general yielded from bodies that are hard, brittle, and violently shook or struck; but grave sounds from bodies of a contrary nature. Sounds, whether acute or grave, are carried through the air Avith a cele- rity equal to about 1038 Paris feet in a second; but a contrary wind retards their progress about one-twelfth of their velocity. Sounds, as arising from elastic tre- mors, are reflected from hard bodies in angles, equal to those of their incidence ; but the same sound conveyed to the open air, and dilating through an immense sphere, groAvs proportionably weaker; but if it pass through a tube in a cylindrical shape, it is increased; therefore, the sonorous waves of the elastic air being driven into the cartilaginous funnel of the ear, are repelled and col- lected together by alternate reflections from its elastic sides into the cavity of the concha, from whence it pro- ceeds through the auditory passage, with a force so much stronger as the surface of the outer ear is larger than the section of the auditory passage, through which the same force is continued entire fonvard, and in- creased by new reflections, excited from the percussion of the elastic cartilages and hard bones, so as to mix imperceptibly Avith the primitive sound. At the bot- tom of the auditory passage is the membrane of the drum of the ear, called membrana tympani; some- times by the barbarous terms myringa, myrinx. It is a thin, transparent, flattish pellicle, the edge of which is round, and strongly fixed in the circular groove which divides the bony meatus of the external ear from the tympanum or barrel: this membrane consists of several plates, one of which is dry, rattling, splendid, and pel- lucid. It is very tense, easily put into a tremulous motion; and upon it the sonorous waves or modulations of external air strike, move the small bones fixed to it, and it proves a means of sound being readily conveyed to the common sensorium. This membrane is stretched over a cavity in the os petrosum, called the tympanum or drum, Avhich consists of several cavities. In the tympanum, Avhich is of an irregular oblong figure, are t A U K 216 ^ U R the bones of hearing, lodged in its hollow part, between the pars petrosa and squamosa of the temporal bones. The cavities of the tympanum are, the opening of the 'mastoid cells ; that of the Eustachian tube, the canalis nemi petrosus, half bony canal, the fenestra ovalis, and rotunda. Within the tympanum are suspended the bones of hearing moveably; the first of which is the malleus, or hammer, whose handle is fixed to the mem- brane of the drum; and at one end to the second bone, called the incus, or anvil, which it resembles in shape, to which it conveys the tremors impressed upon the membrane: the incus rests on the os orbiculare, a small round bone, and this upon the stapes or stirrup; the stapes and the air of the tympanum press the auditory nerve, Avhence the sense of sound is conveyed to the common sensory. When, by the force of external sounds, the membrane of the drum is forced too much iiiAvard, it is probably supported by air which passes from the mouth through the Eustachian tube into the inner ear. The importance of the cochlea of the ear, in order to the conveyance of the sound, is very consi- derable. For a more minute information, consult Hal- ler's Physiology, and the ingenious observations of Dr. Shebbeare on this subject, in his Theory and Practice of Physic, and the article Sonus. AUGME'NTUM,(from augeo, to increase). AUX- ESIS, (from xv\xvu, to increase). The increase of a disease, from its attack to its height. AUGU'STA. An epithet given to several com- pound medicines. AULI'SCOS, (from ««/*«?, a pipe). See Cathete- rus, and Fistula. AU'RA, (from xtip, air, or rather from the HebreAV term aor,) signifies an exhalation, or vapour, Avhich arises from mephitic caves. The chemists mean by it a certain fine and pure spirit, found in every animal and vegetable body; but so subtle as only to be perceptible to us by its smell. Au'ra epile'ptica. A gradual sensation, like air ascending from some determined part of the extre- mities upwards, occasioning an epileptic attack. In the Ephem. Nat. Cur. An. 3. Obs. 336; and in a treatise of Galen on an epileptic boy, there are evi- dent examples of an epilepsy per consensum ab aurd adscende/ite. Au'ra vita'lis. So Helmont calls the vital heat. AURA'NTIA, (ab aureo colore, from its golden co- lour). Enasce'ntia, and Immatu'ra. See Aurantia CURASSAVENTIA. Aura'ntia hispale'nsis, called also 7nala aurantia fructu acido, 7najor arantia malus, aurangia, mala au- rea, chryso7nelea, nerantia, martianum pomum ; poma anarantia; Seville orange. It is the citrus auran- tium Lin. Sp. PI. 1100. The China and Seville orange are both only varieties of the same species: the latter is only found in our Pharmacopoeias; and the flowers, leaves, yellow rind, and juice, are made use of for different medical pur- poses. The flowers of this tree are highly odoriferous, and are used as a perfume; they are bitter to the taste; they give their taste and smell both to water and to spirit, but most perfectly to rectified spirit of wine. The Avater which is distilled from these flowers is called ol. napha. In distillation they yield a small quantity of essential oil, which is called oleum vel essentia neroli, they are brought from Italy and France. The leaves have a bitterish taste, and yield by dis- tillation an essential oil; indeed by rubbing them be- tween the fingers and thumb they manifest considerable fragrance. Westaerhoef, De Haen,*and several Ger- man physicians, have spoken highly in favour both of the floAvers and leaves, but particularly of the latter, and held them in great estimation as a remedy for epilepsy and other convulsive disorders; but from later experi- ence they have sunk greatly in their reputation. The dose of the leaves in powder Avas from 3 ss- to 3 i. two or three times a day, and in decoction propor- tionably strong. They resemble the laurel and the bit- ter almond, and may oAve their taste also to the prussic acid. , The yelloav rind of the fruit, freed from the white fungous part, is Avarmer than the peal of lemons, of a more durable flaA-our, and abounds more with a light fragrant essential oil, which exudes upon wounding it. Infused in boiling water it gives out nearly all its smell and taste; cold water extracts the bitter, but very little of the flavour. In distillation all the oil rises without the bitter. The yellow rind gives an agreeable flavour to the other medicines, and has deservedly gained the character of a pleasant warm aromatic bitter. Its ex- pressed oil is essence of bergamot. The orange peel is commonly employed as a sto- machic, promotes appetite, and is particularly'useful in restoring tone to the stomach Avhen it has been impaired by excess. It has been also much celebrated in cure of intermittents, and in those of a most obstinate kind; and as a powerful remedy in menorrhagia, and immoderate' uterine evacuations. It is, hoAvever, little more than a light bitter, not very powerful in any of these diseases. The London college direct a syrup and tincture. In the former, eight ounces of the peel are steeped in five pints of water; and in the latter, three ounces of the peel are digested in a quart of proof spirit. The juice of Seville oranges is a grateful acid, which, by allaying heat, quenching thirst, promoting various excretions, and 'diminishing the action of the vascular sanguiferous system, proves extremely useful in both ardent and putrid fevers, though the China orange juice, as impregnated with a larger proportion of sugar, becomes more agreeable, and may be taken in larger quantity. The Seville orange juice is par- ticularly serviceable as an antiscorbutic, and alone will prevent or cure scurvy in the most apparently desperate circumstances. In dyspepsia, putrid bile in the sto- mach, both lemon and orange juice are highly useful. The acid of the Seville orange differs in some of its pharmaceutical properties, both from the fermented acid of vinegar, and from the native acid salts of the leaves or plants : from the former in its not being vola- tile, or not exhaling upon inspissating the juice, nor ris- ing in distillation with the heat of boiling water; from the latter, in its being soluble in spirit of wine: the in- spissated juice liquifies in air, water, or spirit of wine; whence it is easily preserved during many years, either m the form of an extract, or in a spirituous solution. Aura'ntia curassave'ntia. Aure'ntium curas- sa'vense. Curassoa, or curassao, apples, or oranges. They seem to be the immature oranges that by some accident have been checked in their A UR 217 AUR growth. They are a grateful aromatic bitter, of a fla- vour very different from that of the peel from the ripe fruit, and without any acid; what little tartness they have when fresh is lost in drying. Spirit of wine ex- tracts perfectly all their virtue; water imperfectly: infused in Avine or brandy they afford a good bitter for the stomach. They are used to promote the discharge in issues, Avhence their name of issue peas, and to give the flavour of hops to beer. Aurantia Sinensis, called also aurantia dulcis, poma Sinensia, mala aurantia Chinensia, China or SAVEET ORANGES. The rind hath a faint smell, with but little bitterness, and is never used in medicine; the juice hath a grate- ful subacid sweetness, in general of the same qualities as our summer fruits. AURA'TUS GERMANO'RUM, (from aurum, gold). It is an oleo-saccharum with the oil of cinna- mon, called Au'rum horizonta'le. AU'REA ALEXANDRIA. An antidote invented by Alexander. AURELIA'NA CANADENSIS IRO'QU^LIS,(ab aureo colore, from its golden colour). See Gensing. AU'REUS, (from the same). A Aveight equal to a drachm and a half; also a pompous appellation for many compound medicines. Blancard says it was a weight amongst the Arabians of a drachm, a seventh part; the same with denarius. AURICHA'LUM, a corruption of orichalcum. See jEs. AURICO'LLA, (from aurum, gold, and xoXXxu, to glue together). A substance with Avhich goldsmiths solder gold. See Tincal. AURI'CULA (from auris, the ear). The exter- nal part of the ear; which is divided into the upper part called pinna, and the loAver soft part called lobus, or lobulus. The pinna is divided into several eminences and cavities; the eminences are the helix, called also capreolus; avti-helix; tragus, called also anti-lobium; and anti-tragus.' The helix is" the large border round the ear, or the exterior compass of the ear; so called because of its tortuosity. The anti-helix is the large oblong eminence, sur- rounded by the helix. The tragus is the like anterior protuberance, oppo- site to the lobe, beloAV the fore part of the helix, which in the aged is often covered with hairs. The anti-tragus is the posterior protuberance below the inferior extremity of the anti-helix. The name of a muscle which acts only upon the cartilage of the ear. The cavities are the scapha, on the inside of the he- lix; the cavitas inno7ninata or fossa navicularis, at the anterior upper part of the anti-helix; the concha, which is situated under the anti-helix, divided by a septum, which is a continuation of the helix; and the meatus cuditorius externus. The auricula is composed chiefly of cartilage, which gives and preserves its shape. It hath the advantage of being variable, for there are certain small muscles called helicalis major and minor, tragicus, and anti- tragicus, which are peculiar to the ear; they act only upon the cartilage, and contribute to direct it toAvards VOL. I. sound; or by giving a greater tension, to increase its intensity. The external ear is fixed to the cranium, not only by the cartilaginous portion of the meatus, but also by the ligaments, viz. the anterior, which is fixed by one ex- tremity to the r6ot of the apophysis zygomatica of the os temporis, close to the corner of the glenoid cavity, and by the other extremity to the anterior and superior part of the cartilaginous meatus. The posterior liga- ment is fixed by one end to the root of the mastoid apophysis, and by the other to the posterior part of the convexity of the concha, so that it is opposite to the anterior ligament. There is also a kind of superior ligament Avhich seems to be only a continuation of the aponeurosis of the frontal and occipital muscles. The lobe seems to be a doubling of the teguments; it is only skin and cellular membrane. For a particular account of the vessels, &c. see Auris. Auri'cula i'nfima. The lobe of the ear. Besides, it is the specific name of several herbs, from their sup- posed resemblance to ears. Auri'cula le'poris. See Bupleurum. Auri'cula muris. See Alsine. Auri'cula uksi, called also sa7iicula Alpina lutea., yellow bear's ears, oricola,. and French cowslips. It groAvs plentifully in SAvitzerland, Savoy, and many other places ; bears thick, large, green leaves; and on the tops of the stalks there are floAvers of different co- lours. In Utrecht this floAver is called primula odorata, on account of its agreeable smell. The juice removes spots on the face. AURI'CULiE CO'RDIS. Tavo muscular bags at the basis of the heart. See Cor. Auri'cula Ju'd.«, called also fungus sa77ibuci, fun- gus me7nbranaceus, peziza auricudam referens, agaricus auricula forma; jews' ears. Peziza auricula Lin. It is a sort of fungus, which grows on elder trees; its internal use is generally thought not safe, but a decoc- tion in milk has been a much esteemed gargle in the quinsy. AURICULA'RIA, (from auricula, the ear). See Mentha palustris folio oblongo. AURICULA'RIS. See Extensor minimi di- giti. Auricula'ris di'gitus. The little finger is called* the ear finger, because with it we are most apt to rub and pick the inner ear. Auricula'ris me'dicus. A physician for the ear. AURICULA'RIUS. Belonging to the ear, also an ear doctor. AURICULA'RUM SEPTUM. See Cor. AURICULA'TUM, vel AURI'TUM FOLIUM, an eared leaf, from auricula, a little ear; twisted into the form of a little ear, or having an appendage like a little ear: or they are heart shaped, but have the cor- ners prominent and rounded, but with an additional smaller lobe near the base AURI'GA. A wagonner. A sort of bandage for the sides, described by Galen. So called because it is made like the traces of a Avagon-horse. It Avas also a name given by the ancients to a lobe of the liver. They divided the liver into four lobes; the first Avas called focus, from a ridiculous belief that there the food Avas concocted; second, mensa, because they thought the Ff AUK 218 A U R aliments of the limbs were placed there; the third culter; and fourth auriga, as conducive to the distri- bution of the aliments. AURI'GO, (ab aureo colore, from its yellow colour). See Icterus. AURIPIGME'NTUM, (from aurum, gold, and pig- mentum, paint,) also called arsenicum croceum, arseni- cum flavu7n, adarnech, albimec althanaca, ethel; orpin, orpiment, and auripigment. Galen called it arseni- cum, and Serapion narueth. There are three kinds of orpiment; the gold colour- ed; the deep.red mixed with yellow, called andarac, auripigmentu7n rubrum; and the greenish and yellowish, which is the least valuable. The best is a yellow shin- ing sulphureous mineral, consisting of little flakes or scales like talc. If powdered orpiment is set on fire, it will flame, and yield the odour of common brimstone; if a plate of copper is held over these fumes at their first rising, it becomes white and brittle ; an iron plate is also turned Avhite by them; and it is soluble in oil. But, as is the case with crude antimony, its sulphureous combination is such as to render the arsenic inert. If it is kept long in a subliming vessel over the fire, the Avhole mass is raised, and concretes in the upper part of the vessel into a red pellucid substance like a ruby, leaving only a very small portion of metallic earth at the bottom. Some use it for fumigating venereal ulcers; Drs. Boerhaave, Mead, and others, commend its fumes in asthmas; mixed with quick lime it hath been used as a depilatory. The painters use it for a gold colour, with- out the idea of its being poisonous; but if swallowed, its effects are similar to those of the hydrargyrus mu- riatus. Auripigme'ntum ru'brum. See Realgar. AU'RIS, (from a~ura, air, as being the medium of hearing). The ear. The ear is usually divided into. the external and the internal. By the external is meant all that lies without the external orifice of the meatus auditorius in the os temporis; see Auricula. By the internal, all that lies within the cavity-of this bone; the orifice of which is called cyar. For meatus audi- torius, tympanum, and labyrinth, see Labyrinthus, &c. The arteries of the external ear come anteriorly from the arteria temporalis, and posteriorly from the occipitalis. The veins are branches of the external jugulars. The portio dura of the auditory nerve having passed out of the cranium through the foramen stylo- mastoidaeum, gives off a branch, which runs up behind the ear, whence it sends off several filaments to the meatus and fore side of the ear. The second vertebral pair send also a branch to. the ear, the ramifications of which communicate with those of the other branch from the portio dura. The bones of hearing, called malleus, incus, orbicu- lare, and stapes, are placed in the cavity of the tympa- num, immediately on the inside of the membrana tym- pani. The malleus is joined by its handle to the mem- brana tympani, and its round head rests on the incus, the long leg, of Avhich rests on the os orbiculare, which is fixed to the fore part of the stapes, the sole of Avhich rests on the hole called fenestra ovalis. The use of the external ear is tp collect sounds, and to render their impression on the other organs of hear- ing most perfect; this is evident from those who have their ears cut off being obliged to use a horn, or some means to assist them in hearing : all animals, as deer, hares, &c. whose ears have much motion, always direct them so as to meet the sound. Hoav hearing is effected, see Auditus and So- nus. On the ears, see Cassebomius, Du Verney, Valsalva, Celsus, and Winslow's Anatomy. They treat either of the anatomy or the disorders of the ear. Au'ris marina. Au'rmar. A shell fish very com- mon on the coast of Scotland, Guernsey, Normandy, Sec. It is shaped like an ear, it adheres to rocks, and to render them eatable they are first boiled, then fried. AURISCA'LPUM, from aurem scalpere, an ear picker. A'URIST, an ear doctor. AU'RUM,(from aor, resplendence, a Hebrew term). Gold ; called also sol, and rex metallorum, deheb, cor. The filings are named catma; the chemists call it sol, because they thought it to be under the influence of the sun. Its_character is a circle with a dot in the middle, thus O, denoting a body perfectly inacrimonious, smooth, and equal. The greatest part of what we have comes from Ame- rica, particularly from the mines of Peru ; but the Asi- atic is esteemed the finest. Sometimes it is found pure and unmixed in small grains or in large lumps, and is then called virgin gold ; but it generally rises in ores of different kinds: its chief matrix is flint; and all sand contains a greater or less quantity of it. Gold is somewhat more than nineteen times heavier specifically than water. The Arabians introduced it into medicine; Avicenna esteemed it for its cordial quality, and a comforter of the nerves; but as in every state it is insoluble by any of the animal fluids, it can only be an amulet against poverty. It is not surprising, hoAvever, that the alchemists, to whom we are indebted for so many chemical remedies, should have tortured this metal for the service of the art of healing. The cordial qualities were supposed to assist medicines of this class; and even a heated mass of gold, extinguished in a fluid preparation, gave it the name of solar. The pure leaf gold has been employed Avith some success to exclude the access of air; and in some measure to prevent the pits of the small pox; and as a defence to sore nipples from the saliva of a child, particularly when affected with aphthae. The aurum-fulminans has been employed as a medi- cine since the time of Crollius, and its use has been lately revived. It is gold precipitated from its solution in aqua-regia (nitro muriatic acid) by a volatile alkali; or, if the sal ammoniac is added to the nitrous acid to form the aqua regia, the fixed alkali will answer the same purpose. Whether from careless washing, or from the metal itself, the worst effects have followed its exhibition; and colics* convulsions, faintings, and cold sweats, have been the consequences. In smaller doses it is said to be an useful sudorific in the Avorst fevers; and Angelus Sala observes, that it is a certain and easy laxative. Lemery has supposed, from chemi- cal views, that it may be of service in diseases arising A U T 219 A V T from a too copious use of mercury; and modern prac- tice, from the usual tonic poAvers of metals, has employ- ed it, apparently Avith success, in chorea. Some other preparations of gold may he shortly men- tioned, though many of these supposed to contain it have not a particle of the metal in the whole composi- tion. The aurum potabile, tinctura solis, with many other sounding applications, are of this kind. The pre- paration is either concealed or described Avith a suspi- cious reserve; but it seems to be only an ethereal oil coloured Avith gold, or some substance resembling its golden hue. The aurum vita of Quercetanus is a calx of gold dissolved in vinegar, seemingly by the medium ot spirit of wine. The magisterimn auri is the aurum fulminans, digested repeatedly with the spirit of baum, and mixed with ^ of ambergrise, as much musk, and 2^ of saffron. This preparation, in a dose of from three to five grains, is said to be tonic, antiseptic, alexiphar- mic, and antispasmodic. It is the foundation of many other preparations which are exuberantly extolled, but Avhich modern practice rejects. We shall notice but one other, which merits some notice, as it is honoured with a place in the Wirtemberg Dispensatory ; and if any preparation of gold is useful, this promises to be so. It is styled cornu cervi auratum; and consists of leaf- gold very carefully rubbed with powdered hartshorn, and calcined in a crucible till it assumes a purplish co- lour. It is used in malignant fevers; in measles and small pox as a cordial; but may probably be an useful tonic. Au'rum ele'mpium. See Succinum. Au'rum horizo'ntale. See Auratus Germano- rum. Au'rum pota'bile. See Lentsigus. Au'rum lepro'sum. See Antimonium. Au'rum vegeta'bile. A name given to saffron. npp Crocus AUR'US BRASILIE'NSIS. See Calamus arom. AsiATICUS. AU'STER, (from xvu, to burn). The south wind, which is Avarm, moist, and productive of putrid diseases. It means also austere, and arises from the union of acid with astringent particles, such as in unripe fruits. AUSTROMA'NTIA, (from xvo-r^, the wind, and u.xvnx, divination). Pretending to tell events from ob- servation of the winds. AUTA'LIS. See Dentalium. AUTHE'MERON, (from xvros, the same, and wepx, a day). The very same day. A medicine is thus called that gives relief on the same day it is taken. Ga- len describes two remedies of this kind. AUTOPHO'SPHORUS, from xvlos, itself, and $ao~$opos, phosphorus: real phosphorus). See Phospho- rus. AUTO'PSIA, AUTOPSY, (from xvlos, hi7nself, and BTrjofjLxi, to see). Occular evidence. AUTO'PYROS, from xvlos, itself, and srvpos, wheat). See Bread. AUTU'MNUS, (from augeo,auctum, because, Festus says, at this time the fruit of the earth, and the labours of men, are increased). Autumn. The season of the year between summer and Avinter, beginning astrono- mically at the equinox, and ending at the solstice : po- pularly it comprises August, September, and October. Celsus Avisely advises^ people to begin early in this season to wear warmer clothes, for the irregularity of the weather subjects them to a variety of diseases. AUXE'SIS. See Augmentum. AUXILIA'RII MUSC, (auxilium, assistance). See Pyramidalis musculus. AU'XYRIS, (a corruption of Osyris). See Asyris. AVACCARI, (Indian). A little tree, the leaves, fruit, and flowers of Avhich resemble the myrtle; but it is more astringent. It grows on mountains in the province of Malabar, and is used against dysenteries ; but not yet described so clearly that its systematic ar- rangement can be ascertained. AVARA'MO, (Indian). The name of a siliquose tree which grows in Brasil. Its bark is externally of an ash colour, and internally very red ; both it and the leaves are astringent: a decoction of the bark hath been" supposed to dry ulcers, and is said to have cured cancers. Raii Hist. It has not been noticed by syste- matic authors. AVELLA'NA, (from Abella, or Ave/la, a tOAvn in Campania where they grow,) corylus avellanalAn. Sp. PI. 1417. The hazle nut. Miller takes notice of six sorts ; viz. the hazle nut, the small manured ditto, the large cob nut, the Spanish nut, the red filbert, and the Avhite filbert. The iuli, or katkins, which grow on the trees early in the spring, and the shells, are restringent or binding. An emulsion made of the kernels of nuts or filberts, and mead, is commended in coughs. Filberts nourish more than nuts; but the oil is so closely united with the mucilage that they are very indigestible ;_the roundest kernels are most esteemed. They all afford a considerable quantity of. an agreeable soft oil by ex- pression. Avella'na catha'rtica. See Cataputia mi- nor. Avella'na Mexicana. See Cacao. Avella'na purga'trix. See Cataputia minor and Ben. Avella'na India'na versico'lor. See Areca. AVELLA'NiE I'NDICiE GENUS OBLO'NGUM. An inferior species of nutmegs. AVE'NA, (from aveo, to covet, because cattle are very fond of them). A. sativa Lin. Sp. PI. 118. Oats. The two kinds, the black and white, have similar virtues, but the black ones are preferred for horses, as more nutritious; they are less so than rice or wheat, yet afford a sufficient nourishment to as active and vigor- ous a people as the world produces; viz. the High- landers. Gruels made Avith the flower, called oat meal, digest easily, have a soft mucilaginous quality, by which they obtund acrimony, and are used for com- mon drink and food in inflammatory disorders, coughs, hoarseness, roughness and exulceration of the fauces. A subacid jelly made with oats is a pleasant summer food, and highly useful as an antiphlogistic diet in fevers. It is called sowins, sometimes frumenty. Water gruel answers all the purposes of Hippocrates' ptisan : it forms externally, with vinegar and oil, emol- lient poultices for sprains and bruises, and stimulant ones with the grovmds of strong beer for tumours, of a gangrenous tendency, or in poor emaciated habits. For that named Gr^ca and Sterilis, see JEgt- lops. AVE'NQUA. See Adianthum Canadense. F f 2 A X I 220 A Z I A'VENS. See Caryophyllata> AVER'SIO, (from averto, to turn from). The di- verting of a flux of humours from one part to another; a nausea or inappetency ; the recession of the uterus from its proper place. A'VES, CY 'PRIjE. See Candela fumalis. AVICE'NNIA TOMENTO'SA. See Anacar- dium. AVIGATO PEAR, laurus persea Lin. Sp. PI. 529. A nutritious tropical fruit, supposed to be antidysente- ric. The sailors eat the unripe fruit as an antiscor- butic. A'VIS ME'DICA, (from avib, HebreAv). The pea- cock. See Aliment. AVOIRDUPOIS. This, in the French language, signifies to have weight; because the pound so called contains sixteen ounces, and hath more Aveight by some ounces than that Avhich is called Troy weight, Avhich contains twelve ounces; more probably from its being employed in weighing the heavier articles. AVO'RNUS. See Alnus nigra. AVRA'RIC. See Argentum vivum. A'VRUM. See Succinum. A'XEA COMMISSU'RA. See Trochoides. AXE'DO. The name of a spell in Marcellus Empi- ricus, to render a person impotent. AXI'LLA, (Atzil, Hebrew; but Scaliger derives it from ago, to act, and from thence axis, and axilla). The arm pit, called also mascale, titillicum, male. When an offensive smell is perceived from the arm pit, Diosco- pides and -ffitius recommend the decoction of wild arti- choke in wine, which, by bringing off much fetid urine, may produce a cure. See also Ala. AXILLARES GLANDULE. Conglobate glands in the axilla, through which the absorbents of the up- per extremity pass. AXILLA'RIA ARTE'RIA. The subclavian ar-, tery having left the thorax immediately above the , first rib, in the interstice between the portions of the scalenus muscle, there receives the name axillary, be- cause it passes under the axilla. This axillary artery detaches the external mammary arteries to the breast; and lies behind, on the inside of the coraco brachiaeus : when it has got to the under side of the subscapularis, it gives off a branch to that muscle, the serratus major anticus, 8cc. The axillary artery gives off the inferior scapular, which passes backwards, chiefly to the infra spinatus. Just below the head of the humerus, the axillary throws off the humeral or articular artery, which, passing round the joint, anastomoses Avith its felloAv. The"axillary artery commonly runs doAvn be- hind the tendon of the pectoralis major, then passes over the coraco brachiaeus, goes down on the inside more and more forward, just covered by the inner edge of the biceps, passes under the aponeurosis of that muscle; and a little below the bend of the arm, be- tween the pronator teres and supinator radii longus, divides into the radial and ulnar arteries. AXILLA'RIS NE'RVUS. The axillary nerve; also called the articular nerve, arises from the last tAvo cervical pair; it runs in the hollow of the axilla, behind the head of the os humeri, between the muscu- lus teres, major and minor, and turning from within outwards and backwards round the neck of the bone, runs to the deltoid muscles. Axilla'ris vena. The axillary vein, is the continuation of the subclavian from its passage out# of the thorax to the opposite side of the axilla. A'XIS, (from ago, to act). That round which any thing revolves or is supposed to revolve. With anato- mists it is the name of the second vertebra, and ac- cording to some the first vertebra, of the neck ; it hath a tooth Avhich goes into the first vertebra, and this tooth is called the axis, by others the axle. Blancard says it is the third vertebra from the skull. A'xis arte'ri.s cceli'ace. See Cceliaca ar- teria. AXU'NGIA, from its use, wiguendi, axem. Hog's lard. See Adeps. Axu'ngia casto'rei. See Castor. Axu'ngia de mumia. See Medulla. Axu'ngia vitri. Sandiver, or salt of glass ; it separates from glass whilst making; it is acrid, and hath been used to clean the teeth., AYAPA'NA. A plant brought to the Isle of France from the Brasils, supposed to be a certain remedy for phthisis and the bites of serpents; but, as Bory in his late voyages informs us, is really useless. AYBO'RZAT. See Galbanum. AY'CAPHAR, and AY'COPHOS. See Ms us- tum. A'ZAC, (from asak, Arabic). See Ammoniacum. A'ZADAR ACHE'NI A'RBOR. See Azeda- RACH. AZA'GOR. See jErugo. AZA'NITiE A'COPON. The name of an acopon or ointment, in P. JLgineta. Aza'nit^ cera'tum. The name of a cerate in Oribasius. A'ZAR. See Adrop. AZA'RNET. See Auripigmentum. A'ZED. An inferior kind of camphor among the Arabians. The finest Avas called alcansuri; the second abriagi. The first Avas the natural exudation from the tree; the second was a very pure kind carefully sub- limed. The azed was the present camphor of commerce. AZE'DARACH, AZE'DRACHINI, (Indian). Called also pseudosycomorus, azadar, tacheni arbor, ar- bor fraxini folio flore cceruleo, zizipha Candida, ana- bepou. Acostcs zodoaria Candida. Melia azederach Lin. Sp. PI. 550. It is a tall tree in the island of Ceylon, and other parts of the East Indies. It resembles an ash; the fruit is like an olive, and from it oil is expressed for staining cotton : the pulp of the fruit is said to be poisonous, but the taste is not disagreeable. Another species is a native of the coast of Malabar; the m. azede- racta Lin. Sp. PI. 550, The oil expressed from its fruit is used to cure bites of serpents, and to restore flexi- bility to contracted limbs. The leaves, infused in juice of lemons, are supposed to be vulnerary and anthel- mintic. Wildenow has described two other species of similar virtues. See Raii Hist. AZE'DEGRIN. See Hematites. A'ZEFF. Scissile alum. See Alumen. A'ZEG. See Vitriolum. AZEMA'FOR. Red lead. See Plumbum. AZEMA'SOR, and AZYMAR. See Cinnabaris. AZE'NSALI, A sort of moss that grows on rocks. A'ZIMAR. Burnt copper. See jEs ustum. A Z Y 221 A Z Y A'ZOTUM, AZO'TICUS GAS, (from x, non, and £»w,vitd). Azote, azotic gas. This is the noxious part of the atmospheric air; see Aer. Formerly call- ed phlogisticated air; and atmospheric mephitis. It has been called azote by modern chemists, because the chemical properties of the noxious portion of atmo- spheric air being hitherto little known, they have thought it right to derive the name of its base from the known quality of killing such animals as breathe in it. It is a tasteless, inodorous element, existing in a large- proportion in the atmosphere, and is obtained copiously from the fibrous parts of animals by means of nitric acid. Mixed with vital air or oxygen, in the proportion of 72 to 28, it forms air similar to atmospheric air; combined with hydrogen, it constitutes volatile alkali; and Avith carbon, the gluten of animal fibres; it is the basis of the nitrous acid. The weight of this gas, at the temperature of 54, 50, and under a pressure equal to 28 inches of the barometer, is 1 oz. 2 drachms and 48 gr. to the cubical foot, or 0.444 of a grain to a cu- bical inch; and to common air it is as 942.6 to 1000. See Lavoisier's Elements of Chemistry. According to Kirwan, it is as 985 to 1000. We have much reason to suppose, as already hinted, that a larger proportion of azote in the air we breathe might be medicinally useful; but on this subject there are many doubts; and until it can be separated from ignorance, presumption, and quackery, such doubts must remain. AZOTH, is a name for brass. It sometimes signi- fies the quicksilver of any metallic body. See Rebis. A'ZRAGAR. See Mrvgo eris. A'ZUB. See Alumen. A'ZUR. See Corallium rubrum. A'ZURIUM. A chemical preparation described by Albertus Magnus. It consists of quicksilver two parts, sulphur one-third, sal ammoniac one-fourth, mixed in a mortar, and set in a vessel over the fire till a bluish smoke arises: it must be then taken from the fire, the glass broke, and the contents powdered. A'ZYGES, (from x, neg. and tvyos, a yoke). See Sphenoides os. AZ'YGOS MORGA'GNII. See Staph^lini AZ'YGOS, vel A'ZIGOS, (from x, neg. and £vyo4, a pair; without a fellow). The musculus azygos of Morgagni rises tendinous from the junction of the ossa palati, and runs down the palatum molle to the middle of the uvula, serving to elevate it. A'zygos proce'ssus. See Sphenoides os. A'zygos ve'na. Vena sine pari. A vein situated within the thorax on the right side, having no fellow on the left. It arises posteriorly from the vena cava superior, a little above the pericardium; it is immedi- ately bent backAvards over the origin of the right lobe of the lungs, forming an arch which surrounds the great pulmonary vessels on that side, as the arch of the aorta does on those on the left, with this difference, that the curve of the azygos is directly backwards, but the other is oblique: from thence it runs doAvn by the right side of the vertebrae dorsi, and before the inter- costal arteries; and passing behind or beloAV the dia- phragm, it terminates by an anastomosis, sometimes with the vena renalis, at others with the neighbouring lumbar vein, sometimes immediately with the trunk of the vena cava inferior. The vena azygos sends out branches from its upper part to the aspera arteria and bronchiae by the name of venae bronchiales; afterwards it sends out the inter- costales dextre superiores; lower down, the intercosta- les dextrce inferiores. Sometimes there is an azygos on the left side, pro- ceeding from the arch of the common azygos: it is afterwards distributed in the same manner as the other on the right side; but this disposition is very variable. The azygos having reached the last rib, sends off a large branch, which, bending outwards, perforates the muscles of the belly, is ramified betwixt different planes, and communicates with the branches of the intercostal veins which run there. A'ZYMOS, (from *, neg. and &/**> ferment). Un- fermented bread, as sea biscuit, which, Galen ob- serves, is not very wholesome, except were the digestive poAvers are too strong. See Bread. 222 B. BAG BAL Jt_B • See Argentum vivum. BABUZICA'RIUS, (from £»£«£•, to speak^ inar- ticulately; because the voice is apt to be inarticulate and confused in this disorder). See Incubus. BA'CANON. Cabbage or rape seed. BA'CCA MONSPELI'ENSIS. See Baccharis. BA'CCtE, are small roundish fruit that grows scat- tering upon trees and shrubs, and in that are distin- guished from acini, which are berries han gin gin clusters. Bacce norlandicje, the berries of the rubus arc- ticus Lin. Sp. PI. 708. Supposed to be cooling anti- septic, perhaps antiscorbutic. Ba'cce bernu'djE. See Saponari/e nucule. BA'CCAR, BA'CCHARIS, (from bacchus, wine,) from its fragrance resembling that liquor. Also called bacca Monspeliensis, conyza tertia Dioscorides, eupato- riu7n. Inula dysenterica Lin. Sp. PI. 1237. Great flea bane, ploughman's spikenard. It is a sweet- scented shrubby plant, used for making garlands; and delights in rough and dry grounds. The roots smell like cinnamon, and are a powerful emmenagogue; the leaves moderately astringent. BA'CCHIA, (from bacchus, wine, because it gene- rally proceeds from hard drinking and intemperance). See Gutta rosacea. BA'CCHICA, (from Bacchus, because he Avas gene- rally croAvned Avith it). See Hedera terrestris. BA'CCHUS. The fish called mullet. See Mu- cins. BA'CCIFER, (of bacca, a berry, and fero, I bear). An epithet added to the name of any tree, shrub, or plant, that bears berries. BACHE'RI PILULE TONICiE. See Ascites. BACI'LLI. See Trochisci. BACI'LLUM. See Candela fumalis. BA'DIAGA. A kind of sponge usually sold in Russia, the powder of which takes away the livid marks of blows and bruises within a few hours. It differs, however, from the sponges and alcyoniums,asit is full of small hard grains, connected by friable herbaceous fibres, and groAvs under the Avater. It is only described by Bauxbaum, and its nature is not properly understood. BA'DIAN. SEM. See Anisum Indicum. BiE'OS. In Hippocrates it means few; but in P. jEgineta, it is an epithet for a malagma- BAGNIGGE WELLS WATERS. These Avells are situated at the bottom of the hill on the south- west side of Islington; the water is clear, and taste* slightly brackish, like a weak solution of Epsom salt. From a gallon of this water evaporated, Dr. Bevis obtained 135 grains of insoluble earth, 257 of bitter purging salt, mixed with a marine salt, from whence they derive their purging quality. Dr. Monro thinks it probable that the salt of this water is mostly an Epsom salt, with a good deal of a bittern; because it runs easily per deliquium, and is very difficult to crystallize. - In most constitutions three half pints are considered a full dose for purging. BA'GNIO. (from bagno, Italian). A" sweating house. BAGS. Various medicinal substances were usually confined in thin bags, and applied to the part affected.. These were chiefly cordials applied to the pit of the stomach in deliquia; anodynes and antispasmodics to the pit of the stomach in hysteria and colic; and seda- tives or discutients to the head in its diseases. Malt liquors are medicated or perfumed by substances in bags; and clothes scented in a similar way. BA'HEI COYO'LLI. See Areca. BA'HEL SCHU'LLI. An Indian tree; also called genista spinosa Indica verticillataflore purpureo caru- leo. It resembles the barleria buxifolia Lin. Sp. PI. 887; but is probably not the same, as the latter is repre- sented in Rheed's 42d table, but the real species occurs in the 45th. It is of the family of the canthoides, and is a thorny shrub, of which there is one species growing in sandy ground, another in watery. A decoction of the roots is diuretic; the leaves boiled and sprinkled in vinegar have the same effect. Raii Hist. BA'IAC. See Plumbum. BA'LA. See Musa. BAL^'NA, major and vulgaris, (from (ixXXa, to cast, from its power in casting up water). See Cetus. Bale'na macroce'phala. See Cete admirabile. BALAMPU'LLI. See Tamarindus. BA'LANDA, (from (ixxxivos, a nut). See Fagus. BALANI'NUM, OL.(from p>xXxtvos,an acorn). Oil of the Ben nut. B ALANOC A'STANUM, (from flxXxivos, a nut,and xx B A O 230 BAR samum Lin. Sp. PI. 549. It is of a reddish yellow, transparent and tenacious, but from age brittle. The $mell is fragrant, the taste slightly warm and aromatic. It consists of oily, with a slight proportion of resinous, particles, united with a large one of benzoic acid, and is from hence partly soluble in watery liquids, though it is wholly dissolved in spirit of Avine. The watery solution is the basis of the old syrupus balsamicus, noAV syrupus tolutanus; and, in spirit, it forms the tinctura balsami tolutani. It is little employed in medicine, though it is at least a safe, if not an effectual, expecto- rant. In gleets it is sometimes useful, and has been applied to wounds and ulcers, when a slight stimulus was required. Balsamum vitje, beaume de vie, consisted of a great variety of the warmest and most grateful essential oils, with balsam of Peru, dissolved in highly rectified spirit of Avine; but it is now greatly abridged in the number of ingredients, and little used. BAMBA'LIO, (from ^x^Qxivu, to stammer). A man that stammers or lisps. BA'MBAX. See Bombax. BA'MIA MOSCHA'TA. See Abelmosch. BAMMA, (from fixifla, to emerge). See Embamma. BANA'NA, BANANIE'RA, (Indian). Called also ficoides, or ficus Indica, musa fructu cucumerino bre- viori, senoria, pacaira, and the banana or plantain tree. It is the musa sapientum Lin. Sp. PI. 1477. The parent tree of all the American bananas, is the m. bihai. Nat. order seitaminea. It groAvs in America; its fruit is diuretic, heating, and highly nutritious. BANDAGE. See Deligatio and Fascia. BANDU'RA; called also planta mirabilis distilla- toria ; utricaria; priapus vegetabilis; Nepenthes. It is the Nepenthes distillatoria Lin. Sp. PI. 1354. It is a plant which grows in the thick forests of the island of Ceylon, where its long fibres supply it with water, and where no sun comes to exhale it. Its seeds and seed vessels are like those of gentian; but it is most remark- able for a foliacious sheath about a foot long and as thick as a man's arm; and for its appendages at the ends of its leaves, which turn up, and contain a cooling limpid liquor, as does its sheath, which is half full and potable. The root is astringent; the liquor in the sheath is cool- ing ; it grows not far from Columbo, in moist shady woods. Raii Hist. BANGU'E, (Indian). Cannabis hidica Lin. cans- java, called by the ^Egyptians assis ; asserac cannabis peregrina, althea foliis cannabinis, kalengi-cansjava, tsyeru-cansjava. It resembles hemp in its stalk, the rind of the stalk, and the leaves; but its medicinal qualities differ very much. The seeds and leaves are heating and intoxi- cating. When in pain the Hindoos mix it with opium: when their object is mirth and intoxication, with musk, amber, and sugar. It grows in Indostan, and other v parts of the East Indies. BA'NICA. See Pastinaca silvestris. BANI'LIA, BANILAS. See Vanilla. BANKSIA. B. Abyssinica Bruce. The flowers are chiefly employed for ascarides in Abyssinia. A hand- ful is infused in two quarts of beer. It is not the same plant with the banksia of the Supplementum Planta- rum, and has not yet found a place in botanical systems. BAO'BAB, BAHOBAB. It is the adansonia baho- bab Lin. Sp. PI. 960, of the natural order i7ialvace<£. The tree is the largest production of the whole vegeta- ble kingdom. The trunk is not above twelve or fifteen ' feet high, but from sixty to eighty-five feet round. The lowest branches extend almost horizontally; and as they are about sixty feet in length, their own weight bends their extremities to the ground, and thus they form an hemispherical mass of verdure about one hundred and twenty, or one hundred and thirty feet in diameter. The centre root penetrates far into the earth; the rest spread near the surface. The floAvers are in proportion to the size of the tree; and are followed by an oblong fruit pointed at both ends, about ten inches long, five or six broad, covered with a kind of greenish down, under Avhich is a rind, hard, and almost black, marked with rays which divide it lengthways into sides. This fruit hangs to the tree by a pedicle two feet long and an inch in diameter. It con- tains a whitish spongy juicy substance of an acid taste, and seeds of a brown colour and the shape of a kidney- bean, which are called goui. The pulp that surrounds these seeds is powdered when dry, and brought into Europe from the Levant, under the name of terra sigil- lata Lemnia. It grows on ths west coast of Africa, from the Niger to the kingdom of Belin. The kernel of the fruit contains a large proportion of alkali when burnt, and the negroes mix it with palm oil to make soap. The bark of this tree is called lalo ; the negroes dry it in the shade, then powder and keep it in little cotton bags, and put two or three pinches into their food; it is mucilaginous, and powerfully prevents too violent perspiration. The mucilage obtained from this bark is a powerful remedy against the epidemic fevers of the country that produces these trees; so is a decoction of the dried leaves. The fresh fruit is as useful as the leaves for the" same purposes. BA'PTES, a fossil medicinal substance, noAv un- known ; probably a bitumen. BA'PTICA CO'CCA. See Chermes. BA'RAMETZ, and BA'ROMETZ, a plant some- what resembling the shape of a lamb. See Agnus Scythicus. BA'RAS. (Arabic). See Alphus. BA'RBA, a beard. Some vegetables have the spe- cific term of barba given them, as their ramifications are bushy like a beard; viz. Ba'rba aro'nis. See Arum. Ba'rba caprina. See Spir^a ulmaria. Ba'rba hirci. See Tragopogon. Ba'rba Jovis. See Sedum. BARBADOES TAR. See Petroleum Barba.- DENSE. Barbado'es che'rry, the fruit of the malphigia glabra Lin. Sp. PI. 609, resembling the inferior of our cherries. BARBAREA. Herba sancta Barbara, nasturtium hybernum, pseudobunias, eruca lutea latifolia, sisymbri- um, carperitaria, winter cresses, garden rocket, rocket gentle, erysimum barbarea Lin. Sp. PI. 922. This plant resembles the mustard, but is distinguish- ed by the smoothness of its leaves and its disagreeable smell. It resembles in quality the cresses, and is a na- tive of Switzerland, but cultivated in our gardens. BAR 231 B A R The wild rocket, called eruca silvestris, sinapis alba Lin. It grows on old walls and amongst rubbish. Its qualities are much the same as the former, but its taste is somewhat more acrid and bitter. The active matter of the leaves is extracted by ex- pression ; by infusion in boiling water; and by diges- tion in rectified spirit. By distillation in water, a pun- gent yellow oil is obtained; by drying, the disagreeable smell and pungency are destroyed. The pungency of the seeds is less volatile, similar to, though Aveakerthan those of mustard. BARBA'RIA, BARBA'RICUM, (from barbarus, wild; because it was brought from a Avild country). See Rhabarbarum. BARBAROS'SA Pil. Barbarossa's Pill. It Avas composed of quicksilver, rhubarb, diagridium, musk, amber, &c. and was thejirst internal mercurial medi- cine which obtained any real credit. See Ajrgentum vivum. BA'RBARUM. The name of a plaster in Scribonius Largus. BARB'OTA. The barbut. A small river fish, Avith a very large head. It is generally about six inches long; it lives on mud and slime; is found in the river Avhich-runs from Tamworth, in Warwickshire. The roe, as well as that of the eel pout, operates both up- Avards and dowmvards. BAREGE WATERS. This appellation is given to four springs near the foot of the Pyrenees on the side of France. Their heat is from 73° to 120°. They contain sulphurated hydrogen, united to a small proportion of soda and some sea salt. The water is however very pure, scarcely exceeding in specific gravity distilled water. It is chiefly useful externally from its heat, and in cutaneous diseases from its sulphureous impregna- tion. It is supposed to be useful in atony of the sto- mach and calculous complaints. See Balneum. BARDA'NA. Burdock. Arctium^ betonica Bri- tannica. By Myrepsus called ilaphis. It grows on high- Avay sides, and is sufficiently known by the burs which stick to the clothes. Barda'na major, called also lappa major, personata aretium Dioscoridis; clotbur, or great burdock. It is the aretium lappa Lin. Sp. PI. 1143. The roots have a little faint smell, but a sweetish taste, with a light austerity. Boiled in Avater, they impart a brownish colour, and a vapid taste. Extracts, however made, are as insipid as the root. They are chiefly commend- ed as diuretic, diaphoretic, and antiscorbutic, and have been successfully employed in rheumatisms, the lues venerea, scurvy, gout, pulmonic complaints, and in all cases where China and sarsaparilla roots, which they resemble, are prescribed. The leaves are bitter, and more saline than the roots, and have no sweetness. The seeds are extremely bitter, and very slightly aromatic. A drachm proves diuretic; but the prickly matter on their surface must be well removed before administering them. The best method of using this plant as a medicine is in the form of a de- coction, in which two ounces of the roots are boiled in three pints of water to a quart; to this two drachms of vitriolated kali have been usually added. Of this decoc- tion a pint should be taken every day in scorbutic and rheumatic complaints; and when intended as a diuretic, in a shorter period. Barda'na minor, called also lappa minor, xanthium, charadolethron; by iEtius, the lesser burdock, or louse bur. Xanthium strumarium Lin. Sp. PI. 1400. From this roughness of the fruit it is called a burdock, though not in the least allied to that plant. It grows in rich fat soils, and is found on some commons. Its juice is commended against scrofulous disorders. Barda'na arcticum, called also lappa major mon- tana, personata altera, arction, and woolly headed burdock. Its virtues are much the same with the other species of burdocks, and it is a variety only of the a. lappa. BARI'GLIA, BARI'LLA, so called from the place where it is produced. See Anatron. BARLEY. See Hordeum. Barley. (Indian). See Verbascum cevadilla. BARNET WATER. It is of the purging kind, of a similar quality to that of Epsom, and about half its strength. BARO'METRUM, barometer, (of fixpos, weight, and (JLerpov, measure). An instrument to determine the weight of the air, or observe the changes of weather; it is commonly called a weather glass, and fre- quently the Torricellian tube, from Torricelli its in- ventor. The bore of the common tubes is too small. The glass tube should be one third, or at least one fourth of an inch in diameter, hermetically sealed at one end, and open at the other; the length should be thirty-four inches: the mercury Avith which it is filled must be pure. Fill the tube quite full with this mercury; and having in readiness a basin with a flat bottom, and about two inches high, in which is also some mercury, invert the tube, and put it in the basin, still holding your finger underneath it till it is in the mercury of the basin, then place it in a frame. On taking away your finger, the mercury in the tube will immediately sub- side to about twenty-nine or thirty inches, according to the state of the air, it being very rarely lower than twenty-eight, or higher than thirty inches, when the air is heavy. If a scale of four inches be divided into tenths, and placed against the upper end of the tube, the instrument is complete, and equal to every change. The mercury, however, still contains some air en- tangled with it, which will in time rise to the upper part of the tube, and not only .by its pressure prevent the rising of the mercury, but by its expansion, from a change of temperature, produce many irregularities in the motion of the quicksilver. The tube may be pre- viously cleaned by a wire, to the end of which a bit of leather is attached, and this will lessen the quantity of entangled air; but, to render the instrument per- fect, the mercury must be boiled in the tube. We once separated in this manner more than an inch of air. The barometer measures the weight of the air with sufficient exactness for the general purposes of life, yet it is affected with many irregularities, that no exactness in the instrument can remedy, and no theory explain. Many of these irregularities can be however explained, by considering the mercury as suspended, not only by the weight of the air, but in part by its elasticity. The barometer is, in reality, a monometer. Moist air is very inelastic, the mercury of course falls; and the human body, from a diminution of the tone which pres- BAR 232 BAR sure gives, feels a languor. Dry air produces a contrary effect; and Saussure found, that water evaporating, produced a gas of very considerable elasticity. When high winds bloAV, the mercury is generally low; it rises higher in cold weather than in warm; and.is usually higher in the morning and evening than at mid day : it generally descends lower after rain than it was before it. On advancing up high mountains, the air is less and less dense, and usually the same inconveniences are felt that are complained of when the air is moist. But M. De Luc and his companions observed, when at the summit of the Buet, 3315 English yards above the level of the Mediterranean, no difference in the effects of the diminished density of the air, which was one third less than that of the plains below them. In this place, M. De Luc observes, ' how much naturalists are deceived in attributing the alterations that many persons expe- rience, upon the falling of the barometer, to a difference either in the Aveight or density of the air. For if these changes, he says, could so sensibly affect our organs, Avhat would become of those chamois hunters, who pass every day from the bottom of the vallies to the highest mountains ? These people perceive no inconvenience; even asthmatic people find little, notwithstanding the barometer varies in these several places, as is usually observed in other similar ones.' If, however, our feel- ings are connected not only with the actual Aveight but the elasticity of the air, these difficulties Avill vanish; for the highly elastic gas which is produced by evapor- ating water, rises to the upper regions of the atmo- sphere, and compensates for the want of density. M. De Luc's reasoning, however, is very vague and incon- clusive. Those accustomed to considerable changes of any kind, experience but little inconvenience from them; and other travellers have really found considera- ble languor on these very elevated spots. The barometer may be applied to several uses, as measuringthe heights of mountains: for twelve thousand and forty inches of air being equal to one inch of mer- cury near the surface of the earth, twelve hundred and four inches, or one hundred feet, must be equal to one tenth of an inch of mercury. Consequently, if a baro- meter be carried up any great eminence, the mercury Avill descend one tenth of an inch for every hundred feet that the barometer ascends. This we do not mean as a correct vieAV of the subject, for many circumstances must be attended to in the actual measurement of heights, particularly the temperature. To consider all the necessary corrections is not a part of our subject. See De Luc, Saussure, Trembley, and Sir G. Shuck- burgh's papers in the Philosophical Transactions. But the great use of the barometer is to predict the future state of the Aveather for several hours, and some- times days preceding, in many instances to a degree of probability. 1st, The rising of the mercury presages fair weather, and its falling, wet.. 2d, In very hot wea- ther, the sudden falling of the mercury foretels thun- der. 3d, In winter, its rising portends frost; and in a continued frost, foretels siioav. 4th, When foul wea- ther happens soon after the falling of the mercury, it Avill soon again change, and so on the contrary. 5th, When the mercury continues to rise for some time be- fore the foul Aveather is over, expect a continuance of fair weather to follow. 6th, In fair weather, Avhen the mercury continues to fall before rains come, then ex- pect a great deal of it, and probably high winds. 7tft, The unsettled motion of the mercury denotes change- able weather. It is not so much the height of the mercury that in- dicates the Aveather, as its motion up and down; there- fore, to know whether the mercury is actually rising or falling, observe whether the surface of the mercury be convex, for it is then rising: if the surface be concave, it is falling: if the surface be plain, or a little convex, it may be considered as stationary. There are different forms of this instrument which have each their advantages and disadvantages: but the common sort is perhaps better than any other if care- fully constructed. BARO'NES. Small worms; called also nepones. BA'ROS. (Greek). Gravity. Hippocrates uses this word to express by it an uneasy weight in any part. Ba'ros. See Camphora. BARTHOLINIA'NiE GLANDU'LjE, (from the discoverer Bartholine). See Sublinguales Glandule. BARYOCO'CCALON, (from frxpvs, grave, and koxxxXos, a nut; so called because it gives a deep sound). See Stramonium. BARYPHO'NIA, (from (ixpvs, dull, and ?«»«, the voice). A difficulty of speaking. BARYPI'CRON, (from (ixpvs, dull, and vixpov, bit- ter). See Absinthium vulgare. BARY'TES, (from (ixpvs, heavy,) called, from its weight, also terra ponderosa, ponderous earth. This is not found very abundantly, or in large conti- nued masses, but chiefly in the vicinity of mines, or veins of metal. Its species are aerated and vitriolated ponderous earth, either in the form of a transparent spar, or an opaque earth, of a white grey, or fawn co- lour ; frequently of no regular figure, but often in the peculiar form of a number of small convex lenses, set edgewise in the ground. We are indebted to the cele- brated chemists, Gahn, Scheele, and Bergman, for our more particular knowledge of this earth; but the vitriol- ated barytes was mentioned so early as 1700, by Legh, in his Natural History of Lancashire, Cheshire, &c. As this has seldom been found pure, in order to ob- tain it in a suitable degree of purity, we are favoured with the following process by M. I. A. Chaptal. The sulphate of barytes, or the vitriolated ponderous earth, which is its most usual combination, is pulverised and calcined in a crucible, Avith an eighth part of powder of charcoal: the crucible must be kept ignited during an hour; after which the calcined matter is to be thrown into Avater. It communicates a yellow colour to the fluid, and at the same time a strong smell of he- patic gas is perceived; the water is then to be filtered, and muriatic acid poured in; a considerable precipitate falls down, which must be separated from the fluid by filtration. The water which passes through the filter holds the muriatic barytes in solution. The carbonate of potash, or mild vegetable alkali, in solution, being then added, the ponderous earth falls doAvn; and the carbonic acid may be driven off by calcination. The product saturated Avith the muriatic acid, and little more of the acid being afterwards added, supplies the terra ponderosa muriata, or salita, which is considered as an evacuant, deobstruent, and tonic. It is given in solution, and half a drachm is dissolved in an ounce of water. On exhibition, it has been found in small doses to in- B A S 233 B AS crease the Aoav of urine, promote perspiration, open the bowels, and improve the appetite and general health. It has been considered as highly useful in scrofulous cases, chronic cutaneous complaints, and ulcerated legs. In some cancers, infarcted mesenteric glands,scirrhous testicle, buboes, asthma, and ascarides, it is said to be of advantage. Its dose is from six to ten or twenty drops; but if ever it occasion vertigo, nausea, purging, or pains in the bowels, the dose must be reduced, or the medicine omitted. Small doses, gradually increased, may be given twice a day, so long as they create no in- conveniences. This medicine is hoAvever suspicious; and the vitriolated barytes is known to be poisonous. As the muriatic acid is but weakly retained, many sub- stances may separate it. E\ren fixed air Avill decompose it; and in its exhibition hard Avater, alkaline, earthy, and metallic salts, particularly tartar emetic, should be avoided. Its irritating quality is so great, that it has produced considerable inconvenience in the more irri- table constitutions and in spasmodic complaints. In scrofula, in some cutaneous diseases, and in indurated scirrhous tumours, Ave have found it successful; and Avhen Ave have failed, have had reason to attribute the failure to the imperfect state of the medicine. Its pu- rity may be ascertained by a little Glauber salt, or any vitriolated neutral. The smallest atom will occasion an evidently conspicuous deposition. Barytes acts on vegetable and animal substances, dissolving muscular fibres, and forming insoluble soaps with oil. For a fur- ther account see Med. Commentaries, vol. iv. and vi. dec. "2; Medical Communic. London, vol. ii. Chap- tal's, Gren's, and Thompson's Chemistry. BASA'AL. (Indian). The name of an Indian tree growing about Cochin. ItfloAvers and bears fruit once every year, from the first year of its bearing to the fif- teenth. A decoction of its leaves Avith ginger in Avater is used as a gargle in disorders of the fauces. The ker- nels of the fruit kill worms. Raii Hist. BASANl'TES. A close grained stone resembling a lava, said by Pliny to contain a bloody juice, and useful in diseases of the liver. See Basilicum. BASILA'RE, (from fixnXtvs, a king). This is used as a term of superior excellence or magnitude Avhen applied to bones.^ See Cuneiforme, Sphenoides, and Sacrum os. BASILA'RIS ARTERIA. It is a branch of the vertebral artery upon the apophysis basilaris of the os occipitis. The tAvo vertebral arteries soon unite after they have entered the skull, and form this artery- about the cuneiform process of the os occipitis. It runs for- Avard under the great transverse protuberance of the medulla oblongata, to which it gives ramifications, as well as to the neighbouring parts of the medulla. Some- times it divides into two branches near the apophysis ba- silaris, Avhich communicate with the posterior branches of the two internal carotids, and are lost in the posterior lobe of the brain. BASILEI'ON. An epithet for a collyrium in jEtiusa BASILIA'RIS APOPHYSIS. The great apophysis of the os occipitis. BASILICA. Black-seeded. See Agrom. Basi'lica ve'na. The ancients termed the basilic vein of the right arm the vein of the liver, hepatica nRACim vena: and that of the left arm, the vein of the spleen, splenica vena lrachii. Sometimes the VOL. I. basilica hath a double origin, by a branch of the com- munication with the trunk of the axillaris. It continues its course along the middle of the os humeri, between the muscles and integuments; and having reached the inner condyle, and sent off obliquely in the fold of the arm the mediana basilica, it runs along the ulna, be- tween the integuments and muscles, a little towards the outside, by the name of cubitalis externa; and, a little below it, sends off another branch, which runs along the inside of the fore arm near the ulna: this branch may be called cubitalis interna. See Cephalica vena. BASILICUM UNGU'ENTUM FLA'VUM. Un- gu'entum re'sin.e fla'v^e. Ointment of yelloav re- sin, consists of a pint of olive oil, yelloAV wax, yelloAV resin, of each a pound. To the Avax and resin melted over a gentle fire the oil is added, and the mixture strained while hot. It is commonly employed as a digestive on Avounds and ulcers; and is as useful as the linim. Arcaei, now- called unguent, e gummi elemi. If required to be a little Avarmer, a feAv drops of ol. terebinthinae com. may be added Avhen used. It justly supersedes the use of every similar application. Basi'licum, (from pxnXixos, royal, so called from its great virtues). Basil ; called also acinos, ocymum vul- gare, herba regia, ocymu77i medium, citratum. Common, or citron basil. Ocymum basilicum Lin. Sp. PI. 833. O'cymum caryophyllatum, bcymiun- minimum, (from oxvs, swift,) so called because of its swift growth. Small, or bush basil, with uncut leaves. O. b. 7iiini- mum Lin. Sp. PI. 833. Nat. order labiate. Both these are natives of the eastern countries, and soAvn annually in our gardens for culinary uses. The seeds, which rarely come to perfection in England, are brought from the south of France and Italy. They floAver in June and July, and produce seed in. August. Infusions of the leaves are drunk in catarrhal com- plaints, uterine and pulmonic diseases. They nrc suc- culent, slightly aromatic, have a mucilaginous taste, and strong smell, which they lose partly in drying. The first sort resembles the scent of lemons; the second that of cloves. Distilled in water they yield much oil of a penetrating fragrance, similar but superior to the oil of marjoram. ClinopSdium majus, (from xXivtj, a bed, and xus, n foot,) so called because its leaves are like the foot of a bed. Called also clinop'oiium'dc'mos Lin. Sp. PI. 826, great, wild, and stone basil; a species of thyme. It groAvs in hedges; is supposed to be an astringent and emmenagogue. BA'SILICUS PU'LVIS, (from pxr,x,xos, royal, a king). The royal poavder. This term has been applied to various purging poAV- * ders, which contain cream of tartar as one of the in- gredients. The term was aftenvards changed to pulvis laxans, and it Avas then cream of tartar with an equal part of senna. A small proportion of scammony is noAv added, a.nd the appellation is the pulvis e senna compo- situs. It is an useful and-convenient purgative, though Avith senna alone not sufficiently active. The folloAving simple purgatives are observed to be both more agree- able and more useful. " R. Calomel, pp. 3 ij- pulv. rhab. | ss. jalap. 5 x- ra- " Or, R. Antimonii tartarisati, gr. iv. calom. 3 i. gr. iv. jalap. 3 ss. gr. viij. m. II h B A T 234 b a r " This is a convenient purge for gouty and rheuma- '• tic people, for Avhom it is best made into pills, and ■; to 'e trken at bed time. It is also one of the best '' purg.s for gross bodied children, Avho are subject to •' bi-ced worms and have large bellies; for though the l< iu6Tcdiei.'s are efficacious, its operation will be mild " and s.Je enough. It clears the boAvels of slime, and "dj.u-haige.8 those humours that obstruct the mesen- " tcric glands, and in a great measure the lacteals them- "scIa.^, Avhich is often the case in children; and is 1 ai.'.- ' /ith a hard belly, a stinking breath, fre- " quent .'jvers, and a decay of strength in the lower •' parts. Those slight intermittents, Avhich such chil- >' dren arc subject to,Avillmuch Sooner be cured by such " a purge than by the bark; for these purges reach, '' and carry off the cause, but the bark pens it up; and >4 by curing one, Avhile such restriction continues, gives " room for a return Avith much greater aggravation. The k< dose for children is from ten grains to fifteen; for adults " from fifteen grains to two scruples." Motherby. BASILI'DION. A cerate described by Galen, and used for the itch. BA'SILIS. A collyrium mentioned by Galen. BASIOGLO'SSUS, (from p>xalt however will not increase. The utility of nitre in all haemorrhages, is certainly- increased by the cold it imparts to water during its solution. Hippocrates remarks, that the cold should be applied ' non supra ipsas partes, sed circa ipsas, unde profluit.' The haemorrhage most cer- tainly relieved by cold is monorrhagia, and particularly that of pregnant or puerperal women. It may be safely and advantageously carried to a very considerable extent. In more general fevers, cold in every form is useful. In' those of our OAvn climate, cool air and cool drinks are perhaps sufficient. In those of Avarmer regions, however, the cold must be more actively exhibited. It is chiefly confined to such fevers as have considerable internal heat Avithout topical affections; and whether, Avith Hippocrates, Ave give Avater ,fundatus sum). A seat, basis, or foundation. Hippocrates andGalen use it to express a cavity of a bone which receives the protuberance of another at the joints, particularly those at the articulation of the humerus and ulna. BATHO'NIiE A'qu.e. Called also solis aque, badi- qua aqua. Bath avaters. Dr. Cheyne accounts for the heat of this Avaterby the folloAving experiment. If filings of iron and the poAV- der of sulphur, made into a paste Avith Avater, are put into a cellar under a cock "which drops Avater gra- dually and slowly, it will ferment, and the water running from it will be of the same heat and virtue with those of Bath, though not equally pleasant. Tour- nefort observes, " that the filings of iron Avill groAv warm by steeping in common Avater, but much more so iii sea Avater; and if powdered sulphur is added, the mix- ture will burn." Most hot waters seem chiefly to consist of sulphur and iron, and to differ only as the sulphur or the iron predo- minates ; where the sulphur most abounds, they are hotter, more nauseous, and purgative. According to the Experiments of Dr. Bryan Higgins, a Winchester gallon of Bath water contains, Of calcareous earth, combined with vitriolic dw't. gr. acid, in the form of selenite - - 0 319-^ Of calcareous earth, combined with accidulous gas.......0 22-flj Of marine salt of magnesia 0 22\\, Of sea salt......1 14^ Of iron, combined Avith acidulous gas - 0 0Tlg •Vcidulous gas, besides what is contained in the above earth and iron, twelve ounces measure; and atmospheric :iir two ounces. The four principal Avaters in England that possess any. remarkable heat, are those of Bath, Buxton, Bristol, and Matlock. The first of which raises Fahrenheit's thermometer from about one hundred and eight to one hundred and nineteen ; the second to about eighty ; the third to seventy-six; and the last to sixty-six or sixty- eight. Dr. Monro, in speaking of these Avaters, says the highest degree of heat attributed to them by Dr. Howard, Dr. Chirlton, and Dr. Lucas, is from the pump of the king's bath, us 115 119. rf FahtwlheU,, lUcl, hot bath 115 116 119 > „„„„,„_ cross bath .108 110 , m 3 momeiei. And that, on evaporation, a gallon has been found to contain of iron -j3T or ^\ parts of a grain; of calcareous earth 22^ grains; selenites 31^ grains; Glauber's salt 25| grains; sea salt 51i grains; Avhich were mixed with an oily matter, but not more so than is common to all Avaters. From this and other accounts it appears that the Bath Avaters are acidulous chalybeates, in which iron and earth are kept suspended by means of aerial acid ; and that they are impregnated with a small portion of selenites, sea salt, and muriated magnesia. Indeed these waters were for a long time esteemed to be sul- phureous ; but certainly they have not a title to that name in the least: they do not affect the colour of silver or metallic solutions, or produce any other effect of Avater impregnated Avith sulphur. It has been doubted Avhether hydrogen or azotic gas is contained in these waters ; and there Avas some pro- bability that the latter was an active ingredient in them, but its existence has never been properly ascertained. Dr. Gibbes has lately added to their impregnations the si- liceous earth. But Ave are still unable to discover in their contents any ingredient sufficiently active to account for their effects, and must resolve the question in the pre- sent state of our knoAvledge to the minute division of the substances dissolved; perhaps to these Avaters con- taining the proximate principles of some active com- pound. They operate poAverfully by urine, and pro- mote perspiration: if drunk quickly, and in large draughts, they sometimes purge; but if taken sIoAvly, and in small quantities, they have an opposite effect. These waters are adapted to weak and exhausted con- stitutions, to atonic gout, to visceral obstructions, nephritic complaints, and dyspepsia. Externally they relieve in all the complaints for Avhich the more active stimulant poAver of the balneum is employed. To the young and plethoric they are frequently injurious; and unless some evacuations are premised, often at first dis- agree, occasioning headach, heat in the hands, droAV- siness, and giddiness. The seasons for drinking Bath waters do not greatly differ. In hot dry summers the Avaters are strongest, but the spring and autumn are pre- ferred, from fashion probably rather than reason. More than two pints in a day can never be required, Avhich may be drunk at three or four times, a feAv hours intervening betAvixt each portion ; and in such chronical diseases as require preparations of iron, the artificial ones may at the same time be used. See Dr. Cheyne's Account of, and Dr. Falconer's Essay on, the Bath Waters; Monro's Treatise on Medical and Pharma- ceutical Chemislrv. BA'THRON. (Greek). The seat ok support. It is also the scamnum Hipjwcratis, an instrument in- vented for the extension of fractured limbs. Oribasius . and Scultetus both describe it. BAT 238 B 1) E BATIIYPI'CRON, (from M»> exceedingly, and Trixpov, bitter). See Absinthium vulgare. BA'THYS. A sort of cheese formerly used in Rome. BA'TIA. Sec Cornumusa. BATI'CULA, (a dim. of/3«r»s, a bramble, from its iikeness). See Crithmum. BAlT'NONMO'RON,(from/3«7o?,a bramble). See RUBUS IdjEUS. BA'TIS, (from the same). Sec Cbithmum. BA'TOS, the bramble. Sec Rubus vulgaris. BATRACHIOIDES, (from (ixr?»Xos, a frog, and sifos, likeness, from its resemblance to a ranunculus). See Geranium. BA'TRACHIUM. See Geranium. BA'TRACHOS, (from fixr^x^^, a frog). See Ranula. BATTA'RISMUS, (from Bxrlos, a Cyrenaean prince who stammered). See Psellismus. BATTA'TAS, (Indian). Galled also battata Virgi- niana, solanU7n tuberosu7n escule7itum, kippa kvlengu, papas vel pappus Americanus, and convolvulus Indicus. The common or Virginian potatoe. They were first brought into Europe by Sir Francis Drake in 1486, Avhen he returned Avith the famous ma- thematician Mr. Thomas Herriot, ay ho Avas sent to Vir- ginia by Sir Walter Raleigh to explore the productions ot the country. Herriot gave them to Gerard the botanist; who first planted them in London, and sent them to Clusius in Holland, Avho also planted them in Bur- gundy ; and he sent them to Italy, as appears from the Avorks of these and several other authors. It Avas from this introduction into Europe that so many writecs say they were natives of Virginia; but it is said that they will not grow there Avithout skilful culture. Other authors have given a different account, and re- late that the first cargo was shipped at Carolina for Ire- land, but the vessel was lost near Liverpool. The po- tatoes that were saved were first planted there. Each may be true; and the former may refer to the first knoAvledge Ave acquired of them, the latter to the first importation. They are of the natural order of solanacee, and the roots of the convolvulus batatas Ljn. Sp. PI. 220. This is not the only instance Avhere acrimony is inviscated by farina, or prevented from being evolved by keeping from the air. Those Avhich groAv near the surface are said to be poisonous. These roots are natives of both parts of the continent of America and of India. The light mealy ones are the best, and, by proper management, a Avholesome nourishing bread is made of them, called by the Peruvians chunno. Their use, as at present, is both profitable and salutary. More brandy may be obtained from an acre of potatoes, than from an acre of barley. They also afford much starch. They uontain more than half their proportion of Avater, which renders them of easy solution and digestion in the stomach, and they are less liable to become ascescent and give the heartburn than the fermented eerealia. A cataplasm is made of potatoes, called cataplasma so- la ni tuberose See Ambusta and Aliment. The varieties of potatoes are numerous, and may yet be increased from the seed contained in the apples. But the usual method of increase is from the tuberose roots. These are cut into pieces, each containing an eye simi- lar to a bud on a branch, Avith so much of the medullary substance connected Avith it as will nourish the young plant tiii it can draAV by the roots. Po.tatoes produced from sets, after a number of years, are found to decrease in bearing; for Avhich reason they should be brought back every fourteen years to their original. It is after this period that those produced from the seeds themseiv-es decline. In Sweden, the leaves of the potatoe plants are ma- nufactured for smoking instead of tobacco. See on this article many remarks, both curious and profitable, in Hunter's Georgical Essays, Cullen's Mat, Medica. Batta'tas Canadensis, also called 720s solis parami- dalis, heliotropium Indicmn, adenes Canadensis, corona solis parvofiore, Isfc. helenium Indiaun tuberosum,chry- sa7ithe7num latifolium Brasil, Americanum tuberosum^ aster Peruanus tuberosus, F"arnesianusr solis Flos. HELIANTHUS TUBEROSUsLin. Sp. PI. 1277. JERUSALEM artichokes. See Aliment. Batta'tas Peregr^na, called also cacamotic fiano- quilo7ii. The cathartic potatoe ; perhaps a species of ipomea, nearly allied to convolvulus : ' caca7notic' is certainly quamoclit, one of the species of ipomea. Many Avorse blunders occur in the synonyms of the former editions. They grow spontaneously in the warmer parts of America. Their taste is very agreeable; and if about two ounces of them are eaten at bed time, they gently move the belly the next morning. As all the species are in a certain degree cathartic in some of their parts, this quality is less surprising. BATTITU'RA,(from batuo, to strike). The squam- ous scales of metals Avhich fly off Avhilst under the hammer. BAU'DA. A vessel for distillation is thus named. B. P. An abbreviation for Caspari Bauhini Pinax Theat7-iBotanici, sive Index in Theophrasti,D.oscoridis, Plinii, et Botanicorum, qui a Seculo scripserunt Opera. B. THEAT. An abbreviation of C. Bauhini Thea- trum Botanicmn. BA'URACH. From the Arabic term bourach. See Borax, Anatron, and Nitrum. BAXA'XA. (Indian). A tree in an island near Or- muz, the smallest quantity of whose fruit is said to suf- focate the person Avho tastes it, and the same effect to be the consequence of continuing under its shade; yet its root, leaves, and fruit, are antidotes to poison in other countries. It is also called rabuxit, Raii Hist. but not sufficiently described to be referred to its pro- per place in botanic systems. BA'ZCHER. A Persian Avord for antidote. See Bezoar. BDE'LLA, (tfxxxa, to suck,) BDE'LLERUM. Horse leech. See also Varix. BDELLIUM, (from the Arabic term bedallah,) called also madelionbolchon, balchus,andhy the Arabians 7nokel, is a gummy resinous juice, produced by a tree in the East Indies, of which we have no satisfactory account. It is brought to Europe both from the East Indies and Arabia in pieces of different sizes and figures, externally of a dark reddish brown, somewhat like myrrh ; internally it is clear and not unlike glue. To the taste it is slightly bitterish and pungent; and its odour is very agreeable. If held in the mouth it soon ■ becomes soft and tenacious, sticking to the teeth. Laid on a red hot iron it readily catches flame, and burns B E II 239 BEL Avith a crackling noise; and, in proportion to its good- ness, it is more or less fragrant. Near half of its substance dissolves either in water or in spirit of Avine; but the tincture made Avith spirit is somewhatstronger, and by much more agreeable. Vine- gar, or verjuice, dissolves it Avholly. The simple gum is a better medicine than any pre- paration from it. It is one of the weakest of the deob- struent gums, but it is used as a pectoral and an em- menagogue. Applied externally, it is stimulant and promotes suppuration. BEAN IGNATI'US. See Faba Sti. Ignatii. Bean Ma'lacca. See Anacardium Orien- tale. BEAR'S FOOT. See Helleborus. Bear's foot. See Uva ursi. BECABU'NGA, (from bach-bungen, wat-er herb, German, because it grows in rivers,) called also ana- gallis aquatica, laver Germanicum, veronica aquatica, cepea: water pimpernel, and brook lime. The ve- ronica begabunga Lin. Sp. PI. 16. It possesses in an inconsiderable degree the virtues of the cochlcaria and nasturtium. It hath not the volatility of the cochlearia, nor is it pungent to the taste, but ra- ther saltish andhitierish than acrid. It should be eaten plentifully as food, or a large quantity of the juice taken, if benefit is expected from it, as its poAvers are very inconsiderable. BE'CHA, (from/3j?|, a cough). Any medicine de- signed to relieve a cough, and of the same import as pectoral. The trochisci bechici albi of the London col- lege consists of starch and liquorice, with a small pro- portion of Florentine orris made into lozenges, Avith the mucilage of gum tragacanth. It is a soft pleasant de- mulcent. The trochisci bechici nigri. consists chiefly of the juice of liquorice Avith sugar and gum tragacanth. BE'CHION, BE'CHIUM, (from the same). See Tussilago. BECUI'BA NUX. (Brasil). It is as large as a nut- meg, of a broAvnish colour, with an oily kernel in a woody brittle husk. A balsam is draAvnfrom it, Avhich is held in estimation in rheumatisms. BEDE'GUAR, (from the Arabic bedegua). See Carduus lacteus Syriacus, and Cvnosbatos. BEDENGI'AN. The name of love apples in Avi- cenna: an esculent fruit of a species of solanum. BE'GMA, (from /3jj|, a cough). Hippocrates by this Avord means a cough and the sputum brought up with it. BE'HEN A'LBUM, (from the Arabic term behen, a finger,) called also jacea orientalis patula, raphanti- coides lutea, and the true white ben, or behen of the ancients. Be'hen a'lbum vulg. ; called also lychnis sylvestris, lanaria, papaver spumeum vulg. muscipula pratensis, vesicaria, spatling poppy, bladder campion, or avhite BEN. Be'hen ru'brum, limo'nium, or limo'nium majus. Be'hen sea lavender, or red be'hen. Tavo roots, viz. the red and the Avhite ben, are de- scribed by the ancients. The Avhite is a long, slender, white root, of an aromatic smell, and sharp taste ; it is hard, but does not keep Avell. It comes from the East, and is the centaurea behen Lin. Sp. PI. 1292. The red is a thicker root, also brought from the East, and is the statice limvnium Lin. Sp. PI. 394. It is cut in slices, and tastes acrid; but the root of the Avhite lychnis is used for one, and the root of the sea lavender for the other. The last grows in salt marshes on some of our sea coasts. It hath a thick root that runs deep in the earth, and is of an astringent quality. BEIDE'LSAR,andBEIDELLO'PAR. A speciesof Asclepias, perhaps the a. gigantea Lin. Sp. PI. 312, used in Africa as a remedy for fever and the bites of serpents. The caustic juice which issues from the roots, Avhen wounded, is used by the negroes to destroy ve- nereal and similar SAvellings. It resembles the apocy- num and anemone. BEJU'IO; called also the habilla de Carthagend, bean of Carthagena, perhaps from the Hippocratea volubilis Lin. Sp. PI. 50. It is a kind of bean in South America, and is famed for being an effectual antidote against the poison of all serpents, if a small quantity is eaten immediately. This bean is the peculiar product of the jurisdiction of Carthagena. BELA'E. (Indian). A particular kind of bark of Madagascar, which Avas first presented by M. Saillant to the college of physicians at Paris. It is thin, of a yellowish colour externally, reddish within, and to the taste slightly bitter and astringent. It is said to be of considerable efficacy in diarrhoeas. BELEMNOI'DES, (from peXe^vov, a dart, and t/^®-, shape). Beloides, and Belenoides: a name for- the processus styloides, and of the process at the loAver end of the ulna." BELE'SON. See Balsamum. BE'LI. See Covalam. BELI'LIA. (Indian). Calledfrutex Indicus baccifer. An Indian berry bearing shrub, a decoction of Avhich is cooling. Raii Hist. The mussendafrondosa Lin. Sp. PI. 251. BELLADO'NNA,(from bella donna, handsomelady, Italian). It is so called because the ladies of Italy use it to take aAvay the too florid colour of their complexion. See Solanum lethale. BE'LLEGU, BELLERE'GI, BE'LNILEG, BEL- LE'RIG/E. See Myrobalani bellerici. BELLIDIOI'DES, (from bellis, the daisy ; and eidbs, fbrm). See Bellis major. BE'LLIS, (a bello colore, from its fair colour). The DAISY. Be'llis minor; called also co7isolida 7nini7na, sym- pythum minimum, bellis sylvestris minor, bruisewort, and common daisy. Bellis perennis Lin. Sp. PI. 1249. It is too Avell known to need a description. Its leaves and flowers loosen the belly, are commended in disorders that arise from drinking cold liquor while the body Avas hot. The leaves are slightly acrid, the roots rather more so.» They have a subtle penetrating pungency, that is not hot or fiery, but like the contrayerva. The root preserves this pungent matter when dried, and an ex- tract made with water, or Avith spirit, retains the greatest part of its virtues. It is said to be an excellent an- tiscorbutic ; but with all these fancied virtues it is wholly neglected. Bellis major, consolida media Lobclii, bellidioides, leucanthemwn bellidis facie, buthalmu7n majus oculis bOVlS, OX EYE, MAUDLIN WORT, Ol* GREAT OX EYE daisy. It is the chrysanthemum leucatithemum Lin.Sp. be >; 240 BE N PI. 1251. It is perennial, groAvs wild in corn fields and in dry pasture grounds; and flowers in May and June. The leaves have been in esteem as diuretic and anti- asthmatic. Bellis lutea foliis profundis. See Chrysan- themum. Bellis Montana irutescens acris. See Py- rethuim. BELLO'CULUS, quasi BELI-OCULUS, a white gum dedicated to Bel, the Assyrian idol. A sort of precious stone resembling the eye ; hence supposed to be good against its disorders. BE'LLON. See Colica. BELLO'NIO and BELLO'NIS ; so called in honour of Petrus Bellonius. See Cedrus folio Cypri. BELLONIUS DE AQUAT. An abbreviation of Petrus Bellonius de Aquatilibus. BE'LLOSTI PI'LLULjE, Belost's pills. R. Hy- drargyri purificati, | iv. in syr. e spin, cervin. g i. ex- tinct, resin, jalappii et pulv. colocynth. al ^i. f. massa cujus cap. 3 ss. 2''° vel 3cia quaq. nocte. BELLU'TTA TSJA'MPACAM. (Indian). Called also amelpo and amelpodi. The name of alarge tree in Malabar. The root, poAvdered and taken Avith ginger, promotes SAveat. A decoction of the leaves is a good expectorant, and it is said to be of service against the bites of serpents. Raii Hist. BELLY. In medical language means the state of the intestines; as a bound belly, a loose belly. Belly of a muscle. The larger fleshy part, in con- tradistinction to the smaller or tendinous extremities. BELOE'RE. (Indian). An Indian evergreen plant. The seeds purge moderately, but the leaves roughly. Raii Hist. BELOI'DES, BELONOI'DES, (from /3«a<>s, a dart, and eia^os, forma). See Bei.emnoides. BELT. A bandage applied round the body. Mer- cury is used externally, by covering the internal part Avith its calx prepared by trituration; and some other medicines have been employed in the same manner. BELU'GA ,STONE. A morbid concretion from the beluga fish, delphinus leucas of Pennant. The Asiatics near the Volga suppose it useful in many complaints, and think it promotes delivery. BELU'LCUM, (from (ieXos, an arrow, or dart, and \xkou, to draw out). An instrument for extracting darts or arroAvs. BELUZA'AR. See Antidotum. BELZU'AR MINERA'LE. See Bezoar fossile. BEM TAMARA, (from the Arabic term, behen- tamara). The Egyptian bean. See Faba ^Egyp- tia. BEN, (from behn, Arabic,) also called balanus 7nyrep- sica, glans unguentaria, 7iux ben, 7iux unguenthria 7iioris, Coatlis. The oily acorn, oily nut, or ben nut, probably from the guillandina 7noringa Lin. Sp. PI. 546. Wahl and Wildenow have formed a new genus for this species with the appellation of hyperanthera. Loureiro styles it anonia 7noranga. It is a Avhitish nut, of the size of a small filbert, roundish, triangular, Avith a kernel covered Avith a Avhite skin. It grows spontaneously in the East Indies and America; and is brought also from Arabia. These kernels have a nauseous bitter, oily taste, are purgative, occasion a nausea and colic: on expression they yield one-fourth of their Aveight of a yellow oil, called oleum 7nyrepsicum; balaninum oleum, almost in- sipid and flavourless; for the nauseous bitter remains behind. This oil does not grow rancid by long keep- ing, as is common with expressed oils, on account of which it is used as the basis of odoriferous unguents and perfumes, and would be highly valuable for oint- ments Avere it easily procured. It is impregnated Avith the odour of jasmine, and other floAvers, by stratifying them with cotton dipped in the oil, and repeating the process" Avith fresh floAvers until the oil becomes suffi- ciently odorous, after Avhich it is squeezed out from the cotton in a press. This is also a name of the behen. It is generally supposed that the lignum nephriticum is the vvood of the tree Avhich bears these nuts: q. v. There is another species of ben much larger than the above. Monardus calls it ben 7nagnum, seu avellana purgatrix, the great ben or purging filbert. It purges and vomits violently. BE'NATH. The Arabic name for small pustules Avhich arise in the night after sweating. BENEDI'CTA AQUA. A former appellation of the aqua calcis simplex; the name of a water distilled from serpyllum; and in Schroeder of an emetic. Benedi'cta aqua compo'sita; i. e. Aq. calcis. composita. See Calx. Benedi'cta herba. The herb bennet. See Ca- rophyllata. Benedi'cta laxativa. A compound of turbeth, scammony, and spurges, Avith some warm aromatics. BENEDI'CTUM LIGNUM. See Guaiacum. Benedi'ctum o'leum. See Lateritium oleum. Benedi'ctum vinlm. See Antimoniale vi- m NUM. Benedi'ctum laxativum. Rhubarb, and some- times the lenitive electuary. BENEDI'CTUS LA'PIS. See Adamus. Benedi'ctus, (from benedico, to bless). A specific term affixed to many herbs and compositions, on ac- count of their good qualities. BENGA'LLE INDO'RUM. From Bengal, its na- tive place. See Cassumuxar. BENINGA'NIO. A fruit Avhich grows in the bay of St. Augustine : it is of the size of a lemon, red with- out, and grateful to the stomach. Raii Hist. BENI'VI ARBOR, BENiVI'FERA, BENJA- MIN, BE'NJUI, BENZO'E, Benzo'ifera, and Ben- zoin. See Benzo'ixum. BENZO'INUM, (from the Arabic term benzoah,) called also assa dulcis, assa odorata, liquor syrenaicus, or,cyreniacus balzoinum,o\ju benjamin. Itisaconcrete resinous juice, obtained from a middle sized tree, Avith leaves like the bay leaves, but not ribbed, and falling off in Avinter, bearing flattish nuts, the size of nutmegs, whose fleshy covering is externally- rough and hairy. It is a native of the East Indies and of North America, parti- cularly of Virginia and Carolina; but only brought from the East Indies: it grows in open ground with vigour in England. Mr. Dryander has fully ascertained this tree to be a sty rax; hence it is called styrax benzoin Lin. Sp. PI. Wildenow, vol. ii. 623, nat. order bicornes. It is the styrax foliis oblongatis acuminatis suotus tomentosis, racemis compositis longitudine foliorum Drvander. Phi- losophical Transactions, vol. 77, p. 308. The leaves J* EN 241 BER and the bark smell like the gum; and to rectified spi- rit of wine they give out a resin like the benjamin, but no resin naturally flows from it: the resin is obtained by incisions made in its trunk, about the origin of the first branches; as it runs out it is Avhite, but soon be- comes yelloAvish, reddish, or brownish. It is brought into Europe in brittle masses, composed partly of white, and partly of yellowish or light brown pieces. The white pieces are called benzoes amygdaloidcs, and are reckoned the best; they are hard, solid, 6hining, trans- parent, and possess a very fragrant 'smell: this gum resin hath but little taste, impressing the palate with a slight sweetishness ; its smell is very fragrant if rubbed or heated, and it is less heating than most of the other balsams. Its specific gravity is 1.092; and though enumerated among the resins, it is in reality a balsam, uniting an oil Avith an acid : 100 parts contain 9 of acid, 5\ of acidulated water, 60 of thick empyreumatic oil, 22 of brittle coal, and 5\ of carbonated hydrogen and carbonic acid gas. If the oil is examined, 5 grains . more of acid may be discovered. Brande Ap. Nichol- son's Journal. If pure it totally dissolves in rectified spirit of wine. By digestion it imparts to water much of its fragrance and pungency : the filtered liquor, gently exhaled, leaves a crystalline matter of a seemingly saline nature, amounting to an eighth part of the Avhole. The flowers.o/"benjamin, which is the gum sub- limed, and purified, if yellow, by repeating the opera- tion, partake of the fragrance of the resin : they dissolve in spirit of wine, and, Avith the assistance of heat, in water; from which they are prevented from separating, if as much sugar is added as will give the consistence of syrup to the water. The essential oil of benjamin rises after the flowers, mixed with a little acid, and tainted with a slight empy- reuma. It is purified by re-distilling it from water: the tincture is made by-digesting four ounces of benjamin Avith a pint of rectified spirit; the compound tincture, dignified by the names of commander's and traumatic balsam, drops of life and Persian balsam, by digesting three ounces of benjamin, two of strained storax, one of balsam of Tolu, and half an ounce of socotorine aloes in a quart of rectified spirit. The lac virginaiis consists of the tincture of benjamin in water, which becomes milky, and the gum deposited is the magistery of benzoin, and is chiefly the resinous without the saline part of the gum. In the original receipt of the com- mander's balsam, called also Jesuit's drops, balsam of Berne, and friar's balsam, the ingredients Avere much more numerous, and the composition seems to have been warmer and more fragrant. Of gum benjamin, the principal use is in perfumes, and as a cosmetic. It resembles in virtues and fra- grance the storax and balsam Tolu, and may be useful in asthmas and other disorders of the breast, promot- ing expectoration : the floAvers are also a poAverful errhine. The floAvers may be given from ten to fifteen grains, and the tincture in doses from eighty to one hundred and twenty drops, but is chiefly used to clear the skin and give a scent to Avash balls. The lac vir- ginaiis must be used Avhen a roughness or blotches render the skin unsightly : it may be rubbed on gently every day Avith a soft rag. The flowers of benjamin are manifestly a saline sub- VOL I. stance of the acid kind, of some acrimony, and stimu- lant poAver. They' have been recommended as a pec toral; but Dr. Cullen has employed them in some asth- matic cases without effect: half a drachm appeared to be heating and hurtful. This is the benzoic acid of the chemists, which claims a share of our attention from its so often occurring in animal substances, though, as a medicine, it is almost, if not wholly, useless. About fourteen drachms of concrete acid may be obtained from a pound of benzoin, by Scheele's process, which is pre- ferable to any other. Its specific gravity is 0.667. It is white; Avith difficulty reduced to powder; its taste sharp and pungent, subliming by heat, but not volatile in an ordinary temperature. Cold water dissolves xhf part of its weight, and boiling water -^v. Benzoat of lime is found in the calculi of herbivorous animals, and in some human concretions. The benzoats have not, however, been employed as medicines. From Herms- staedfs experiments, Journal de Physique, vol. 34, it appears to contain some prussic acid. It has been reckoned among the correctors of opium ; and, to pre- vent the latter checking expectoration, has been added to the old elixir paregoric, though without any particu- lar advantage. It is also an ingredient in the balsamum traumaticum; and in fumigations has been employed as a corrector of foul air. BE'RBARIS, BE'RBERIS, (from the Arabic term berberi, wild). Called also oxyacantha Galeni, spina acida, crespi7ius, crispinus; piperidge or .piperage bush, and barberry. The berberis vulgaris Lin. Sp. PI. 471. Nat. order trihilate. It is a large prickly bush, Avith brittle branches, co- vered with an ash coloured bark, under which lies an-. other of a deep yellow colour. Some of the individuals have no seeds in their berries ; and sometimes berries with and without seeds are found on one bush. It grows wild on chalky hills, floAvers in May, and its fruit ripens in September. The fruit is a mild restringent acid, useful in hot bi- lious disorders, and colliquative putrescent state of the fluids. The leaves have the same virtues as the ber- ries, but in less degree. The inner yellow bark is austere and bitterish, gently purgative, and supposed to be useful in the jaundice. The bark of the root is mildly astringent. These barks do not keep long, and are best used by infusing one ounce of bark in a pint of Avater. Simon Paulli recommends an essential salt of bar- berries under the appellation of tartaj- of barberries. Two ounces of lemon juice are added to two pints of the juice of barberries : they are digested, the liquor eva- porated, and the salt suffered to crystallize. A jelly of barberries is made in the usual way. The vicinity of the barberry tree has been accused of communicating the fungus, on Avhich Avhat is called the rust depends, to Avheat; and it was long since observed that the ears of corn in its neighbourhood Avere barren. BERDIRA'MON. See Bistorta. BERE'DRIAS. The name of an ointment mention- ed in iEtius. BERENT'CE, (from the city of Berenice, from Avhence it Avas brought"). See Succinum- BERE'XS SE'CUM. See Artemisia. BE'RGAMOTE, or BE RGAMOT, (French). It is a species of citron, produced at first casuallv bv an I i BE 11 242 BET 1 talian's grafting a citron on the stock of a bergamot pear tree, Avhence the fruit produced by the union par- ticipated botli, of the citron tree and the pear tree, and the plant is a variety of the cit7-us medica Lin. The fruit hath a fine taste and smell, and its essential oil is in high esteem as a perfume. The essence of bergamot is also called essentia de ce- dra. It is extracted from the yellow rind of the fruit by first cutting it hi small pieces, then immediately squeezing the oil into a glass vessel. This fluid is an ethereal oil. A water is distilled from the peel by adding the outer rind of three bergamots to a gallon of pure proof spirit, and four pints of pure water: a gallon may be drawn off in a balneum mariae, and as much of the best white sugar as will be agreeable must be added. It may be prepared also by distilling off three pints from the es- sence of bergamot three drachms and a half, rectified spirit of wine three pints, ammonia prepared a drachm. BERIBE'RI, BERIBE'RIA. In the East Indies, the terms mean, in a medical sense, a species of palsy, in Avhich, according to Bontius, patients seem to imitate sheep in lifting their legs when they walk. This palsy consists in a partial deprivation of the motion and sen- sation of the hands and feet, and sometimes of the body. Sauvages defines it under the order of clonic spasms: ' In walking, a retraction of the knee, with tremor; a sense of craAvling, or tingling, and hoarseness, com- mon in the Indies.' Linnaeus describes it as ' a tre- mor of the parts, contracture of the knees, i. e. con- tinual chronic agitation of the parts without a sensation of coldness, stupor, and hoarseness.' Sagar adds to the definition of Sauvages, ' painful stupor of the limbs.' lie once saAV some sheep, observing a wolf, seized with this "spasmodic affection ; and that they, whether standing still or Avalking, momentaneously retracted . their knees, Avhich immediately returned to their na- tural situation. Dr. Aitkin makes it synonymous with contracture, Avhich see. The cause is generally thought to be exposure to the cold vapours of the night too soon after exercise. The cause of this disease is whatever weakens the moving powers, and relaxes the ligaments. Generally its approach is gradual; but sometimes it seizes suddenly. The symptoms are, an universal lassitude, a faulty motion of the hands and feet, and the same throbbing utilla'tion is felt in them as is felt in the fingers and toes in a cold country in the winter season, only the pain is not so great: sometimes the voice is so obstructed as to render articulation difficult. The disease is not mortal, except by seizing the muscles of the breast, so as to ob- struct respiration and the voice. In the cure, moderate exercise and frictions are useful: the Indians use a semicupium made of Avater, in which is boiled an aromatic herb called lagondi, or, in Avant of it, camomile and melilot. The affected parts are rubbed Avell Avith a mixture of the oils of mace and roses. Bleeding is not required; but, on the contrary, Avarm nervous strengthening restoratives are to be used, Avith an occasional gentle purge. Decoctions of sarsa- parilla and guaiacum are also of service. See Bontius De Medicina Indorum. BERICO'CCA. A corruption of the Tuscan lan- guage from prjecocca, which see; and also Arm entaca mala. BERMUDE'NSES, BA'CCjE, (from Bermudas). See SAPONARIiE NUCULJE. BE'RNAVI. An electuary mentioned by Prosper Alpinus in his work De Medicina. jEgyptiorum. It is prepared in India ; its composition is unknown; but very extraordinary effects are attributed to it. BERNHA'RDI TESTI'CULUS. See Asphodelus LUTEUS. Bernha'rdi eremi'ta. See Cancellus. BERRIO'NIS. See Colophonia and Juniperi gum. BERS. A sort of electuary used by the Egyptians to promote gaiety; it contains opium, and creates a temporary delirium. BE'RULA. See Becabunga. Be'rula Ga'llica. See Sium angustifolium. BERY'TION, from Berytus, its inventor. The name of a collyrium described by Galen as good against an ophthalmia ; and of a pastil against the dy- sentery. BES. See Cyathus. BE'SACHER. See Fungus and Spongia. BE'SASA. See Ruta. BESL. FA'SCIC. An abbreviation of Basilii Bes- leri Fasciculus rariorum. Besl. Gazophyl. An abbreviation of Gazophylacium Rerum Naturalium Michaelis Ruperti Besleri. Besl. Hort. Ezs. An abbreviation of Besleri Hor- tus Eystetensis. BESO'NNA. Rulandus explains it by muscarum fungus. Probably he means a sponge. BESSA'NNEN. An Arabian term. In Avicenna it is a redness of the external parts, resembling that which precedes the leprosy: it occupies the face and extremities. Dr. James thinks it is what we call chilblains, but is more probably erysipelas. See Per- nio. BE'STO. See Saxifraga. BE'TA. So called from the river Baetis in Spain, where it grows naturally; or from the Greek letter /3, beta, which Avhen turgid with seed it is said to re- semble. Beet. It grows on some of the sea coasts of England and Holland. There are numerous varie-' ties of the beta vulgaris et maritima Lin. Sp. PI. 322, distinguished rather from their colour than their pro- perties; and a wild sort called by Dioscorides Umoniu7n. The parent of all is probably the b. maritima Lin. The mangel wurtzel, with whose Avonderful virtues the world was some years since so much amused, is a variety of the b. cicla Lin. From the b. vulgaris M. Achard has attempted to extract sugar, hitherto Avith little suc- cess. By a miserable pun, both have been* said to be baits for popularity. Beets, used as food, are difficult of digestion, and afford but little nourishment. If freely eaten they are laxative and emollient. The red ones give out their colour to spirit of wine; and on expression the colour accompanies their juice. The juice of both kinds has been considered as a powerful errhine, occasioning a copious discharge, without sneezing; but Dr. Cullen observes, in the trials he made, the juice snuffed up the nose gave no large or durable evacuation. The dried red beet roots yield one-twentieth part their weight of sugar, and the dried Avhite beet roots one-tenth. BE Z 243 BEZ BETLA. (Indian.) Called also belre, betele, bethle, betellr, betle, and bulatwaela. It is a scandent plant, groAving in different parts of the East Indies, bearing a fruit Avhich resembles a liz- ard's tail; its taste is agreeable; and the ancient bo- tanists confound, its leaf with the malabathrum. It is, however, a species of piper, viz. p. betele Lin. Sp. PI. 40. Another species growing in Java is thep. scriboa P. 41. Mixed with other things, as fancy directs, the Indians chew it almost continually. It is gratefully cordial, hut seems to injure their teeth. BETO'NICA, corrupted from vetonica, perhaps from Vetones, a people of Lusitania. Called also veto- nica cordi, cestrum, drosiobetanon, common or woody betony. The betonica offici7ialis Lin. Sp. PI. 810. Nat. order verticillate or labiate. The leaves and tops are somewhat disagreeably scented, but the odour soon flies off from the dry herb: to the taste they are Avarm, rough, and bitterish ; if powdered, they make a.good errhine. An infusion of the leaves in boiling water contains all the virtue of the herb, and is its best preparation. From large quantities a small portion of essential oil is obtained by distillation. The roots are said to be nau- seous and emetic; and, as a medicine, very similar to the helleborus albus. Scopoli thinks it a cephalic and a tonic. It is an ingredient in RoAvley's British herb snuff. Beto'ntca aqua'tica. See Scrophularia aqua- tica. Beto'nica pau'li. See Veronica. Beto'ntca corona'ria. See Caryophillus ru- ber. BE'TRE. - See Betla. BETTO'NICA. See Bardana major. BE'TULA, (from batuo, to beat, because rods are made of its twigs). The birch tree. The betula alba Lin. Sp. PI. 1393. Nat. order amentacee. If this tree is wounded in the spring pretty deeply into its trunk, there gradually issues a large quantity of a limpid sweetish juice. It is best when drawn from the upper part of the tree : soon after the leaves have v begun to appear, the juice loses its sweetness. This juice hath been drunk as an antiscorbutic; it sensibly promotes urine, and, freely taken, proves laxative. It has been used in diseases of the skin, and against worms. By fermentation it becomes a vinous liquor; and, inspissated to the consistence of a syrup, it yields in cool places a broAvnish concrete like manna. The leaves and bark are antiseptic. The former are applied to erysipelatous inflammations, and the latter is burnt to correct bad air; and for this purpose it is the next in goodness to juniper'. The oil is SAveet, but not particularly employed : that of the epidermis is black. BEUTU'A. See Pareira brava. BEX, (from (iyo-oa, to cough). See Tussis. BEXU'GO. The root of the clematis Peruviana of C. B.; one drachm of Avhich is enough for a purge. BEXUGU'ILLO. The Peruvian ipecacuanha. See Ipecacuanha. BE'ZOAR, so called because it is found in the sto- mach of the sort of goat named bezoar. This is ori- ginally a Persian word, viz. badzcher, or lazcher, or phahazar, which signifies an antidote. Avenzoar is the first who mentions it as a medicine, or Avho gives its history. Bezoar stones are preternatural or morbid concre- tions formed in the bodies of many animals; they are composed of several strata, or layers, like an onion. In the Hist, de 1'Acad. an. 1703, it is asserted, that all be- zoar stones are bilious concretions of the respective animals which afford them. Bezoars may be divided into : 1. The true oriental and occidental. 2. Animal concretions which resem- ble bezoar; as those from apes, and even the various species of pearls and crabs' eyes. 3. The several spe- cies of fossil bezoars. 4. Those Avhich have only the shape, without the virtues of bezoar, as the calculi in the human bladder, kidneys, and gall bladder; or in the same parts of oxen. 5. The aegragropila, balls of matted hair, and bezoar Germanicum, see Capua Al- pina. Be'zoar orienta'lis, called also lapis bezoar, hircu.s bezoarticus, and the oriental bezoar stone, from the East Indies. It is supposed to be produced in the cavity at the bottom of the fourth stomach of a species of goat in Persia called parau. Antelope gazella Lin. though not peculiar to this species, as it occurs also in the antilope cervicapra and the capra egagrus Lin. It is only found in the old ones, and exclusively in those which feed on particular moun- tains. This stone, finely powdered and levigated with spirit of wine, was formerly made into balls, which Avere called Gascoigne balls, from Gascoign their inventor. What are at present sold under that name by the trad- ing chemists, if any remain, are a sophisticated medi- cine without bezoar. Be'zoar occidenta'lis, called also lapis bezoar, Pe- ruvianus, the American or occidental bezoar, from the West Indies. It is found in the stomach of an animal of the stag- kind, called animale bezoarticum occidentale, a native of Peru, and other parts in the Spanish West Indies; and in the stomach of the yzard of the Alps, antilope rupi- capra and capra ibex Lin. Be'zoar hystri'cis, (from t5otyhells made into small balls Avith gum water, and per- fumed Avith ambergris. They effervesce Avith acids, and, Avhen cut, have no concentric laminae ; nor, Avhen broken, any crystalline striae; nor, Avhen rubbed on paper previously covered Avith chalk, do they leave an olive coloured mark. The Goa and Malacca stones are of this kind. Be'zoar fo'ssile. Fossile bezoar is a small hollow body from Italy, found in sand and clay pits, of a purple colour, Avith a rough surface, the-size of a Avalnut, and light. When broke, it is found to consist of an irony crust, containing in its IioIIoav a fine greenish white earth resembling pale bezoar. The earth is used, and not the shells. It seems to be of the nature of bole armoniac,or rather calcareous; and is also called bezoar mincralc, terra sicula et noceriana, lapis bezahan, sicu- lus albus, belzuar 7ninor. Siciliana, mineral bezoar, and Sicilian earth. NotAvithstanding all the boasted virtues of these be- zoars, viz. the poAver of destroying poisons and reani- mating the vital powers, it is certain that they are ab- solutely indigestible in the stomachs of the animals in which they are found; and they are equally so in the human, except when accompanied with an acid; so that no more can be expected from them than from any of the testacea that are soluble in acids; but they are inferior to them, as far less absorbent, and more diffi- cultly acted on by any acid. Be'zoar microcosmicum, called also calculus huma- trus, the calculus of the human bladder. It is various in its degrees of hardness, as well as in its size and figure. It has been used in the place of the more costly sorts. Be'zoar anima'le. Animal bezoar. Take the whitest calcined hartshorn levigated to the greatest subtility, pour on it, drop by drop, the spirit of vitriol, to form it into a paste to be made into balls. A powder of livev and heart of vipers is called ani- mal bezoar. Be'zoar bo'vinus, called also alcheron lapis. The Portuguese call itMESANG de vaca. It is a stone found in the gall bladder of a bull. Be'zoar mi'neral. See Bezoar fossile. BEZOAR'DICA RA'DIX. See Contraverva. BEZOA'RDICUM JOVIA'LE. Bezoar with tin. See Antimony. This differs very little from the anti-hecticum Pote- rii, and might as well be prepared by simple deflagra- tion with nitre, since it is a mere calx. BEZOAR'DICUS PULVIS. See Bezoar orien- TALIS. BEZOA'RTICUM, Bezoartic ; such was the opi- nion of the ancients respecting the virtues of bezoar, that physicians held it as a medicine highly efficacious in a vast variety of cases, particularly as a counter poison or alexipharmic, and placed a very great depend- ence on its powers; therefore, all medicines supposed to possess similar virtues, were termed bezoartica. Bezoa'rticum minerale. The common calx of an- timony generally supplies its place, for, like that calx, it is absolutely inert. BIA'NCA ALEXANDRI'NA. See Album His- panicum. BIBITO'RIUS MU'SCULUS,(from bibo, to drink). See Adductor oculi. BI'BULUS LAPIS, (from bibo, to drink, so called from its drinking or absorbing power). See Pu- MEX. BICAUDA'LIS MUSCULA'RIS, vel INTRICA'- TUS MU'SCULUS,(from bis, twice, and cauda, a tail, so called from having two tails). See Abductor auris, N° I. BI'CEPS MU'SCULUS, (from bis, and caput). A DOUBLE HEADED MUSCLE. Bi'ceps hu'meri, called also biceps internus humeri: Dr. Hunter calls it biceps flexor. It rises by two heads; one of them, Avhich is a slender tendon, from the up- permost part of the glenoid cavity; it runs across, within the cavity of the joint, under the ligament of the articulation, passes in the groove between the two tu- bercles, and, going down, grows fleshy. The second head rises from the extremity of the coracoid process, runs down the axilla, and joins the first, forming a ten- don, which sinks betAveen the interstices of the muscles, to be inserted into the tubercle on the inside of the ra- dius. This muscle, besides being a flexor, acts as a rotator of the radius, when the hand is prone. This muscle sends off an aponeurosis towards the inside of the arm, which is the part wounded when the tendon is said to be pricked by bleeding. This aponeurosis was first noticed by Cowper. Bi'ceps exte'nsor. This muscle rises by two heads; the longer, taking its origin from near the neck of the os humeri, runs between the teres major and minor, down the back part of the arm, and joins the short head which rises on the outside of the deltoid, and is inserted into the olecranum. Bi'ceps fe'moris. This muscle hath two heads; the longer rises in one mass Avith the semitendinosus, but, having advanced a little Avay, they part: they arise from the protuberance of the ischium on its back part; as the biceps advances it becomes fleshy. Between the biceps and the semitendinosus, the vessels lie in the ham. The short head rises from the lineal aspera, be- tween the insertion of the biceps and the origin of the vastus externus. The two heads join, and are inserted into the superior epiphysis, or outer part of the fibula. BI L 245 B [ L It bends the tibia, and partly rotates the leg by turning the foot outwards. CoAvper. BI'CHOS, (from bicho, port). A Portuguese name for the worms found under the toes in the Indies, and which are destroyed by the oil of the casheAV nut. BI'CION, (from fiixos, a pitcher, from the shape of its pod). See Vicia. BICO'RNE OS, (from bis, double, and cornu, horn- ed). See Hyoidis os. BICO'RNIS, (from the same). A muscle is so called Avhen it hath two terminations; also a. name of the flexor carpi radialis, and of the extensor carpi radialis. BICU'SPIDES, (from bis, twice, and cuspis, a point). Double pointed. See Molares. BI'DENS, (from bis, twice, and dens, a tooth,) so called from its being deeply serrated or indented : called also verbesina, cannabina aquatica, hepatorium aquatile, eupatorium Arabum, ceratocephalus, agrimony, and avater hemp. Bidens tripartita Lin. Sp. Pi. 116 5. Nat. order discoidee. The leaves have a light agreeable smell, and pungent bitter taste ; are supposed to be aperient, corroborant, and of some efficacy in icteric complaints, scurvy, and oedematous SAvellings of the feet. An infusion in boil- ing water, drunk freely, is the best method of using them. The juice of the fresh herb may be taken in doses from one to two ounces : larger doses operate by vomit and stool, and the root purges actively. Bi'dens zeyla'nica, Bi'dens urtica. See Ach- MELLA. BIE'NNIALIS, (from bis, twice, and annus, a year). Biennial. Herbs are said to be biennial when their roots continue two years. BI'FIDUS, (from bis, twice, and findo, to cleave). bifid, cloven; called also dicreus. BIFO'LIUM, (from bis, twice, and folium, a leaf) because it sends up two leaves upon one stalk : also called ophris, ophris major, orchis bifolia, didyme, ordinary wood bifol, and" common tavayblade. Op try s ovata Lin. Sp. PI. 1340. It is found in woods and other shady places, flowers in June, and rank- ed among the agglutinant astringents. Miller's Bot. Off. BIG A'STER, (from bis, twice, and yxs-l*ip, belly). A name given to muscles that have two bellies. BIGXO'NIA CATA'LPA, Lin. The leaves, as Thunberg informs us, are applied with success xto limbs affected Avith rheumatic pains by the Japanese. BILA'DEN. See Ferrum. BILIA'RIA ARTE'RIA, (from bills, appertaining to bile). The biliary artery. When the hepatic ar- tery hath advanced as far as the vesicula fellis it gives out the biliaria, which accompanies the two cystic branches in the gall bladder, and then is lost in the great lobe of the liver. See Hepatica arteria. BILI'MBI. (Indian). A tree of about eight or ten feet high, Avhich Bontius calls billing bing; and by the Europeans it is named malus hidica,fruclu pentagono. Averhoa bilimbi Lin. Sp. PI. 613. Nat. order terebin- thinacea. It is cultivated in the gardens in Malabar, bears flowers and fruit all the year. The juice of the root is cooling; that expressed from the fruit cures the itch, and several other diseases, if applied by laying on linen cloths that have been dipped in it. Inwardly taken, it abates the gripes and a diarrhoea. The ripe fruit is eaten as a delicacy, the unripe made into a pickle for the use of the table. There is another species called neli poll, or bilimbi altera minor, averhoa acida Lin. The male species of the nebipouli is called alapouli. Raii Hist. BILIO'SA FE'BRIS, (from bills, bile). The bilious fever; called also the marsh, remittent, autumnal remitting, and camp fever. Febris fiava, febris ma- ligna Barbadensis, icterodes. When a fever is accompanied with bilious discharges by vomit or stool, whether it be continual, intermittent, or remittent, it is called bilious. It is the second spe- cies of typhus in Dr. Cullen's Nosology, named icte- rodes, defined a typhus with yellowness of the skin. In his First Lines, vol. i. he observes that the typhus is a genus that comprehends several species; that these, however, are not well ascertained by observation; many of the different cases do not imply any specific difference, and seem to be merely varieties, arising, from a different degree of power in the cause, from different circumstances of the climate or season in which they happen, or from different circumstances in the»constitution of the persons affected. One effect, arising from these circumstances in the constitution of the persons affected, is an unusual quantity of bile ap- pearing in the course of the disease, Avhich is almost a distinguishing character of intermittent fevers; but if it should appear with a continued fever, it could only be considered in such a case as a coincidence owing to the state of the season, producing no different species or fundamental distinction, but merely a variety of the disease. In Britain it generally prevails in the first cold that succeeds hot weather; in hot countries it is most fre- quent in damp marshy places, and after great rains that are followed by great heats. In both situations, those who are exposed to damps, and to the night air, are most subject to it. Besides the causes in general of fevers, it is occa- sioned by a copious secretion of the bilious fluid poured into the duodenum and stomach, Avhence the symptoms proper to this fever arise. Besides the usual symptoms of fever, there are an ex- traordinary inquietude and anguish, a burning heat, cardialgia, nausea, vomiting, and purging; and, in con- sequence, a copious discharge of bile. The thirst is excessive, and the dejection of spirits equally so; the pulse is small but quick ; sometimes it remits very sen- sibly, at others the remissions are more obscure; and at last an inflammation of the bowels comes on. If the evacuations are cadaverous, death is approaching; and an involuntary discharge of the excrements is usually fatal. If the pulse is full and hard, bleeding may be ad- mitted in the beginning; a repetition is rarely, if ever, required; and in hot countries it is best to omit this evacuation. In all cases a grain or tAA'o of antimonium tartarisatum, as an emetic, is necessary. If saline medicines are given, the citrated potash is the most proper; but each dose should be administered in the act of effervescence. As soon as an intermission is perceived, the bark, Avhich is the chief dependence, must be given. But if the disease be very violent, or the disease occur in a B I L 246 B T L hot climate, the bark must be given before the inter- mission, for on its early use depends the cure; a drachm may be given every hour in wine and water, or what the patient uses for his common drink. If the bark, in substance, is not agreeable, a cold infusion of it may be substituted, which may be acidulated with the acidum vitrioli dilutum, and the patient may take it as freely and frequently as his stomach will bear. If it excites stools or vomiting, a few drops of the tinct. opii will prevent the inconvenience. Incolder climates and less urgent circumstances, the pulv. rad. columbo, gr. xv. ad xx. with the kali vitriolat. 3 i. ad 3 ii. given every four, five, or six hours, pro- duce both speedy and beneficial effects. The neutral salts, Dr. Percival observes, abate the febrile heat, allay thirst, and bring on a gentle salutary diarrhoea; Avhilst the columbo supports the patient's strength, obviates the sickness, and checks the septic ferment in the primae viae. Dr. Haygarth adds, that after the primae viae are cleared from their bilious contents, the columbo root allays the nausea so constantly attendant on this disorder: and that in this fever, though the remissions are very evident, and the accession marked with chills and other symptoms of an intermittent, yet the bark is not always so successful in this climate as to encourage its use. The columbo, he observes, answers our warm- est wishes, by correcting the bile, restoring the proper tone of the stomach, and of the Avhole habit; it also pre- vents relapses, to which, in this fever, the patient is peculiarly disposed. Bilio'sa a'rdens fe'bris. The burning bilious, called also the yellow, fever, the West Indian fever. It is a variety of the typhus icterodes of Cullen, and has no connection with the biliosa febris just noticed, except in the bilious discharges, and the colour of the skin. This, as just observed, is a typhus of a very rapid and dangerous kind, as nervous debility, torpor, and mortification, soon come on. It is the fever which has made such considerable devastation on the North American continent, and, with a little variety, in Spain and Gibraltar. It has proved a more general and fatal epidemic than any other, the plague excepted, to which it bears no inconsiderable relation. This subject Ave must however soon again return to. It attacks with a transient chilness and shivering, which are soon succeeded by a burning heat all over the body, but more particularly about the praecordia: the pulse is high and quick, but not hard; the eyes are heavy, the face flushed, a violent headach comes on, with beating in the temporal arteries, and a thick labo- rious respiration; a nausea soon follows, and what is discharged upwards is black and highly bilious. Anxiety is very great; a shooting pain is complained of in the back and loins, and an uneasy lassitude in the limbs. In about twelve hours after the first invasion of this dis- ease, the tongue is very dry, rough, and discoloured; thirst is excessive, vomiting incessant, anxiety increas- ed, a soreness is felt all over the body, and a delirium comes on. In the last stage, which soon arrives, the patient labours under a coma, manifests a great oppres- sion about the praecordia, the respiration is very difficult, the face swollen and darkly yellow, and at length the tendons tremble; cold sweats and convulsions usher in death. Blood taken the first day is florid but thin, and the crassamentum scarcely coheres : on the second or third day it is still more loose, and the serum is more yellow. When the patient recovers, the crisis usually happens in the fourth day after the attack, and generally discovers itself by a brighter suffusion of the bile all over the body. The yellow tinge sometimes appears in the eyes twelve hours after the symptoms of this fever come on; the sooner it appears the more favourable is said to be the prognostic. 'This however is not correct, for the bilious suffusion is only salutary when the disease is protracted. If the skin continues dry and rough the patient rarely recovers, however good his pulse may be. Incessant vomiting, and the discharges growing darker coloured, with dark spots on the skin, are fatal signs; and if a dry skin accompany an inflamed redness of the eyes, death may be expected in a few hours. The violence and fatality of this disease have direct- ed very poAverfully the attention of physicians to its na- ture, and particularly of those who have been engaged in the conduct of such epidemics. As it obviously oc- curred at the period Avhen autumnal remittents Avere common on the American continent and in the southern parts of Europe, it was highly probable that this was only the usually returning epidemic, from accidental circumstances rendered more violent and fatal. Yet Avhen its nature Avas more closely examined, this idea was entertained with greater hesitation. It was ob- viously bilious, but less clearly remittent; its rapid progress did not keep pace with that of the true bilious fever, and symptoms of peculiar debility came on in a very early stage. Io short, it Avas highly probable that it was a typhus, attended with bilious symptoms, rather than a remittent of a peculiarly malignant kind. Some little remission may be observed in the earliest stage, but it is transient, and perhaps not more than by careful attention may generally be observed in typhus. When the violence and malignity of the disease Avere ascertained, no country was,willing to claim the de- structive visitant. It was supposed to be an importa- tion, and probably was so. At Martinique it Avas the fever from Siam : in America, from Bulam. The dis- cussion would be too long; but, from a careful exami- nation of all the facts, it appears probable that some contagion, uniting with the epidemic tendency of the bilious autumnal remittent of the country, has pro- duced the destructive monster. The observations in Philadelphia seem to trace it to some foreign importa- tion. At Martinico, at Grenada, and Jamaica, there appears always to have been a concurring cause. It is doubtful, hoAvever, Avhether this is constantly contagion. The putrefaction of vegetable and animal substances, which in any situation may occasion typhus, in concur- rence with the autumnal remittent, may produce the yellow fever. These views will discriminate it from the causus4 from the gaol and hospital, as well as from the common bilious fever. In the gaol fever there are little accumu- lation and discharge of bile: in the others, little of the asthenic and putrefactive state. When we consider fever more generally, we shall distinguish these states, and point out in what cases putrefaction may produce debility, and where debility occasions putrefaction. The yellow fever and the plague are, we think, referable f the latter; and the distinction is not an object of cu- riosity and refinement only, for it assists in directing the cure, particularly the exhibition of the Peruvian OIL 247 B1L bark. Much idle—it is an improper Avord—many highly pernicious disquisitions have been indulged, whether this fever is contagious. The existence of a doubt shows that it may not be highly so. Yet it has in so many instances been communicated from an infected person, that the utmost caution is requisite. It has been even doubted whether the plague is contagious; but those who have suggested and disseminated the doubts, are answerable for the lives of thousands, and in some in- stances have paid the forfeit with their own. On dissection, the contents of the brain and thorax were uninjured; but the blood is fluid like that of per- sons who have been destroyed by electricity. The sto- mach and duodenum were generally inflamed; some- times a little extravasation; sometimes pus and a black fluid, black, generally from containing flakes, and evidently a depraved secretion of bile, were observed. On the surface of the odier viscera some distended veins Avere seen, but the liver was generally sound. Negroes and mulattoes escaped better than the white inhabitants, and those were less frequently and violently affected than strangers. In America, however, the in- habitants and strangers Vere equally susceptible of the disease. The American physicians have differed greatly in opinion, whether this fever was an inflammatory or a putrid one. The difference has, we fear, led each party to an injurious plan of treatment: which, as usual, has been pursued with more pertinacity, because it was their own system. We see in this disease, as Ave have said, an asthenic fever, joined with biliary accumu- lations ; a fever hastening rapidly to a fatal termination, while we do not possess a power of supporting the strength without previously exciting proper discharges; or of producing the necessary evacuations without in- ducing a fatal debility. The great debility, the anxiety, the sighing, the distended veins, prove the existence of a highly asthenic state. The absence of internal mor- tification shows, that if the disease becomes putrid, it is when long protracted. In the cure, Dr. Rush, adopting the idea of its being inflammatory, bled largely and repeatedly ; he adds with success. But were his success so conspicuous, his bre- thren would not probably have so strenuously urged an opposite plan; nor would the relations of the patients screamed Avith terror when the bleeding was proposed. This he tells us has often happened. Though we con- sider Dr. Rush, however, as the slave of prejudice and system, we believe him to speak Avhat he thinks; and we can easily suppose that early bleeding in the man- ner described may have been useful. We know that Sydenham bled in the plague, and Dover in putrid fevers; we know, too, that other practitioners in the West Indies have bled in the yellow fever with ad- vantage. The bleedings must however be large, and confined to the first twenty-four, or at most thirty-six hours. Dr. Rush at first extended the period in which mis remedy might be proper, but in the following epi- demics was more cautious. It is not necessary to as- sign a reason for the utility of bleeding, though Ave can perceive some foundation for the practice. When in asthenic cases the blood is determined to the larger ves- sels, if these are not excited to action by the distention, they become still more torpid. Lessening actively the general mass relieves the over distended torpid vessels in a greater degree than the loss of blood Aveakens the whole system: their action commences, and the salu- tary discharges are induced. To fulfil the other indications may appear an easy task; the stomach and bowels are to be emptied, the bark and wine given, and the Avhole is at an end. Such is the easy track of the theorist. In practice, however, we find the stomach so highly irritated that we dare scarcely add to the irritation. To assist the vomiting with mild, diluent, nutritious fluids, as mutton, and chicken broth; or, if the urgings are violent and in- effectual, to aid them Avith a small dose of ipecacuanha, or tartarised antimony, is all that can be alloAved. We have already remarked, that all neutral salts possess a:i anti-emetic power, and a dilute solution of these with manna and tamarinds may be drunk frequently to eva- cuate the bowels. Some physicians have added a small proportion of tartarised antimony; and this medicine, in the dose of one-sixth or one-eighth of a grain, will sit easily on the stomach, and tend rather to produce a discharge downward than to vomit. In some instances where the vomiting and diarrhoea are dangerously vio- lent, a slight opiate may be given to regulate rather than repress them. When a sufficient discharge is procured where ne- cessary, or regulated when excessive, warm cordials may be safely employed to support the strength; and wine cautiously given, observing its effects, and from these directing its repetition or omission. The dis- charge by stool must be kept up according to the symp- toms and. the nature of the evacuations. Respecting the cordials and tonics practitioners have differed: the bark irritates the stomach and boAvels, and can seldom be retained. When it is so the effects have not often been salutary. The contrayerva and serpentaria have been employed; but the disease treated by Hillary and Lining seems scarcely to have been the violent fever, which has so lately forced itself on our attention, and animated our-exertions. The columbo root may be useful in correcting putrid bile, but it has a very incon- siderable effect as a tonic. The quassia is by far more serviceable, and the cascarilla has been employed with advantage. Practitioners have greatly differed respecting the pro- priety of applying blisters. The discharge from these is thin, acrid, and yellow; nor have they been seemingly of any utility. Indeed they are not apparently indicated in any stage of the fever, except from the affection of the head, which is rather a mark of debility than of fulness. Theoretical views have occasioned the dis- cussion rather than observation of their effects; and their power of attenuating the blood, of which there is not the slightest evidence, has been the chief subject of dispute. Acrid cataplasms to the feet have not been more useful; and the Avarm bath, though often em- ployed, seems to have done little service. The whole plan of cure consists in evacuating the stomach and boAvels Avith the least irritation, and supporting the force of the circulation. Two other plans have engaged the attention of prac- titioners. The folloAvers of Brown, with the rashness and indiscriminate violence of sectaries, urge their tonic plan of cure, and give at once the Avarmest stimulants-. Bl L 248 BIL If the view avc have given of the disease be correct, Ave need not say with what success over distended vessels are thus excited to transitory and ineffectual action. In fact they have been very unsuccessful. The second plan is that, avc believe, noAV generally folloAved, viz. the mercurial. Calomel unites the dif- ferent objects, since it not only evacuates the alimen- tary canal, but effectually stimulates the vessels of the biliary system, and supports the action of the smaller vessels. When the boAvels are so irritable as not to bear its being given internally, frictions of mercurial oint- ment Avill supply its place. This practice is not yet unquestionably established, but it is rapidly gaining ground, and'promises to be highly useful. The mer- cury must be introduced as usual into the system, until some sign of its actiomon the minuter vessels is observed. The late fever in Spain and Gibraltar showed the same marks of asthenic venous accumulation, with a similar affection of the biliary system. We cannot perceive, from the very accurate description in one of the last volumes of Dr. Duncan's Annals, that it had any very peculiar or discriminating marks to distinguish it from the yellow fever of America. Nor have Ave found a single improvement in the conduct which re- quires a detail. See Bisset on the Bilious Fever of the West Indies. London Med. Obs. and Inq. vol. iv. p. 156. Blicke on the Bilious Fever of Jamaica. Sir John Pringle, Drs. Chalmers, Lind, ToAvne, Warren, Cleghorn, and Rouppe. Of the more modern authors Dr. Rush, Dr. Chisholme, Drs. Mosely and Grant, merit the most considerable attention. BI'LIS. In Ainsworth it is derived from (pxvXos, scil. succus, juice; and also fel, bile, or gall; and we knoAV no better etymology. It is a bitter viscid juice, secreted from the blood in the liver, and collected in the receptacle knoAvn by the name of gall bladder. The blood collected from the ad- jacent abdominal viscera is thrown into the vena portae in the liver, from Avhence it is secreted. When formed, it is carried to the beginnings of the biliary ducts, called pori, or more properly tube biliarie, and by them is con- veyed into the ductus hepaticus. This duct, passing on a little way, enters into the ductus communis chole- dochus, Avhence the bile is partiy discharged into the, duodenum, partly regurgitates into the ductus cysticus, and falls into the gall bladder. By lodging there some time its thinner parts transude, or are reabsorbed, and the rest becomes thicker and more acrid; increases in bitterness, and the depth of its colour. The hepatic bile before it is mixed with the cystic is subalkaline and rather oily ; it continually passes into the duodenum, but the cystic only when required. The bile is formed from the blood in the secretory vessels of the liver. It is of a yelloAV colour, varying to green ; has a bitter taste, Avith something like sweet- ness ; the mucilage Avhich it contains is decomposed, not coagulated by acids, and some of their compounds ; the acids precipitating only a part which is resinous. It is soluble in alcohol, but incompletely. It has a peculiar smell of the species of animal in which it is produced, and is a powerful antiputrescent. Dr. Saunders, from some experiments, draws the following conclusions re- specting the elements forming the bile, and says it con- sists, 1st, Of water impregnated Avith the odorous prin- ciple. 2dly, A mucilaginous substance, resembling the albumen ovi. 3dly, A resinous substance, containing the colouring principle and bitter taste. 4thly, A mild mineral alkali. With respect to their combination, it seems that what has been styled the saponaceous matter consists of the bitter resin in union with the alkali; this admits of a ready union Avith a mucilage, and with this again the aqueous matter very easily combines, so that the whole forms an apparently homogeneous mass. The soap, or the saponaceous matter of the bile, is equally soluble in Avater and alcohol. It is the least putrescent of any fluid in the body; its apparent use is to mix the chyle, to support the pe- ristaltic motion of the intestines, and to assist in com- pleting the assimilation of the food. When the stomach is full, the cystic bile is more copiously discharged into the duodenum; when it is empty, the hepatic more freely into the gall bladder. The odour of the bile is nauseous, though when eva- porated or spontaneously decomposed resembling that of musk, an odour which at times the perspirable mat- ter, if confined, will also exhale. Its specific gravity to that of water is 1.0246 to 1.0000. It is perfectly solu- ble in water. Acids separate the soda and the coagu- lated albumen; and the bitter inflammab'e matter, styled the resin, is left in the filter. The sulphuric- acid gives the bile a deep green colour; concentrated nitric, a brilliant yellow; and the muriatic, a beautiful clear green; oxygenated muriatic acid destroys the colour of the bile, and coagulates its albumen, Avhich it precipitates, furnishing the albumen seemingly with oxygen. The colourless bile, however, still contains an oil, though changed by the oxygen, so as to be soluble in water. This oil is precipitated by an acid, and con- sequently the fluid still seems to retain a portion of soda. Bile contains also a white crystalline matter, Avhich sometimes contributes to the formation of biliary calculi, but it differs-greatly from, the white oil, since it is more soluble in alcohol, and not precipitated in laminae. The oil also is as fusible as fat, but the laminae require a heat exceeding that of boiling water. When putrified in a considerable heat, its odour is more nauseous ; its colour changes; white mucilaginous flocks are precipitated; and it becomes more fluid. When putrefaction was further advanced, the smell be- came more pleasant, resembling that of ambergris. From inspissated bile kept a long time without decom- position, the musky odour may be obtained by distil- lation, combined with the water. The coal remaining after distillation contains carbonat of soda, phosphat of lime, and a small proportion of oxid of iron. Four- croy adds a small proportion of prussic acid, to which probably the bile owes its bitterness; but this part of the subject we shall soon again notice. The sapona- ceous nature of the bile has occasioned many dis- quisitions and disputes. It is, undoubtedly, not a soap in the strict chemical sense of the term, though ap- proaching a saponaceous nature; but, as on this point no physiological question hinges, Ave need not enlarge on it. Various authors have supposed that bile exists al- ready formed in the blood. Mr. Higgins, in his Com- parative VieAV of the Merits of the Phlogistic and Anti- B I L 249 B I L phlogistic systems, describes some experiments on the Wood, in which a yellow matter not unlike bile was separated: and Fourcroy, by a more complicated pro- cess? has changed the blood into a fluid resembling bile. Yet, in the economy of the animal system, in all its subordinate gradations, there is no organ more constant than the liver, no apparatus of secretion more com- plicated than that for preparing bile. In the human body, the blood designed for this purpose, has already cir- culated, without being again exposed to the atmospheric air, so that it is deoxygenated; but the fluid itself resists rather than promotes putrefaction, nor do we find it on experiment highly azotic. The bile, it is said, neu- tralises acids; and, as in children it is thin and wa- tery, authors have supposed that it performs its office imperfectly, and that for this reason acids abound in their stomachs. Bile, hoAvever, never passes naturally into the stomach, and when there produces consider- able inconvenience: on the other hand, though acid may be prevalent in the stomach, it does not appear beyond the duodenum, Avhere the contents of the stomach meet with the bile. One of its use is, therefore, very proba- bly to correct acidity. Its saponaceous nature Avas said to assist the union of the "oil and water in the formation of chyle; but this idea is effectually destroyed by the experiment of Dr. G. Fordyce, who tied the ductus choledochus communis, and still found the lacteals filled with a chylous fluid. The ancients supposed the liver to be the organ by which the nourishment was prepared; and.Fourcroy has lately endeavoured to revive the opinion, supposing that the long protracted circulation was destined to unite more intimately the molecules of the blood with the neAV nourishment, with the air taken in by the lungs, and that formed during the circulation. When Ave re- flect on the general importance of the liver, and that its place cannot be supplied by any other organ; Avhen the emaciation which folloAVs its diseases, and the immense size to Avhich inactivity Avith highly nutritious food en- larges it, this idea will appear to have greater force. Yet we think it acts only, in this respect, a secondary part. We shall find, in our enquiries into the process of digestion, a very great change produced by it on the food taken in; an immense distance betAveen, for in- stance, the herbage of the field and the muscular fibres of the sheep and ox: Ave shall, of course, perceive the necessity of a powerful agent for the production of this change. A fluid highly animalised, is necessary to join the vegetable matter before it is permitted to mix Avith the general mass; for the mildest chyle immediately injected into.the vessels is fatal: and this matter must be very distant from a putrescent fluid, since this pro- cess, already going on in the sanguiferous system, re- quires a check rather than a ferment. It is then a fluid necessary for perfecting the assimilation of the aliment, and giving to the chyle some principle Avhich enables it to join the general mass with impunity. We con- sequently- see it formed from blood which has under- gone a languid circulation, but not from those parts Avhere it might meet with a putrid fomes; for the hae- morrhoidal veins do not form a portion of the vena por- tarum. This blood is said by some authors to be pe- culiarly fluid; it probably contains a larger portion of soda, with hydrogen and carbone. The two latter, in consequence of the languid circulation uniting Avith VOL. I. the remaining oxygen, form Avith the fibrin of the blood. the oil, which is rather a spermaceti than a truly oleaginous fluid. In those animals Avhose re- spiratory organs are small, the liver is unusually large ; ana Ave find birds, whose livers are naturally small, Avhen pent up in a close coop, have this gland con- siderably increased in bulk. When this oil abounds and the fluid no longer holds it in solution, a crystalli- zation takes place, and biliary calculi are formed, of which Ave shall afterwards treat. See Calculus bi- liaris. It is observed, in general, that the gall of small ani- mals is stronger and more acrid than those of larger kinds ; that the gall of carnivorous animals is more ac- tive than those of herbivorous. Instances are those of the hawk, serpent, eel, and pike, but in general all their secreted fluids are more acrimonious. Physiologists have warmly contended, Avhether the bile Avas derived from the hepatic artery or the vena portae. But, as the former artery is small, as its rami- fications are not peculiar, and as the circulation in the latter is singularly complicated, and has no apparent object but the preparation of a very important fluid, it is generally supposed that the hepatic artery only nour- ishes the viscus, while the secretion is exclusively from the contents of the vena portae. The changes of the bile from disease are not nu- merous, but merit particular notice. We have intro- duced the appearances which putrefaction really oc- casions, to shoAv that this state of the bile is often ac- cused, when in reality it does not exist. The dark acrimonious bile is often a depraved secretion; and the dark flakes in bile are equally produced by a de- rangement in the functions of this organ. These are generally the result of too great indulgence in spirituous liquors. Bile Avill sometimes assume so dark a hue as to be mistaken for blood. Dilution destroys the error; for the diluted fluid has a yellow tinge; and the flakes, to which this dark colour is often owing, are then ob- vious. With acids the bile assumes a greenish colour; and, as bile Avhen in the circulating system is soon carried to the kidneys, Ave once saw it convey this green hue to the urine. The cause Avas evident, since an alkali destroyed it. Another disease of the bile is an oiliness; in other words, the adipocire becomes a more perfect oil, which the soda does not unite to the Avatery part of the fluid. It is often vomited in this state, and is the strongest proof of a considerable in- jury experienced in the process of digestion. The de- fect of bile is knoAvn from the white colour of the stools; but more certainly from the appearance of bile in the urine and under the skin. We see occasionally the kidneys torpid from a paralysis of the renal vessels, but Ave recollect no instance of a want of bile from the same cause. Fernelius, in his Pathology, speaks of a defect of bile as producing different diseases; but he means rather an obstruction, and that kind which is oAving to a scirrhous liver. In fevers the bilious discharges are often copious and troublesome; and the liver is the organ generally- affected Avhen the fluids are not propelled to the sur- face, since its vessels chiefly contain the blood from the venous system. Yet copious discharges of bile are pe- culiar to remittents and intermittents, though in con- tinued fevers of every kind the liver is unusually filled— K k B 1 L 250 BIS in medical language infarcted—and peculiar attention to the discharge of its contents is required. According to the supposed uses of the bile has it been employed as a medicine. It is a saponaceous ape- rient, a stomachic, a laxative, or a tonic, if the opinion of the author is in favour of either system. When the bile is deficient, it has been supplied with that of the ox; the practitioner forgetting that bile in the stomach Avas the source of numerous inconveniences, particularly sickness, faintness, and cold sAveats. It has, hoAvever, been fortunately given in pills, and escaped the stomach Avithout greatly disordering it. That bile is a stimulus to the action of the intestines is more probable; yet in jaundice Ave have not found costiveness peculiarly pre- valent, and it seems to have been marked as a symptom rather from theory than observation. Inspissated bile of oxen has been given to children in a dose of one grain, and to adults in three or four, three or four times a day, to relieve visceral obstructions, to promote urine, and the menses ; or half a drachm has been ad- ministered in clysters. If this has not succeeded, Boerhaave recommends the gall of the eel or pike; and remarks that the hard bellies of rickety children have been relieved by these remedies. We cannot doubt the utility of such an acrid fluid ; but the small proportion of an ox's bile above recommended can have very little effect. If it has any, we cannot think that it would be a salutary one. In jaundice it has been given to supply the defect of bile; but modern practice disregards it, and we cannot speak of it from experience. On recur- ring to those authors who have recommended it, we find those vague and general praises which in similar circumstances we have had so much reason to distrust. As putrid, acrimonious, and copious discharges of bile from the intestines are so often accused as causes of disease, when in reality they are only effects or symp- toms, so in the stomach it is often supposed to be in- jurious, when brought by the medicines intended to discharge it. When bile is suspected of producing in- convenience in the stomach, and an emetic is given to discharge it, we often find no bile evacuated, but the next food or medicine brings it up; in fact the fluid, which the emetic, by inverting the action of the duo- denum, had brought into the stomach. A too copious secretion of bile sometimes occasions inconvenience, and in this case the alternation of laxa- tives and opiates removes the cause of complaint. We have thought that opiates really check the secretion of bile; but as any stimulus on the mouth of the opening' of the ductus communis will increase the discharge, opium may act only by diminishing its too great sensi- bility and irritability. We may just add, that, in judging of the pains occasioned by accumulations or obstructions of bile, we must recollect that the under edge of the gall bladder, and the entrance of the biliary duct, are nearly at the pit of the stomach; the pain is felt there when 3 stone enters the duct, and a fulness is perceived in that part when there is an accumulation of bile. The course of the duct is then backward; and when the stone is near the extremity of the duct which opens into the duodenum, the pain is felt on the opposite side at the back. Haller's Physiology, in the chap, on the Liver. Per- cival's Essays Med. and Exp. Fordyce's Elements of ihe Practice of Physic, part. i. Macbride's Experimental Essays. The Appendix to Sir John Pringlc's Diseases of the Army. Maclurg on the Human Bile. Coe on Biliary Concretions. Saunders on the Structure, Eco- nomy, Sec. of the Liver; and Fordyce on Digestion. Fourcroy Systeme .de Connoissances Chimiques. Cadet Experiences Chimiques. BI'LIS A'TRA. See Atrabilis. BI'LLING-BING. See Bilimbi. BINA'RIUS, (from binus, double). Among the Romans it is the number two. But the Spagiric phi- losophers affix other ideas to it. See Theat. Chim. vol. i. BINGA'LLE. See Cassumunar. BINO'CULUS, (from binus, double, and oculus, the eye). A bandage for retaining the dressings on both eyes. It is either a single or a double headed roller, is twelve feet long, and two or three fingers in breadth. Its application will be easily understood by referring to Monoculus. BI'NSICA. ■ A Rabbinical term signifying mental sickness, or a disordered imagination. By the addition of mors to this term,it is a binsical death; the death Avhich follows the disorders of the mind, such as are produced by the bite of a mad dog. BINTA'MBARU ZEYLANE'NSIBUS. (Indian). Convolvulus maritimus Zeylanicus; pes capre Lusita- nia; the convolvulus pes capre Lin. Sp. PI. 226. A plant growing in Malabar and Ceylon; it abounds with an acrid milky juice. A drachm of the resin of the root purges. Raii Hist. BIOLY'CHNIUM,(from /3,oS, life, and Xv^nov, a can- dle or lamp).- The lamp of life. . Vital heat, vital flame, or natural heat. See Calidum innatum. It is also the name of a secret remedy prepared from human blood by Beguinus. Bl'OS. (Greek). Life and its course. But some- times it only means victuals. BIO'TE, (from /3o5, life). Life. In an affected sense it signifies the time of a continuance of aliment in the body; thus weak food hath a short life annexed. BIOTHA'NATI, (from (iix, violent, and Sxvxlos, death). A term applied to those who die a violent and sudden death; it is sometimes applied to suicides. BIPINE'LLA, and BIPEMULLA. See Plantago MINOR, and PlMPINELLA. . BI'PULA. A worm mentioned by Aristotle. BI'RA. See Alla. BIRA'O. See Amomum. BIRD'S NEST. The nest of the hirundo esculenta. See Aliment. BIRE'THUS, (from (iippos, a priest's hood, from its resemblance). See Cucupha. BI'RSEN. An Arabian or Persian word, signifying an inflammation or imposthume in the breast. BIRTH. A term in midwifery. It is styled natural, when the head presents; premature, Avhen at too early a period; preternatural, when any part but the head presents; and laborious, Avhen from obstacles or weak- ness it is protracted. See Labours. Birth wort. See Aristolochia. BISCO'CTUS, (from bis, twice, and coquo, to boil). Tavice dressed. This word is chiefly applied to bread twice baked, or that is much baked; i. e. biscuit. BISCUIT, SEA. This is doubly baked; but its ex- cellence consists in its not being fermented, and conse- quently not easily becoming acid in the stomach. It B 1 8 251 BIT is on this account more fit for children, and those troubled with acid in the stomach. These biscuits may be long kept; and the rusks, Avhich are also twice baked, have the same advantage, but are not equally useful with the unleavened biscuit in diseases. See Bread. BISE'MATUM. See Plumbum. BISLI'NGUA,(from bis, twice and lingua, a tongue,) so called from its appearance of being double tongued, or of having upon each leaf a less leaf. See Laurus Alexandrina. BISMA'LVA. Supposed to be a corruption of the word vii>malva, quasi viscum 7nalva, from its superior viscidity. V and B Avere convertible letters, and hence this line of Scaliger: ' Felices populi quibus inhere est bibere.' See Althea. BISMU'THUM,(from bismut, German). Bismuth ; also called wismuthum, marcasita, Galena inanis,plum- bum cinereum Argricole, blende Germanis, marcasite of silver, and tin glass. It seems not to have been knoAvn to the Arabians, for their marcasite avbs the lapis pyrites; and the first traces of it occur in Basil Valentine. It is a brittle metal of a silvery whiteness; of the specific gravity 9.8217, melting at 460° of heat, smoking, and in a more intense fire rising in fumes. If calcined in close ves- sels the calx is in part volatile: if agitated it grows yellow, next red, and soon becomes a glass, vitrifying with it some of the less perfect metals. It may be easily powdered. The nitrous acid dissolves it, from which it is precipitated in the form of a bright white powder by dilution Avith water, The marine acid does not readily affect it, and the vitriolic scarcely at all. It impregnates the vegetable acid with a nauseous taste, and from all the acids may be separated by water alone in the form of a milky calx. By zinc and iron it may be precipitated in a metallic form. The chief of it brought into England is from Saxony. Dr. Alston de- nies that the ores of bismuth contain any arsenic; it is true that the bismuth, when brought to us, is Avithout such particles. It mixes easily with several metals, but destroys their ductility. It promotes the fusion of other metallic bo- dies. Mixed with lead and tin it forms a compound that melts Avith a very small heat; the following pro- portion is so fusible that it hath been proposed for ana- tomical injections, two parts of lead, three of tin, and five of bis77iuth. If bismuth is mixed with lead, a larger portion of the latter can be combined with quicksilver than Avithout this method; and the quicksilver cannot be by the common methods. The magistery of bismuth is a precipitation of the calx from nitrous acid by means of water, and with the addition of poAvdered pearls. It is styled pearl white, and chiefly used as a cosmetic. Internally, it has been said to occasion great anxiety. Dr. Odier has, hoAvever, recommended it in hysteric colics, diarrhoeas, and all diseases OAving to too great irritability, particularly in the violent pains arising from a scirrhus of the pylorus. Carminati of Pavia, and Bonnat in France, have also experienced its good effects in similar diseases. Dr. Odier found it serviceable in the toothach. The dose is one or two grains suspended by mucilage, gradually increased to six, and by Odier to twelve, four or five times in a day. The Spanish avhite is a magistery of bismuth, macfe by dissolving it in spirit of nitre, and precipitating it with salt and water. The calx further calcined has been commended by Jacobi, but not employed by any of his successors for more than a hundred years. BISTA'CIUM. See Pistacia. BISTO'RTA. Bistort: quasi bis torta; twice twisted, or Avreathed. So called from the contortion of its roots. Called also the greater bistort, or snake- aveed; colubrina, beadira7non. It is thepoligonum bis- torta Lin. Sp. PI. 516. Nat. order oleracee. "It is perennial, a native of Britain, grows Avild in moist meadows about Battersea, and by the side of Bishop's Wood near Hampstead, and flowers in May and June. The root is bent vermicularly, and jointed at each bending. It is commonly about the thickness of a fin- ger, surrounded with-bushy fibres, of a blackish brown colour on the outside, and reddish within. It is distin- guished from the other bistort roots by being less bent; that of the officinal species having only one or two bendings, and those of the other three or more. This root is powerfully astringent, and as such anti- septic. It is of a singular efficacy in haemorrhage, ob- stinate fluxes, looseness of the teeth, spongy gums, and soreness in the mouth. It is said to be refrigerant; but this is from its being antacid, whence all astringents are cooling. The dose is from gr. x. to 3 h Water totally dissolves its astringent matter. Extracts made with Avater, or with spirit, retain all the styptic quali- ties. All the parts of this plant possess the same qua- lities as the root, but in a less degree. If the roots are boiled in vinegar, an excellent antiseptic gargle is ob- tained. Dr. Cullen says it seems to be one of the strong- est of our vegetable astringents, and justly commended for every virtue that has been ascribed to any other: he has frequently employed it in intermittents, and has given it both by itself and Avith gentian to. the quantity of three drachms in one day. Cullen's Materia Medica. The tormentil root is so similar in its efficacy, that it may ahvays be substituted for it. BISTOU'RY. In surgery is a small knife, either straight or crooked, single or double edged, round point- ed or probe pointed. Its form must be regulated by the purpose for which it is employed. Sometimes a director or a grooved canula is employed, along which the knife passes; and at others the instrument is con- cealed in a kind of sheath, Avhich supplies the place of a director, and raised at the moment it is to be em- ployed. BlSU'L. An abbreviation of bisulcis, (from bis, twice, and sulcus, a furrow,) cloven footed. Bl'THINOS. The name of a plaster described by Galen. BITHNIMA'LCA. A word coined by Dolaeus to signify a peculiar acting principle residing in the sto- mach, and presiding over the functions of digestion and chylification; called also gaste7'anax. BITHY'NICI TONSO'RIS EMPLASTRUM. The Bithnian barber's plaster for splenetic people. See -^Etnas' Tetrabib. iii. serm. ii. cap. xxii. BI'TI. (Indian.) A tall evergreen tree in Malabar, and other parts of the East Indies. An oil is prepared from its root to cure the alopecia. BITTERN. The oily fluid left after the crystalliza- tion of salt, stvled the mother Avater, eau were, since Kk 2 B I T 252 B L E no other salt will crystallize in consequence of the vis- cidity of the fluid, arising from the oily matter, occa- sioned by the decaying fish molluscae and alga. It con- sists chiefly of vitriolated magnesia, and from it the Epsom salt is now prepared. BITTERS. See Amara. BITTER ALMONDS. See Amygdyla. Bi'tter gourd, or apple. See Colocynthus. Bi'tter purging salt. See Sal catharticum ama- RUM. Bi'tter saveet. See Solanum. BITU'MEN, 7x-, to hurt; so called from its injuring books or clothes,) or BLATTA FCETIDA. The SLOAV-LEGGED BEETLE, Or BOOK WORM. It is that species of beetle Avhich is so common in bake houses. If they are boiled and bruised in oil, then dropped into the ear, they are said to relieve pains in that part. BLATTA'RIA LUTE'A, (from blatta; so called because it engenders that reptile). Yellow moth mul- lein. It is said to possess the same virtues as the ver-" bascum, but merits no particular notice. BLA'TTI, sonneratia acida Lin. Supplem. 252. Wil- denow, vol. ii. 999. The seeds are surrounded by an acid juice, and the fruits are dressed as alimentary sub- stances. The leaves are applied to the head to relieve vertigos, and their juice is supposed useful in aphthae. BLEE'DING- See Phlebotomiv. BLE'NDE. A German name for bismuth. See Bismuthum; Zincum. BLE'NNA, or Ble'na, (Greek, mucus). A thick phlegm descending from the brain through the nostrils. BLE'NORRHAGIA,andBLE'NORRHCEA,(from fiXewos, mucus, and peS, fluo). A neAvly formed genus of disease, to supersede the probably too general use of catarrhus. It is intended to include the mucous BLE 253 BL1 discharges, but it should have been confined to those from the genital and urinary systems. We shall divide them into discharges from venereal, from miscellaneous acrimony, and from relaxation. For the first, see Gonorrhoea. The acrimony we have styled miscellaneous, may be any internal irritation, the stimulus of cantharides, or some other poison; gouty irritation, calculus, and cancer. See Strangury and Cancer. The blenorrhcea is attended with very slight, if any, inflammation; though this may be occasionally excited by free living, riding on horseback, excess of venery, or either of the former acrimonies. But, except from the venereal poison, this superadded inflammation is tran- sitory. The discharge may occur from any part of the urinary or genital organs. See Gonorrhoea benigna, Leucorrhosa, Catarrhus vesica. BLE'PHARA ; quasi, ^>Xe-xovs Qxpos, as being the cover or defence of the sight. See Palpebrje. BLEPHA'RIDES, (from pXeQxpov, an eye lid). The hairs on the edges of the eye lids ; also that part of the eye lids themselves on which the hairs grow. BLEPHAROPTO'SIS,(from/3Ae^0i,/2c//2^ra, eye lid, and kImo-is, casus, descent,) called also ptosis. A DISLOCATION, Or DISPLACING OF EITHER, Or BOTH EYE lids, by elongation, retraction, turning inwards or out- wards, with different symptoms in different species. But the true blepharopjosy, or preternatural descent of the eye lid, arises from a wound of the frontal muscles of the temple, or the superior levator of the eye lid, or from any large tumour dragging down the eye lid; from inflammatory or cold defluxions elongating the palpebra; from mere relaxations of the eye lids, or from a palsy of the palpebra, which is sometimes constant, sometimes periodical. See Ptosis. The varieties of this species are obvious. With re- spect to the first it must be remarked, that the cheek of the same side, the lower jaAV, the tongue, eyes, and other parts, are affected. The second and third varieties are cured by conquering the primary disease to which they owe their origin; to the fourth, corroborating spi- rituous fomentations are useful; to the fifth anti-para- lytic remedies administered externally and internally. If these remedies do not properly succeed in the tAvo last, a cure must be sought for from a surgical operation, performed on the prolapsed palpebra, or on the skin of the forehead. Internal remedies are scarcely useful; but such as will draw off the superabundant serous fluids, which are chiefly purgative and diuretic remedies, particularly jalap, and sal diureticus, may be employed. Amongst the remedies for any paralytic affection, elec- tricity may be mentioned as occasioning the increased action of any particular muscle. In that variety said to proceed from relaxation, the use of alum with an infusion of oak bark is recommended for an external application; but if it does not succeed, the relaxed skin must be cut away, and the edges of the wounds confined together by sutures, and healed in that situation. There are se- veral other species of this disease. See Ectropium, Trichia. BLEPHAROTIS, (from (iXepxpov, the eye lid). In- flammation of the eye.lids. See Ophthalmia. BLEFHARO'XYSIS, (from pxeQxpov and %eu, to scrape off). See Ophthalmoxystrum. BLEPHARO'XYSTON, the rasp-like probe. So Paulus iEgineta, in lib iii. cap. xxii. calls the specillum asperatum, from (iXe«, an ox, and xvSefMv, a flower, so called from its likeness to the ox's eye). See Buphthalmum. BOBE'RRI. See Borriborri. BOCHETUM. A secondary decoction of lignum- vitae, and of similar woods. BO'CIA. See Cucurbita. BO'CIUM. See Bronchocele. BOD. a STAPEL. An abbreviation of Johannes Bodeus a Stapel, in Theophrasti Historia Planta- jum. BOERHAAVIAN SYSTEM. In a work of this kind, it would have been desirable to have given a short account of the lives, and an abstract of the opi- nions, of the most eminent physicians. It Avas for a long time a favourite object of the editors to have thus inter- weaved the history of the progress of medicine; but the extent to Avhich it might proceed, forbade the attempt. While, however, a short history of medicine and its different branches will be found under that title, many reasons induced them to offer, in separate articles, a short account of the most distinguished systems. They need not conceal that the strongest of these was, that the early occurrence in the alphabet of the more impor- tant ones Avould enable them to give more fully the opinions on Avhich the practical remarks in this work are founded. With these views, we shall in their place mention the Boerhaavian, the Brunonian, the Cul- lenian, and the Stahlian, systems, enlarging chiefly on the second and third, as they now principally influ- ence the practice of medicine. Few physicians enjoyed, for so long a period, such unbounded, such unalloyed, reputation as Boerhaave. He was represented, for we are old enough to have conversed with his favourite pupils, as equally amiable in private life, and respectable in science: he first gave chemistry a philosophical systematic form, and reduced medicine to a science at least plausible, neat, and per- spicuous. At his era, the chemical reveries of Van Helmont were yielding to the more abstract sciences; and, from unreal fancies, the change to the necessity of demonstration was so rapid, as to leave scarcely the vestige of an intermediate step. Calm, penetrat- ing, and reflecting, Boerhaave could distinguish be- tween the visionary theorist and the attentive observer; and, equally judicious, could appreciate the merits of each. We have no reason to think that he expected to be the founder of a sect; yet he proceeded with the caution of a veteran, and culled from each the flower which was to adorn his own parterre. Though Paracelsus had burnt the writings of Hippocrates and Galen in solemn state, yet they Avere not forgotten; and the Avise observations of the Grecian sages formed the ground Avork of his system. The Galenic doc- trine of humours he assimilated Avith wonderful ad- dress to his chemical doctrines, and gave them a spe- cific character, founded on their chemical relations. The mechanical philosophy, then attracting universal attention, added to the fabric: the vessels were cones or cylinders ; the fluids, consisting of various particles, adapted only to given apertures, were at times forcibly impelled and impacted in vessels to which they were not fitted, and consequently produced numerous com- plaints. The whole of this doctrine was combined with so much precision, with such scientific skill, as highly to prepossess even the experienced observer. Each found his own opinions placed in a respectable view, illus- trated by language elegant and perspicuous, and sup- ported by collateral doctrines, which, in another situa- tion, he would have rejected. The Galenist could not object to the elegant illustration of the various hu- mours ; the chemist saw, with surprise, that the works Avhich his master had burnt, illustrated his favourite system; and the mechanical philosopher, probably, never suspected the very extensive application of doc- trines which he had cherished exclusively for their own BOI 261 B O L sake. In fact, Boerhaave's system was a selected one; and he has, of course, been styled an Eclectic. We have engaged in this short comprehensive view, partly to account for the enthusiasm with which this system was received; for it must not be concealed, that, in treating of the properties and functions of a living body, he overlooked the principle of life, and the kvws of a living organised machine. He seems to have seen his error, and in his later works he speaks, but still in the language of a sectary, of the ' inertia liquidi nervosi.' The first decisive step in opposition to this mechanical pathology Avas taken by his own nepheAv; and this heresy is followed, apparently, with some reluctance, by Gau- bius, the pupil of Boerhaave. Yet though we have spoken thus freely of his doc- trines, we mean neither to depreciate the man nor his talents. He was far above the common race of mor- tals ; and, with Newton almost alone, might be shown by angels as imitating their superior powers, and emu- lating their brighter intellectual acquisitions. When in different parts of this work also we speak disrespectfully of saponaceous aperients, of attenuants, and the other scions of the humoral pathology,* or of the more rigor- ous demonstration of qualities and poAvers which re- fuse the trammels of mathematics, we must still profess an admiration of the talents of Boerhaave. Those who have contemplated the state of medicine, previous to his time, will see order rise from confusion, precision from vague analogy ; in a word, science from doubtful un- connected facts. The practitioners of the Boerhaavian school have, in general, been distinguished for patient attention and acute observation. They have not perhaps extended the bounds of medicine, but been contented to imitate their master, and his preceptors, Hippocrates and his successors. This Avas perhaps an error, and it resulted from the unbounded admiration they felt for Boerhaave. It was a very advantageous trait of Dr. Cullen's cha- racter, that he wished to raise his pupils into critics on himself. The writer of this article can add, that he re- ceived the most cordial assistance from the latter in a work, the leading principle of which was in opposition to one of Dr. Cullen's favourite doctrines. BOETHE'MA, (from j3«j»^«, to assist). See Reme- dium. • BOETHEMA'TICA SEMEI'A, (from the same, and e-t)[*,eiov, signum). Auxiliary signs in diseases, such as give notice of a cure observable in them. BO'GIA GUM. See Esula Indica. BOICINI'NGUA, BOICININI'NGUA. The rat- tle snake, and Dominicum serpentum. Crotalus horri- dus Lin. It is said, that this serpent cannot approach a piece of a root which in Virginia is known by the name of seneca, rattle snake root; but the blood root is the most frequent remedy against their bite, which, when bruised, is applied to the wound, and a decoction of it is drunk. Troches are made with the gall of rattle snakes, which are caught in spring mixed with chalk or meal; these are called trochisci Connecticotiani, from the Connec- ticut colony. They are anodyne; three or four grains are taken after great fatigue, but may be given to four- teen grains or more. When a person is bit by a rattle snake, purple spots, and a difficulty of breathing, soon attend. Many me- dicines are used by the Americans as an antidote to the poison of this animal; (see Senega). Those in most esteem have a quick, warm, pungent taste, though mdd and volatile on the tongue ; but the most noted remedy is the following, Avhich was discovered by a negro. Take of the roots of plantain and horehound, in sum- mer the whole herb, a sufficient quantity; bruise them and squeeze out the juice, and give immediately a large spoonful. If the patient be SAvelled, pour it down his throat. If it does not relieve in one hour give a second spoonful, which never fails. If the roots are dried, moisten them with a little water. Modern practice has substituted volatile alkali and eau de luce. It is said that rattle snakes have a power of charming birds, and other small animals, so as to make them their easy prey. This has been denied, and the appearances with greater probability referred to a restless anxiety for the safety of their young. BOIL. See Furunculus. BOITI'APO. A serpent of Brasil, which the Por- tuguese call cobus de cipo. Its bite is venomous. BOJO'BI. A serpent in Brasil, which the Portuguese call cobre verde. Its bite is venomous. The cure is the root of the caa-apia, Avhich the patient is to swallow in a little water. BOLBI'DION. A small fish, mentioned by Hippo- crates BO'LBITON. BOLYNTHON. Cow's dung. BO'LCHON. See Bdellium. BOLE'SIS. See Corallium. BOLE'SON. See Balsamum. BOLETUS, (from paxos, a mass). Spunk. A genus of the fungi. It is an horizontal fungus ; and porous underneath. The boletus igniarius is commonly called agaric of the oak. Bole'tus ce'rvi. See Amanita. Bole'tus pi/ni la'ricis. See Agaricus. Since the article on agaricus was printed, we have received a very laboured and interesting analysis of the Avhite agaric, and agaric of the oak, from M. Bouillon La Grange, in the 151st number of the Annales de Chimie, of which we shall here give a short abstract. He found the white agaric to contain an uncombined acid. Water dissolved a small quantity of extractive matter, as well as sulphates of potash and of lime, some muriat of potash, and an animal matter. When dis- tilled in close vessels, acetat and carbonat of ammonia Avere formed. When burnt, he discovered, in the cin- ders, carbonats of potash and of lime, muriat of potash, sulphat of lime, phosphat of lime, and some iron. With the assistance of nitric acid, the malic and oxa- lic acids were formed with a spermaceti, mixed with resin; alcohol extracted a large proportion of acid resin, which was the benzoic acid. Caustic alkalis separated a considerable quantity of ammonia. From the agaric of the oak water took up an extract- ive matter, with sulphat of lime, and muriat of potash. In the cinders, when burnt, were found phosphats of lime and magnesia, with some iron. With the nitric acid, the malic and oxalic acids were alone discovered. Alcohol dissolved only a small pro- portion of resin, and caustic alkalis disengaged a much less proportion of animal matter than from the white agaric. BOLI'SMUS. See Boulimos. BOM 262 B O N BO'LSTER. A soft pillow, to be laid under a broken limb, or a gouty joint. BO'LUS, (from /3»A«s, a mass, from the HebreAv term balah, to agglutinate). A bole or bolus. Boluses differ not from electuaries, only they are made of a firmer consistence, in single doses, and therefore more proper where accuracy is required in the administration, and Avhere evaporation would injure the medicine. The light and ponderous powders may more conveniently be mixed with mucilage, for so they are the least bulky. The quantity of each is as much as can be conveniently SAvalloAved at once. The more disagreeable powders should be given in another, form, and the more bulky doses mixed in draughts. This form is, however, now little employed, and the poAvders are usually mixed in draughts. Where sAvallowing is difficult, boluses are often improper. Yet we once saAV 3 ss. of valerian or- dered in a bolus for a man in an apoplexy, by a fashion- able physician. Bolus, bole. Boles are argillaceous earths, which readily fall doAvn into a loose mass in Avater ; smooth, and rather unctuous to the touch. It is the argilla bolus of mineralogists ; and, like other reputed argillaceous earths, contains the largest proportion of flint. Boles were once highly prized ; and the Armenian and Lem- nian boles Avere dug and-sealed with numerous cere- monies. They were accounted cordial, alexipharmic, and sudorific ; and, in imitation of these, other argilla- ceous and calcareous earths Avere sold under the title of terre sigillate, because they had, like the two former boles, the impression of a seal. They are all noAV ne- glected ; yet, Avere avc to interpose against authority, we would whisper some defence of the former, pulvis £ bolo CU711 opio, now the pulv. e creta compositus cum opio. Bo'lus ga'llicus, French bole, is a friable earthy substance of the argillaceous kind, intimately blended Avith a slight portion of ferrugineous calx, and siliceous earth. It is of a pale red colour, variegated with irre- gular specks, and veins of a Avhitish yellow. It is said to imbibe sharp acrid humours, and has been recom- mended in alvine fluxes and cardialgia, in doses of from ten to sixty grains. Pipe clay, coloured with red chalk, is its very innocent substitute. Its sudorific and alexi- pharmic poAvers have no foundation. There are various other species that are not alloAved to possess any medical virtues. The London college have consequently exchanged two compositions under the titles of pulvis e bolo co7npositus, sine opio et cum opio, for the pulvis e creta co7npositus, without and Avith opium. In the former, half a pound of prepared chalk is added to four ounces of cinnamon, three ounces of tormentil root, and as much gum arabic. In the latter, eight ounces of this powder are mixed with a drachm and half of poAvdered opium. Thus, about two scru- ples of the powder contain a grain of opium. BOLY'NTHON. See Bolbiton. BO'MBATS, (from bombyx). Salt formed by the union of the bombic acid with different bases. BO'MBAX. Cotton. Called also xylon, gossi- pium, cotonium, moulelavou. Bombax pentandrumhrn. Sp. PI. 959. There are three sorts of cotton trees : one creeps on the earth like a vine, the second is thick like a bushy dAvarf tree, the third is tall as an oak. All the three, after producing beautiful flowers, are loaded with a fruit as large as a Avalnut, Avhose outAvard coat is black. When this fruit is ripe, it opens and discovers the cotton; the seeds are separated by a mill from the cotton^ This tree grows in many places in the Levant, East and West Indies, especially in the Antilles. The fruit is oval. The cotton of the first sort, Avhich creeps on the ground, is the best: that brought from the East Indies is supposed to be the byssus of the ancients. That produced near Smyrna is greater in quantity than any where else. They sow the seeds, which are like little beans, in June; gather the cotton in October; and the soil there produces three crops in a year. The skin of the seed is mucilaginous, the kernel is SAveet like an almond, and of virtues similar to the althea. If cotton is applied to wounds, it excites inflammation; and, Avhen worn next the skin it checks perspiration. That called moulelavou is also denominated arbor lanigera spinosa; gossipium arboreum caule spinoso, bo7nbax ceiba Lin. Sp. PI. 959. A tall cotton bearing tree, of the bark of whose root an emetic is prepared. BO'MBICUM A'CIDUM. Bombic acid. Acid of silk Avorms. Silk worms contain, in every state, an acid liquor, in a reservoir placed near the anus ; but at the more advanced periods of their growth it is mixed with a gummy matter. It is obtained by expressing their juice in a cloth, and precipitating the mucilage by spirit of Avine, or by infusing the chrysalides in that liquor. This acid is very penetrating, of a yelloAV amber colour ; but its nature and combinations are yet not well known. It has never yet been employed in me- dicine. BO'MBUS, (from (io^ea, to sound like a drum). A resounding noise, from flatulencies rolling in different cavities. If a sound of this sort, or a ringing, is perceiv- ed in the ears in acute diseases, it is a dangerous symp- tom. It also means a noise in the boAvels from flatus. BO'MBYX, (from (iopgea, to resound). So called from the noise it makes in spinning its web. The silk avorm. They are of no medical use; but it is said that if their bags are burnt they yield a larger quantity of volatile salt than any other animal substance, and con- sequently may be superior to burnt sponge. BOMPO'URNICKEL. See Coliphium. BON ARBO'R. See Coffea. BO'NA. The kidney bean. See Phaseolus. BO'NDUCH INDORUM. (Indian.) Called also bonduch cinerea, bonduch pianta Indiana, arbor spinosa Indica muricatis siliquis, lobus echinatus, acacia glo- riosa marsjis. Guillandina bonduc Lin. Sp. PI. Wilde- now, 534. Molucca nuts, and bezoar nuts. The plant runs up to five or six feet in height; it is a native of both the Indies.. The round beans only are of use, which are of an ash colour on the outside, and white within. They are warm, bitter, and carminative. Ray mentions another species, which he calls bon- duch, Indorum siliqua minime spinosa. BON. SEP. An abbreviation of Bonetus Sejiul- chretum. BONE. Its Latin tenn, os, is supposed to be de- rived from the Hebrew word ozam, strength. The bones of animals constitute their firm, solid support; and their varied articulations give the animal that flexibility, those minute and complicated motions, on which our numer- ous functions depend. There appears to be no bone in the human body that does not possess every move- BON 263 BON ment required, except such as Avould be inconsistent Avith its more general and useful purposes. The solidity of bones depends on an earthy deposition, in a manner to be aftenvards described; a deposition which some have styled a secretion, though with little propriety, as a bony substance is sometimes deposited by all the ex- halant arteries: we have even seen ossifications in the corpora cavernosa penis. The bones are said by minute anatomists to be 304 in number. Bones consist of fibres crossing each other in differ- ent directions. In the middle of the long bones these fibres are closely united, so as to form an almost solid substance. At their extremities the fibres are more distant, forming a distinct reticulated texture. As the long bones are solid, so they are holloAv, to give re- sistance in a greater proportion than weight: the ex- tremities are enlarged in bulk, to afford a more advan- tageous attachment to the muscles; but their cavities are divided into cells, and in these there is no part free from this reticulated substance. In this Avay, we be- lieve, the weight of a given length at the extremity or the middle is not very different. The substance of bones is noAV known to be a calca- reous phosphat, which is deposited by exhalant arteries; and this substance is constantly renovated, while an equal portion is carried off by absorption. The part absorbed is carried off by urine; and we find in the disease styled mollities ossium the urine containing a large portion of this calcareous neutral. Lime is found in a great variety of our aliment; but the acid is the production of the animal economy, or rather perhaps a modification of some common acid, (probably the mu- riatic,) by means yet unknown to us. This calcareous salt is deposited in fibres in the long bones, and these fibres placed longitudinally are in the middle of these closely compacted, but diverge and separate towards the joints, leaving a space connected by cross threads of bone to form the net work. We find by proper preparation, not only this fibrous but a laminated struc- ture also; that is, the fibres are disposed even in the hardest bones in strata, connected by crossing threads of a bony matter. The flat bones have no cavities; but, when they rise in protuberances, the same reticu- lated structure is observed in their substance: so cau- tious, apparently, is nature to give every advantage to the muscular poAver, Avithout adding inconveniently to the weight. The form Avhich bones ultimately assume, is in a great degree OAving to the action of the muscles and of the arterial system. In the youngest foetus indeed the general shape is observable; but the extremities are larger, and the cavities of the long bones still retain the reticulatedbony structure. When the action of the strong muscles of the extremities condense the bony substance, these last cancelli disappear as no longer useful; but the tendons which possess no contractile power, cannot have the same effect on the ends of the bones, though these are in some measure condensed ; for, by increasing age, their bulk becomes less, and their density greater. In old age the contrary change takes place. The bones in- deed retain their form, but the proportion of the cal- careous phosphat is lessened, and their specific gravity greatly diminished. The process of the formation of bone Avas for a long time overlooked or mistaken; and even so late as the era of Duhamel, it was generally thought that bony layers were deposited from the periosteum, as the woody layers of trees are from their bark. Traces in- deed of more philosophical and correct views appear in earlier authors, but they were disregarded ; and it was singular that it should not have occurred to Duhamel and his followers, that, if their system Avere true, man must yearly increase in bulk like a tree. Another error long prevailed, that bone Avas only a hardened cartilage. Were this the case, Ave should find the one gradually changing to the other: they are united indeed by bony protuberances in appearance, shooting into the carti- lage, but it is at once obvious Avhere bone ends, and cartilage begins. In the foetus, at its earlier stages, we find the future bone a gelatinous substance, covered with a membrane, the future periosteum. It gradually becomes firmer and whiter; but even at birth the bony system is flexible, so as to admit of considerable motion in all its parts, to adapt itself to the passage in birth. For a time a con- siderable proportion of the extremities of the bones is cartilaginous, which has occasioned the idea just men- tioned ; but when the change is carefully observed, new blood vessels are perceived to penetrate the cartilage, and the osseous matter is deposited from them in the body of the latter, Avhich enlarges till it extends to the bone. This additional portion is for a long time easily- separable from the rest of the bone, as united, only by a layer of cartilage, and called an epiphesis; and when the union is more complete, this additional portion is called an apophysis. The object of this mechanism is easily explained. Bones are formed from the osseous matter deposited in points, which are either added to longitudinally, or in rays, as from a centre. Where great strength is required, the former structure is ob- servable ; but a continuation of the longitudinal fibres would weaken the bone, and a different direction is ne- cessary ; besides, as from bony centres, a substance is more quickly produced, when the child begins to walk, his strength will thus increase with a rapidity propor- tioned to his increase of bulk. We know that bones are nourished by arteries, since in young animals they are reddened by an injection thrown into the general arterial system ; and in more advanced age, are coloured by feeding an animal Avith madder. The experiment so often tried and quoted to support many different sys- tems, was not understood till lately examined by Dr. Rutherford. He found it to arise from an affinity be- tween the colouring matter and earth, forming what the painters call a lake. If to a solution of madder in dis- tilled Avater with muriat of lime phosphat of soda is added, a double decomposition takes place: the mu- riated soda continues in solution, and the colouring part of the madder is precipitated in union Avith the phos- phat of lime. It is thus attracted in the blood vessels by the calcareous phosphat, and deposited with it. Bones, if they have arteries, must have accompany- ing veins, and they have also absorbents; for a diseased bony part is absorbed as well as other parts of the body: and the cavities of the round bones bear the same pro- portion to the Avhole bulk of the bone in the foetus and the adult. The earth Avhen out of the circulation has no longer any peculiar quality; andAvhen dissolved by spirit of salt, the vessels and membranes remain unchanged, displaying the same laminated arrangement us the bony BON 264 BON jjarts. The earth of bone is however valued as a ma- terial for cupells in the nice assays of silver, and styled virgin earth; but its properties are owing to a portion of the phosphoric acid. The circulation in the bones is peculiar. The vessels run in the direction of the fibres in the long bones longitudinally, occasionally dipping perpendicularly; in the flat bones they are radiated, diminishing towards the centre. The bones are full of pores for the admission of vessels : in the middle they are large and few; at the extremities smaller and more numerous. In every long bone, there is about the middle a hole for the passage of an artery and vein : the artery passes slantingly through the bone, branches on the internal periosteum, and externally again through the bone. These branches freely anastomose, and thus form an uninterrupted circulation between the internal and external parts. In the flat bones, the vessels anas- tomose in the meditullium or diploe. In their external form bones greatly vary. Besides the epiphesis, they rise, we have said, in various pro- tuberances, named processes, and they are sometimes depressed in cavities. These if deep, Avith large brims, are called cotyle; if shallow, glene or glenoid. Ana- tomists have employed other appropriate terms. Thus, pits are small roundish cavities; furrows, long narroAV canals; niches, small breaches; sinuosities, broad super- ficial depressions without brims; sinuses, large cavities within the bones, opening by a small aperture; fora- mina, holes that pierce through the bone. Bones are usually divided into, 1st. spherical, which are spongy, except a thin plate on the surface: 2dly, cylindrical, which are compact in their middle, and spongy at their extremities; 3dly, the flat, Avhich are compact on both sides, but spongy in the middle; 4thly, the irregular, which Avhen thick are like the round, and when thin like the flat bones. It will be sufficiently obvious that these terms are not mathematically accurate. Bones, we have said, owe their solidity to phosphorated lime. They contain also gelatine, and the proportion of each differs in different animals, and at different pe- riods. The bones of an adult contain the greatest pro- portion of earth; those of a foetus, of gelatine. Fish bones, from Mr. Accum's experiments, contain one- sixth part more of phosphoric acid than the bones of quadrupeds. Carbonated alkalis decompose the phos- phat of lime in bones. They contain also a small pro- portion of selenite, carbonate of lime, and, according to Proust, of mineral alkali. Mr. Hatchett's late experi- ments in the Philosophical Transactions, greatly illus- trate the chemical analysis of bone, horn, zoophytes, 8cc. but as less applicable to human bones, they fall not Avith- in our immediate province. See Hair and Horn. Bones are covered with a strong, firm, fibrous sub- stance, styled periosteui7i, which is acutely sensible when inflamed, as indeed all the denser membranes are. Its chief use is to defend the bone, and perhaps to prevent its irregular growth. Bones themselves when inflamed are also highly sensible. The internal parts of bones and the minutest cells are filled Avith marrow; a fluid fat contained in mem- branes, forming, in the language of some authors, the internal periosteum. The marrow does not differ in its analysis from suet and fat, or perhaps it has not been minutely examined. The marrow of herbaceous ani- mals hardens Avhen cold; that of carnivorous remains fluid; and in young animals a little blood is occasionally deposited. We suspect that the harder fats are distin- guished by their containing a larger proportion of oxy- gen, and the softer by a greater proportion of hydro- gen or carbon. MarroAV is contained in follicles not communicating Avith each other: at the heads of the bones these follicles are supported by the cancelli,but in the middle they have no such support, though the mar- row is still confined by follicles, which lessen its weight on the lower parts of the bone, where the cancelli again lend their assistance. The bone is apparently always full. It has been supposed that the larger arteries which penetrate the middle of the bone, are exclusively ap- propriated to the nutrition of the marroAV. The facts however lately noticed of the mutual anastomoses of the internal and external vessels, oppose this opinion, which, we believe, is not supported by any well authen- ticated observation. The use of the marrow is not known: it is a part of the adipose system, and perhaps intended for occasional support, and to correct the acri- mony produced by inanition. Animals that remain tor- pid during the Avinter repair to their retreats with con- siderable coverings of fat, and leave them in a most im- poverished state. We suspect also that the fat may be a reservoir of oxygen; for when this principle is ex- hausted little fat remains. In the last stage of phthisis some fat is found in the adipose membrane, and in this disease the oxygen is not deficient: but in dropsy it is quite exhausted; and in this complaint the retention of the excrementitious urine would be soon injurious, were not its acrimony blunted by either an oleaginous or an oxygenated fluid. The products of bones employed in medicine are the empyreumatic oil, styled Dippel's animal oil, highly rectified. When distilled they afford ammonia; and from 4»ese the spiritus cornu cervi is now exclusively prepared. Bones calcined in open vessels are styled cornu cervi calcinatum, now seldom employed. The oil remaining after distillation burnt Avith the earth produces lamp black; the finest kinds of which are furnished by the more compact bones, and the horns of animals, thence called ivory black. Bones rasped and macerated in hot Avater, or exposed to consi- derable heats in Papin's digester, furnish a nutritious soup; and in a more condensed state a valuable glue. Six pounds of dry bone shavings produced fifteen ounces of clear glue ; and fifty pounds of ivory shav- ings yielded nine pounds and a half of transparent glue. The exact proportion of gelatine in bones has not however been ascertained, since the driest glue contains some water. These preparations were made by boiling only; but the soluble parts are more perfectly extracted in Papin's digester, though the fat acquires an un- pleasing empyreumatic flavour. Proust informs us, that the enlarged extremities of the bones, boiled for a quarter of an hour in water, yield one-fourth of their weight in fat, and the haunch bones one-eighth. The hard bones must be poAvdered, reduced to a fine paste by trituration with water, and boiled for a longer time. See Proust's ' Memoir for Meliorating the Condition of a Soldier,'published at Madrid 1791; an abstract of which may be found in the 53d volume of the Journal de Physique. The diseases of the bones, independent of frac- tures and dislocations, are wounds, necrosis, B O II 265 BO II caries, exostosis, osteo sarcoma; including spina. ventosa and PjEDArthrocace, rickets, fragility of the bones; injury from ruptured ligaments, dropsy in, and wounds of, the joints, avhite savelling of the joints, anchylosis, distortion, mollities, scro- fula. See Haver's Osteolography, Monro on the Bones, Cheselden's Osteology, Memoires de Pelletier, vol. ii. Proust (Journal de Physique, 1. c), Hatched, Phil. Trans. 1799, 1800. BONIFA'CIA,(from bonum, good, and facio, to do,) from its utility to the human frame. See Laurus Alexandria and Hippoglossum. BONONIE'NSIS L'APIS. The Bononian stone. Called also phosphorus Bononic7isis, spongia solis, luci- dus lapis, illumina bilis lapis, phosphorus Kircheri; the li<;ht carrier and Bononian phosphorus. It is a small, grey, soft, glossy, fibrous, sulphureous sloue, about the size of a Avalnut. When broken, a kind of crystal, or starry talc, is found in it. This sto7ie is met with in the neighbourhood of Bologna, in Italy; and, Avhen duly prepared,makes a species of phosphorus. This phosphorus gradually emits light for six or eight hours after being exposed to it. As a medicine, the stone is caustic and emetic; and the phosphorus itself has been highly injurious, Avhen used as a medicine. BO NT. An abbreviation for Jacobius Bontius, a writer of good credit. BONUS HENRI'CUS. See AIercurialis. BOO'NA. See Phaseolus. BORA'SSUS. The tender medullary substance Avhich grows at the top of the great palm tree. BO'RAX, (from the Arabic term borac). Called also chrysocolla, capistrum auri, ancinar, bordxtrion, anucar, atincar, ti7ical, a7nphitane, baurach, nitrum fac- titium, santerna, and nitrwn nativum. Borac signifies nitre, but it Avas corrupted into borax, and applied to the chrysocolla. It is not much unlike alum, and if genuine, hath a SAveet taste at the first, but afterwards an unctuous one. Its pure crystals arc hexaedral prisms, terminated by three sided summits finely cut; it dis- solves Avith difficulty in cold, but easily in boiling Avater; requiring of the former more than twelve times its Aveight. It is soluble in alcohol, savcIIs and bubbles in the fire, and soon becomes a glass, Avhich dissolves again in water; but if mixed with flint or sand, it be- comes a durable glass, hard enough to cut common glass. It is an excellent flux for metals, and for their ores; changes the colour of blue floAvers to green; precipitates earthy and metallic bodies dissolved in acids; and ren- ders vegetable and animal oils miscible Avith Avater. A solution of borax made in a menstruum Qf vegetable acid, when inspissated by evaporation, is a tenacious substance that will not crystallize, but will dissolve in the air. Borax Avas originally brought from Thibet, Avhere it Avas found on the shores of a lake, seemingly the crater of an old volcano. We receive it inviscated in a greasy substance, and in an impure state, then called tincal. It has been since found more pure in the mines of Ritinquipa and Escapa, and still more pure in China. In Europe it has been discovered in a mi- neral lake in Tuscany. It is purified by long boiling and repeated crystallization; but when most pure, Avhite, and transparent,it hasasomeAvhat greasy fracture. We noAv knoAV it to be a compound salt, with an ex- vol. i. cess of alkali; containing thirty-nine parts of boracic acid, seventeen of soda, and forty-four of water. It is decomposed by barytes, magnesia, and lime. Its acid, the sedative salt, is of a white, scaly, glitter- ing appearance, has a cooling saline taste, and reddens the blue vegetable infusions. A pint of boiling Avater dissolves 183 grains, but it dissolves more easily in al- cohol. Its solution in spirit is green, and burns Avith a green flame. If dry, it is fixed in the fire. The borax of the shops is sometimes adulterated Avith alum : but then it is not so light nor clear, nor does it swell so much when put on burning coal. Borax itself is used for soldering gold, whence its name chrysocolla. It is also a solder for other metals ; and a powerful flux for fusing minerals of all kinds. It is used to give a gloss to silks. As a medicine it seems to possess inconsiderable vir- tues, or these have not been sufficiently examined. It has been, hoAvever, styled a deobstruent, diuretic, and emmenagogue, in doses of half a drachm, or tAvo scruples, A mixture of it Avith honey—viz. borax one drachm, honey one ounce—is efficacious in removing aphthous crusts from the mouth and fauces, but a solution in wa- ter is considered to possess superior poAver. Externally it is a far better cosmetic than bismuth. If given in poAvder it is^said to be emetic, but, mixed Avith aromatics, this quality is checked, and in the fluor albus it is sup- posed highly useful. A dose of borax is from gr. v. to Qs%. BORBONE'NSIS,or BORBO'NICA. A patrony- mic epithet for the Bourbon Avater. See Aqu.* sul- phured. BORBORO'DES, (from popSo^, filth). Feculent, MUDDY, DIRTY, EARTHY. BORBORY'GMUS, (from (iop€o^a>, to make a noise). A rumbling noise, excited by Avind in the boAvels. BO'REAS. The north east wind. The northern Avinds are cold, but, unless in the east, not umvholesomc. They resist putrid diseases, but often occasion those that depend on an inflammatory state. BO'RI. (Greek). Great eaters. BORI'DIA, (from (iopx,food). Salted fish eaten raw. Oribasius. BORO'ZAIL. The zail of the Ethiopians. It is a disease epidemic about the river Senegal, principally in- festing the pudenda, but different from the lues venerea, though OAvingto immoderate vencry. In the men it is called asab, in the women ossa batus. BORRA'GO, vel BORAGO, formerly written Co- rago, the C being now changed into B, (from cor, the heart, because it was supposed to comfort the heart and spirits). Borrage. Also called buglossu7n verum, buglossum latifolium, borago officinalis Lin. Sp. PI. 197. Nat. order asperifolie ; boraginee of Jussieu. The leaves are succulent; their medical qualities are not discernible until the juice is separated by pressure, and are then inconsiderable. A decoction of them af- fords a small quantity of the nitrous and muriatic salts. The leaves are ranked among coolers, and the floAvers among cordials. See also Buglossum. A syrup is prepared from the leaves in France, and used in pleurisies and inflammatory fevers. It is some- times put into negus, forming what is called a cold tankard. BO'RRI-BO RRL boberri. (Indian). See Cuu- M m BOT 266 BOT cuma. It is also a name in the East Indies of an oint- ment in which are the roots of turmeric. BOS, (from/3o, to pour). See Guttur. Also a small kind of drinking vessel. BRO'CHUS. One with a prominent upper lip, or one Avith a full mouth and prominent teeth. BRO'DIUM. Broth. (See Jus). It sometimes means the liquor in which a solid medicine is preserved, or with which it is diluted. BRO'MA. Food, (from Ppwrxa, to eat,) in opposi- tion to drink. See Aliment. BROM. CHLOR. GOTH. An abbreviation of Olai Bromelii Chloris Gothica, seu Catalogus Stirpium circa Gothoburgum nascentium. BROMELIA. See Ananas. BRO'MION, (from jS^/ms, the oat). A plaster mentioned by P. JEgineta: and so called because it was made of oaten flour. BRO'MUS STE'RILIS, (from Ppuo-xa, to ^eat). Dank or wild oats. See jEgylots. BRO'NCHIA, (from Ppoyfrs, the throat). See Aspera arteria, and Bronchus. BRONCHIA'LES ARTE'RItE. They sometimes go from the fore side of the superior descending aorta, at others from the first intercostal, or from the arteriae oesophageal. Occasionally they arise separately from each side to reach each lobe of the lungs, and some- times by a small common trunk, which afterward se- parates towards the right and left hand, at the bifurca- tion of the aspera arteria, and the branches accompany the ramifications of the bronchia. The bronchial artery on the left side often comes from the aorta, while the other arises from the superior inter- costal on the same side; Avhich variety is owing to the situation of the aorta. Sometimes there is another bron- chial artery, Avhich goes out from the aorta posteriorly, near the superior intercostal, above the bronchialis an- terior. Communications have been observed betAveen the bronchial artery and the vena azygos, and Avith the co- ronary artery of the heart. Ruysch first discovered these vessels, and he describes both the bronchial ar- teries and veins in his fourth epistle. Bronchia'les gla'ndule. At the angle of the first ramification of the trachea arteria, we find on both the fore and back parts certain soft roundish glandular bodies of a bluish or blackish colour, and of a texture partly like that of the thymus, and partly like that of the thyroid gland. There are many similar glands at the origin of each ramification of the bronchia. Dr. Hunter supposes their office is to separate a mucus to lubricate the lungs: they are different both in colour and struc- ture from the conglobate and lymphatic glands. BRONCHI'ALLSGLA'NDULA. See Thyroidea GLANDULA. BRONCHOCE'LE, (from Ppoy%os, the wind pipe, and xr,Xv, tumour). Also called bocium,botium. It hath various names in different Avritings; the SAviss call it gotre; some have called it hernia gutturis, gutter, tumi- . dum, et trachclophyma, gossum, exechebronchos; gon~ grona, hernia bronchialis: Heister thought it should be named tracheocele. Mr. Prosser, in his late publication B R O 283 B R O on this disorder, from its frequency on the hilly parts of Derbyshire, calls it, with others, the Derbyshire neck; and, not satisfied respecting the similitude of this tumour Avith that observed on the neck of women on the Alps, the English bronchocele. As various causes give rise to this complaint, he endeavours more strictly to distinguish that in which he expects success in his attempt to cure. When not produced by accidents, such as loud speaking, crying, blows, he calls it the na- tural, the spontaneous, or the curable bronchocele. The seat of this disease is the thyroid gland, Avhich Dr. Hunter hath observed lies just below the larynx, round the trachea. The tumour appears in the fore part of the neck, between the skin and the wind pipe. Women are the most frequent subjects of it, and in them it usually appears early. Dr. Hunter met Avith one case of this kind in a young surgeon ; but it rarely happens in males. Various causes arc assigned by different writers. On the mountainous parts of Genoa and Piedmont, they attribute these tumours to drinking water cooled Avith ice. Dr. Leake thinks it very probable that such glandular SAvellings as happen about the neck and face, may be owing to the severity of the cold moist air, especially since they generally appear in winter, and rarely in the Avarm dry climates of Italy and Portugal. This, he adds, is probable, because the intense degree of cold may constringe the glandular ducts, and lock up that fluid Avhich ought to pass freely- through them. Some Avriters attribute it to a scrofulous cause. Mr. Prosser inclines to think that it is a dropsy in the gland, and similar to the dropsy in the ovaries. He relates, that Dr. Hunter dissected one of these glands that had been considerably enlarged, and it Avas found to be distended by a number of cysts filled with water, which must have been hydatids. Yet most Avriters agree that its true cause and nature are alike unknoAvn. The bronchocele, Mr. Prosser observes, is a tumour arising on the fore part of the neck ; it generally first appears some time betwixt the age of eight and twelve years, and continues gradually to increase for three, four, or five years; and sometimes the last half year, Ave are told, it grows more than for a year or two before. It generally occupies all the front of the neck, for the avhole thyroid gland is enlarged; but it does not rise near so high as the ears, as in the cases mentioned by Wiseman ; and it is rather in a pendulous form, not un- like, as Albucasis says, the flap or dewlap of a turkey rock, the bottom being the larger part of the tumour. In figure, it varies considerably in different cases. It is soft, or rather flabby to the touch, and someAvhat moveable ; but, when it has continued some years after it has ceased to increase, it becomes more firm or con- fined. By the situation and nature of the complaint, it generally occasions a difficulty of breathing, which is increased on the patient's taking cold, or attempting to run. In some the tumour is so large, and so much af- fects the breathing, as to occasion a loud wheezing; but Ave meet with many exceptions to this general rule. When large, patients sometimes suffer but little; others suffer much from an inconsiderable tumour. In gene- ral, however, it occasions little inconvenience. Dr. Hunter observed, that this tumour now and then sup- purates. The bronchocele should be distinguished from a scirrhus, from'an aneurism, and from those SAvellingsin the neck that arise from strains or ruptured vessels. The distinction, however, is not difficult. This tumour never becomes cancerous. Mr. Gooch says, he never kneAV this tumour, however large, to en- danger life; but he observes a considerable inconve- nience from it in cases of quinsy combined with it. Mr. Sharpe mentions, that the only cases of quinsy requir- ing bronchotomy, were OAving to the presence of bron- choceles. Dr. Hunter has observed, that this disorder appears two or three years before or after menstruating; and that it sometimes spontaneously disappears, if the menstruation approaches kindly. Mr. Pr-^ser thinks that this change in the constitution scarcely ever affects the tumour. We have never found that it has produced any diminution of its bulk. The drain of an issue, or of a perpetual blister, ap- plied on some other occasions, has apparently prevented the growth of the bronchocele, though the effect conti- nued only during the drain. It cannot be extirpated, as it is entangled with the recurrent nerves, and the first branch of the external carotid artery; and if by chance a suppuration is formed, an ill conditioned ulcer, diffi- cultly cured, is the consequence. Mr. Prosser hath succeeded, in many instances, in discussing it. On this plan, the late famous Coventry practice Avas formed., Avhich Mr. Wilmer has inserted in an Appendix to his Cases in Surgery. It begins Avith an emetic the day after the moon is at the full, and, the day after that, a purge is given; the night folloAving, and seven nights successively, the following bolus is laid under the tongue at bed time; and, in the days, a bitter stomachic poAvder given at noon. On the eighth day the purge is to be repeated; and, in the Avane of the succeeding moon, the Avhole process to be repeated, except the emetic. The tartar emetic ointment rubbed in on the tumour is supposed to assist the cure; and, indeed, by adding this application to the Coventry receipt, we have often succeeded in greatly reducing bronchocele. Mr. King gives the burnt sponge in the dose of a scruple three times a day ; but, if his recipe be correct, tAvo ounces of the sponge in twenty-four troches must amount to two scruples in each. He attributes the cure to the quantity, which, we think, with many stomachs would be inconvenient. The lozenge to be laid un- der the tongue is formed of calcined sponge, cork, and pumice stone, of each ten grains, syrup a sufficient quantity. Mr. Prosser has succeeded by the use of his medi- cines, though the patient Avas nearly advanced to her twenty-fifth year, more than twelve years after the ap- pearance of the tumour on the neck : after the twenty- fifth year, no instance of success hath occurred. He or- ders oneof the folloAving poAvders to be taken early in the morning, an hour or two before breakfast, and at five or six o'clock in the evening, every day for a fortnight or three weeks. The poAvder may be taken in a little syrup, or sugar and Avater, or any thing else, so thai none may be lost. If it does not sit Avell on an empty stomach, it may be taken betAvixt breakfast and dinner. R. Cinnab. ant. op. levigat. milleped. ppt. et pulv. aa gr. xv. Spong. calcinat. 9 i. m. These powders should be taken for two or three weeks, then omitted for about a week or nine days ; the same course must be then repeated. At bed time everv O o3 B R IT 284 B R U night, during the second course of the poAvdcrs, three of the folloAving pills are to be taken : R. Ilydrargyr. 5 v. terebinthinae Strashurgensis 5 ij- extracti colocynthidis comp. 9 iv. pulv. rhabarbari 3 j- First grind the quicksilver with the turpentine till it appears no longer, then add the rest, and form a mass. If the turpentine be too thick, a little olive oil must be added. These medicines do not require confinement, except they are taken in severe Aveather, and then only to the house; nor need the diet be much regarded. It may be sufficient that the medicines are taken in a temperate season, or rather Avarm Aveather, and the patient lives exactly in the usual Avay, guarding against cold during the second course of the medicines. The patient, if a servant, should avoid standing, especially at the washing tub, or any Avork with cold Avater. As to diet, Avhen no alteration hath been made in it, the success has been the same as Avhen stated regulations Avere regarded. In this discretion may occasionally direct. If the pills continue to purge, after taking them a feAv days, it would be better to have out the extr. coloc. comp. in their preparation, and lessen the dose in the same pro- portion. In general it will be proper for the patient to be purged twice or thrice Avith manna and salts, or any- gentle cathartic, before the powders are begun. The medicines are here proportioned for an adult of a good constitution ; therefore, if the patient is younger, or of a weakly habit, the doses must be managed accordingly. As to external applications, they may be hurtful, but do not appear likely to be useful. The patient must not expect to find benefit in a little time; perhaps it will be as long after the medicines are all taken, as the time they are in taking, before much difference will be perceived in the tumour of the neck. It is necessary that the medicines be begun at a proper time, especially the second course; a few days should always be dispensed with on that account. Amongst the earlier writers, Albucasis is the first Avho gives any useful account of this disorder. See it trans- lated into Friend's Hist, of Physic, and into James's Med. Diet. art. Bronchocele. See also Turner's Sur- gery, vol. i. p. 164. Wilmer's Cases and Remarks in Surgery, in the Appendix. An Account of the Method of Cure of the Bronchocele, by Thomas Prosser, edit. 3. Gooch, in his Med. Obs. gives an instance of an aqueous bronchocele. Bell's Surgery, vol. v. 514. White's Surgery, 289. Memoirs of the Medical So- ciety of London, 217. BRO'NCHOS,(from Ppoy%os, wind pipe). A suppres- sion of the voice from a catarrh. Also a catarrh, when it principally affects the fauces. See Catarrhus. BRONCHOTO'MIA, (from Ppo{yJ&>, the windpipe, and re/Mu, to cut). Bronchotomy. See Tracheo- tome. BRONCHUS, (from P^xa-> to pour). The ancients believed that the fluids were conveyed by the bronchiae; Avhence its name. According to Galen it is the aspera arteria, from the larynx to the lungs; but, bronchiae or bronchi, as now understood, are the ramifications. BRO'NTE, (quasi Ppovm, from PpeftM, to roar). Thunder. Was it from hence Lord Nelson derived his title? BRU'MA. Some derive it from Bpopios, Bacchus, because at that time the feasts of Bacchus ay ere cele- brated : but, more probably, quasi brevima, for Srevis- si7na dies. Winter. But particularly when the days are shortest. BRU'MASAR. A spagirical term for silver. See Argentum. BRUNE'LLA. Common self heal; called also prunella, consolida minor, and Symphytum petraum. It is the prunella vulgaris Lin. Sp. PI. 837. Nat. order labiate. It is perennial, groAvs wild in pasture grounds, and floAvers in June and July. In taste it is slightly- austere and bitter, and much used in fluxes, haemorr- hages, and in gargarisms, as well as to remove aphthous exudations in the mouth. Miller's Bot. Off. BRUNNIE'RIGLANDU'L-'E.Brunnier's glands. So called in honour of their discoverer. They arc lodged under the villous coat of the intestines, closely adjoining to the nervous; and are smaller than in the large ones. They are also called Peyeri glandule, Peyer's glands. BRUNONIAN SYSTEM. We have already ex- plained our reasons for adopting the plan of giving dis- tinct views of the most prevailing medical systems in different articles (see Boerhaaatan system), and shall pursue the present meteor from its first spark to its meridian : others may perhaps record its decline or fall. The history of Dr. BroAvn would not be of importance in this place, were it not necessary to explain some parts of his doctrines. Originally a teacher of Latin, he at- tended the medical classes by the permission of the dif- ferent professors; and, as the tutor of his sons in that language, Avas first connected with Dr. Cullen, to whom he became an useful assistant, and of whose doctrine he was a Avarm admirer. His great object for a future maintenance when we kneAV him, Avas to repeat Dr. Cul- len's lectures in London after his death. Some dis- agreement turned him to a virulent antagonist, and from hence arose the Brunonian doctrine. We mean not by this to prejudge or disparage the system : it must rest on its own merits: but, to explain that decided opposition, and the virulent language em- ployed Avhen speaking of the Cullenian doctrines. We suspect, hoAvever, that it may explain the source of some of his own opinions, Avithout giving him the credit of a very brilliant genius ; for, in possession of a system Avith the arguments in its support, it is not very diffi- cult to say that any part is ' false,' and to Avrest the ar- guments to the opposite opinion. If, however, his sys- tem be well founded, it proves his genius to be pre- eminent, for little Avas gained by study. We recollect but one author quoted, Avhich is Triller; and, from the manner of the quotation, we should suspect that he Avas not intimately acquainted Avith him. The opinions and practice of different authors he could not have been ignorant of, from the lectures he attended; yet it is singular that his practice is so little discriminated, that he seems scarcely to have visited the sick bed, or at- tended to the distinguishing symptoms Avhich influence the practical physician in the minuter variations of his conduct. Dr. Brown, hoAvever, started as a self appointed lec- turer, and the avoAved opponent of the Cullenian sys- tem. His doctrine, even more simple than that of the methodists, admitted only of the strictum and laxum, the sthenic and asthenic states, without alloAving the union of both. Simplicity is attractive to youth; it is BRU 285 BR II falsely called ' the seal of truth ;' and to escape from professorial dogmas, added to the seduction. It is at least certain, that after some months of hesitation Dr. BroAvn Avas greatly followed, and his doctrines were echoed in the " Medical Society," where the Cullenian system had gained a complete victory over the Boer- haavian; and, by the aid of the numerous pupils of that school, AA-as disseminated through Europe, Asia, and America. It Avas eagerly caught at on all sides; but, by a strange perversion, in escaping from the humoral patho- logy, many professed Brunonians adopted doctrines es- sentially distinct from-those of Brown, supposing that if they were not Boerhaavians, they were of his sect. Dr. BroAvn seemed to consider man, not as a being compounded of an organised system to Avhich the principle of life Avas superadded, but as a machine, to which a certain series of actions and effects is allotted by means of an excitability, differing in degree, but generally, though on the whole imperceptibly exhaust- ing. In fact, it is a flame kept alive by excitements, such as heat, food, passions, Sec. Avhich, however, de- stroy by degrees the pabulum, or, in his language, the excitability. As the machine is merely passive, and the flame kept up by blowing, it cannot be depressed ex- cept by an intermission of the blast. It may, hoAvever, be exhausted by blowing too violently ; or the pabulum, not exhausted by the constant blast, may burn with greater fury on its recommencement. We mean mere- ly to facilitate the reader's conception by our metaphor, not to render the subject ludicrous. Life, therefore, is a ' forced state ;' every thing sti- mulates ; some substances too violently, others not suf- ficiently : and Ave thus have two kinds of debility, in- direct and direct. In the former case, the strongest stimuli are necessary; in the second, the slightest de- stroy in consequence of too great irritability. In the gaol fever, for instance, Ave must give the strongest stimu- lants : to the man long pent up in darkness, Avith scanty food, the light must be moderate, the aliment of the mildest kind, and stimuli of every sort most sparingly administered; as the flame, long repressed, aaouM be roused by the slightest excitement. Such is the basis of Dr. BroAvn's system; and for one part of it, accumulated excitability, he deserves the greatest credit. It is a laAV of the animal economy so general, that the attention to it directs the practitioner in various Avays; nor should he, on any occasion, lose sight of its consequence, that too frequent and violent excitements are destructive. It had been well if Dr. BroAvn had kept it more often in vieAV, particularly in his arrangement of diseases. There is, however, an- other law of the system connected Avith this, Avhich has been less adverted to, viz. that excitability, long re- pressed, is Avith difficulty, if at all, to be roused by stimulants. Constitutions of this kind are ruined from inactivity; they rust, as Ave have said, on their hinges ; and the Brunonian will not refuse this addition to his svstem, since it is so connected with his principle, that- life is a forced state. This principle, hoAvever, we cannot admit. Life is superadded to organized matter; for organization itself Avill no more produce it, than the most skilful union of wheels Avill produce a time piece without its spring. This leads to a fundamental objection to the Brunonian system; that, by giving man in the beginning a de- termined proportion of excitability, he has no where provided for its renewal, Avhen exhausted. It accumu- lates from Avant of exhaustion, but from Avhat source ? For, let only an atom be taken from a mountain, and in no way restored, the mountain must in that pro- portion be diminished, and cannot regain its former bulk. Boerhaave and Cullen felt the difficulty. Boer- haave supplied it by secretion ; Cullen, more indistinctly, made it the consequence of collapse, alluding by some remote analogy to the electrical fluid. Brown cut the knot, and, like Jack in the tale, would be ' as unlike the rogue Peter as possible;' so that there must be 710 col- lapse. Brown himself speaks of ' recruiting the ex- citability ; and his followers, Avhen urged by the difficul- ty, have either evaded it, or explained in a Avay not very- consistent with the general principle. Again : Dr. Brown speaks of indirect and direct de- bility, of the two states of exhausted and accumulated irritability. The gaol fever is alloAved to be an instance of the former, and the person, secluded from light and air, of the latter. Yet, did Dr. Brown never sec (AAre be- lieve he never did) in the gaol fever, inordinate stimuli fatal by their excess ? Did he never see phlegmonic in- flammation sometimes supervene? To the angina ma- ligna, too, a very similar disease, the inflammatory an- gina sometimes succeeds from too violent and long con- tinued stimuli. How, hoAvever, in the gaol feyer, one of his oavii instances, is the excitability exhausted by excess of stimuli ? Every previous cause, every con- comitant circumstance, has a tendency totally different. In this and the other instance of indirect debility, Ave see only the powers of life gradually exhausting, in a certain degree to be roused with augmented violence by stimuli; but, after a certain period, incapable of any excitement: while even the effects of stimuli, though apparently for a time successful, often contribute to de- stroy the remaining portion of excitability. The dif- ference of the two cases consists in this only, that the excitability in the latter is only accumulated ; but in the former, by the debilitating poAver of the fever, added to that from the confinement, in a great measure de- stroyed, or at least so far diminished as to be very ge- nerally irrecoverable. A striking instance of accumulated excitability- oc- curred in that singularly intrepid exertion of captain Bligh, Avhen he crossed the Pacific in a small boat, Avith a very inconsiderable stock of provisions. On reaching Timor, one of his creAV died of an inflammatory fever. Had these men after their voyage been thrown into a loathsome prison, or an infected hospital, Avould they have escaped? We know they Avould not, for similar instances have occurred; yet in these Ave might in vain look for the stimuli by Avhich the excitability had been exhausted. A consequence of this doctrine must be, that every medicine stimulates; and the difference betAveen Avhai are styled stimulants and sedatives is, that the latter are not sufficiently stimulating. This, however, must soon become a verbal controversy. The oxygen of the at- mosphere stimulates the lungs, and hence the Avhole system; but if the oxygen is deficient, the stimulus i-, abstracted, and the machine no longer urged on. 1 et this is hot the only stimulus; if Ave abstract oxygen, we may supply an additional stimulus by warmth: ab- stract Avarmth, also, and the passions may supply its >" B R U 286 BR IT place. Without all these exciting powers, we need not despair; Ave have brandy, laudanum, and aether. It is sufficient to state this reasoning, which, on Brunonian principles, is fair, to show its fallacy. Azote and hy- drocarbonate, when breathed without dilution, imme- diately kill. Is this from deficient or excessive sti- mulus ? If from the former, it differs in no degree from a sedative : if from excessive stimulus exhausting ex- citability, Ave can only say that the existence of the pre- vious stimulus is gratuitous ; and we have long since learnt, that, quod verba dicitur, verbo negare sat est. If no stimulus appears, we cannot place sufficient confi- dence in any assertion to believe that it exists. But these are harmless speculations. When we find them applied to practice, humanity shudders at the dangerous tendency of many of these doctrines. If we can trust reports, their application has been very exten- sively injurious. As the trammels of a system are every where conspicuous, so diseases are supposed to be either sthenic or asthenic. Those arranged under the former class are,peripneu7nonia,phrenitis, variola,rubeola, ery- sipelas, rheu7natism, cynanche tonsillaris, catarrhus, sy- 7iocha, scarlatina, 7nania,pervigilium, and obesitas. The asthenic diseases are, 7nacies, inquieludo, eruptio scabi- osa, diabetes lenior, rachitis, 7nenstruorum cessatio sup- pressio et retentio, menorrhea, epistaxis, hemorrhois, sitis vo7nitus et indigestio cum affinibus ali77ientarii ca- nalis 7norbis, pueriles affectus scil. vermes et tabes, dy- senteria et cholera, scorbutus, hysteria levior, rheuma- talgia, tussis asthenica, pertussis, cystirrhea, podagra validioru7n et i77ibeciliorum, asthma, spasma, anasarca, colicodynia, dyspepsodynia, hysteria gravior, hypochon- driasis, hydrops, epilepsia, paralysis, apoplexia, tris- mus, tetanus, intcrmittentes, dys'enteria et colica gravior, synochus, typhus simplex,, cyna7ichegangrenosa, variola confluens, typhus, pestilens et pestis. The local dis- eases folloAV, among which Ave see Avith some surprise, the iriternal infiammatio7is of the abdomen, abortion, and difficult births. Deep wounds, suppuration, pustula, anthrax, bubo, gangrene, sphacelus, scrofulous tu- mours, and scirrhus, may Avith more propriety be con- sidered as local diseases, yet these often require gene- ral methods of treatment. The cure is as simple as the arrangement. Bleeding, Ioav diet, and purging, cure the sthenic diseases; sti- muli, of different kinds and degrees, the asthenic. Is it surprising then that this system should have its ad- mirers ? The labour of study is at once abridged. The Avorks of Galen and his followers may be again burnt in solemn state; and the degree of strength or debility registered on a scale, may be at once attacked by the ap- propriate Aveapon. Sad is the history Avhich must folloAV. The victims of the yellow fever in the West Indies were often laid Ioav after full doses of Madeira, bark, and laudanum. We have seen the hectics raised into a destructive flame by similar means ; and th$ typhus fever aggravated by equally undistinguishing management. We cannot pursue the list minutely, but shall take an instance or two from each class. Peripneumony is a sthenic disease, and is attacked, as usual, by bleeding and purging. If this plan be followed, the fever is mi- tigated, but the affection of the breast remains the same. For this, the only salutary discharge is the expectoration, which should be conducted with care. Of this dis- charge Dr. Brown takes no notice; and, unfortunately, active purging will not only supersede, but prevent it: and we have no hesitation in saying, that feAv patients treated in this way would survive. We might notice also scarlatina and erysipelas. Either, treated by active bleeding and purging, would soon prove fatal. The treatment proposed for the latter may succeed in Scot- land, but in this metropolis would at once sink the patient irrecoverably. Once more: obesity is a disease to be cured by bleeding and purging. In fact, there is no state of the system in which these evacuations arc borne Avith so little advantage. The truly inflammatory habit is the strong, thin, firm, muscular highlander, or the English mountaineer. The opposite state is the irritable, hysteric female, generally plump, but Aveak, and soon sunk by discharges. In the second class Ave see the asthenic cough, by which Dr. BroAvn means consumption; and apoplexy. In each case we must use active stimulants. In the latter we have said they must soon be employed, but not without previously lessening the quantity of fluids in the head, clearing the bowels Avith the most active laxatives, and establishing some drain to prevent the secondary accumulation. Of these precautions not a word is said, and without them the physician will not be very successful. We knoAV this, for we have wit- nessed the events, and we alluded to them in the article of apoplexy, when we spoke of the accumulation of stimulants, till it Avas uncertain to Avhat the relief, or, more often, the failure Avas OAving. Of the fatal consequence of the stimulating plan in consumption, Ave have unfortunately had too many in- stances. With the best management the picture is gloomy; with the methods proposed it is deeply darken- ed. If there is any more striking feature than another in this complaint, it is increased irritability of the arterial system, and a larger proportion of oxygen in the fluids, with its accompanying irritation. Every meal of a* animal nature increases the heat, the smallest quanthv of wine or spirits raises it to a greater degree; and Avhen again cooled, the patient sinks Avith languor and debility. Yet this is the disease treated with ail the warmth of Brunonian stimulus ! We are free to oavii that the lowering system has been carried too far ; and that while we Avere guarding against fever, Ave neglect- ed properly supporting the strength. The Avhole sub- ject Ave shall have occasion to state at length, with the necessary distinctions; but the plan sanctioned by ex- perience will be found far, very far distant from the practice recommended by Dr. Brown. Nor is the change in the plan to be attributed to him. It was sug- gested by experience, before the splendor of his corus- cations- had reached this country. Of the gout Ave shall not again speak. Undoubtedly the system may be brought too Ioav; and Dr. Brown, we suspect, would raise his arthritics too high. He himself suffered severely when he changed his free pjan of living to a more abstemious one; but his case is not to be brought as an example, till his plan and its long continuance are more particularly known. We kneAv it; and in these more rational days, till we find similar plans have been adopted by our patients, Ave shall not recommend those in the work noAv before us, his own Latin edition, published in 1784. Scurvy also is to be treated by stimulants; and these without the usual remedies, it is said by this author, B R I 287 B R Y Avill succeed. Uniform experience has decided differ- ently ; and lemon juice without stimulants is, even at sea, found to be an effectual remedy. In the hooping cough, stimulants are also essential in Dr. Brown's opinion. Change of air is nonsense (fabula), and vo- miting, death. It is somewhat surprising, that, in op- position to this dogma, hooping cough is seldom fatal, though these useless or dangerous remedies are em- ployed, and with those recommended—but we have not heard of any one who has so far sinned against common sense as to employ them. We have enlarged on this system and its application, because, as we have said, it is seductive from its sim- plicity, and the little labour required either in its study or its management. We have not dAvelt on the minute investigation really required to adapt the stimulus to the state of direct or indirect debility in a given case; for, though we knoAV that every disease varies in this respect, yet no provision is made for it in the system: the name and the class are only necessary. We ob- serve, indeed, that Dr. Brown, in one or two instances, orders the stimulus to be someAvhat less than that of the disease; but he no where points out the symptoms Avhich discriminate its degree. It is not Avholly the neglect of distinguishing the de- gree of debility, either indirect or direct, and, of course, the proportion of stimulus to be employed, that renders the application of this system difficult or dangerous, but the very imperfect distinction of diseases. - The de- scriptions are often the most meagre and imperfect; the diagnosis is seldom attended to.- These, in fact, would require Avhat the author never possessed, practical knoAv- Iedge. The distinction also of different circumstances of a disease, which Avould require very different and often opposite treatment, is neglected; and when we find in the same class, to be treated with the same reme- dies, menstruorum,suppressio, and maenorrhcea,we shall begin to suspect that an attachment to system has preclud- ed the observation of the operations of nature. When we see in the opposite classes, pervigilium and inquietudo, phrenitis and epistaxis, colica gravior and enteritis; in the same chapter the podagra imbeciliorum andvalidio- rum, treated in the same manner, we cannot greatly re- iyon the judgment or practical knowledge of the author. We had supposed the Brunonian system hastening to oblivion ; but, in the last edition by Dr. William Cullen Brown, we are informed that it is generally adopted; and he asks triumphantly, what would have been the event had this system been promulgated from a pro- fessorial chair ? Perhaps the delusion might have lasted longer, but the pupil will at last become a practitioner, and will bring his master's doctrine to the test of ex- perience, nor any longer foster it than he finds it suc- cessful. His son speaks of the numerous converts to this neAV doctrine; but Ave have found feAv Avho, though they profess themselves the disciples of BroAvn, follow implicitly his system; and Ave have had numerous op- portunities of remarking, that those Avho, on leaving the banners of Boerhaave, have adopted the nervous pa- thology, are rather Cullenians than Brunonians. Dr. Darwin, it is said, was a Brunonian before Brown was knoAvn : in reality, his language is in some parts nearly the same, but his practice, though peculiar, most re- mote; and, if the analogy is pushed further, the term should at least be altered, and the system styled Dar- winian. BRU'NUS. See Erysipelas. BRU'SCUS. See Ruscus. BRU'TA. (Arabic). That virtue of the celestial influence manifested by the brutes, as in the stork teaching the use of salt in clysters. BRU'TIA. An epithet for the most resinous kind of pitch, therefore used to make the oleum fiissinum, said by Ray to be the same as the pisselaeon of the ancients; for that Avas called by them oleum picinum ; and was, according to Galen, a medicine made of oil and pitch. The pix Brutia Avas so called from Brutia, a country in the extreme parts of Italy, and made from the teda, MOUNTAIN PINE. BRUTI'NO. See Terebinthina. BRU'TOBON. The name of an ointment used by the Greeks. BRUTU'A. See Pareira brava. BRUXANELI. (Indian). A tall tree in Malabar: its bark is diuretic. Raii Hist. BRY'GMUS, (from Ppv^a, to make a noise). A pe- culiar kind of noise, such as is made by the grating of the teeth, or their gnashing. BRY'ON, (from Ppvu, to germinate). Called splach- non by some: a kind of moss found on cedars, oak, 8cc. It is astringent. BRY'ON THALA'SSIUM. See Alga. BRYO'NIA, (from Ppvu, to abound). So called from its abundance. It is a name for the white jalap; also BRIONY. Bryo'nia a'lba. White briony; called also vitis alba, vel sylvestris; agrostis, ampelos, archeostris; echetrosis, by Hippocrates; bryonia aspera; cedrostis; chelidonium ; labrusca ; 7nelot/i7-U7n, ophrostaphylon; psilothrum; wild vine. This species is chiefly used. It is the bryonia alba Lin. Sp. PI. 1438. It is a perennial rough plant, groAvs Avild in hedges, and climbs up bushes, with curled tendrils: the leaves are in shape someAvhat like those of the vine. These roots are taken up in spring, and afford a thin milky juice, which hath a disagreeable smell, and a nauseous, biting, bitter taste: if applied to the skin, it blisters. If the root be dried, or its milky juice in- spissated, they lose most of their acrimony and nauseous smell. Externally, this root is powerfully discutient. Dr. Alston observes, that in SAvellings, strains, and stiffness of the joints, he has experienced surprising effects from it; in contusions, a decoction of it Avith the addition of wormwood, does great service. According to Bergius, it is a purgative, hydragogue, emmenagogue, and diure- tic; the fresh root emetic: it has chiefly been employ- ed in dropsies, in asthma, mania, and epilepsy. In small doses it is said to be diuretic, resolvent, and deobstru- ent. In poAvder, from 9 i. to a drachm it is strongly purgative. The juice, which issues spontaneously, in doses of § ss. or more, has similar, though more gen- tle, effects; but the Avatery extract acts more mildly than the powder, and with greater safety. The dose 5 ss. to 3 i- Of the expressed juice, a spoonful acts violently both upAvaids and doAvnAvards; but cream of tartar is said to take off its virulence. As a discutient, the catapla'sma bryo'nie composiium is much re- B U B 288 BUB « ommendcd. Of briony root three ounces, elder floAv- ers one ounce, are boiled till they become tender; to which are added half an ounce of gum animoniac dis- solved in vinegar, muriated ammonia two drachms, rAmphorated spirit one ounce. Bryonia nt'gra. Black briony; called also tam- •cus, sigillu7n beate Marie, chironia, apronia, gy7iecan- the; black vine, and the Chironlan vine. This plant climbs without tendrils, the leaves are smooth, and, like those of the great bind weed, it bears black ber- ries; the roots and leaves are commended as expecto- rant. Raii Hist. According to Gerrard it is called agriampelos, but is a variety of the b. alba. Bryo'nta mecoacha'nv nigra. Bryo'nta Peru- viana. See Jalap and Mechoacana alba. BRYTHION. (Greek). A malagma so called. It is described by P. ^Egineta. BRY'TIA, (from Ppwla, to devour). The solid parts of grapes Avhich remain after the must is expressed. BRY'TON. Bgvlov, (from Pgva, to pour out). A kind of drink made of barley or rice, Avhich Aristotle calls pinon. It is said that those who are drunk with it never fall but on their backs. BU'BALUS, (dim. of pas, an ox). Antilope bubalis Lin. The buffalo; called buffelus, and bos Indiana. It is a kind of ox. This name it hath from the country in Asia from whence it was brought into Europe. BUBASTECORDIUM, the heart of Bubastus, (from Bubastus, and cor, heart). See Artemisia. BU'BO. A'bubo, (from povQuv, the groin). Vogel names it bubon when in the groin; it is also named cambuca, cambuca 7nembrata, codocele; by some it is called fugile, and aclin. It is a tumid gland Avhich is inflamed, or tends to suppuration : but it is generally understood only of those glands Avhich are in the arm pits or the groin. Galen says, in his first book De Diff. Febr. ' a bubo is a kind of inflammation.' Dr. Cullen ranks this genus of disease in the class locales, and order tumores. He defines it to be the suppurating tumour of a conglobate gland. See his Nosology, edit. 3. Buboes are distinguished into mild and malignant; the mild is that Avithout manifest disease; the malig- nant, Avhen excited by some pestilential or infectious disease, as the plague, or lues venerea. The chief danger is from the bad habit of body, or some attendant disease : if neither of these accompanies the buboes, at the worst they are troublesome, painful, and tedious. The cure of the mild kind will easily be effected by gentle mercurials externally applied, and occasionally a purge; though, if a suppuration threaten, it is best to encourage it, and proceed as in a common abscess. A pestilential bubo is knoAvn by its appearing at the time of a pestilence, and being attended with its symptoms; though, indeed, the bubo is sometimes the first symptom. The appearance of a bubo, when the plague either prevails or attacks a person, is generally a happy presage, and in the management repellents must not be used, but suppuration encouraged; and as soon as a tumour appears, apply the speediest suppu- ratives, and second them by the use of cordial antisep- tics imvardly. Its most common seat is the arm pit or groin. See Pestis. A venereal bubo very generally- occurs in the groin, though, Avhen the poison has been received in the hands or fingers, the arm pits are the seat; they tend very sloAviy to a suppuration, and are with difficult} healed when suppurated. In the beginning,- these tumours are sore if touched; hard, and gradually increasing, they become painful; if they tend to suppurate, an inflammation appears. The distinction of bubo is of considerable import- ance. We shall not enlarge on pestilential buboes, only to urge the necessity of examining, during the prevalence of any epidemic highly asthenic fever, the groins and arm pits. The severity of the regulations in former eras respecting those affected with the plague, has led to the most dangerous concealments. We shall continue to speak exclusively of the venereal bubo. SAvellings in the groin may'arise from hernia, from a retention of the testicle at the ring of the muscle, from a general scrofulous habit, or from poison absorbed •from any part of the loAver extremities. Those who arc accurately acquainted Avith the situation of the lym- phatic glands, Avhich receive the absorbent vessels from the penis and from the loAver extremities, for their situation is different, will not be easily deceived. It is not, hoavever, usually suspected, that the latter are nearer to the root of the penis than the fonner. Those also Avell acquainted Avith the situation of the ring of the muscles, will not easily mistake a hernia for a bubo. But error is more easy in this, than in the former case. If therefore the tumour be hard, if it does not recede on lying back, if it has not receded in its earlier stages, if it does not force doAvn on coughing or sneezing, and if the state of the boAvels have not influenced it, the disease is either a bubo or a scrofulous SAvelling: the latter, hoAvever, is scarcely ever single. A chain of small obstructed glands occupies the groin, and the scrofu- lous diathesis is, in other respects, obvious. We omit mentioning the previous venereal complaints; for these are often industriously concealed, or it may happen that a bubo is the first symptom. The testicle, Avhen de- tained, sticks at the ring of the muscle; but, were the situation not sufficient to discriminate the complaint, the Avant of one testicle would immediately lead to a suspicion and a full examination. It has been usual to consider buboes as arising from irritation on the glans penis and mouths of the ab- sorbents, or from the absorption of matter. The idea is consoling to the patient that the swelling is not venereal, but Ave fear it is fallacious. We knoAV of no instance of irritation conveyed from the opening of a lymphatic to a gland, except by poison. No one will trust his health to this idea, and the distinction may be neglect- ed. We know that some buboes yield easily, but we should not, on that account, be less apprehensive of lues folloAving. A secondary bubo, viz. a deposition of ve- nereal virus from the habit of the gland, has certainly no existence. The virus is directed to very different organs, and the opinion has been adopted in consequence of the deceit of patients, who are unwilling to confess the probability of a more recent infection. It has occasioned some dispute, whether a bubo should be discussed, or brought to a suppuration. Two ideas have influenced either opinion; one, just noticed, respecting the source of the bubo from irritation; the B U B 289 BUB other, that the virus is there arrested, and if suppura- tion can be produced, may be evacuated Avithout in- jury to the system. If, however, we examine injected lymphatics, we shall sometimes find, that of the nu- merous vessels directed towards a gland, some will not enter its substance, but pass over, or one side; nor can we be certain that, previous to the inflammation, some portion of the virus may not have been carried into the blood. To trust, therefore, to the opinion, that the poison can thus be arrested in its passage, is highly dangerous; and we lose a strong argument in favour of promoting suppuration. It is then reduced to a question of convenience; and there can be little doubt of the propriety of resolution, since in each view a mercurial course is indispensable. To discuss buboes emetics have been employed. They* undoubtedly promote absorption, but the most violent ones are requisite, and they are seldom necessary. Mer- curial frictions on the part have been recommended, to extinguish, it is supposed, at once the peculiar virulence of the poison. In general, however, these from their irritation may produce inflammation; and, though for the ease of the patient's mind some part of the oint- ment should be rubbed on the bubo, the larger portion should be employed on the thigh, the groin, and peri- naeum. We reserve the discussion of the specific ac- tion of mercury at present. Cold applications freely em- ployed have been useful; and the volatile liniment, rub- bed around rather than cm the tumour, has assisted the resolution. Leeches have been applied in the neigh- bourhood when inflammation has begun; and whatever plan be adopted, the patient should be kept on a low cooling diet and at rest, while frequent laxatives are in- terposed. When we can thus succeed in discussing buboes, the remaining treatment will be that of syphilis. If, how- ever, Ave fail, and suppuration is indispensable, Ave may be apprehensive of fatal effects from too great inflam- mation or irritation. In this case the most cooling me- dicines, with opium and bark, are necessary. In ge- neral, the irritation proceeds, pari passu, with the in- flammation ; and the cooling plan cannot be carried far, before the latter medicines are necessary. # As the dis- ease is before our eyes, we can distinguish the degree of inflammation, and-be able to account for the symp- toms Ave perceive. During the suppuration of a bubo, it is the most judicious practice to leave off mercury. When, however, the suppuration proceeds tardily, a mercurial course will accelerate it; and in such circum- stances, wine and other cordials are requisite. In these situations we can often discuss buboes, even when they .appear hastening to suppuration. Poultices of the man- dragora and mezereum have been employed for this purpose. Disputes have also arisen respecting the opening of the buboes. We certainly run little risk in suffering them to remain till they are soft, and the fluctuation of matter is evident; but we would then advise opening them, and employing the knife rather than the caustic. The latter is preferable when, from symptoms of irritation, a discharge is necessary before the abscess be quite ripe. When the abscess is formed, it must be treated ac- cording to the usual methods, stimulated, and the con- stitution supported by bark and wine, if the circula- tion be languid; but by a contrary plan if irritable VOL. I. and inflamed. In either case mercury is improper : but, in intermediate circumstances, we may begin our mercurial course with little hesitation. When sinuses are threatened, the stagnation of mat- . ter must be guarded against: if formed, they must be opened. We have seen the opening of a single sinus give such a stimulus to the neighbouring parts, that the sore has soon assumed a healthy, instead of a cancerous aspect, without any other application. When morti- fication threatens, bark, Avine, and opium, are neces- sary; when cancer, hemlock. Yet Ave suspect that real cancer has never been the consequence of a venereal - bubo. We have never'at least seen it in a long prac- tice, nor have been informed of such an event by a com- petent witness. See Lues venerea, and Abscessus inguinis. See Heister's Surgery. Astruc on the Venereal Dis- ease, or Chapman's Abridgment of Astruc. Bell's Surgery. Wallis's Sydenham, vol. i. 143. White's Surgery, 20. Plenck on the Lues Venerea; SAve- diaur and Bell on the Venereal Disease; Hunter; Foot. BU'BON, (from povQov, the groin). BUBONOCE'LE, (from pvQov, the groin, and xyXr., a tumour). It is also called hernia inguinaliSj or rup- ture of the groin, Avhen the intestines are forced through the ring of the external oblique muscle of the belly. When through the cavity in the thigh, between the musculus pectineus and sartorius, it is called hernia femoralis, or cruralis. The cause may be great distention of the bowels from wind, violent exercise, as leaping, or lifting burdens. A relaxation of the ring of the muscle is not an un- common cause, and on this account the disease is some- times hereditary. In lean persons the ring is also fre- quently relaxed, and in fat people the weight of the parts Avill occasionally bring them down. The signs are, a tumour in the groin, or upper part of the scrotum, beginning at the ring of the abdominal muscle, and extending more or less doAvnward, toAvards or into the scrotum in men, and the labia pudendi in Avomen. This tumour appears different to the touch, according to its contents. If a portion of the ilium forms the tumour, its surface is smooth and elastic, but much more so if the patient coughs and sneezes. If only a piece of the omentum hath slipped down, the tumour is more flabby when felt, its surface is more unequal, and it makes less resistance to the finger. If both the intestine and omentum have descended, the diagnostics will be less distinct, and it requires gene- rally some experience to assist in judging of what can hardly be learnt by description. The distinction of bubonocele is of considerable im- portance, and the greatest injury has been done by mis- taking it for bubo, for hernia humoralis, for cancer of the testicle, and hydrocele. Of the symptoms distin- guishing it from bubo Ave have just spoken. Hernia humoralis, or a swelled testicle from venereal irritation, is distinguished by the symptoms of its attack; for the . latter is preceded by a hardness of the epididymis, followed by a hardness and acute pain of the body of the testicle itself, while the hernia is not equally pain- ful, till external inflammation, and other symptoms of affections of the boAvels, sufficiently point out its nature. It could scarcely be supposed that a cancerous tumour BUB 290 BUB of the testicle could be mistaken for hernia, had we not seen the error committed. The sIoav progress of the swelling, the scirrhous feel, and the undisturbed state of the bowels, sufficiently discriminate the tAvo diseases. The dropsy of the tunica vaginalis testis is most often mistaken for hernia. This, however, feels more smooth and equable; a fluctuation can be perceived, a transpa- rency, Avhen a candle is placed on the opposite side, is obvious: and if we can observe its progress, we shall find that it begins at the bottom of the scrotum, gradu- ally rising upAvards, and the spermatic cord is gene- rally free; Avhile in hernia, the enlargement is felt from above doAvmvards. The increase of the tumour on coughing or sneezing, and the obstructed state of the boAvels ; above all, its receding or lying back; are fully sufficient, even for the less experienced practitioner, to discriminate the two diseases. One other complaint should be noticed as sometimes confounded Avith bubonocele, viz. the varicocele, par- ticularly the A-arices of the spermatic cord. These are forced doAvn in coughing, and disappear in a recumbent posture. The distinction is not difficult. When emp- tied from a recumbent posture, if a finger is placed on the ring, and the patient raised, the tumour will re- appear should it be from varices, but not if it is a hernia. # The ring of the muscle so often mentioned, is an aperture in the tendon of the external oblique, formed by the splitting of its fibres. Through this passage the testicles in the foetus, or soon after birth, descend ; and the spermatic cord is, by the testicle, drawn down through it. No process, except the occasional accu- mulation of fat, contributes to close it, and through this aperture the intestines descend. Though authors speak of the ring, yet there are two; for another aperture is formed by the tendons of the internal oblique and trans- verse muscle behind, and a little on the outside of the other ring. Though Ave have said nature has not closed the aperture, yet the ring is drawn close by the action of the external oblique; and this action, while it often prevents rupture when it has occurred, occasions Avhat is called strangulation. The term is perhaps improper, as the tendon is not capable of contracting. In reality, the distention of the boAvels occasions the contraction of the external oblique, which draws the fibres of the tendon closer; Avhile the distention of the portion of intestine filled Avith air, contributes to fill more com- pletely the contracted aperture. The internal ring is more muscular, and may be spasmodically contracted. The symptoms of all intestinal herniae are those of ilius'; and in every case of violent colic, the prac- titioner should, ahvays examine whether some hernial tumour can be discovered. The pain is generally most violent ^at the pit of the stomach, as the omentum, Avhich accompanies the intestine in the sac, is dragged doAvn Avith it. The pain goes on increasing, incessant vomiting comes on, and what is discharged is at first watery, then bilious, and lastly, feculent; stools are obstinately retained, and mortification closes the scene. Vomiting' and hiccough frequently occur in herniae; and the cause will be obvious when the connection of the omentum Avith the stomach is considered. The pulse is at first hard, but when mortification and cold sAveats come on, it is softer and more regular, but soon becomes small, frequent, and tremulous, When a hernia comes doAvn, if the patient is strong and plethoric, some blood may be taken, and a clyster injected ; the reduction is next attempted. To reduce the hernia merely by the hand, Avithout cutting or eroding the part, is called taxis ; and when it is thus reduced by the hand, if the rupture consisted of a portion of the intestine only, it generally slips up at once. The posture of the patient, if laid on his back, Avith his heels brought near to his buttocks, assists the return of the protruded parts : if a piece of the omentum is the contents, its return is not so speedy ; if there are both omentum and intestine, the latter ascends first, and the former feels flabby, but soon after follows also. Some- times after the intestine is returned, a soft knotty sub- stance remains unreduced, and resists all the efforts to reduction, until the patient's vessels are emptied by bleeding, repeated purges, and a low diet; the varicous feel which this substance hath, seems as if it was the mesentery with its vessels distended. In infants the reduction is generally easy, and as they acquire strength they are less subject to a relapse. In the vigour of life the return is generally more difficult, and the neglect or bad management more dangerous. It often happens that raising the buttocks while the body is depending, will alone succeed. Should this not be the case, the surgeon should grasp the tumour with one hand, press it steadily upAvards and outwards, while Avith the fingers he begins to reduce the last pro- truded portion. Should he succeed in part, the rest soon follows, and the patient is relieved. If he fail, different plans have been advised. . Of the remedies, copious bleeding is the first, and often an indispensable one. When the patient faints, the tumour often spontaneously recedes. Purgatives have been next employed, and absurdly given by the mouth; we say absurdly, because, by increasing the peristaltic motion above the tumour, it rather adds to the disease. It has been usual to join the purgatives with opium to relax the stricture, while the purgative con- tributed to conquer the constipation. In such cases, however, the purgatives are so often retarded by the opium, as to lose their effect; and should this com- bination succeed, it must be attributed to the opium only. Purgatives injected as clysters are not liable to the same inconvenience; for the increase of the peri- staltic motion below the tumour, has a tendency to draw back the intestine. Soap, particularly the black soap, is highly useful in this way ; and purgatives of the most active nature, and of every kind, have been employed. The most ready and advantageous one, however, is the infusion of tobacco in clyster. From half a drachm to two scruples of tobacco may be infused in ten or tAvelve ounces of boiling water for ten minutes, and injected as a clyster. It is not only useful as a laxative, but produces so much languor and fainting, as often to occasion the gut to recede without other assistance. The digitalis also seems chiefly useful, by producing syncope. It has been usual to apply Avarmth in every form to the hernial sac, Avith a view probably of relaxing the ring; but it was not considered t*at even if this effect , was certain, that the flatulent contents of the sac would be enlarged in a greater proportion, and even the substance of the intestine itself. We believe it has seldom suc- ceeded ; and Avhen useful, the faintness induced by its BUB 291 B U B continuance has been the chief cause of the relief. The Avarm bath for the same reasons has sometimes suc- ceeded, but much oftener failed; and we think that, in many cases, it has accelerated mortification. The con- trary method is now more advantageously adopted; ice and snow have been applied with success to the hernial sac. When these cannot be procured, the coldest wa- ter, often renewed, has been of service; and water cooled artificially has been used. The most ready way of cool- ing Avater is to suspend it in a wet bladder to a current of air, and the effect will be increased if the outside of the bladder be moistened with aether, carefully purified from the acid. A solution of nitre Avith sal ammoniac will be equally effectual, in the proportion of eight parts to five; and with management, by further cooling water first artificially cooled, all the effects of ice may be procured even in summer. The constant applica- tion of cold has thus often succeeded, and it is one of the most valuable improvements of modern practice. All will in many cases fail, and the operation, though dreadful, and often fatal, must be attempted. Yet there is one further step to avoid it, viz.' to dilate or divide the ring, to prevent strangulation, and suffer the tumour to remain. This is the advice of Dr. Monro, and we think it merits more attention than it has received. This operation is not formidable, is not perhaps highly dangerous; and should it be performed hastily and un- advisedly, does not prevent reducing the rupture at a subsequent period. The danger and the severity of the operation have occasioned its being too long delayed; but though it succeeds in some apparently desperate cases, it fails in others Avhere the prospects were more favour- able. The external appearances of mortification are undoubtedly among the symptoms Avhich would render it unsuccessful, since mortification takes place in the intestine before it is communicated to the integuments, and is, of course, more violent in degree in the former than the latter part. Feculent or putrid vomitings have been considered as highly unfavourable to success; yet even in such instances the patient's life has been saved. Mr. Cooper thinks that a general soreness in the ab- domen is the chief symptom Avhich should prevent the attempt. In Mr. Home's opinions, the symptoms are influenced by the state of the gut. If no inflammation has taken place in it, the consequences of obstruction only are ob- servable. When inflammation takes place, there is a general soreness, Avith constant vomiting, that does not relieve, and considerable depression of spirits. When the stricture produces mortification, all the unfavour- able symptoms are observed, and a general coldness comes on. The last symptom is decisive against at- tempting the operation. To proceed in the operation, the pubes and groin should be shaved; and, in order to have as much empty space as possible for the return of the protruded parts, the patient should -be advised to empty his bladder en- tirely. The patient being then laid on his back, on a table of a convenient height, with his legs hanging easy over the end of it, with a straight dissecting knife an incision must be made through the skin and membrana adiposa, beginning just above the ring of the abdominal muscle, and continuing quite down to the inferior part of the scrotum. Upon the division of the membrana adiposa, some small tendinous bands appear distinct from each other, lying close upon the hernial sac, which is next to be divided with the utmost caution, as the sac is thinner in some parts than in others: even the ex- ternal incision of the teguments ought to be made Avith great care; for although, in by much the greatest pro^ portion of hernial SAvellings, the spermatic vessels lie be- hind the protruded parts, yet on some occasions they have been fou7id on the anterior part of the tumour ; so that, in order to avoid the risk of wounding them, so soon as the skin is divided, the remainder of the operation must be done in the most cautious manner, care being taken to avoid every large blood vessel that makes its appear- ance. The incision in the sac is best made about an inch and a half, or two inches, below the stricture, and need be no more than such an aperture as will just ad- mit the extremity of the probe. If the probe will pass freely up and doAvn, enlarge the opening with a probe pointed bistoury, sufficient to introduce your finger to divide the whole, remembering to divide it first down- Avards, Avhich gives more room, and lessens the hazard of the intestines being Avounded by the knife, Avhich might easily happen in dividing it in the opposite direction. The fore finger is the best of all directors, and upon that finger a narroAV bladed curved knife, with a bold probe point, will be the only instrument necessary to finish the operation. With this knife on the finger the sac should be divided, first doAvnward to the bottom of the scrotum, then upward to the ring. Upon the first division of the hernial sac a fluid is discharged, differing in quantity and colour in different patient*. The sac being fairly divided up to the ring, the intestine pushes out, and seems to be more in quantity than it did Avhile in confinement. At this juncture, if the quantity of the protruded intestine is not very great, try to reduce it by first pulling doAvn a little more, for thus, its bulk being lessened, it perhaps may pass without dividing the ring; if this does not succeed, the probe pointed knife, conducted on the fore finger, will imme- diately divide the upper part of it, and set all free. The sac and ring divided, the contained parts come into vieAV, and, according to their different states, will be va- riously managed. If sound, immediately reduce them, remembering that the parts last protruded should be first returned. Slight adhesions may be separated with the finger, or snip/ped with the scissors. If the parts are so adherent as not to be capable of being returned, remove the stricture by dividing the sac and ring, and leave the prolapsed parts in the scrotum as you find them; but this case seldom happens. If the contained parts are mortified, death will be the issue; but if the mortification is not very extensive, return them, and trust to the efforts of nature, and the effects of medicine. If the intestine is mortified, make a ligature and fix it to the wound; thus the faeces Avill pass out at the aper- ture, and the patient may live many years after. Herniae in Avomen are treated as in men, but in them the disease is less common, as the aperture is much smaller, not requiring the passage of a body so large as the testicle, but only the round ligaments. Women, hoAvever, more frequently conceal the disease, and we must be more attentive to the cause of every kind of violent colic. One inconvenience arises from not dis- tinguishing in them the inguinal and femoral hernia, since the tumour in each species is not \ c. y distant, and the mode of reduction is different. If the operator feel Pp 2 • BU C 2 with his finger the course of Poupart's ligament, and find the neck of the tumour above its edge, the hernia is inguinal; if below, femoral: as, in the male, the in- testine is sometimes not protruded beyond the external ring, and the disease may remain undiscovered. After the operation, the patient must be laid in bed, with his body somewhat raised, and an opiate adminis- tered. A clyster should be soon given, and immedi- ately after its operation, a mild but effectual laxative, as manna, castor oil, or the pulv. e senna c. administered. The Avound, dressed in the common way, should be se- <■ cured by a T bandage. The consequent bad symptoms are those chiefly of irritation from air admitted into the cavity of the abdomen, or mortification. Bark and opium are the chief remedies, and must be administered in proportion to the violence and nature of the complaint. The bowels must, however, be kept open Avith the great- est attention. When a hernia has been of long continuance, adhe- sions between the gut and the sac, and between the contiguous portions of the gut, take place. Greater caution must be used in opening the sac when adhesions are suspected; and those between the gut and the sac must be carefully separated. If the disunion of the others be not easy, the intestine should be returned without its being effected. When the separation of the gut from the sac is found difficult, a part of the latter may be separated and returned with the gut. The omentum often causes much uneasiness. If gangrenous, the diseased portion may be cut off. In ge- neral the vessels are small, and little haemorrhage oc- curs; but this is sometimes considerable, and it is ne- cessary to tie a vessel, or even tAvo. In this case the ends of the ligature should be brought beyond the Avound, and they will soon separate. The method of separating the mortified portion of the omentum by a ligature, is often inconvenient from the irritation it induces, and no injury happens from dividing it. When a portion of the intestine is mortified, it has been recommended to separate it, and unite the sound portions of the gut by ligatures, or, by placing them in contact, to leave the union to nature. This plan has been suggested by nature occasionally separating a mortified part of some extent, while the canal was not interrupted. It is impossible in this place to enlarge on the minute details which such an operation requires; and the reader will find ample information in Mr. A. Cowper's most excellent work on hernia. The portion of gut found in hernial swellings is very various, no part of the intestinal canal being entirely exempted from falling down. Hitherto the ileum has been commonly supposed to form the substance of the greatest proportion of such tumours: later and more accurate observation, however, renders it probable that the coecum, appendix vermiformis, and part of the co- lon, are more frequently contained in the hernial sacs than any other portion of the gut. See Pott on Ruptures, Le Dran's Operations in Sur- gery, Sharp's Operations of Surgery. Lond. Med. Obs. et Inq. vol. iv. Bell's Surgery, vol. i. White's Surgery, 318. CoAvper on Ruptures. Monro on Herniae. BU'BON GAL'BANUM. See Galbanum. Bu'bon Macedo'nicum. See Apium Macedoni- i:UM. BU'CCE, (from the Hebrew term bukkah). The >2 BUF cheeks. Hippocrates terms them cyclos; the cheek is also called gomphale, gela, maxilla, melon. They are the sides of the face; and reach from the eyes and temples between the nose and ears. The upper prominent parts of the cheeks are called Mala, Avhich see. BUCCACRATON, (from buccella, a morsel, and xpxw, to mix). Morsels of bread sopped in wine, which formerly served for a breakfast. Paracelsus calls by the name of bucella, the carne- ous excrescence of a polypus in the nose, because he supposes it to be a portion of flesh parting from the bucca, and insinuating itself into the nose. BUCCA'LES GLANDU'LjE, (from' bucca, the ' cheek). The small glandular bodies on the inside of the cheeks. They open by small holes or orifices through the inner membrane of the mouth. Winslow BUCCEA, BUCCELLA. A morsel. BUCCELATIO, (from buccellatus, cut into small pieces). A method of stopping the* blood by applying lint, cut into small square pieces, upon the vein or artery. BUCCELATON, (from buccella, a morsel. Buc- cella purgatoria, and buccellatus. A purging medicine, made up in the form of a loaf, consisting of scammony, • Sec. put into fermented flour, and then baked in an oven. BUCCE'LLA. See Bolus, Buccacraton, and BUCCELATON. BUCCINATOR MUSCULUS, constrictor muscu- lus. The trumpeter's muscle, (from pevxxvov, a trum- pet). It is thus named because of its use in forcing the breath to sound the trumpet. It has two distinct beginnings on each side, one tendinous and fleshy from ' the loAver jaAv, between the last dens molaris and the root of the fore part of the processus corona?; the other is fleshy from the upper jaw, between the last dens mo- laris and the processus pterigoides, from Avhose extre- mity also it arises tendinous, being continued between these two origins to the pterigo pharyngaeus on one side, and the mylo pharyngaeus on the other; from thence proceeding with straight fibres, and adhering to the membrane that covers the inside of the mouth, but without touching the gums of either jaw. It is inserted and lost in the angle of the lip. By its substance on each side it constitutes the cheeks, and through its middle the ductus salivalis superior passes. Its use is not only to move the cheeks with the lips, but also to contract the cavity of the mouth by bringing them inwards, and so thrust the meat between the teeth for its better comminution. BU'CCINUM, (from buccino, the trumpet). So called from its trumpet-like shape. The whelk. Whelks cal- cined have the same effects as the purple fish, but are somewhat more caustic. The shells filled with salt, then burned in a crude earthen pot, make a good denti- Ince. It is a sea shell fish, of which there are many sorts, but the shells are all absorbents. BU'CCULA, (a dim. of bucca). The cheek. The fleshy part under the chin. BU'CERAS, or BU'CEROS. See Bouceras. BUCRA'NION, (from £«, an ox, and xpxviov, a head). So called because it resembles an ox's head. See Antirrhinum. BU'CTON. See Hymen. BU'FFALO. See Bubalus. BUL 293 BUN BU'FFELI. A ring made of the horn of a buffalo, Avhich is worn on the ring finger to cure the cramp. BU'FO, (from pas, an ox, and Qovos, death). So called because it is death to any cattle which eat them. The toad; also called rubeta, rana rubeta. The toad is of the frog kind, and of the number"of those animals Which have only one ventricle in the heart. It is much like the frog, but its belly is more inflated, and skin more full of tubercles; it is of an ash colour, with brown, blackish, and yelloAV spots. It does not croak like the frog, but makes an indistinct 'noise that is ob- scure, and like the word geu, or rather bu, from which some suppose it is called bufo. It is said to have its name rubeta from rubus, because it is often found under bramble bushes. There is a very poisonous species in America called cururu by the Brasilians, artd capo by the Portuguese. The common toad was first introduced into medicine from a cure being performed on an hydropic person.^ to Avhom powdered toads were given in order to despatch him, but he voided a large quantity of urine after taking them, and soon recovered of his disorder. Since this, toads, gently dried and powdered, have been used as a diuretic, but the present practice rejects them. They have also been applied alive to cancers to suck the virus, a method of extracting it said to be fatal to the animal; the plan is, however, disused, probably from its want of success. BUGA'NTIA. Chilblain. See Pernio. BUGLO'SSUM, (from pas, an ox, and yXae-rx, a tongue; so called from the shape and roughness of its leaf). Bugloss ; called also buglossum angustifolium 7najus, buglossu7n vulgare majus, buglossu7n sativum. Garden bugloss. Anchusa officinalis Lin. Sp. PI. 191. The garden bugloss is a rough plant, resembling bo- rage, and differing from it chiefly in the leaves being narrow, less prickly, not wrinkled, and of a bluish green colour, and in the segments of the floAvers being obtuse. It grows wild on waste grounds in the southern parts of Europe, is cultivated with us in gardens, floAvers from June to the end of summer, and in winter it dies to the ground, but the roots continue. It is a name of the borrago, and as a medicine is nearly similar, but its roots are less mucilaginous. BUGLO'SSUM RADICE RUBRA. See AnCHUSA. BUGO'NES, (from pas, an ox, and yivofjuxi, to be bred, or generated of). An epithet for bees, because the ancients thought them to be bred from the putrefaction of an ox. See Apes. BU'GULA, (a dim. of buglossa; and said to be so called from its resemblance). Bugle. Called also con- solida Media, prunella Germanis, symphitum medium, and middle consound. The sort used in medicine is the ajuga reptans Lin. Sp. PI. 785. It is a low plant, Avith round, creeping, and upright square stalks. They bear loose spikes of blue floAvers; the leaves are somewhat oval, soft, and set in pairs about the joints of the stalks. It is perennial, found Avild in woods and moist meadows, and flowers in May. It is mildly astringent; the root is the most so. BULA'T WELA. See Bktla. BULBOCA'STANUM, (from poxQos, a bulb, and kxtIxvov, a chestnut,) agriocastanwn* nucula terrestris, balanocastaneum, bulbocastanum majus et minus, earth nut, hawk nut, kipper nut, and pig nut. Bunium bul- bocastanum Lin. Sp. PI. 349. The b. fiexuosum of modern authors appears to be specifically distinct, and similar in its qualities. This root is as large as a nutmeg, hard, tuberous, and -whitish. It groAvs in sandy and gravelly places; flowers in May; is eaten either raw or roasted. It is sweetish to the taste, nourishing, and supposed to be of use against strangury and bloody urine. BULBOCO'DIUM, (from poxQos, bulbus, bulbous, and xu$ix, a globe). So called from its round bulbous root. See Narcissus luteus sylvestris. BU'LBONACH. (German). Called also viola lu- naris, lunaria major, leucoium lunatum, satin and honesty. Lunaria rediviva Lin. Sp.Pl. 911. The root is knotted, whence the name bulbonach; the seeds are large, red, and acrid to the taste. It grows spontaneously in Germany and Hungary, is sown in gardens in England; and is said to be a warm diuretic. Raii Hist. Modern practice, however, re- jects it. BULBUS, vel BO'LBOS, (from pa, a particle of excess, and XxGy, from Xxf*.€xva>, to take, because it is easily taken hold of from its roundness). Blancard. Bul'bus escule'ntus, such bulbous roots as are commonly eaten. Bul'bus vomito'rius, called also muscari, ash coloured grape flower, muscari obsoletiore fiore, hyacinthus racemosus moschatus, sibcadi, dip'cadi, and musk grape floaver. Hyacinthus muscari Lin. Sp. PL454. It hath a leaf as flexible as leather; the root is bulbous, covered Avith a black rind, and is emetic and diuretic. It grows in gardens about Constantinople, and in other parts of Asia. Raii Hist. ' Bu'lbus sylvestris. See Narcissus luteus syl- VEST. BULI'MIA, BULIMI'ASIS, and BU'LIMUS. See Boulimus. BULITHOS, and BULITHUM, (from pas, an ox, and Xi8os, a stone). A stone found in the gall bladder, kidneys, or urinary bladder, of an ox. See Capra Al- pin a. BULLA. A bubble ; a vesicle. An elevation of the cuticle of a large size, irregularly circumscribed, and containing a transparent watery fluid. Clear vesicles arising in the eye, or from burns or scalds, are called bullae. Vesicles, Avith a dark red, or livid coloured base, are usually denominated phlycten,e. - BULLION, (from the French billon). Gold or silver in the ore, or imperfectly refined. BULLOSA FEBRIS, (from bulla, a bubble). An epithet applied to the bullous or vesicular fever, from the appearance of the eruptions attending it. See Pemphigus. BUME'LIA, (from pa, a particle of increase, and fceXix, the ash). See Fraxinus. x BU'NA. SeeCoFFEA. BUNIAS, vel BOU'NIAS, (from p*wos, a hill, be- cause it delights in rugged places,) called also actinc, napus: Navew. It is a plant of the turnip kind, Avith oblong roots, groAving slender from the top to the extremity. Linnaeus supposes the wild and SAveet navew to be varieties only. It is also the napus sativa, napus dulcis, NAA'EAV GENTLE--RAPE, FRENCH NAVEAV, SAVEET BUP 291 BUR naveav, and French turnip. Brassica napus Lin. Sp. PI. 931. Nat. order crucifere. It is cultivated in gardens for the kitchen. The roots are warmer and more grateful than the common turnip, and afford a juice supposed to be pectoral. The seeds of both sorts are Avarm and pungent, ap- proaching to the virtues of mustard, but much inferior in their efficacy. Water extracts all their virtues. They yield by expression a large quantity Of oil, which is sold under the name of rape oil: the Avild sort is cul- tivated for this purpose. The cake remaining after the oil is expressed retains the acrimony of the seed. There is a species Avhich Galen prefers to the above; is called pseudo bunium, or napus sylvestris cretica, or Candy avild navew ; a variety only. Dale. BUNI'TES VFNUM, (from bunium, wild parsley). Wine of bunium. It was formerly made of buniu7n, two drachms ; and must, four pints. BU'NIUM, (from pavos, a little hill; so called from its tuberosity). Wild parsley ; also called daucus petroselini, or coriandri folio; saxifraga montana mi- nor. Seseli mo7itanum Lin. Sp. PI. 375. It groAvs in stony places, and is somewhat Avarm and diuretic. BUPEI'NA, (from pa, a particle of increase, and Treivx, hunger). See Boulimos. BU'PHAGOS, (from pa, and (pxyu, to eat). The name of an antidote in Marcellus Empiricus, which created a voracious appetite. BUPHTHA'LMUM, (from pas, an ox, and o06xX^s, oculus, an eye; from its resemblance to an ox's eye). Ox eye, or ox eyed, named boanthemon. In Myrepsus it is called crespulum. Buphtha'lmum co'tul^e Fo'Lio,also cotulafiore luteo radiato, is the camomile like ox eye. Buphtha'lmum Germa'nicum, called also bupthal- mu7n tanaceti minoris folio, chamemelum, chrysanthe- mu7n, buphalmu7n vulg. common ox eye. Buphtha'lmum ve'rum, called also buph. perigrinu7n', tenuifolium folio mille foliifere, chrysanthemum cotule folio, cotulafiore luteo radicato, cachlan, ox eye. These are all species of the anthemis or bupthalmum, resembling the camomile flowers. It is unnecessary to distinguish them, as the floAvers of the common daisy are sold for them, and they possess no real medical virtues. These plants have tender stalks, with leaves like those of fennel, and yelloAV flowers resembling an eye. They grow in fields near towns. All the species are com- mended in the jaundice, perhaps because they are yel- low. Buphtha'lmum creticum. See Pyrethrum. - Buphtha'lmum ma'jus. See Bellis major. BUPHTHA'LMUS. A distempered eye, (from pas, an ox, o, to curry leather; because it is chiefly used in tanning). See Rhus. BYSA'UCHEN, (from pvo, to hide, and xvXw, the neck). People are thus called Avho, by elevating their shoulders, hide their necks. The name also of a person who hath a morbid stiffness of the neck. BY'SMA,(from pvu, to stop up, obstruct, fill up, con- stipate, or stuff). The covers, or stopples of any ves- sels. Some take the bysma to be the same with the amurca. See Byzen. BY'SSUS. A woolly kind of moss. It is a name for thepudendii7n muliebre, from its mossy or hairy coat; and a sort of fine cloth worn by the ancients. See also Bombax. BY'STINI ANTIDOTUS. An antidote often men- tioned by iEtius, which seems to be much like Mithri- date. BY'ZEN. In a heap, crowd, or a throng; called also bys7na. It is derived from the word /3t>£«, or pvu, to fill up by^ stuffing, to condense; thus it expresses any. thing that is sufficiently dense. Hippocrates uses this word to express the hurry in which the menses flow in an excessive discharge. 297 C A A \^J • See Nitrum. CAA-APIA. (Indian.) It is a small Ioav plant, Avith a root about tAvo fingers' breadth long, as thick as a swan's quill, and sometimes as large as a man's little finger. This root is knotty, and covered Avith filaments that are three or four fingers' breadth long. Outwardly, it is of a yellowish grey colour, but inwardly white. After being chewed a little it is acrid, and hath nearly the same virtues with ipecacuanha, whence it hath also received that name. It is a species of dorstenia, the plant Avhich furnishes the contrayerva, and is the d. Brasiliensis of WildenoAV, vol. i. p. 682. The Brasilians cure the wounds from poisoned *darts with the juice of this root, which they pour into the wound. Piso says it hath the same efficacy against the bite of serpents. See Bojobi. CAA-ATAY'A BRASILIE'NSIS. (Indian.) It is a plant which grows in Brasil, of no smell, but bitter to the taste. A decoction of it operates powerfully, both upward and downward. It resembles the euphrasia. Raii Hist. CAACHI'RA. See Indicum. CAACI'CA BRASILIA'NTS. (Indian.) Called also colubrina Lusitanica. An herb growing in Brasil, whose leaves resemble those of the male speedAvell, someAvhat hairy, green above, and Avhite underneath. It is full of a milky juice. When fresh, it is bruised, and applied against venomous bites, Raii Hist, but unknoAvn in the system of the botanists. CAA'CO. (Indian.) The sensitive plant, also called eschyno7nene spinosa Brasiliensibus secunda, herba viva, noli me tangere, mimosa casta Lin. Sp. PI. 1500. It is a native of Brasil. If the leaves of this plant are touched, they immediately contract, but soon after re- turn to their former state, a singular appearance seem- ingly connected with electricity, though Avith some cir- cumstances which oppose this idea. The tops of this plant are noxious, and the roots are said to be their an- tidote. A decoction is made of a handful of that part of the root Avhich is under ground, boiled in six pints of Avater for a few minutes, half a pint of which is to be drunk every hour or two, until the patient is well. The root used in this way is an antidote to several poisons in America. VOL. I. • CAB There is another species, called herba viva term. species, eschynomene spinosa tertia; m. pudica Lin. Sp. PI. 1501. CAAETIMA'Y BRASILIENSIBUS. (Indian.) Called also senecio Brasiliensis. It is a tall plant which grows in Brasil; the leaves of which have a hot and acrid taste. A decoction of them cures the itch, by washing the parts affected Avith it. Raii Hist. Its systematic name is unknoAvn. CAAGHIGU'GO BRASILIE'NSIS. (Indian.) Frutex baccifer Brasiliensis. A shrub growing in Brasil; its leaves are powdered, and then applied to' ulcers as a desiccative. CAA-OPIA. (Indian.) Called also arbusculagum- mifera Brasiliensis. It is a tree groAving in Brasil, from the bark of Avhich, if incisions are made, a juice is emit- ted, which, when dry, resembles the gutta gamba in all respects, only in being somewhat redder. Raii Hist. It is the hypericum bacciferum of modern naturalists, but not yet introduced into the Linnaean system. CAAPE'BA. See Pareira brava. CAAPO'NGA. (Indian.) The Brasilian name for crithmum; also called trifolia spica, crithmum marinu/n non spinosum: inula crithmoides Lin. Sp. PI. 1240. The leaves and young stalks are pickled for the use of the table, though they are gently diuretic. There is another species ; it is called perexyl Lusi- tanis; it resembles purslane, and is of the same nature as the above. CAARO'BA. (Brasilian.y A tree whose leaves are bitter; a decoction of them promotes perspiration, and is useful in the venereal disease. Raii Hist. CABALA, CA'BULA, KABALA, CABALI'S- TICA ARS. The cabalistic art. It is derived from the Hebrew word kabbalah, signifying to receive by tradition. It is a science Avhich consists in a myste- rious explication of the Scriptures, hoAvever they Avere received. This is the Jewish cabala; but, from this original, the word is applied to every mysterious or ma- gical explanation. Paracelsus uses it in a medical sense, saying cabalistic signs cannot deceive, si Dis placet. Some enthusiastic philosophers and chemists have transplanted it into medicine, importing by it some- thing magical. CABALA'TOR. See Nitrum. Qq C AC 298 C A C CABA'LLICA ARS, (from xxrxZxXXu, to throw down). A term in gymnastics, importing amongAvrest- lers the art of foiling, or throwing an antagonist down. CABALLINE,(from caballus,a horse). See Aloes. CABA'SSONUS MASSILIE'NSIUM. A fish found in the Mediterranean sea; also called lavoronus. CABE'LIAU. Cod fish. See Asellus major. CABULATOR. See Nitrum. CABURE IBA, CABURH'BA. See Peruvianum Balsamum. CACAGO'GA, (from xxxuv, excrement, and xyu, to expel). Ointments, that, by being rubbed on the fun- dament, procure stools. P. jEgineta, lib. vii. ix. CACA'LIA, (from xxxov, bad, and Xixv, exceedingly, because it is mischievous to the soil on which it grows,) also called leontice veterinn, caca/num, and strange colt's foot. Cacalia Alpina Lin. Sp. PI. 1170. Nat. order corymbifere, Jussieu ; composite discoidee Lin. It groAvs in shady places. Paulus of jEgina, and Dioscorides, suppose this to be the cacanum; for their virtues are similar to the common sort, for which see Tussii.ago. The c. sonchifolia, Lin. 1169, is esteemed a febrifuge, an expectorant, and useful in diarrhoeas. CACALIA'NTHEMUM, (from xxxxXix, and xv6ep.ov, afiower, because its flower resembles that of the caca- lia,) so called by Dr. Dillenius: the cabbage tree, and the carnation tree. Cacalia kleinia Lin. Sp. PI. 1168. Originally it Avas brought from the Canary islands; and another species came from the Cape of Good Hope. See Miller's Diet. CA'CAMUM. See Cacalia. CA'CAO, (Indian); called also cacoa, amygdalus si- milus Guatt7nalensis, cacava,cacari, quahoitl, caravata, chocolata, avellana Mexica7ia, cacavera, cacavata cacao Americe; the pear bearing wholesome almond tree, cacao, and chocolate. It is the theobroma cacao of Lin. Sp. PI. 1100. Nat. order malvacee. The nut is the only part of the tree used; its shape is nearly that of an almond, but of a much larger size. The shell is dark coloured, brittle, and thin; the kernel throughout is of a brown colour. It is produced by a small Ameri- can tree, which bears a large red fruit like a cucumber; in this fruit is contained from thirty to a hundred of these nuts. A good tree produces a crop in June, and anoihi r in December. The principal distinctions among these nuts are the size, and place from whence they are brought: the larger kind from the province of Nicaragua, in Mexico, are most esteemed. The chief of those brought to England are from Virginia and Jamaica. Cacao nuts have a light agreeable smell, and an unc- tuous, bitterish, but not ungrateful, taste. Those from Nicaragua and Caracco are the most agreeable; those from the French Antilles, and our American islands, are the most unctuous. They invigorate the stomach, and are supposed to recruit rapidly the exhausted strength. In diseases of the lungs they are commended in their native soil. In this country they require so iiii'ch heat that they scarcely ever bear any seed. The principal use of this nut is for making the liquor known by the name of chocolate; which is a mild, unc- tuous, demulcent, and nutritious fluid. In hectic, scor- butic, and catarrhal disorders; in atrophy, malignant itch, and hooping cough ; chocolate, made in the usual way, is said to relieve. Cacao nuts afford by pressure an oil of the same kind as those that are obtained the same way from other kernels and seeds. This oil is anodyne, used in cor- recting the effects of corrosive poisons, and in relieving haemorrhoids. It does not contract any smell, dries, readily, and is considered as a good cosmetic. It is said to preserve the flexibility of the joints, and prevent rheumatic affections. Oleum seu bu'tyrum e nucleis. The oil or butter of the chocolate nut. Roast the nuts slightly in an iron pan. When cleared from the rind and levigated on a hot stone, dilute them with a proper quantity of hot Avater, and keep them in a Avater bath till the oil rises to the top; which, a\ hen concreted, is of a brown colour, and, by repeated liquefactions in hot weather, becomes white. Cacao nuts thus managed, afford sometimes more than half their quantity of this vege- table sebaceous matter. As it is not liable to turn ran- cid by long keeping, it is a proper basis for odoriferous unguents : but its indigestible property renders it unfit for internal use. The mucilaginous pulp contained in the husks, if pressed, yields a cream grateful to the taste; and an emollient for external application of some efficacy. As we owe our knoAvledge of the tea plant to China, so we are indebted to the Mexicans for'choco- late, but they were unacquainted with the sugar cane, which was only brought to St. Domingo in 1506. To prepare the kernels of the chocolate nuts for use, they bruised them after having separated their husks, then placed them before a clear fire, by which they are so dissolved as to be fit for making into cakes or rolls. These cakes Avere rendered more solid by adding the meal of maize, and were flavoured with pimento. Such are still brought from NeAV Spain, but the union of the oil with the mucilaginous parts is not complete, and this chocolate often occasions complaints of the stomach. The Mexicans noAV mix Avith these nuts a portion of Indian corn, a feAv seeds of rocou, and a little vermi- lion. The French mix Avith theirs a little cinnamon, vanilloe seeds, and fine sugar. In Paris they make their chocolate for sale as follows: Take of chocolate nuts, freed from their husks, and fine sugar, of each a pound; of cinnamon, finely poAvdered, two drachms; and of va- nilloes half a drachm ; beat them Avell together, and form them into cakes or rolls. " The chocolate of health" contains, however, only canella ; and the chocolate of one, two, or three vanilloes, is denominated from the proportion of this condiment. In Spain six pounds of the cacao nut are mixed with three pounds and a half of sugar, seven vanilloe pods, a pound and a half of maize, half a pound of cinnamon, and six cloves, with a drachm of capsicum. The whole is scented Avith musk, and co- loured with the rocou. The choice of the nut is of im- portance : that from the Caraccos is too dark and dry ; the cacao of the islands too unctuous. The best pro- portion is three parts of the former to one of the latter. Chocolate is often adulterated in a variety of Avays; sometimes common flour, the farina of rice, of lentils, and of pease, or the starch of potatoes, are added to in- crease its bulk. If ever any additions become neces- sary, the gluten of the seeds should be Avholly excluded, and the fecula only employed. Some manufacturers "are said, by Parmentier, to pur- chase at a low price the residuum of the cacao nut, C A C 299 C A C from which the oil has been expressed, and to supply the latter by animal fats, and the yolks of eggs. Others add roasted almonds and gum arabic. It is not an uncom- mon practice to purchase the unripe nut, and lower its sharp bitter taste with a large proportion of sugar, Avhich is the cheapest ingredient. Chocolate, without any bad intention, is sometimes injured in the preparation. If the nut is not sufficiently roasted, the taste is disagree- able ; if burnt, bitter; and the chocolate is black, without the soft unctuous taste natural to it. If the germ is not separated from the two lobes of the seed, it is found in the chocolate, since it resists the Aveight of the grinding stone. Good chocolate should in its fracture present no gra- nulated appearance. It should melt in the mouth, leav- ing a kind of freshness ; and Avhen boiled in water or in milk, the consistence should be moderate. Those who cannot bear milk in any other way, find no incon- venience from it in chocolate. When chocolate tastes in the mouth like paste, Avhen on the first boiling it exhales the smell of glue, or in cooling becomes a jelly, it has been adulterated with farinaceous matters. If little grains are deposited, it is probable that the nut has not been sifted, that it has been badly cleaned, or the coarsest sugar employed. The smell of cheese shows that animal fits have been added; rancidity discovers mucilaginous seeds ; and a bitter or musty taste, that the nut is unripe, or too much roasted. We shall add the receipt for making choco- late from Baume's Elements of Pharmacy: Take of Caracco cacao nuts five pounds, of the islands nut one pound, sugar five pounds, fine canella an ounce and half, cloves tAvelve in number. After drinking of chocolate, if it is uneasy in the sto- mach, relief will be found from drinking a tea cupful of cold water. An artificial chocolate is made of sweet and bit- ter almonds of each an ounce, roasted in an iron pan until they are brown, then Aviped clean, and bruised in a mortar, gradually mixing four measures of warm milk, two eggs that have been Avell mixed with a little cold milk, and as much cloves, cinnamon, and sugar, as may be agreeable to the palate. CACAPHO'NIA, (from xxxo$, bad, and glass falls to the ground from gravity; and, though we knoAV not the cause of gravity, we can, however, preserve it. We know not the source of calculi, but we can often mitigate their symptoms; relieve, perhaps, in some, though very rare, instances cure. If chemistry, hoAvever, does not assist us, we may perhaps draw some useful hints from analogy. The connection of calculus with gout is Avell known; and the latter is certainly in a great degree depending on a weakened or disordered stomach. If animal matter is formed, but in a state not adapted for nutrition, it must be carried out of the body as an injurious substance, - and it may be deposited on the kidneys or joints. We shall here be accused of inconsistency, and told that we are supporting the doctrine of morbid matter as a cause of gout. It is not, hoAvever, the cause, but the effect . of the cause ; in reality, the first in the chain of effects or symptoms. In the constitution that has long suf- fered from the gout, it seems to be determined to the kidneys Avith the phosphoric acid retained in the early period of the paroxysm ; and its concretion is assisted by the long confinement on the back, which the pain of gout often demands. In relaxed constitutions of the scrofulous kind, it may also be occasionally deposited in different parts, though the kidneys seem to yield it the most ready outlet. This appears to us a step, at least, tOAvards the explanation of the cause. If fanciful, or unfounded, it has detained the reader only for a very short time. The calculous diathesis is so imperfectly knoAvn, and calculus of the bladder so rare a disease, that little has been attempted to prevent it. As stone, hoAvever, Avhen once extracted, will sometimes recur, preven- tives, at that time, should be employed. In this class, general tonics will be found useful; and if there is any whose action is more particularly directed to the kid- neys, these should be preferred. The uva ursi has been supposed to have this effect, and it may be em- ployed Avith the decoction of the bark: at the same time, a mild diet, Avith every plan that will dilute the urine, without stimulating the urinary vessels. The free use of watery fluids; some of the diuretic vege- tables ; fruit, of which Linnaeus seems to prefer straAV- berries; are proper, though with an admixture of mild animal food. The acidulous soda Avater will be an useful drink. If the danger is apparently more urgent, the use of the bitters may be occasionally intermitted; and soap, with lime Avater, given for six weeks or two months, Avhen the bitters may be again resumed. The patient should never suffer the urine to stagnate, but use himself to discharge it at stau-d times in the day and night, Avhich will soon bring on the habit of doing so, Avhatever the quantity in the bladder may be. This, however, must not be too often practised. Once in the night, and three times in the course of the day, at least, the discharge should be encouraged. If his life is a sedentary one, it should be more frequent. A calculus, hoAvever, at last shoAvs itself by symp- toms somewhat equivocal, differing, hoAvever, accord- ing to its seat. Gravelly concretions in the kidneys, which seem to consist almost exclusively of the uric acid, we must consider under the article Nephritis ; and a stone occurring in the ureter cannot be easily mistaken. Acrid matter in the urine, a coagulum of blood, or gluten, will sometimes occasion violent pain, Avhich will be mistaken for a fit of stone, and nothing can ascertain the complaint but the catheter, unless the offending cause should be discharged. An abscess of the prostate, or in the rectum, pressing on the blad- der, has been said also to imitate the pain of a calculus; yet, as these are easily ascertained by an examination per rectum, the error can neither be long continued nor dangerous. When a calculus exists in the bladder, it produces pain chiefly by paroxysms. There are intervals, often long ones, of the most perfect ease, but the paroxysms are extremely severe. These are relieved by emollient oily clysters, folloAved by opiates in the form of clyster, and by the mouth ; the doses of which must be such as to meet the pain, whatever quantity may be required. We may notice, in this place, that the proportion of opium which is employed in relieving the pain, has no effect on the constitution in general; it is the excess of this close which is felt. The disease, however, remains; and it must then be considered whether the operation should be hazarded, or the solution of the stone attempted by internal medicines. The operation, though severe, is not peculiarly danger- ous ; yet, to attempt it on exhausted arthritic constitu- tions Avould be highly improper: if firm, no period of life is an obstacle. Another consideration must, how- ever, stop us. We do not remove by the operation the disposition to form stone; and the disease has been known to recur. It does not, however, always return ; and, within our observation, it has not returned in the greater number of instances. We remember an ob- servation of Mr. Justamond, that the operation does not succeed if the patient has previously used lithon- triptics. But this Ave have not found supported by ex- perience. If, therefore, the constitution of the calculous patient is firm, if the paroxysms are frequent and se- vere, if lithontriptics are not found in three or four months to greatly relieve, the operation is advisable. See Lithotomy. Many, however, will not submit; and, in all, Ave think lithontriptics- should be tried; for, though we have no decisive evidence of their dissolving stone, they greatly mitigate the pain, render the paroxysms more distant, as well as more mild. It has been seen from the experiments of Pourcroy, that almost every ingre- dient in calculi is dissolved by the caustic alkali; and various experiments have shown that the Avhole cal- culus yields to its poAvers. Lime water has been found also a solvent of calculus out of the body ; and on these our hopes have chiefly rested. It is obvious, however, that what is taken by the mouth, has not only a circu- i o :* route to reach the bladder, but is subject to many chemical changes; nor, indeed, are there many well- CAL 310 CAL authenticated facts of the urine being so changed, as to become a menstruum for the stone. Almost the only instance, except the case of Dr. Newcombe, recorded by Dr. Whytt, is -.hat of Mr. Holme. Yet, though it may not be so accumulated in the urine as to render it an active solvent, it may destroy the animal oxide in it, or prevent its tendency to concretion; and it may have suf- ficient poAvers to soften the surface of the stone so as to lessen the irritation, and, of course, the spasmodic symptoms, Avhich are its consequence. It is, we believe, an incontrovertible fact, that, where the stone has been unchanged, the paroxysms of pain have been greatly mitigated; and, to lessen pains so violently excruciating, is surely an object of no little importance. Lime Avas long known as a solvent of stone, and dif- ferent methods were employed to administer it Avith safety. One of these plans fell into the hands of Mrs. Joanna Steevens, daughter of a gentleman of a respect- able family in Berkshire, and her success occasioned a considerable anxiety to discover the secret. At last, parliament bought it for 5000/. after different trials had been made of it with advantage. In many instances, stones, Avhich had been sensibly felt, were no longer to be discovered; and, as the sa7nepersons were examined by surgeons, men of the greatest skill and eminence, both before and after the exhibition of the medicines, it is fair to conclude that in some instances they Avere dissolved, though we have recorded the singular mode which, in one case, occasioned the deception. Mrs. Steevens, it is said, first gave the calcined egg-shells only, but finding these produce costiveness, she added soap. In time she rendered her process more com- plicated, adding snails burnt to blackness, a decoction of camomile floAvers, parsley, sweet fennel, and the greater burdock. When we consider the effects of bitters, Ave shall not perhaps think, Avith Dr. Hartley, these additions to have been wholly'useless. It is singu- lar, hoAvever, that the egg shells, though calcined, Avere exposed to the air till reduced to a fine powder. No one seems to have carefully examined them in this state; and it is only presumed that they retained some portion of the caustic acrimony. Various other in- gredients were confessedly used as disguises. As soap Avas with reason supposed to add consider- ably to the virtues of the lime, it led to the use of the caustic alkali, softened by a more pleasing mucilage, veal broth. Since that time it has been used alone. The folloAV ing is the best mode of preparing and ad- . ministering it: Take of kali prepared, eight ounces; of fresh quick- lime, four ounces; of distilled water, a quart: mix them well together in a large bottle, and let them stand for twenty-four hours; then pour off the ley, filter it through paper, and keep it in well stopped phials for use. Of this the dose is from thirty drops to tAvo drachms, Avhich is to be repeated two or three times in a day. Mix the quantity to be used in the day Avith three pints of plain broth, Avhich has been made with the lean part of veal, all the fat or oily parts being sepa- rated from it, by putting it, when made, into a large boAvl, and skimming them off Avith a spoon Avhen cold, and let the patient drink Avithin an hour a pint of this' broth three times a day, early in the morning, at noon, and in the evening: continue the use for three, four, or more months, living during this course on such things as least counteract the course of this medicine. Various other lithontriptics have been employed; but the calculus seems a more uniform concretion than has been supposed, particularly by Dr. DaAVSon in the Lon- don Medical Transactions, vol. ii. p. 105. The com- mon fixed alkali, or, in stricter language, thecarbonated alkali, has been employed; and, more lately, the alka- line carbonated Avater, viz. the alkali with an excess of carbonic acid. Some cases have been related, in which this remedy has been employed with success, and we may easily find a foundation for its use. Honey, has been used also with success; and Mr. Home, surgeon at the Savoy, has recorded its utility in his OAvn and his father's cases. It was an ingredient in Mrs. Steevens' farrago, but in too small a proportion to be of advantage. Bitters have been also employed, and Ave have already mentioned their use as preven- tives : we have reason to think that they may be ser- viceable in mitigating and protracting a fit. When Ave reflect on these different means, Ave shall perhaps find only the pure alkali and the lime Avater adapted for the solution of the calculus ; and, Avhen the circuitous course of each is considered, Ave may suspect that they seldom reach the bladder Avithout impaired virtues. We have, indeed, tAvo instances in opposition; but, Avithout offence to either, may Ave not suspect a little predilection in fa- vour of the remedy to have influenced the observation ? It once happened in a clinical Avard, that the urine Avas reported to effervesce with alkalis. Some of the elder students, in private, suggested that they could perceive no effervescence but the slight separation of air, occa- sioned by the mixture of any two fluids. On the next day it was reported that no effervescence had taken place, nor Could it, adds the professor, for the alkali was caustic. What adds to our scepticism on this subject is, that from the use of lithontriptics the symptoms have been often relieved, though the stone has remained with- out any change. When we reflect on the connection of stone Avith gout, on the weakness of the stomach, apparently the origin of each, and the utility of bitters, stimulants, and antacids, we own that we rest with more con- fidence on the idea of the whole originating in im- perfect digestion, and the production of an animal oxide not admitting of application as a nutritious sub- stance. But, Avhatever becomes of the theory, lime water and soap, acidulous soda Avater, caustic alkali, or bitters, are highly useful. Of the soap as much must be taken as the stomach Avill bear, or as much as -will prove gently laxative; but of the lime Avater few can take more than a pint daily. The acidulous soda Avater may perhaps be taken in larger quantities, as it is more agreeable; and the acidulous salt is noAV prepared, so as to produce this water extemporaneously. It must, how- ever, be swallowed Avhile dissolving, as the carbonic acid gas rapidly escapes. Of the liquid caustic alkali, from thirty to a hundred and twenty drops may be taken in veal broth tAvo or three times a day. The inconveniences arising from the use of large quan- tities of soap and lime water are, impaired digestion, and, consequently, debility and emaciation. With the superfluous, the necessary acid seem to be destroyed. This effect has not, however, folloAved the soda with an CAL 311 CAL excess of carbonic acid; though the bitters are suspect- ed, by long continuance, of diminishing the tone they were intended to preserve. Generally speaking, there- fore, these remedies should not be continued long Avithout intermission: yet they will not soon produce a change; and a trial of three months is at least ne- cessary. If no benefit is then obtained, they should be relinquished or changed. If any amelioration of the symptoms should be observed, they may be pursued longer; yet in no case, probably, beyond nine or twelve months, without some intermission, or interposing a Avarm tonic for a few weeks. As the management during the paroxysm has much engaged the attention of physicians, Ave shall add the outlines of Avhat has been directed. During a fit, if the habit is plethoric and sanguine, bleedinghoth guards against and removes inflammation. Those persons Avho are subject to regular returns, may lose blood a little before the expected period. Diuretics should never be of the stimulant kind; the emollient and oily are the most proper; and after these, the diluents should be freely employed. In ge- neral, the more painful the fit, the gentler should be the diuretics, and the less copiously given. The aged and weak should be allowed the use of cordials Avith their diuretic medicines. When the pain and spasms are very violent, and yet there is hope that the stone will pass the urinary ducts, gentle diuretics, mixed Avith mild anodynes, do the greatest service: for the latter relax the parts and ease the pain, and the former more easily and safely propel the stone. When gravelly matter hath been seen to be discharged with the urine, and to subside presently after it is made, light steel Avaters, either of the purging or of the diuretic kind, very safely and effectually expel it, and strengthen the kidneys: the water should be continued some weeks, and repeated at proper intervals. But if a stone in the kidneys is so large that there are little hopes of its passing through the ureters, which is known from the continuance of the disease, the steel waters should not be used. Of all the purging medicines the oleum ricini is to be preferred in calculous disorders; whether a stone, or other cause of inflammation, produces gravelly symp- toms. To relax the passage for the calculus to pass from the kidneys to the bladder, this oil is preferable to any other knoAvn medicines, either by the mouth or 1 clyster. Oil, manna with nitre, or vitriolated mag- nesia with the oil of almonds, may be used in its stead; for they empty the intestines, take off all pressure upon the ureters, moderate the heat of the body, lessen the inflammation, and relax the spasm Avhich the pain occasions. If the ol. ricini is taken in the fit, so as to keep the belly lax, and the aqua kali puri at proper in- tervals, mixed in any suitable vehicle, their efficacy in calculous disorders will equal that of the most boasted remedies used in these cases. In slighter attacks, a mix- ture of soap four parts, and rhubarb one part, twice a day, in doses sufficient for keeping the bowels easy, will be sufficient. The use of clysters is singularly beneficial. The colon forms an arch over both the kidneys, is sometimes joined to the left; and, consequently, a Avarm emollient decoction thrown up, may, by its heat and moist va- pour, relax and soften the kidney like a fomentation. Hence Ave see why flatulent or other accumulations usually occasion a fresh fit; and A\hy the left kidney is more subject to complaints than the right. The ol. ricini is peculiarly useful in emollient clysters; but turpentine should make no part of their composition. Tavo drachms of the tinctura opii may be thrown up, after the opera- tion of the laxative clyster, when the pain is great. When the vomiting abates, the stomach and bowels are freed from their contents; then it is proper to give opiates, Avhich, by easing the pain, and relaxing the spasm, most effectually open a passage. Their repe- tition can only be determined by the attending physi- cian. When the pain is of very long continuance, and accompanied with great prostration of strength, espe- cially if these occur in advanced age, and Avith a weak state of the pulse, Hoffman forbids the use of opiates, as of a poison; and says that, in such cases, gentle cordial waters, as those of mint, balm, and cinnamon, with the addition of a few grains of saffron, and the moderate use of wine, are the best means of support- ing nature. Yet, if the loss of strength is caused by the violence of the pain alone, opiates will be ne- cessary. The semicupium is an useful assistant when the pain is violent, for it powerfully relieves the stricture of the part. After sitting a sufficient time in it, ten or twenty of the soap pills may be taken. Vo7niting is sometimes a troublesome symptom; but if not very severe, it is rather useful, and ought not to be suddenly checked. Whilst moderate, it rather pre- vents the cohesion of the gravel, and promotes its ex- pulsion. When it is necessary to remedy this complaint, the patient may drink freely of some warm aqueous liquor to unload the stomach of its contents; and the saline draught in the act of fermentation, followed by an opiate, may be given. If a stone stick in the kidney, or the ureter, stimu- lating medicines are unsafe, and diluents arethroAvnup without producing any advantage ; but Avhen the ano- dynes have considerably abated the spasms, Avhen the pulse is grown calm and soft, and the whole body is of a moist and equal heat, then the expulsion of the stone or gravel may be expected, often Avithout further as- sistance. Bloody wine is sometimes a symptom attending the gravel, in Avhich case a dose of manna may be taken as a purge, in a quart of milk Avhey, at several draughts. (See Wallis's Sydenham.) To quicken its operation, and render it easier in the stomach, a slice of lemon may noAV and then be sucked. This may be repeated every day, or every other day, for it both eases the pain and moderates the discharge of blood. After its operation, a dose of opium may be taken at bed time. If the bloody urine is from the bladder, and attended with spasms there, or an ulcer, warm external applications are useful just above the pubes. When calculous complaints attend during pregnancy, which very seldom happens if the pain is violent, a slight bleeding may be admitted, Avith oily laxatives, and afterwards opiates. If a stone is perceived in the bladder, it should be extracted before pregnancy; but if the Avoman is already pregnant, we should wait until her delivery. During the time of labour, the stone should be pushed and kept up above the child's head, if possible; if this cannot be done, the assistant CAL 312 CAL must pass up his hand as soon as the os internum is sufficiently dilated, and, breaking the membranes, turn the child, and bring it away by the feet. There will then be room for the stone to be raised by the catheter, to prevent the child's head from pressing it against the urethra, Avhich would give the Avoman great pain, and perhaps lacerate the parts. See Boerhaave, Aretaeus, Alexander Trallian, Lom- mius, Hoffman, Wallis's Sydenham. Lobb on the Stone and Gout. Medical Museum, vol. i. and iii. Bell's Surgery, vol. ii. 9, &c. White's Surgery, 348. Memoirs of the Medical Society, vol. i. 225. A stone is sometimes forced from the bladder into the urethra, and sometimes it is generated in this passage. Boerhaave observes, that if recent urine be placed in a heat no greater than that of a healthy man, it soon throws oft' a stony matter to the sides of the vessels ; a calculous matter, by too long a detention of this fluid in the bladder, may therefore be soon and easily formed; and a little of it may on its passage Avith the urine be so entangled in the urethra, as not readily to be extricated, but become the basis of a larger stone. Mr. Warner observes, that the urethra, in cases of this kind, becomes a cyst, which acquires a great degree of hardness, remaining compact and whole till an inflam- mation is produced by its no longer admitting any fur- ther distention. The inflammation is then soon com- municated to the teguments, by which means they be- come painfully tender, and are easily lacerated. If a stone is obstructed in its passage through the urethra after bleeding, an emollient clyster and an anodyne draught will be proper; common emulsion should be drunk freely, and if the patient is placed in a Avarm bath presently after the clyster is administered, the stone often escapes. If the stone stick in the neck of the bladder, and re- quire an operation for its extraction, introduce two fin- gers into the anus, to detain the stone until the incision is made through the perinaeum upon it. After the ope- ration, as well as for some days before, Heister-advises the patient to drink as sparingly as possible, that the wound may not be irritated by the urine. To guard against this inconvenience, a canula may be introduced beyond the wound, and kept in the urethra until it is healed. In whatever part the stone is lodged, the in- cision must be made in the course of the urethra, and the wound in the skin parallel to that in the urethra. When the stone is extracted, close the wound, and keep its lips together, by first laying on it a pledget of lint spread with some digestive ointment, then secured with slips of plaster, as directed for the dry suture. It has been lately recommended to inject the caustic alkali into the bladder, diluted in any mucilaginous fluid; and experiments have been adduced to show, that the bladder can bear, without inconvenience, a sufficient quantity to render the urine an active solvent of cal- culus. On this subject, however, we would lay down no precise rule; for the bladder differs greatly in irrita- bility in different persons, and it will be proper to begin with a small proportion. The plan is too obviously useful to be neglected, and experience may enable us to give a further account of its success in some future article. We may add, hoAvever, in this place, that weak vinegar, Avhich may with safety be injected into the bladder of a horse, is found, from the experiments of Vauquelinand Fourcroy, an effectual solvent for the calculus of that animal. We shall conclude this article with some compara- tive remarks on the human and animal calculi, from a second Memoir of M. Fourcroy, in a subsequent vo- lume of the Annals of the National Museum, and with an analysis of the other human calculi. The difference between the human urinary calculus, and those of other domestic animals, is truly singular. The renal and vesical calculi of the horse, the ox, the hog, and even of the rat and rabbit, in whom calculi are frequently found, consist only of carbonate of lime, connected by an animal gluten. Once M. Vauquelin suspected that he discovered the uric acid in the calcu- lus of a tortoise, but it was not in sufficient proportion to render it certain. "SI. Fourcroy and his associates constantly found a striking analogy between the nature of the urine, and that of the calculus of the domestic mammalia. But, though the urine of horses does not contain phosphat of lime, they found it in the sweat, Avhen dried on the hair; and, from Mr. Hatchet's ex- periments, it .will appear that nature is uniform in her productions. The same substances are formed in the animal economy, deposited only on different organs. Many of the bezoars of different forms and colours chiefly consist of calcareous phosphat, but they seldom contain the acid phosphat, and are consequently formed in the intestines; which is sufficiently proved by their nuclei, which are often the kernels of fruit, and some- times small branches. In these animals, therefore, the substance, not carried to the kidneys, concretes in the intestines. In the domestic animals, and those wild ones confined to the menageries, intestinal concretions, from the size of a large hen's egg to that of an ostrich, are often found in the ccecum. Those in the horse are of a grey- ish colour, formed of prismatic radii, Avithout any distinct strata: the surface consists of irregular crystals worn doAvn by attrition, with cavities between them. All these bezoars are composed of an ammoniaco mag- nesian phosphat, a substance lately discovered in barley and oats, as well as in some of the legumina, though in a less proportion. We thus find the source of these concretions; and their nuclei are generally some un- digested seed, or a bit of straw. This salt does not naturally concrete in man; and it requires some ad- ditional substance or circumstance to assist its appear- ance, when it is discovered in the calculi of the kidneys and bladder. Nor is it easy to say, why some of the bezoars of Avild animals should consist of the ammo- niaco magnesian phosphat, while others contain the phosphat of lime only. Dr. Pearson has analysed also the calculi of many animals. That of a dog was found, by him, to contain phosphat of lime and ammonia, with some animal mat- ter: that of a rabbit yielded chiefly carbonate of lime, with common animal gluten, and perhaps a small pro- portion of phosphoric, but no uric acid: those of horses, whether vesical or intestinal, afforded phosphat of lime and ammonia, with animal matter, Avhich melted like super phosphat of lime, after separating the animal substance and ammonia by burning. A large quantity of matter found in the bladders of horses not crystallized, each of several pounds Aveight, was car- bonate of lime Avith the animal fluid. Bertholdi found CAL 313 CAL the calculus of a pig, which Avas nearly twice as heavy as distilled water, to consist of phosphat of lime. Arthritic calculi were once supposed to be chalk, then to resemble the earth of bones; to be insoluble in acids, to be soluble in them, or to be soluble only in the ni- trous acid. Various other discordant opinions were entertained, till Dr. Woolaston, in the Philosophical Transactions for 1797, gave us more distinct ideas oh the subject: he found them to consist of the lithic acid and soda. We thus find the foundation of the use of antacids, and perhaps of bitters, in cases of gout. The calculi of the pineal gland were supposed by many authors to be imaginary. Sabulous concretions, hoAvever, in this part have been often discovered; and Dr. Woolaston, by a delicate chemical test, has dis- covered them to consist of phosphorated lime. This is, however, a refinement only, for these concretions are not connected with any concurrence of symptoms so as to form a disease. The calculi of the prostate gland also consist, accord- ing to Dr. Woolaston, of phosphorated lime. Calculi of the salivary glands, calculous incrustations on the teeth, ossifications in the larger vessels of the heart, between the muscles, in the corpora cavernosa penis, and in the pancreas, resemble the earth of bones. Those of the bronchial glands we have found to be similar: those from the uterus have not been examined. See Heister's Surgery, Warner's Cases in Surgery, Gooch's Treatise on Wounds, and the Med. Mus. vol. i. and ii. Bell's Surgery, vol. ii. 9, Sec. Baillie's Morbid Anatomy. Woolaston's Phil. Trans. 1797. Pearson's Phil. Trans. 1798. Annales de Chimie, xvi. 63. xxiii. 123. xxviii. 52. xxx. 57. xxxii. 185, 213. Ca'lculus bilia'ris, (from bilis, bile). Gall stone. Though we have spoken of these stones at sufficient length, yet some facts, chiefly of a chemical nature, re- main. Biliary calculi are divided by Walker into the striated, lamellated, and cortical; and by Vicq. d'Azyr into those Avhich consist of a yelloAvish bilious matter, whether filamentous or not; those composed of crystal- line matter of different degrees of lustre, with or with- out a covering, and into calculi consisting of both sub- stances. Externally they are usually laminated; inter- nally, radiated : the greater number have no taste, but many are intensely bitter. From their chemical pro- perties they are divided into two species; those con- sisting of a shining, foliated, crystalline substance, analogous to spermaceti, and those which resemble inspissated bile, in which the former seems to have crystallized. In every instance, the crystalline matter resembled spermaceti; though, in a calculus analyzed by Gren, it seemed to approach more nearly to wax. The hepatic calculi have not been examined. They often lie quiet in the gall bladder; and, until dissection after death, are not known to exist: but, when they are prevented from passing through the gall ducts, they generally obstruct the passage of the bile into the intestines, and produce many other distressing symptoms. The diagnostics of this disorder are often obscure and uncertain; for other causes produce similar symp- toms. An instance occurs in Mr. White's Treatise on the Disorders of the Bile: the usual symptoms, how- ever, are, a loss ol appetite, a sense of fulness in the VOL. I. stomach, sickness, A-omiting, languor, inactivity, sleep- lessness, and, if the obstruction continue a feAv days, a wasting of the flesh; a yellowness of the eyes, skin, and urine; whitish stools ; a pain at the pit of the stomach, without any change in the pulse. The last symptom is considered as peculiarly distinguishing this affection. This pain, Avhich in some is extremely acute, in others light, is felt about the region of the liver, and its parti- cular seat is in the gall duct, just where it enters the duodenum. In some patients the yelloAvness does not appear; in others it is observed for several months. It is a disease peculiarly painful, and as frequent as any disorder of the liver; it receives much relief from art, and is not immediately dangerous. In the cure, pain is the first object of attention; and, when it is considerable, opium is the only resource: a dose may be taken as soon as the patient perceives its approach, and repeated every hour or two until a re- mission is procured. The vomiting, Avhich generally attends, is nature's effort to dislodge the gall stones; and, whether it is present or absent, as soon as the pain begins to abate, an emetic should be administered, and repeated if required. After its operation an opiate may be given. Purging medicines are equally neces- sary ; and of these, such as act with the most ease, and may be most safely continued, as manna, castor oil, the Avaters of purging springs, and. neutral salts, are preferable. These may be repeated every other day for several months, without palling the appetite, or lessening the strength. A little rhubarb may also be taken occasionally. See London Med. Transactions, ii. 123. Memoirs of the Med. Society of London, i. 373. The juice of grass and the decoction of its roots in the spring, are supposed, from a fanciful analogy, to be powerful solvents. Mr. White says that he hath given alcohol saturated with the oil of turpentine, and advan- tageous effects have been soon manifested. See Dr. Coe on Bilious Diseases. Gooch's Cases and Remarks, p. 163—169. Lond. Med. Trans, vol. ii. p. 105, Sec. Mr. White's Treatise on the Diseases of the Bile. Lewis's Translation of Hoffman's Practice of Medicine. Annales de Chimie, v. 186. Ca'lculus huma'nus. See Bezoar microcosmi- cum. CALDA'RIjE ITA'LICjE. Hot baths nearFer- rara, in Italy, useful in difficulty of urine. CALDA'RIUM, quasi calidarium, (from caleo, to make hot). See Balneum. CA'LDUS, for Ca'lidus, is frequently used by Scri- bonius Largus ; and calda, by many authors, for warm AArater. CALEFACIE'NTIA, (from calefacio, to make hot). Such medicines as Avarm the habit. They belong to the class of stimulants, and, from the effects they produce, are called calefacients. See Stimulantia. CALEFA'CTIO. See Calcinatio by calefaction. CALE'NDULA, so called—quod singulis calendis, i. e. mensibus fiorescat—because it floAvers every month. Garden marigold, called also caltha, calendula saliva, chrysanthemum, sponsa solis, single marigold. C. saliva Lin. Sp. PI. 1304. Nat. order, composite dis- coidea; corumbifere of Jussieu. Of the many sorts of marigolds, this is the only one generally received in medicine. It is so common in Ss C A L 314 C AL our gardens, that a particular description is needless. It is annual, propagates itself by seeds, and floAvers from May to the end of autumn. The leaves have more virtue than the flowers, their expressed juice contains most of their pungent matter: it is thought to be aperient, and to promote the secre- tions in general. The flowers are a slight cordial. Cale'ndula Alpina. See Arnica Montana. Lin. Sp. PI. 1245. p. Cale'ndula arvensis, the wild marigold, also called caltha arvensis, caltha minima; c. arvensis Lin. Sp. PI. 1303. These leaves are stinking and bitter, and if burnt in the candle they crackle like nitre. It is sometimes preferred to the former. Its juice is given from one to four ounces in the jaundice and ca- chexia; and the leaves are commended as a salad for children affected Avith scrofulous tumours. Cale'ndula palustris. Common single marsh marigold. Caltha palustris Lin. Sp. PI. 784. Also called populago, caltha palustris, pseudo helleborus, ranunculoides pratensis. Grows in marshes, and is very acrid. It is so caustic that cattle avoid it, for it excites an inflammation if they chance to swallow it. CALENTU'RA, (from caleo, to make hot).^ It is a violent ardent fever, in which a delirium comes on both early and suddenly. It happens to those Avho sail into very hot countries. Dr. Oliver gives the history of a case in the Philos. Trans. Abr. vol. iv. in which he ob- serves, that \vhen the delirium came on, the patient imagined that he was in green fields; that after a free bleeding he slept, and waked without any other com- plaint than Aveakness from the loss of blood, and sore- ness from struggling during his delirium. He further adds, that this fever attacks in the night, whence the patient, under the notion of green fields, runs into the sea before any one is aware, so that few of these cases occur to observation. Dr. ShaAV advises, that the pa- tient should indulge in rest, be bled freely, take a few hours afterwards an emetic ; dilute plentifully Avith barley water, and that a blister should then be applied. It is probably a species of phrenitis, though of the milder kind, and of the nature of the coup de soleil. C. Stubbs in the Philos. Trans. N° 36. . CALE'SIUM. (Indian.) A tall tree, which bears clusters of berries like grapes or currants. These ber- ries contain a flat stone with a kernel in it. It groAvs in Malabar. Of the wood is made sheaths for knives and sAvords. The bark, made into an ointment with butter, • cures convulsions from wounds, and heals ulcers. The juice of the bark cures the aphthae; and, taken inwardly, the dysentery. ' Raii Hist. CA'LI, (from kali, Arab.). See Clavellati Ci- neres. CALICHA'PA. See Spina alba. CA'LIDRIS BELIO'NII. The French call it chevalier, from the length of its legs and SAviftness of its motion. This bird is of the bigness of a pigeon; met Avith in meadows where there are pools and rivu- lets. It is the scolopax of Latham, and all the species afford a nourishing food. CA'LIDUM INNATUM is an expression borrowed from the Stoical philosophy to express the natural heat of animals, which, as connected Avith life, has been also tailed pioXv&viov, the lamp of life. By the ancient phi- losophers in general, heat was considered as connected Avith life, as the peculiar distinguishing property of living animals, or as the effect of divine interposition: Est Deus in nobis, agitante calescimus ipso. The ideas of Hippocrates on this subject were not very- different ; and, though Galen deviated somewhat from his master, no attempts were made to explain its source, till the chemical schools attributed it to effer- vescence and fermentation; the mechanical philoso- phers to friction—either of the particles of the blood on each other; of these on the vessels ; or of the solid parts themselves. Each of these theories is, hoAvever, wholly inconsistent with the appearances, or with the functions, of the animal economy; nor need we in this place enter into arguments to refute opinions which no one at present adopts. Dr. Franklin supposed that fire, or, in modern lan- guage, caloric, Avas combined with our aliments; and, in the progress of the circulation, when the alimentary substances were decompounded, again separated in an active state: an idea simple and ingenious, in reality the basis of more modern systems. When phlogiston was in fashion, Dr. Black supposed that the air acting on the blood, separated the inflammable principle; and since it Avas apparently changed in the same manner as it would have been by a burning body, a similar process probably occasioned the change. Dr. Duguid Leslie, in his Thesis, afterwards published separately, opposed this idea; and suggested an opinion not very different from Dr. Franklin's, that the phlogiston contained in all our fluids, was separated during the circulation; and, as in every other circumstance where this principle was separated, heat ensued. This doctrine was, we believe, taught by Dr. Duncan in his class about that time: at least we have good reasons to attribute it to him. Yet each of these opinions must fall with phlogiston; but, though terms alter, we shall find that the principle of each has been retained, and that the same or similar ideas, in different forms, approach very nearly the so- lution of the problem. The facts, however, have not been ascertained with accuracy. The heat seems to be almost uniform in every part of the body; and a thermometer under the tongue, in the axilla, in the rectum, in the urethra, and in a sinous ulcer, has pointed to nearly the same de- gree. There is, undoubtedly, a difference in the degrees of heat of different persons, and probably in different parts. The earlier observations, as the construction of the thermometer was less correct, we shall omit; but, in general, the heat appears to vary from 96° to 98°. Dr. Martine and Dr. Hales found the urine to be 99° and 103° Avhen the skin was 97°. Mr. Hunter observed the heat of the rectum to be 98°, and that of the bulb of the urethra 97°. A thermometer, two inches within the rectum of a dog, was at 100°, in the left ventricle of the heart 101°, in the substance of the liver 100|°, and in the stomach 101°. De Haen, however, remarks, that if a thermometer be applied under the arm for half a quarter of an hour, its height is 95° or 96°; if for a quarter of an hour, 97°, 98°, and 99°; if for half an hour, 100°, and 101°; if for an hour, 101°, and 102°. This passage has been little noticed, though we suspect it is alluded to by an author, avIio remarks, that the irritation pro- duced by any body confined so long to a part, must) C A L 315 CAL increase the heat above its natural standard. To as- certain the fact, the author of this article put a very accurate and sensible thermometer, made by Dr. Wil- son, of Glasgow, under his arm, Avhen in perfect health; and, confining the humerus loosely, so as not to produce the slightest inconvenience, sat doAvn to read. The pulse, as usual with him*when sitting still for some hours, sunk to 56°, were the same in both arms, and the feelings in each arm continued the same for three hours, during Avhich the experiment lasted. In a quar- ter of an hour the thermometer was 97°, in about an hour 98°, and in two hours after 99°. It never rose higher. We must add, that in other trials, when the author's heat has been compared Avith that of different persons, it has ahvays been found at least a degree loAver; so that, perhaps, the real heat of the human body should be considered as 100°. This fact is, Ave think, of importance, when, with the accuracy of mo- dern chemists, the capacity of the blood for heat in dif- ferent situations is estimated. Another fact, for which Ave are indebted to De Haen, is, that in putrid fevers the heat at the moment of death has been considerably increased, and that it even continued to increase after death, till, if we recollect rightly, it amounted to 104°. To this meagre cata- logue of facts we can only add one other, which we think should be again examined, viz. that the venous blood of the internal organs is hotter than the ar- terial. Observation, which ought to have preceded theory, should have furnished many additional circumstances to assist our enquiries; and it Avould have been of advan- tage to have ascertained the comparative capacity of heat of the blood in the vena portae and the hepatic veins, perhaps of the blood in the splenic artery and the vasa brevia; nor AA'ould it have been Avholly useless to have determined the capacity of heat of the different component parts of the vital fluid, Avith more accuracy than has yet been attempted. We must proceed, how- ever, to explain the modern theories of Dr. CraAvford and M. Lavoisier, taking the liberty of changing the language of the former; for, though phlogiston is no more, the language only, so far his theory extends, is changed. We must anticipate a little the doctrines of an ap- proaching article (Caloric), by explaining some terms essentially necessary to .the proper comprehension of Dr. CraAvford's system. If Ave suppose at this moment the existence of heat as a separate principle admitted, absolute heat is the real quantity of this principle; rela- tive heat that quantity only Avhich is obvious to the senses, or can be measured by a thermometer. Thus, according to the common instance, a pound of water and as much calx of antimony have the same tem- perature to the thermometer; but the water contains four times as much heat as the calx. The capacities of bodies for retaining this principle, are also different and measured by the degrees of sensible heat in each, after being exposed to the same temperature. Thus, if water and mercury are exposed to the same heat for a given time, while the temperature of the water is raised one degree, that of the mercury is raised 28°. The ca- pacity of water then to that of mercury, is as 28 to 1. These two qualities, absolute heat, and capacity for'heat, are often confounded, and particularly by Dr. Crawford, who was not aware, that in the diaphoretic antimony the heat Avas really a component part of the calx. . In pursuance of the general distinction betAveen ab- solute and relative heat, Dr. CraAvford examined the arterial blood compared with water, and found it to be as 1.03 to 1.00. He consequently suspected, that the blood absorbed heat from the air in the lungs; and this idea Avas confirmed by the intimate connection betAveen the increase of temperature and the frequency of re- spiration, as well as the extent of the respiratory organs. On pursuing the enquiry, he found that the absolute heat of atmospheric air was changed bypassing through the lungs; and, in general, air contained absolute heat in the same proportion that it Avas adapted for respira- tion. On examining the state of the blood in the pul- monary vein and artery, he found the heat greater in the former than in the latter. The colour of the venous blood resembles more nearly that of arteries in a Avarm than in a cold atmosphere, for less heat is of course absorbed; and, in general, the heat absorbed by air is nearly the quantity produced by burning a Avax taper, for. the air is vitiated in nearly the same proportion by both processes. The absolute heat of different animal substances he ascertained to be as folloAvs. Supposing water 1.0000, inflammable air Avas 21.4000, oxygen gas 4.7490, atmospherical air 1.7900, aqueous vapour 1.5500, carbonic acid gas 1.0454, azote 0.7936, arterial blood 1.0300, venous blood 0.8928, fresh cows' milk 0.9999, hide of an ox Avith the hair 0.7870, lungs of a sheep 0.7690, lean beaf 0.7400. To apply these facts to the subject before us, he found that the absolute heat of pure air, at the common tem- perature of the atmosphere, Avas equal to 1550°. The heat of fixed air and aqueous vapour being one third less, pure air changed to the two latter, would give out 3 X 1 550° ZZ 4650°. Many causes concur to reduce this quantity, but it will be evident that a large proportion of heat must be absorbed by the blood, as so little sen- sible heat is produced. The capacity of the heat in venous blood, appears to that of arterial as about 23 : 20. If venous blood be therefore converted to arterial, there will be this pro- portional loss of heat; but venous blood contains 1580°, and consequently the loss from the change of venous into arterial blood, Avould be very nearly 200°, if the deficiency were not supplied from the air. We noAV know, also, more clearly than at the period Dr. Craw- ford wrote, that oxygen contains a considerable propor- tion of caloric, and its ahstraction is of course connected with a diminution of this principle. As oxygen, there- fore, disappears in respiration, heat is lost to our senses, but recovered again in the increased capacity of the blood, after it has circulated through the lungs. The blood in circulation becomes replete Avith azote, and, of course, its attraction for oxygen is diminished. Heat, therefore, escapes in every part of the circulating system, and supports an equable warmth; till the blood, returning to the lungs, again absorbs a fresh propor- tion of oxygen from the air, to be again partly separated for the support of animal life: we say partly, for the capacity of the remaining fluids being increased, a por- tion is absorbed, and becomes of these a component part. This doctrine is recommended by its simplicity, its conformity to other appearances, and the ready appli- cation it affords to different phenomena; particularly S s 2 CAL 316 CAL the connection of animal heat with the extent of the respiratory organs, and the frequency of respiration. It explains also some other facts which require a more ample consideration. The heat of animals, at whatever degree it may be phced, is uniform. We see that the lower the sur- rounding temperature is, the separation of the oxygen from the air will be more complete, and, of course, the separation of heat in the circulation. The arterial and venous blood will, as we have said, differ nearly in the same proportion in their colour. Thus the changes balance each other; and in warm countries, where pu- trefaction powerfully vitiates the air, breathing has a proportionably less effect. This balance of the effects of heat in the air, and of the production of animal heat, goes further; for, when heat is increased beyond its due bounds, the same prin- ciple produces cold. Mr. Tillet found that a girl could live for some time in an oven heated to 220°; and Dr. Fordyce observed that a dog could live, with little in- convenience, in a heat of 260°; and he himself endured the heat of 230° for fifteen minutes, while the thermo- meter under his tongue pointed only to 100°. Dr. Crawford proved, that when a living and a dead frog were exposed to a great degree of heat, in air or water, the former acquired the heat of the surrounding tem- perature more slowly than the latter. These facts are readily explained from our author's system. It appears, from Avhat Ave have observed, that the blood brings with it to the lungs such an increased capacity for containing heat, that if its temperature Avere not supported by the oxygen of the air, it Avould sink 200°: but, in great heats, this capacity is supplied, and a small proportion only is absorbed; in very high degrees of temperature, probably none: and when, from the changes produced by the circulation, this extraordinary proportion of heat is separated, as it will be by the more rapid increase of the animal process, the superabundant heat is lost in the aqueous vapour, and in the evaporation, or rather the change of that vapour into air. Thus Ave see, also, why the heat in putrid fevers is so considerable, and Avhy it may even increase after death; for the putrid fluids, having a less capacity of heat, lose whatever they contained in consequence of their former capacity, and putrefaction, hastening on rapidly after death, indeed more rapidly than the heat can be carried off, occasions its apparent increase. The opinion of MM. Lavoisier and Seguin is more simple, but by no means meets so satisfactorily the phe- nomena, as the theory of Dr. Crawford. They consider respiration as a kind of combustion, in which pure is converted into fixed air, and the heat separated as the cause of animal heat. This, however, establishes a focus of heat in the lungs. This part must be the Avarmest, and the extremities the coldest, in the body, Avhile the heat of the intervening parts must vary in proportion to their distance from the centre of inflam- mation. They avoid this difficulty, hoAvever,by alleging the rapidity of the circulation; and they elude the consequence of extraordinary heat in the lungs, by its diminution in consequence of evaporation; but, if ex- amined, neither would be found equal to the effects. Lavoisier, however, adopts part of the idea of CraAvford; and, when Ave recollect that the work of this latter au- thor appeared in 1779, and the improved system of Lavoisier in 1780, we shall not doubt to Avhom this ad- dition is owing. On the whole, the system of Dr. Crawford is apparently the true one. In the first edi- tion there were some errors, both in the experiments and calculations; nor is the second, perhaps, though much more perfect, wholly free. Modern discoveries have, indeed, added to Dr. Crawford's system, and con- firmed it; for, whether we consider the formation of carbonic acid gas from the addition of carbon, or that of water by the union of hydrogen, Ave shall find that in each change the vital air must lose a part of its specific heat. Yet it may be alleged, that Dr. Crawford, by ascertaining the capacity of aqueous vapour and of ve- nous blood, has given a solution, though not so particu- lar, equally satisfactory. Various modifications of these opinions have been published. M. Girtanner, in the Journal de Physique for the year 1790, has suggested an opinion, that a part of the oxygen of the atmosphere unites with the arterial blood; a part Avith the carbon in the carbonated hydro- genous gas, which escapes from venous blood, forming carbonic acid gas; a partAvith the mucus, which is con- stantly decomposing; a part Avith the hydrogen gas of the blood to form water; and a part only remains in the blood to supply the animal heat. The effects of respi- ration will, therefore, be very numerous and different; but, when the products are examined, they will, he thinks, be found the same with those of combustion. If Dr. Crawford's system be considered with attention, . it Avill not, we suspect, be found to require such a com- plicated process. De la Grange adopts the opinion of Dr. Duguid Leslie, or rather of Dr. Duncan, putting it only into a modern dress; and Hassenfretz does not greatly differ. - Dr. Gren, in the Annales de Chimie, supposes that no oxygen is communicated to the blood; but that the change from the venal to the arterial is owing to the separation of carbon and hydrogen, with Avhich the oxygen forms carbonic acid, and the water expired in respiration. M. Metheric, in the Journal de Physique, will admit only of the combination of oxygen as one cause of animal heat, recurring as assistants to muscu- lar motion and fermentation. Respiration, he thinks, conducts the electrical fluid to the blood, as the air of an apartment in which a person has long breathed, is electrified negatively; but this-proves nothing, as all our excrementitious fluids possess a negative electricity. Linnaeus hints at a similar cause of the heat of animals, when he observes, in his concise, energetic language, Flagrat electrico pulmonibus hausto. Dr. Menzies' experiments are connected rather with the subject of respiration than with animal heat; and Ave need only remark, that he thinks all the heat ob- served in the animal system may be explained from the quantity of pure air vitiated in the lungs; thus referring the heat of animals, like Lavoisier, to a species of com- bustion. The conclusion is, however, more correct in a chemical than in a physiological vieAV. It will un- doubtedly explain the heat of the blood in the lungs; and if Mr. Hunter's experiments, formerly mentioned, be admitted, for a little increase of the heat in those organs; but it will not explain the nearly uniform tem- perature in different parts. Indeed, we know of no sys- tem which so readily meets all the physiological and pathological facts as that of Dr. Crawford, and it is, avc believe, generally adopted. See Respiration. CAL 317 CAL To this system, hoAvever, one objection remains, viz. the heat, which the embryos of animals, and particu- larly of oviparous ones, possess, independent of the parent. As the blood, however, of the foetuses of viva- parous animals passes regularly through the lungs of the mother, it may be supposed to convey sufficient heat for the embryo ; and, in confirmation of this idea, the blood of pregnant women seems to be highly oxy- genated. No blood from the mother, however, can reach the embryo inclosed in an egg; and, though na- ture has provided a reservoir of air at one end, it is too inconsiderable to supply the young animal with Avarmth. It is singular, however, that the nature of this air has not been examined; nor has it been ascertained, though the quantity is known to be diminished in the progress of incubation, whether it undergoes any chemical change. Yet, as the yolk by which the chick is nou- rished, and the albumen itself, contain oxygen, this may be gradually evolved and impart its caloric; nor is this change merely imaginary, for we know that the mild fluids of the egg are gradually changed to azotic ones, whose capacity for heat is of course diminished. There are, however, many arguments which lead to Dr. Cullen's opinion, that the warmth of animals is connected with their life, and the effect of the principle which distinguishes them as living beings. It is certain, also, that vegetables which possess life, possess also some innate heat; though the change respecting the air, the inhale and exhale, is reversed; for they expire oxygen as an excrementitious fluid, while they draAV in carbon at the radical fibres, and absorb hydrogen proba- bly from the leaves. At present, however, we know too little of the vegetable economy to suffer a system, other- Avise highly probable, to be disturbed by its apparent anomalies; and, while we thus put our readers in pos- session of all the facts, we shall leave the ultimate de- cision for the result of further investigation. See Haller's Elementa Physiologiae ; Hale's Statical Essays; Dr. Duguid Leslie's Philosophical Enquiry into the Cause of Animal Heat; Girtanner sur ITrri- tabilite (Journal de Physique, 1790); Gren (Annales de Chimie, vol. xxiv.); Crawford's Experiments and Observations on Animal Heat, 2d edition, 1788; Me- moire sur la Chaleur, par MM. Lavoisier and De la Place; Memoires de l'Academie, 1790; Menzies on Respiration, 1796. CALIETA, or CALIETTE, (from xxXms, a nest, which it somewhat resembles). See Juniperinum LIGNUM. CALI'GO, (from caligo, to be dark). A groAving darkness of the eye, or dimness of the sight, from a manifest cause; as in cases of the cataract, Sec. Dr. Cullen places this genus of disease in the class locales, and order dysesthesie. He defines it to be sight dimi- nished, or wholly abolished; from a dark barrier be- tween the object and the retina, in the eye itself, or in the eye lid. He also enumerates five species; viz. 1. Cali'go lentis ; the glaucoma Woolhousi, maitre Jean St. Yves; this he denominated the cataract, and Sauvages calls it the true cataract, it is caused by a thickening of the coats of the crystalline lens. See Cataracta. 2. Cali'go corner, from an opacity of the cornea. See Achi.ys and Albugo. 3. Cali'go puriLLiE, from obstruction in the pupil. See Synizesis ; called also amaurosis et synchysis a Myosi. 4. Cali'go humorum, glaucoma Vogelii, from a fault in the humours of the eye. 5. Cali'go palpebrarum, from a disorder in the eye lids. See Cullen's Nosology, edit. 3. CALIHA'CHA. See Cassia lignea. CALLjEO'N, (from xxxXvvu, to adorn). The gills of a cock, a food neither to be praised nor condemned. Galen. CALLE'NA. A kind of saltpetre. See Nitrum. CA'LLI, stopx. Nodes in the gout. Galen. CALLIBLE'PHARON, (from xxxos, beautiful, and pxeQxgov, an eye lid). Medicines appropriated to the eye lids. CALLICOCCA, Lin. Gen. PI. Schreber, 316. Nat. order rubiacee, Juss. See Ipecacuanha. CALLICRE'AS, (rom xxXos, good, and xpexs, meat). See Pancreas. CALLI'GONUM, (from xxXos, beautiful, and yew, a joint, or knot; so named from its being handsomely jointed). See Polygonum. CALLIOMA'RCUS. See Tussilago. CALLIO'NYMUS, (from xxXos, good, and ov»um, a name). See Uranoscopus. CALLIPHY'LLUM, and CALLITRI'CUM, (from xxX«s, beautiful, and fvXXov, a leaf, or 0f<|, a hair). See Adianthum nigrum. CALLOS'ITAS, callosity. See Callus. CALLUS. From calx, the heel, or calco, to tread; because it used to be applied to the thick skin at the bottom of the heel, hardened by pressure; but it is a cutaneous or osseous hardness, either natural or pre- ternatural. Generally it means the callus generated about the edges of a fracture. Sometimes it means a corn on the toes, the hardness in the hands produced by labour, or the hard edges of ulcers. See Bell's Sur- gery, ii. 326. Kirkland's Med. Surgery, ii. 246. This term and callositas are, in a special sense, spo- ken of the eye lids, both by Galen and Scribonius Largus; and callus has a particular signification, in Avhich it means the corpus callosum of the brain. Para- celsus gives the name of callus to an abscess, or ulcer, caused by acrid Juices which excite violent itching. For callus on the hands and feet see Clavus. The retraction of the part divided is a common symptom in wounds; and the stronger the contractile force, the more the sides of the Avound recede from each other. The skin of the head is thick and strong, and equally tense on all parts of the skull, and under it lays a cellular membrane; so that Avhen the skin of the cranium is divided, the lips of the Avounds are far re- tracted, and are called callus, consequently Avounds of the forehead generally leave large scars behind them. As the growing vessels in wounds of the soft parts are tender in consequence of their not being pressed by the skin, they may degenerate into fungous flesh. The same holds true in the callus of the bones, which may becOme luxuriant Avhen the vessels which constitute the substance of the growing bone are distended, cither by a redundance, or too strong impetus of the fluids. Dr. Nisbet and Dr. Hunter imagine a callus of the bone is not formed by the inspissation of any fluid, but from a regeneration, or, as it Avere, granulation from the fibres of the bone. CAL 318 C A L CA'LMET. See Antimonium. CALOCATANOS, (from xxXos, beautiful, and xx- Ixvov, a cup; so called from the beauty of its flower and shape). See Papave"r rubrum. CALOMELA'NOS TURQUETI. So Riverius calls a certain purgative medicine which he often used. It is thus prepared. R. Merc. dulc. 9 j. gum. scammon. cum sulph. im- pregn vel rez. jalap. 9 ss. mucilag. e gum. trag. q. s. f. pil. mediocr. CALOME'LAS, (from xxXos, good, and y,eXxs, black). It used to be called Ethiops mineral. But calomelas is, iii common acceptation, the mercurius dulc.sexties sub- limatus, which, if ground with the volatile spirits, be- comes black: it is called also aquila alba. See Argen- tum vivum. CALOMO'CHANUS, or CALOMOCHNUS. See Adarces. CALO'NIA. So called from the place where it was procured. Calonian Myrrh. Hippocrates often pre- scribes it. CALORIMETER. An instrument contrived by La- voisier and De la Place, to measure degrees of heat se- parated. Mr. Wedgewood, Philos. Trans. 1784, has offered some objections to this instrument, which M. Berthollet replies to in Chemical Statics, vol. i. p. 404. CALORICUM, (from calor,heat). Caloric. Lavoi- sier, in giving his reasons for the adoption of this term, says, "All bodies are either solid, liquid, or in a state of aeriform vapour, according to the proportion Avhich takes place between the attractive force inherent in their particles, and the repulsive poAver of the heat acting upon them; or in proportion to the degree of heat to Avhich they are exposed. It is difficult to comprehend the phe- nomena, without admitting them as the effects of a great and material substance, or very subtile fluid, AA-hich, in- sinuating itself between the particles of bodies, separates them from each other. This substance, whatever it is, being the cause of heat; or, in other Avords, the sensation, Avhich we call warmth, being caused by the accumulation of this substance; Ave cannot, in strict language, distin- guish it by the term he at, because the same name would very improperly express both cause and effect." He therefore gave it the names of igneous fluid, and matter of heat. These periphrastic expressions, however, lengthen physical language, render it more tedious, less distinct and correct, so that the cause of heat, or that fluid which produces it, has been distinguished by the term caloric, considered as the respective cause, what- ever that 7nay be, which separates the particles of' 7nattcr from each other. See Elements of Chemistry, p. 5. There is, however, an intermediate state of water in air, or rather approaching the form of air, which M. Lavoisier has not considered, viz. vesicular vapour. It contains a greater degree of specific heat than water, and less than either of the permanent elastic gases. Its fonn, however, does not seem wholly to depend on its heat, but on its electricity; by which it is repelled from the higher regions, and does not descend in rain. This is the state of water in fogs and in clouds; but as this subject admits of no application to medicine, we need not pursue it in this place. We have anticipated the distinction of absolute and relative heat in our article on Calidum innatum, q. v. and shall how pursue its other effects. When we speak of heat and its effects, we measure a very small part of an extensive scale. It is computed, though on no very secure foundation, that at about 1500° beloAV the scale of Fahrenheit, it no longer exists; and we have in our power a degree equal to 32277° of that scale, the highest heat measured by Wedgewood's pyrometer. Our limits are between the 32d and the 120th degree of Fahrenheit, scarcely 88 degrees, yet even the effects of these changes are interesting. Expansion is one of the first and most striking effects. So far as it is applicable to the human body, we have noticed it under the article of Balneum, and may again advert to it under that of Heat. We there mentioned the blood as one of the least expansile fluids; but, as in the experiment some gas must escape, a little inac- curacy might be suspected. We had then in our view the experiments by Lavoisier, Prony, Guyton, and Prieur, on the expansility of different gases; of the considerable and equable expansility of carbonic acid gas; and the very great expansility of azotic gas in high temperatures. We find, however, from a Memoir of an ingenious chemist, Guy Lussac, an abstract of which occurs in the Annales de Chimie for 1802 (Thcrmidor, an X.), that when every cause of error is removed, par- ticularly the presence of water, atmospheric air, oxy- gen, hydrogen, azote, nitrous, ammoniacal, carbonic, sulphureous, and muriatic acid gases, as well as the va- pour of sulphuric aether, are dilated equally by the same degrees of heat; and that in the centigrade thermome- ter, from 0 to 80°, each dilated about -^\3 of its bulk for each degree. Of the fluids, the most expansile ii nitric acid, then linseed oil, sulphuric acid, alcohol, water, and mercury, in their order. Of the metals, the expansility is nearly in the order of their fusibility, A'iz. zinc, lead, tin, pewter, brass, copper, bismuth, iron, steel, antimony, and platina. Of liquids the expansion is different, but few expand equably, viz. in equal de- grees with equal increments of heats. Those Avhich approach nearest to an equable expansion are mercury and alcohol, and are consequently preferred for filling thermometers. This effect of heat admits but of little application in the practice of medicine. Cold applica- tions in hernia and in topical inflammations, are the principal remedies Avhich act in this way; though the latter admit of a someAvhat different explanation. Another effect of caloric, is the equilibrium which it affects: but this admits of modifications Avhich we have already explained. The heat which raises one body a given degree, very slightly affects another; but to the touch and the thermometer the heat is in time the same. This law of heat chemists have found it difficult to ex- plain. The popular idea, though not a correct one, may be the usual allusion of a sponge, which suffers the superabundant fluid to escape when its pores are filled. This allusion also explains another effect, viz. when any body is dilated, heat is absorbed, when com- pressed, it escapes. Thus, in an exhausted receiver, if the air is humid, a cloud is formed on exhaustion. In a condensing engine Ave find heat escape sometimes ra- pidly ; and, when suddenly dilated before the air can again absorb the free heat, even inflammation has ta- ken place. We must repeat, however, that this allusion to the sponge is by no means correct. The equilibrium of heat depends rather on affinity, though apparently subject to some peculiar laws, and is little connected with physiology, as it relates to free caloric, and not to absolute or specific heats. CAL 319 CAL The laws of heat, most interesting to the chemical physiologist, relate to the powers of different substances in conducting heat. The motion of heat is slow, par- ticularly when the conductors are fluids. Some authors, confounding heat with light, have given the former the velocity of the latter. They are, however, essentially distinct; and Avhen air and Avater are interposed be- tween small filaments of a solid, its motion is peculiarly slow. This renders feathers, eiderdown, and boiled mashed apples, bad conductors of heat: metals of every kind are, for the opposite reason, good conductors. We preserve the heat of the body by fur and eiderdoAvn, and apply rasped potatoes to burns, which keep the part constantly cool. Count Rumford endeavoured to show that water was a non-conductor of heat, and that it boiled in a vessel over the fire by successive currents coming in contact with the bottom. Such currents evidently exist, and explain the common paradox of the bottom of a kettle being cold while the water boils; but that water is a non-conductor of heat, can be by no means concluded from the experiment. On the contrary, Dr. Thomson has shown in Nicholson's Journal, vol. iv. p. 159, that water really conducts heat. Metals we have said are good, indeed they are the best, conductors. Of these, silver is better than gold, and this last metal excels copper and tin, which do not greatly differ. Pla- tina, iron, steel, and lead, are greatly inferior, and nearly in this order. Next follow stones, then glass, and afterwards dried Avoods, fine sand, charcoal (Annales de Chimie, xxvi. 225,) feathers, silk, and wool, in the in- verse ratio of their fineness. Of fluids, Dr. Thomson found an equal bulk of mercury to be twice as good a conductor of heat as water; and linseed oil somewhat better. It is highly probable, that the conducting power of bodies is in the ratio of their affinity for heat. Bodies of different colours convey heat also differently. The difference between white and black is Avell known; and the more intense colours, as red, orange, Sec. convey it more readily than the blue or indigo. If heat and light are distinct bodies, as is now generally supposed, and light only excites the action of caloric, Ave can easily understand why bodies which reflect all, or the greater proportion of light, excite little heat. Count Rumford, in the Philosophical Transactions for 1804, has shown, that blackening a cylinder expedited the cooling of water in it: in fact, the communication of heat from bodies to air is slow, and an intermede of less density, if no air is interposed betAveen its particles, fa- cilitates it. Another reason of this unexpected effect is the destruction of the polish. Polished surfaces com- municate heat slowly; and this is an additional reason for the warmth of furs, whose fibres possess a high polish. For this reason silk clothes are cold; and even black clothes, in this author's opinion, in the shade, are cooler than those of other colours. Of specific and absolute heats Ave have already spoken at sufficient length. Specific heat, however, depends on the affinity between the body and caloric; and consequently is in the inverse ratio of their conducting power. We shall add, therefore, a table of the specific caloric of different bodies, collected from the tables of Mr. Kirwan, M. Meyer, and some others, by Dr. Thomson. Table of the Specific Caloric of various Bodies, that of Water being— 1.0000. Bodies. I. Gases. Hydrogen gas - - - Oxygen gas - - . - Common air - - - Carbonic acid gas - - Steam - - - - - Azotic gas - - - - II. Liquids. Water..... Carbonate of ammonia - Arterial blood - - - Cows' milk - - - - Sulphuret of ammonia - Venous blood - - - Solution of brown sugar Nitric acid - - - - Sulphat of magnesia 1 Water .... 8 Common salt H ammonia Water Nitre 1 > Water 8 5 Muriat of Water - Tartar 1 Water 237.3 Solution of potash Sulphat of iron 1 Water - - 2.5 Sulphat of soda 1 Water - - 2.9 Oil of olives - - Ammonia - - Muriatic acid Sulphuric acid 4 Water - - 5 Alum 1 Water 4.45 Nitric acid 9^ 1 'I 1.55 Lime - 1 Nitre 1 Water 3 Alcohol Sulphuric acid - - Nitrous acid - . Linseed oil - - - Spermaceti oil - - Oil of turpentine Vinegar - - - - Lime 9 Water 16 Mercury Distilled vinegar III. Solids. Ice...... Oxide Avith the hair Lu.igs of a sheep - Lean of ox beef - - Specific Gravity. Specific of equal weight. 0.000094 0.0034 0.00122 0.00183 0.00120 1.0000 1.0324 0.818 1.346 0.9153 0.997 1.122 0.8371 1.840 1.355 0.9403 0.9910 13.568 21.4000 4.7490 1.7900 1.0459 1.5500 0.7036 1.0000 1.851 1.030 0.9999 0.9940 0.8928 0.8600 0.844 0.844 0.832 0.8167 0.779 0.765 0.759 0.734 0.728 0.710 0.7080 0.6800 0.6631 0.649 0.6181 0.646 0.6021 0.5968 0.576 0.528 0.5000 0.472 0.3870 0.3346 0.3100 0.1030 0.9000 0.787 0.769 0.7400 Caloric of equal volumes. 0.00214 0.006411 0.002183 0.001930 0.000952 1.0000 1.0322 0.8130 1.2216 0.6498 0.7041 0.763 0.4993 1.120 0.780 0.4964 0.4132 0.3966 4.123 0.1039 CAL 320 CAL Bodies. Pinus sylvestris - - Pinus abies - - - - Tilea Europaea - - - Pinus picea - - - - Pyrus malus - - - - Betula alnus - - - - Quercus robur sessilis - Fraxinus excelsior - - Pyrus communis - - Rice...... Horse beans - - - - Dust of the pine tree - Pease...... Fagus sylvatica - - - Carpinus betulus r - Betula alba - - - - Wheat..... Elm...... Quercus robur pedun- culata - ' - - - - Prunus domestica - - Diaspyrus ebenum Barley - - - - - Oats...... Pitcoal..... Charcoal - - - - - Chalk..... Rust of iron - - - - White oxide of antimony Avashed - - - - Oxide of copper nearly freed from air - - Quicklime - - - - StoneAvare - - - - Agate...... Crystal..... Cinders - - - - - Swedish glass - - - Ashes of cinders - - Sulphur - - - - - Flint glass - - - - Rust of iron nearly freed from air - - - - White oxide of antimo- ny ditto - - - . Ashes of the elm - - Oxide of zinc nearly free from air - - - Iron ------ Brass...... Copper - - - - . Sheet iron .... Oxide of lead and tin - Gun metal .... White oxide of tin near- ly free from air - - Zinc...... Ashes of charcoal - - Silver...... Yel. oxide of lead near- ly freed from air - - Specific Gravity. 0.408 0.447 0.408 0.495 0.639 0.484 0.531 0.631 0.603 0.692 0.690 0.608 0.646 0.668 0.687 1.054 2.648 3.189? 2.386 1.99 3.3293 Specific of equal weight. Caloric of equal volumes. Bodies. Specific Gravity. 7.876 8.358 8.784 7.154 10.001 0.65 0.60 0.62 0.58 0.57 0.53 0.51 0.51 0.50 0.5050 0.5020 0.5000 0.4920 0.49 0.48 0.48 0.4770 0.47 0.45 0.44 0.43 0.4210 0.4160 0.2777 0.2631 0.2564 0.2500 0.2270 0.2272 0.2199 0.195 0.195 0.1929 0.1923 0.187 0.1885 0.183 0.174 0.1666 0.1666 0.1402 0.1369 0.1264 0.1141 0.1121 0.1099 0.102 0.1100 0.0990 0.0981 0.0909 0.082 0.0680 0.265 0.268 0.252 0.287 0.364 0.256 0.270 0.321 0.301 0.358 0.831 0.291 0.321 0.300 0.302 0.453 0.517 0.6151 0.448 0.3680 0.5792 0.993 0.971 1.Q27 0.735 0.833 Tin - - Antimony Gold - - Lead - - Bismuth - 7.380 6.107 19.040 11.456 9.861 Specific of* equal weight. 0.0661 0.0637 0.050 0.0424 0.043 Calorie of equal volumes. 0.444 0.390 0.966 0.487 0.427 CA'LTHA, or CA'LTHULA,(comvpted from y,xx- xx, yellow). Marigold. See Calendula. Ca'ltha arve'nsis, mi'nima. See Calendula arvensis. Ca'ltha palustris. See Calendula palustris. CA'LTROPS. It derives its name from the form of its fruit, Avhich resembles those instruments of war Avhich were cast in the enemy's way to annoy their horses. This plant is also called tribulus; trapa natans Lin. Sp. PI. 182. The fruit is nutritious and demul- cent, of use in diarrhoeas from abraded bowels, and it is said in the stone. CA'LVA, CALVA'RIA, (from calvus, bald; so cal- led because it is often bald). See Cranium. CALVA'TA. See Phalacra. CALVITIES, CALVITIUM, (from calvus, bald). See Alopecia. CA'LX. This word is applied to whatever is sub- jected to calcination, or change from burning. It chiefly refers to metals after having sustained the action of fire; and to calcareous earths, Avhich are burnt to lime. See Calcinatio. Lime stone, also called saxum calcarium, abesu7n, algeria, is a general name for all those stones from which quick lime is commonly prepared. Though the limes prepared from different stones answer many ge- neral purposes equally well, they differ greatly in their efficacy in medicine, and in many chemical and other experiments. When stones of the calcareous kind have been cal- cined by the fire, they are converted into quick lime, called calx viva, and in some obsolete authors, anora, gir, nixfumans, and almyzinthra. Quick lime dissolves in nitrous, marine, and vege- table acids; unites with the vitriolic into selenite, an earthy salt, scarcely soluble and insipid ; produces heat on mixing with water, imparting to it a medicinal quality. If quick lime is exposed to the atmosphere, it falls into a powder, and loses all its distinguishing pro- perties except that it retains its acrimony longer in a moist than in a dry state. The stones from which quick lime is produced con- tain a large quantity of air, which, in calcination, is ex- pelled: hence strong quick lime raises no effervescence, and emits no air bubbles during its dissolution in acids. Ca'lx vi'vA,or quick lime, is lime in its most caustic state, with the air wholly separated. When styled extincta it has been long exposed, and fallen to powder. When deprived of its acrimony by repeated affusions of water, it is called washed lime. Calcareous earth is commonly found saturated with aerial acid, which exhibits the appearance of effer- vescence upon being driven from its basis by a stronger acid. It is found dissolved in most waters by means of a redundant portion of this acid, which by burning is CAL 321 CAL lost, together Avith a proportion of water Avith which it Avas combined. It also absorbs a considerable propor- tion of caloric, which on slaking is let loose. Quick lime is employed for increasing the activity of alkaline salts, for making the milder kinds of caustics, and for destroying the hair on places Avhere it is thought to be unseemly; it dissolves sulphurs and vegetable resins, and produces many effects similar to those of the fixed alkaline salts. It has been also often employed in paralytic af- fections ; and Coelius Aurelianus directs us to rub pal- sied limbs with this earth. Mixed with honey, it is em- ployed as a stimulant by Tissot; and with different ointments in the morbus coxarius by De Haen. Two parts of lime, as much wheat flour, with four parts of hog's lard, are employed in the Bath hospital in tu- mours of the knees (Falconer on Bath Waters). Seve- rinus recommends a formula of quick lime not strictly chemical as a caustic. He mixes it with soap, and sprinkles it with the sharpest vinegar; which will con- sequently lessen the acrimony of the former ingre- dients. Quick lime, however, with soap, was long a favourite remedy; and is spoken of with commenda- tion, by Heister, in warts and tumours of every kind. As promoting suppuration, with flour and lard, it is recommended by Valentine; and is generally useful in destroying the spots on the skin, supposed to be OAving to the irregular fancies of the mother's appetite during pregnancy. Internally it is employed only in its watery solution. In the London dispensatory, twelve pounds of boiling distilled water are added to half a pound of lime, and infused for one hour. The Edinburgh college order four ounces of water to be first added to the lime, or as much as it will absorb. When the lime has fallen into a poAvder, the remainder of the water is mixed with it, stirring the whole together, and the agitation must be often repeated. There is a little too great refinement in both : distilled water is unnecessary in the first, and the frequent stirring in the second. If, in the latter formula, the remaining water is well mixed, and suffer- ed to remain on the lime in a covered vessel for a night, the Avater -will be as strongly impregnated with the earth as its affinity will permit. If the Avater is heated, the taste is said to be less disagreeable. The lime, in both formula;, is greatly in excess, for a very small pro- portion only is soluble in water; but it is cheap, or rather, in such small quantities, of no value. The choice of lime is of consequence in agriculture and the arts, but of little in medicine. Mr. Tennant has informed us that limestone, mixed with magnesian earth, is injurious in agriculture ; and the tanner is peculiarly anxious that his lime should be well burnt. Dr. Whytt thought that the lime from oyster shells was the strongest; but the difference seems only to consist in its being more completely calcined to separate the animal gluten. In general, the deficiency in the calcination, if it exists, is compensated by the quantity; and lime water may easily be made as strong as the stomach will admit. N The lime water is a solution of the quick lime in water, and receives no improvement from the in- gredients added in the compound sorts which used to be ordered, for they precipitate much of the lime Avhich the Avater suspended. The taste is acrid and earthy ; VOL- x. the smell pungent. With its taste, the lime water loses its virtues. It hath a strong styptic taste, Avhich is fol- lowed by a sweetish one : it changes the juices of blue flowers to a green ; it precipitates metallic bodies that are dissolved in acids; it tinges silver of a copper hue ; it turns red wine to a dark colour; and by those pro- perties its strength may be estimated. The specific gravity of Avater is increased by the lime more than the weight of the calcareous matter taken up, on account, perhaps, of the Avater being deprived of its air. If lime water is close kept, it maybe preserved many months; but in open vessels the calcareous matter ab- sorbs carbonic acid, and soon separates from the water, concreting on its surface. The earth Avhich floats upon the surface of lime water fresh made, is called calcis vivi flores, but it is in reality only the carbonated lime. Its virtues are also destroyed by every substance con- taining fixed air; the vitriolic, phosphoric, oxalic, or tartarous acids, as well as by astringents. Milk covers its acrimony very successfully Avithout impairing its virtues. Lime has been often employed Avith olive oil in burns ; and when we recollect the changes produced on the acrid serum that exudes in the vesicles, by the cal- careous earth in Mr. Cleghorn's poultice, little doubt will remain of its having a good effect. If by uniting Avith this serum it produces some warmth, it will not on this account be injurious. In the stomach, lime water corrects acidity ; but, though out of the body it has been found antiseptic (Hales and Macbride), in the stomach it has probably* a contrary effect; for when acids abound, putrefaction is checked. In hot bilious habits, by destroying the natural corrector of bile, acidity, it is also injurious; nor do Ave think it can strengthen the stomach or assist digestion, as some authors have supposed, except Avhere acids greatly abound. Perhaps, from its antacid power, though its astringency in the primae vise is by no means equivocal, it relieves old diarrhoeas; and in some cases of dysentery has been successful. Grainger, in the Edinburgh Essays, mentions its having succeeded after being continued three weeks, when the patient took three pints daily. Xavier mentions its utility, Avith milk, in destroying the poison of arsenic in the stomach, or counteracting its effects. We have already mentioned the expectation we had entertained of its dissolving the viscid mucus in this organ, and our dis- appointment. Some experiments, recorded by Gaber, in the Turin Transactions, seem to support its utility in this respect; but they were not made on the mucus "of the stomach. In leucorrhcea, it has been supposed to be very beneficial. Perhaps the idea of its dissolving viscid fluids oc- casioned its being employed in intermittents, in pleu- risy, in mesenteric and other scrofulous tumours, in rheumatism, and gout. We see Kempf seriously en- gaged in examining its solvent power on the pleuritic crust of the blood ; and the step from calculous to arthritic concretions Avas too obvious to be overlooked. We cannot deny its utility in gout; but in the other complaints it is certainly of very little importance. If it possessed any poAver in dissolving viscid mucus, it Avould very probably be a more useful anthelmintic than it has been found. From its astringent poAver it has been an useful ap- T r C A L 322 C A M plication in old ulcers; and from thence it seems to have been supposed serviceable in scurvy, in cancer, and in internal ulcers, when swallowed. Names of un- common celebrity have given a sanction to its use in these complaints; and Vogel, in a dissertation publish- ed at Gottingen in 1769, speaks of its efficacy in cancer, given in the quantity of six and eight ounces of lime Avater, Avith as much common Avater, boiled with sarsa- parilla or guaiacum; interposing, every four or eight days, Beecher's balsamic pills. In Germany it has been very generally employed in internal ulcers of the uterus, the bladder, and even in ulcers of the lungs. In the latter, however, we are in- formed by Quarin that it is useless or hurtful. Gir- tanner recommends it as an injection in gonorrhoea; and, from the time of Hippocrates, it has been used as a lotion in all the variety of chronic cutaneous erup- tions, especially if attended with exudations. For this purpose it is also taken internally; and it has been re- commended to nurses, to prevent the child from being affected. Indeed, cutaneous eruptions are very in- timately connected Avith a disordered state of the sto- mach, and often with a redundant acid. As an astrin- gent it has been applied externally with a sponge to dropsical swellings ; and Fabricius, ab Aqua pendente, informs us, that he cured an ascites by frequently ap- plying a sponge moistened with lime water to the ab- domen, and confining it with a tight bandage. Of its lithontriptic power we have spoken at some length in the article Calculus, q. v. We find numerous cautions in various authors re- specting its use in different situations Avhere they sup- pose it to be injurious. We have already mentioned, however, the inconveniences that might result where the stomach and bowels are loaded with bile; and we should suppose it likewise improper in all cases of hec- tic fever. We are told, however, that it must be also avoided in all fevers; in hot climates; in dry and hot temperaments; in congestions of blood, either affecting the head or kidneys; in spasms; in the early stages of dysentery; ' in orgasms of the blood, and discharges depending on them ;' in inflammatory habits and tense fibres ; in obstructions of the bowels, or any diseases in them arising from scybala, till these are removed. Caution is at all times requisite; but we do not think it a medicine of so great power as to require so much attention. The last remark, we would, however, wish to enforce. See Creta ; Neumann's Works ; Experiments, &c. on Quick Lime, by Mr. Henry; Macbride's Essay on the dissolving PoAver of Quick Lime; Percival's Essays, Med. and Exp. edit. 2. p. 328; Lewis's Mat. Med ; and the Edinb. Ess. Phys. and Lit. vol. i. art. 13. and vol. ii. art. 8. Dr. Whytt on Oyster Shell Lime Water. CA'LX ANTIMONII. See Antimonium. Ca'lx cum ka'li pu'ro. See Causticum commune fortius. Ca'lx hydra'rgyri alba. See Argentum vivum. CALY'PTER, (from xxXvxlu, to hide). A carnous excrescence covering the haemorrhoidal vein. CALY'PTRA, (from xxXvttIu, to hide). A veil. It is the thin involucrum or cover of some seeds, used by former botanists to express that which Linnaeus means by arillus: also a thin cup which covers the an- there of some of the mosses. CA'LYX, CALIX, or EMPALEMENT, (from **- Xwla, tego, to cover). The first of the seven parts of fructification, by Linnaeus defined to be the outer bark of the plant present in fructification. In general it is that green cup which supports the bottom of the corolla, and is otherwise called pcrianthium or cup, involucrum, amentum or katkin, spatha or sheath, gluma or husk, calyptra or veil, volva or curtain, as it happens to be differently circumstanced. It is generally single; in some plants double; and in others entirely wanting. It is com- monly divided into the same number of segments with the corolla. The calyx commonly withers Avhen the fruit is ripe, which distinguishes it from bractee in du- bious cases. It is generally less in point of height, but more substantial than the corolla. CAM. An abbreviation of Joach. Camerarius de Plantis Epitome. CA'MARA, or CAMA'RIUM, (from xxpxpx, a vault). The fornix of the brain. LikeAvise the vaulted part of the auricle leading to the external foramen. Ca'mara. See Viburnum. CAMARO'MA, CAMARO'SIS, CAMERA'TIO, (from xxfAMpx, a vault,) an arched roof; a fracture of the skull, which appears like an arch of a vault. CA'MARUM, vel CA'MMORUM, (from xxftxpx, a tortoise). A species of shrimp of the crab kind, which has a shell like a tortoise; also the aconites, and, ac- cording to some authors, cicuta. CAMBING, a tree of the Molucca islands, whose genus is unknown, but whose bark has been recom- mended in dysenteries. CAMBODIA, CAMBO'GIA, CAMBO'GIUM, (from Cambogia, from whence it is brought). The In- dian yellow orange of Malabar, coddam pulli. It is the garunia Cambogia of Gaertner, the Cambogia gutta Lin. Sp. PI. 728. The fruit is slightly acid, and supposed to be astringent. See Mangoustan. CA'MBRO BRITA'NICA. See Cham^morus. CAMBU'CA, or CAMBU'CA MEMBRA'TA. Bubo, ulcus, or abscess on the pudenda; also a boil in the groin. CA'MBUI. The wild American myrtle of Piso and Marcgraave. There are two species. Their fruit, flowers, and leaves, are fragrant and astringent. One species is low and bushy, the other very tall. Ray says there is a third species which is white, but is very rare. CAMELI'NA, (from xx^Xos, a camel; because they are fond of it). See Erysimum. CAMERA'TIO. See Camaroma. CA'MES, or CA'MET. See Argentum. CA'MINGA. See Canella alba. CAMI'NUS. A furnace and its chimney. In Ru- landus it signifies a bell. CAMI'SIA FCE'TUS (from the Arabic term kami- sah, an under garment). See Chorium. CA'MMARUS. The lobster, or cray fish ; so named from the shape of its shell. See Cancer ' fluviatilis. CA'MMORUM, (quia homines xxxu popa perimat,) nightshade-; because if eaten it destroys in a deplo- rable manner. See Camarum. CAM 323 CAM CAMO'TES I'NDICA. See Battatas Hispa- NICA. CAMO'MILLA, corrupted from Chamemelum, which see. CAMPA'NA. A bell; so called because Paulinus, the bishop of Nola in Campania, first used bells for religious purposes. In chemistry it is a receptacle for the gas of sulphur, where it is concentrated and col- lected together into a fluid, the oleum sulphuris per Campanam, Avhich is only the modern sulphuric acid. CAMPA'NULvE, (a dim. of Campana). See Cer- vtcaria. CA'MPE, (from xx^.t1u, to bend). A flexure or bending. It is also used for the ham, because it is the part usually bent; and for a joint, or an articula- tion. CAMPECHE'NSE LI'GNUM ; brought from the bay of Campeachy in America. Logwood ; also call- ed Acacia Zeylanica, lignum Campcscanum, sappan lignum, tsiam pangam, lignmn Ca7npechianum, Indi- cum montanum lignum, lignum tinctile Campech. Cam- peachy, Brasil, or Jamaica wood. It is the wood of a prickley pod bearing tree, a native of Campeachy island. It is brought to Europe in large compact logs of a red colour. Its fruit resemble cloves in their quality. It is the he7natoxylon ca7n- pechianu7n Lin. Sp. Plant. 549. Nat. order lomenta- cee. H^mato'xylox, (from atpx, blood, and %vXov, wood,) also called erythroxylon. This wood, of which the tree is a native of Honduras, is chiefly brought for the dyers, but used medicinally as an astringent or corroborant. It is peculiarly efficacious in diarrhoeas, and in the last stages of dysentery. When the obstructing causes are removed it restrains the dis- charge, without contracting the fibres like astringents : it sheaths acrimony, and its astringent taste is combined with a sweetish mucilaginous one; strengthens the boAvels, and perhaps the general habit. It is an agree- able medicine, being free from any thing disgusting to the taste, and almost void of smell. The London college direct a pound of the shavings of logwood to be boiled in a gallon of distilled water to one half; this must be repeated four times. The fluids must be mixed, strained, and boiled to a proper con- sistence. The shavings are ordered to prevent it from being mixed with the Jamaica, or other cheaper Avoods; Avhich might be the case if bought in powder. The dose is from 9 i. to 3 ss. repeated according to the urgency ©f the symptoms. Rectified spirit of Avine takes up more from this wood than Avater; therefore it is better to digest its powder in as much spirit as will cover it three or four fingers' breadth above its surface, then boil the resi- duum in Avater, as directed above. The Avatery men- strua are first evaporated to the consistence of honey, then the spirituous extract, formed by drawing off the spirit, is mixed Avith it. The decoction of logwood is made by boiling three ounces ofpoAvdered logwood in four pints ofAvater to Iavo, at the end of which tAvo drachms of cinnamon are added, and boiled together a feAv minutes. When cool the decoction is strained. Both the extract and decoction are agreeable, mild, and safe, when stronger astringents are less advisable; and may be used Avith equal safety Avhether a fever attends or not. These preparations make the stools and urine appear like blood. The decoction may be taken in the quantity of four ounces three or four times a day. The preparations of this Avood are chiefly held in esteem for their astringency, and may be given safely in fluxes and at the close of dysentery; but in the be- ginning they are hurtful. Cullen. When flatulencies attend in diarrhoeas and dysen- teries, a feAv grains of the cortex elutherise is a proper addition to each dose of the above extract or decoction. See LeAvis's Mat. Med. Neumann's Chemical Works, and Cullen's Mat. Med. CA'MPHO'RA, (from the Arabic term caphura). Camphor; called also caf, cafar, ligatura veneris, caphora; capur, alkosor, altefor; camphor. It is a solid concrete, chiefly obtained from the Avoody part of some trees Avhich are met with in the island of Borneo in the East Indies, and in Japan; it is only from the latter that it is brought into Europe. The Indians have a species, Avhich they distil from the roots of the true cinnamon tree, that they call baros ; (see Cin.vamo- mum;) and also a species which separates from the cam- phore oleum on re-distilling it. It sometimes oozes from the bark of the root of the cinnamon tree in the form of oily drops, which insensibly concrete into Avhite grains : these are called caphura baros Indorum. In the state camphor is extracted from the roots of the camphor tree, it is named camphor a rudis. The Ja- panese cut the Avood of the roots and branches in small pieces, and boil them Avith Avater in an iron pot. The camphor sublimes in a clay head in friable, granulated masses of a yellowish or dark colour, like the coarsest sugar, mixed with stnrw, 8cc. The Chinese macerate the branches in Avater, and then place them in a pot over the fire: the contents are stirred with a willoAv rod, on which the camphor concretes. It is obtained chiefly from the laurus camphora Lin. Sp. Plant. 528. Nat. order oleracee. In smaller quantities it is ob- tained from several other vegetables. The thyme, the rosemary, the peppermint, the root of the canella, many of the labiated plants, and the Avhole tribe of the laurels, afford it. As first sublimed or distilled from the Avood, it is of a broAvnish colour, and composed of semi-pellucid grains, mixed with some impure matter; in this state it is imported by the Dutch, then called unpurified camphor. It is purified by a second sublimation, but after a manner only known to themselves, except the Venetians, Avho formerly Avere the only refiners of it. Bomare discovered in Holland that it Avas puri- fied by sublimation. The last process in the manage- ment is so contrived, that the head of the subliming glass is kept warm enough to make the camphor run together into a mass of its own figure, in which form it is brought into the shops. Dr. Lewis says, that it may be purified in sp. vin. rect. by solution, and re- covered from the spirit by distillation, the spirit all rising before the camphor; and after this it may be formed into loaves by fusion, with a gentle heat, in a close vessel. The ancient Greeks do not mention camphor: it Avas first used in medicine by the Arabians. Camphor is a vegetable concrete, Avhite, semitrans- parent, brittle, of a shining fracture, and of a crys- T t 2 C A M 324 C A M talline texture, unctuous to the touch, with a fragrant smell, somewhat like that of rosemary i and a bitter, aromatic, pungent taste, accompanied with a sense of coolness on the tongue: it is volatile like essential oils, but without their acrimony; it also differs both from them and from the sebaceous oils, in suffering no sensi- ble alteration from long keeping, in being totally vola- tile in a warm air, without any change or separation of its parts, and subliming unaltered in the heat of boiling water. It is lighter than water, burns in it Avithout receiving any empyreumatic impressions, nor is it de- composed by any degree of fire to Avhich it can be ex- posed in close vessels, though readily combustible in the open air. It combines with concentrated vitriolic, nitric, and acetic acids, rectified spirit of wine, oils, resins, balsams, alcohol, and aether. Of resins, balsams, and oils, it considerably diminishes the consistence. It does not dissolve, except in a very small proportion, and by the assistance of sugar, in water, in the weaker acids, or alkaline liquors. It melts into an oily ap- pearance with a less degree of heat than that of boil- ing water; laid on a red hot iron it totally evaporates in a bright white flame and copious fumes, which, con- densing, form a soot. As camphor is found in so many different vegetables, it has been generally recognised as a vegetable prin- ciple. It contains an acid united Avith an oil, and the former may be separated by means of nitric acid. In the best camphor some of the essential oil is separated, and the jets of this oil occasion the peculiar motions of the camphor when swimming in water, described by Prevost and Venturi in the Annales de Chimie, vol. xix. Camphor is known to be good, if, when it is put upon hot bread, it turns moist; if it becomes dry it is adulterated : it should be kept close in a bottle or a blad- der, not to prevent it from losing its quality, but to pre- serve the whole of it from being lost by evaporation. As camphor is so useful a medicine, it is necessary to examine its effects on the human machine in the clear- est point of view. The first question is, whether its power is of a stimulant or sedative nature ? Dr. Cullen seems clearly to have proved the last when taken into the stomach: externally it is certainly stimulant, for when taken into the mouth it has an acrid taste, and, though by its evaporation it excites a sense of cold air, what remains is a feeling of heat in the mouth and fauces. When taken into the stomach it often occa- sions pain and uneasiness, which Dr. Cullen imputes to the action of the acrimony upon the upper orifice. When applied to any ulcerated part, it perceptibly ir- ritates and inflames. When thrown into the stomach of brute animals, it operates there by its effluvia; for though it has produced considerable effects on the body, neither the bulk nor weight is found sensibly dimi- nished ; hence he concludes the operations have been upon the nerves of the stomach, and to be entirely that of a sedative poAver. The sudden death of many ani- mals occasioned by it, as experimentally proved, show still more evidently its sedative effects on the senso- rium, destroying the mobility of the nervous power, and extinguishing the vital principle. Camphor first operates by inducing stupor and sleep, and the different symptoms of delirium ; convulsions soon folloAV, and are a part of the same series of sedative effects. It evidently shows no stimulant power on the sanguiferous system; for the pulse, where it has been observed, has been sloAver than before its effects took place by ten strokes in a minute. It is in general also softer and fuller, and a gentle diaphoresis is excited on the skin. As camphor then seems to repress inordinate or ir- regular actions in the sanguiferous and nervous systems, while without any very striking or perceptible stimu- lus it determines to the skin, we may expect to find it highly useful in those affections where the action of either system is disturbed. If, however, we were to judge from its effects in diseases, Ave should pronounce it to be rather a stimulant than a sedative antispasmo- dic ; since, when the actions are irregular and excessive, it requires more caution, and some additions of a re- frigerant nature. No stimuli, on the contrary, are apparently required when the irregularity is attended with defective energy. It has been long since employ- ed in inflammatory fevers, particularly when attended with delirium ; but, in this state, the addition of nitre has generally been found necessary. When the deli- rium is violent, the doses which may be given, after due evacuations have been procured, are considerable; but, in general, an equal dose of nitre is necessary. This medicine is more convenient, as in the state which connects the more inflammatory with the lower or more putrid periods of the disease it is well adapted to each, if, on the one side, the nitre is omitted, and on the other, cordials are avoided. In the irregular delirium of the nervous and putrid fever it is highly useful; and while at any period its effects are assisted by the antimonial poAvder, so in these it may be ad- vantageously combined with the aromatic confection, or, in a later stage, with volatile alkali. In short, we know no medicine that, with different additions, is so well adapted to every period of fever: it is soothing, calming, and composing. It prevents opium from pro- ducing irregular action in the brain; it prevents bark from inducing stricture on the skin; and stimulants from exciting a dry and uncomfortable heat. In the lowest pestilential fevers it is said to act as a cordial: in fact, it relieves the internal accumulations by its ten- dency to the surface, and seems to give strength when it only takes off oppression. These are its effects, not collected from books, but from experience; not sug- gested by theoretical speculations, but from attentive observation at the sick bed. Yet camphor has been said to be useless; an opinion which must.be the result of prejudice, since it has been offered by those not without discernment, not Avithout experience. From the same train of reasoning we might suppose it highly useful in inflammatory or putrid sore throats. It has undoubtedly been found so, but the topical sti- mulus in the first instance has occasioned it to be swal- lowed with difficulty ; and in the second, the necessity of giving the most active tonics and stimulants in the largest doses that can be taken, has often precluded the use of camphor. Yet it has been employed with suc- cess, though, for the reasons just assigned, Ave cannot speak of it from any very extensive experience. If we pusue inflammations to the chest, we shall still find it an useful auxiliary. In pleurisy we seldom want its aid; and in the earlier stages of peripneumony the most active refrigerants are necessary. Yet, when the excess of inflammation is diminished, when the akin CAM 325 C A M remains dry, and expectoration does not come on, cam- phor, with antimonials, is highly useful. Common practice prefers, as we have foranerly said, the kermes mineral, perhaps with reason; for should it not act as an expectorant, it will not so readily prove laxative; an effect always to be dreaded in peripneumony, as it checks expectoration. In the putrid peripneumony, cam- phor is the chief remedy. Though this disease is un- common, it has been the author's fortune to Avitness four extensive epidemics of this kind; and camphor was among the most generally useful remedies. We find little room for this medicine in gastritis or enteritis; but in the peritonitis puerperarum it is highly beneficial. This inflammation is not, however, confined to the puerperal state: we have often seen it, with no very dissimilar symptoms, in each sex, unconnected with parturition; and have found the camphor equally useful. In inflammations of the kidneys and bladder it seems a very efficacious medicine; yet chiefly appli- cable to that chronic inflammation of the neck of the bladder which often takes place from acrimony, or sometimes from abraded mucus. On the bladder and the genital system its sedative poAver is considerable, without the slightest mixture of stimulus; and, not to return again to the subject, we may remark, that in that Aveakened, irritable state of the genital powers, from excessive or unnatural indulgencies, it is essen- tially useful. In inflammations of the joints it has been commended, particularly in gout and rheumatism; yet we know of no very decided instances of its efficacy. In inflammatory rheumatism,with nitre and antimonials, it may be useful. In the exanthemata, camphor is a medicine of singular utility. In confluent small pox, and particu- larly in repressed eruptions, it is peculiarly useful from its determination to the skin, without any injurious stimulus. In scarlatina, that equivocal disease, which, with the most violent external heat, is often putrid, it is equally advantageous:-and, in plague, it has been highly extolled by those who have had more numerous opportunities of observing its effects than have been offered to us. In the putrid measles we should sup- pose it, from analogy, to be useful; but we recollect no instance of its employment in this disease, and it has never occurred to us. We have said, that, with its power of diminishing ir- regular action, it leans rather to the side of a stimulant than a sedative power. Thus, in mania, Avhere it has been employed with success, it is necessary to add nitre or the acetous acid. In convulsive disorders it is seldom trusted alone, but it has been advantageously joined with the metallic tonics. In convulsive asthma it has not been often employed; and the stimulus of its oil on the cardia has often rendered it inconvenient in hysteria. United, hoAvever, with the warm gums, it has been, in our hands, very useful. When joined to other medicines, it adds to their effi- cacy, or corrects the inconveniences they might other- wise produce. Thus, in fevers, as we have said, it greatly assists the action of opium : it promotes the solution of gum resins, resins, and oil. By this power it may probably mitigate the acrimony of drastic pur- gatives, a quality assigned to it by many authors. By the same effect it assists the absorption of mercurial ointment; and sometimes seems to render it, by ex- ternal friction, an useful antispasmodic. It has been said to mitigate its action; but this is probably unfounded. Camphor has also been supposed to correct the incon- venient stimulus of cantharides; yet we suspect that it rather, by its sedative power, relieves the inflammation they excite. When united Avith them in the blistering plaster it seems not to prevent strangury. It has been said, by a French author, that camphor may be given in a clyster, in a dose of two drachms, in inflammations, or other irritations of the bladder or uterus. We once injected a drachm, and at another time, half that quantity, but from each an alarming coma was produced. The patients were, indeed, re- lieved; but at the expense of such anxiety, that we have never dared to repeat the practice. Externally applied, it has been useful, in very small proportions in ophthalmia; and in external tumours, united with spirit of Avine. In this form, also, it has been used with fomentations to gangrened parts with success. The dose of camphor has been variously directed. It has been said that it should either be given in large doses not under twenty grains; or if in smaller, that they must be repeated at short intervals, should any sensible effects be expected. This, however, is too vio- lent. In fevers, such large doses would be injurious from too great irritation, and we can seldom venture above six or eight grains. In nervous disorders this dose may be doubled: and in mania, twenty grains will not be too much. It may be divided and rubbed with nitre or sugar, and a few drops of spirits of wine; or united with mucilage of gum arabic, the camphor pre- viously dissolved in a little spirit of wine, or expressed oil. Camphor, mixed with equal quantity of myrrh, makes an uniform solution in aqueous fluids; and this is the best mode of giving camphor in a liquid form, where myrrh may not be thought an improper combination with respect to the intent which we wish to produce. With the gum pills it readily unites, and it may be also formed into a convenient mass with the conserve of hips or stiff mucilage. This conserve most effectually covers it, if the form of a bolus is preferred. An imprudent dose of camphor produces coldness of the extremities, vertigo, a small weak pulse, drowsi- ness, uneasiness about the precordia: but these effects are relieved by an emetic, followed with small doses of vinegar or other vegetable acids; and sometimes by mucilaginous drinks. The camphorated emulsion may be prepared by adding a drachm of camphor to a pint of the almond emulsion, now called lac amygdale, almond milk ; to mix the camphor, it will be necessary to use an addi- tional quantity of the mucilage of gum arabic : a large spoonful, or more, may be given every two hours. Ni- tre, or acids, may be added, as the occasion may require. In the camphorated julep, little more than the smell of camphor is retained. The dose, in its best state, does not exceed a grain and a half. The London college direct the following preparation of the camphorated mixture. Take of camphor one drachm; rectified spirit of wine, ten drops; of double refined sugar, half an ounce; of boiling distilled Avater, a pint. Rub the camphor first with the rectified spirit, then with the sugar; lastly, add the water by degrees, and strain the mixture. Thia C A 31 326 C A N is better made by mixing the ca7nphor with double its quantity of gum arabic, for thus it is less apt to irritate the stomach; a large spoonful contains about a grain of camphor. Vinegar may be added instead of Avater; as it renders the camphor more agreeable to the sto- mach, improves its antiseptic poAver, and renders it, according to Mr. Parteger, more successful in mania. The emulsion and the mixture of camphor are useful in Ioav and putrid disorders, being, in these cases, the lightest and best cordials, especially for women or fee- ble men affected Avith spasmodic symptoms; and this effect shows, that the medicine may be useful in the smallest doses. The London college also order the folloAving cam- phorated spirit for external uses: Take of camphor, four ounces; of rectified spirit of wine, a quart; mix them so that the camphor may be dissolved. This is often successful in removing pains, inflammations, numbness, or palsy, by rubbing the part affected with it. An ounce of camphor will dis- solve in an equal quantity of spirit; and in these solu- tions it does not evaporate, for the spirit must all be eva- porated before the camphor will exhale. The spiritus camphor a tartarisdtus, is made by mix- ing equal parts of camphor and salt of tartar in a proper quantity of proof spirit, and drawing off one half. But this preparation does not possess any advantages above the sp. camphoratus. The college of London used to add 3 *• of camphor to lb i. of the white ointment, and called it ung. alb. cam- phorat.; but have now rejected it, though it is esteemed as cooling, emollient, and discutient, and useful against cutaneous heats, tettery, or serpiginous eruptions. Different preparations are called oils of camphor, several of which may be seen in Neumann's Chemical Works, and other writers; but they do not appear to possess any peculiar advantage above the crude camphor. CAMPHORS LINIME'NTUM AMMONLV- TUM. See Ammonia. Ca'mphor.e elix. Hartma'nni, i. e. Spt. Camphora cum pauxillo croci Anglicani. CA'MPHORiE flo'res. The subtile substance which first ascends in subliming camphor. CA'MPHORiE flo'res comp. The compound flowers of camphor, made by subliming eight parts of camphor with one of the flowers of benjamin. Ca'mphor.s o'leum. See Cinnamomum. CAMPHORA'SMA,(from camphora, so called from' its smell). See Melissa turcica. CAMPHORA'TA, (from camphora, so called be- cause it resembles it in smell). Stinking ground pine, called also cham^peuce, and camphorata hirsuta. Camphoros77ia Monspeliaca Lin. Sp. PI. 178. It is a Ioav plant, a native of the Avarmer parts of Europe, smelling like camphor, but more disagreeable. It is much esteemed in fomentations against pain, and com- mended in gouty complaints. Miller's Bott. Off. CA'MPHORATS, (from camphora). Campho- rats. Salts formed by the union of the camphoric acid Avith different bases. CAMPHORA'TUM O'LEUM. A mixture of olive oil, two parts, Avith one of camphor: of use in inflammatory SAvellings of the throat, if mixed with a proper cataplasm and applied to it. In ascites, when the abdomen is much distended, if rubbed on freely every night and morning, it is supposed to be useful. See Neumann's Chemical Works, LeAvis's Mat. Med. Alexander's Exper. Essays, Rieger and Hoffman on Camphor. CAMPHO'RICUM A'CIDUM. Camphoric acid is produced by distilling the nitric acid, six or eight times, from camphor. It is a crystallized salt, which reddens syrup of violets and the tincture of turnsole; of a bitter taste, and differing from the ox- alic acid in not precipitating lime from the muriatic acid. CA'MPSIN. The Egyptian name for the south wind. See jETESLfli. CA'MPULUM, (from xxy.7rlu, to twist about). A distortion of the eye lids, or other parts. CA'NABIL. See Eretria. CANABI'NA AQUATICA. See Bidens. CA'NABFS I'NDICA and PEREGRINA, (kanaba, from kanah, to mow). See Bangue and Cannabis. GANADE'LLA. See Channa. CANADE'NSE BA'LSAMUM. See Balsamum and Abies. CANALI'CULUS, vel CANALIS ARTERIO'- SUS. Dim. of Canalis. See Arteriosus ductus. CANA'LIS, (from canna, a reed). A canal. It is also a round IioIIoav instrument for embracing and holding a broken limb. Hippocrates speaks of its use, and Scultetus represents different sorts in his Anna- mentarium, part. i. tab. 23. According to Gorraeus, canalis signifies the hollow in the spine, which contains the medulla. Cana'les semicircula'res. The semicircular canals of the ear. They are three in number, one superior and perpen- dicular, one posterior and perpendicular, and one hori- zontal; their size is nearly the same, but generally the superior perpendicular is the largest. They begin in the vestibulum, wind round the bone, and terminate in the vestibulum again: each at its origin has a sepa- rate orifice, but the two perpendiculars meet and return into the vestibulum by one common orifice. That these ducts contribute to hearing, appears from their being found in birds and fishes, though the cochlea is not found in either. Cana'lis semis, petros. The bony half canal. See Auditus. Canalis veno'sus. The vein of the funis umbi- licalis proceeds from the placenta to the navel of the child, and thence to the vena porta, with which it communicates by its main trunk, where there is a canal, which goes to the vena cava hepatica. It is called ca- nalis, and ductus venosus ; it runs betAveen the lobulus Spigelii, and the left or small lobe of the liver. This duct enters the vena cava hepatica of the left side, just Avhere it pierces the great trunk of the vena cava in- ferior. CANA'NGjE O'LEUM. (Indian.) Hoffman men- tions this oil as being scarce, and brought from India, adding that it is distilled from the flowers of the lime tree. It is in reality from those of the uvaria Lin. Sp. PI. 756. The species u. aromatica is not found in his system. See Hoffman's Obs. Physico Chim. and in his Med. Rat. Syst. vol. i. § ii. cap. 6. CA'NCAMUM Graco'rum. See Courbaril CAN 327 CAN CANCE'LLUS, (dim. of cancer, a crab). The wrong heir, also called Bernhardus eremita, cancer in testes degens. It is a small species of cray fish, which the French call Bernard the hermit, because it shuns others, and retires into the first shell it meets with. It is found in the slime near the rocks, but commonly in a shell of a conic figure, and as large as a nut. There is a larger species in the American islands : it is three or four inches long. They call it the soldier, be- cause it fortifies jtself in a shell which is not its OAvn. Father Du Tertres says, half its body is like a grass- hopper. When hung in the sun they dissolve into a kind of oil, which is supposed to cure rheumatism if rubbed on the part. CA'NCER. The crab, (xxpxivos, from xx^vos, rough, because of the roughness and sharpness of its claAvs. Cancer in Latin corresponds with xxpxivos, the xs-xxos, or the xxpLULxpos of the Greeks, and to the crab in the English). Cancer mari'nus, (from mare, the sea). Is that called the sea crab ; named also pagurus, cancer ma- nas Lin. Cancer fluvia'tilis, (from flluvius, a river). The river crab, or cray fish ; cammarus and gam7narus; cancer astacus Lin. See Astacus marinus. The black tips of the claw of sea crabs are levigated and used as an absorbent under the name of pulv. e. chel. cancrorum ppt. The London college direct a compound powder, made with crabs' claws, red coral, and chalk; but they all consist of the same calcareous animal earth. Pulvis e chilis cancrbrum compbsitus, is made by uniting a pound of the tips of crabs' claws prepared to three ounces of chalk, and as much red coral. The composition has been considered to be inelegant, for the chela cancrorum consists of a calcareous earth, part of which is combined with the phosphoric acid and glutinous matter; the corallium rubrum contains the same, and these are mixed with chalk, a someAvhat more pure calcareous earth. The preparation is there- fore far from a pure absorbent. The creta and testae ostreorum will better supply the place; and if calca- reous earth is desired to be combined with phosphoric acid, it may be found in the cornu cervi ustum. Ob- servations on the Sp. Alterum Pharmacop. Londinen- sis, 1788. The college of Edinburgh in a former edition direct- ed the following preparation called piilvis .testaceus compbsitus. Take of oyster shells prepared, one pound; and of white chalk prepared, half a pound. Mix. The use of all the absorbent earths, and preparations of shells, is to absorb acidities in the primae viae; and this prescription from the Edinburgh dispensatory is equally valuable as a medicine with any other prepara- tion of the kind, however attended with pompous epithets. If they meet with no acid to dissolve them, they should be accompanied by gentle purges. They are suspected of promoting putrefaction, but produce this effect only by absorbing acid, as we have already explained. If oyster shells form Avith a very weak acid a mucilage, like that Avhich lines the inner surface of the stomach, bladder, and blood vessels, tins mucilage may supply in some measure the want of the natural mucus when abraded. See Lewis's Materia Medica, and Neumann's Che- mical Works. Cancer, (from %xpxivos, a crab). By the term can- cer, the Roman writers understood what the Greeks called gangrene and sphacelus; but the disease which is now called cancer is what the Greeks and Romans meant by carcinoma and carcinos. It is called also lu- pus, because it eats away the flesh like a wolf. See Celsus, lib. v. cap. xxviii. Galen observes, that, as the crab is furnished with claws on both sides of its body, so in the carcinoma, or carcinos, the veins, which are extended from the tu- mour, represent with it a figure like a crab; hence is the disease called cancer. Boerhaave adds, that if the stagnating matter of a scirrhus is put in motion, so as to inflame the vessels situated in its margin, it becomes malignant, and then is called a cancer. With Hippocrates we may, perhaps, most properly consider all the species as comprised in the occult and open cancer. A cancer then is, according to P. -®-, or carus, synonymous Avith sopor, (from xxpx, the head, Avhich is chiefly affected). It is a slight degree of apoplexy, in which some broken incoherent ansAvers are obtained from the patient. When called, he scarcely opens his eyes; yet, if stimu- lated, he hath feeling enough to manifest his uneasi- ness. The Avalnut tree is named from this disease, Caryon, q. v. The coma lethargus, coma vigil, coma somnolentum, cataphora, differ only in degree; but apoplexy is the most violent of these diseases. Galen says, that if the carus oppresses respiration, as in those Avho snore in their sleep, it must be considered as apoplexy. See Coma. Zz CAR 354 CAR Boerhaave observes, that a carus is a slight apoplexy from a hot cause, attended Avith a fever; and a lethargy is a slight apoplexy from a cold cause. Hippocrates sometimes calls this disorder aphonia; Galen, in his Method. Med. lib. xiii. catoche; Coelius Aurelianus, gravatio; and Pliny, gravedo. Dr. Cullen arranges carus as synonymous with apoplexia. In a carus there are insensibility and sleepiness, with quiet respiration. It sometimes signifies a loss of sense and voluntary motion, respiration remaining uninjured. The immediate cause of sleepy affections seems to be a defect of, or an impediment to the passage of the vital principle. The remote causes are, Avhatever diminishes the vis vitae, or that can obstruct its influence; as tu- mours pressing on the brain, a turgescency of the ves- sels from obstructed menses and haemorrhoids, a too free use of spirituous liquors, exposure to offensive va- pours, blows on the head, &c. Co'.ma vi'gil is knoAvn by a burning and extensive pain in the head, attended with a sense of ebullition in it. There is a strong inclination to sleep, but the pa- tient either does not sleep, or awakes immediately Avith little or no relief: there is, however, no delirium. This disorder is always symptomatic, often attends acute fevers, and occasionally is the prelude of a phrensy, sometimes of an hemiplegia. Co'ma somnole'ntum, (from somnus, sleep). In this disorder the patient is languid, and his chief complaint is a constant drowsiness. He often falls asleep at meals, in conversation, and in the midst of business ; and, when awaked, he soon sleeps again. Luxurious old men are most subject to it. It is a primary disorder, and unat- tended Avith fever, but often the first symptom of apo- plexy. This and the former species equally arise from over distended vessels: but, in the coma vigil, the distention is only in a degree to produce irritation; in the second it is increased so as to occasion com- pression. Ca'rus is a profound sleep, from Avhich the patient is Avith great difficulty roused, though he seems sensi- ble of pinching, or pricking him Avith pins, he either does not speak, or he immediately relapses into the same degree of sleep. This disorder is either idiopathic or symptomatic, and often attended Avith a fever. When symptomatic, it is said to be of three kinds; but is only the same disease in the different periods of that com- plaint, of which it is a symptom. The first happens early in acute fevers; and, if convulsions and hic- cough come on, is soon fatal. The second appears after acute fevers; and, when the patient is exceed- ingly weak, the sleep will continue for several days: if it happens in acute fevers on critical days, with a SAveat, and the countenance not changed, it is salutary. The third happens a day or two before death, when, the patient's strength being exhausted, he lies de- prived of sense and motion, as it Avere in a profound sleep, and under it expires. In this state the counte- nance sinks. Letha'rgus, (from Xtiiy, forgetfulness, and xpyos, slothful,) also called veternus, a lethargy ; is a heavy perpetual sleep, with scarcely any intervals of waking. When awakened, the patient answers; but, ignorant or forgetful of what he said, he immediately sinks into the same state of sleep: indeed it is attended Avith such a stupidity and forgetfulness, that whatever the patient begins to do, he forgets to proceed in it, and falls asleep. It is attended with a fever, Avhich is chiefly- discovered by the frequency of the pulse; and does not invade so suddenly as an apoplexy, nor kill so soon. By some it is considered as generally symptomatic; it is often the attendant of fevers, and usually a very dan- gerous symptom. In this disease there seems to be an utter loss of all the rational powers, and inaptitude to motion, Avhence some have named it desidia obliviosa. Dr. Cullen thinks it a symptomatic apoplexy. Bonetus, in his Sepulchretum Anatomicum, observes, that in those who died of sleepy disorders, a copious serum was found diffused through the substance of the brain, chiefly in the cortical part: in some he found the ventricles replete with serum, and the cortical part un- affected ; and these, he says, were never troubled with lethargic diseases. But he observes, that the more this Avatery fluid penetrated into the medullary part of the brain, the more obstinate was the sleepiness during the life of .the patient. In some Avho died of drowsi- ness, he found abscesses, tumours, and scirrhosities of the brain; but these Avere only on its anterior and cor- tical region. In some he found the vessels of the pia mater very much distended Avith blood. The coma vigil should be distinguished from the pervigilium ; each of these disorders from one another; and all from apoplexy, hysteric fits, syncope, and hy- drocephalus. In whatever view Ave consider this disease, it will ap- pear to be chiefly a less violent apoplexy, varying in its degrees rather than its nature or causes. To distin- guish the different species from each other, or from apoplexy, is therefore of little practical importance; but these diseases often so nearly resemble a tit of hys- teria, syncope, or the advanced state of hydrocephalus, that some little attention will be required. The previous state of the patient will point out the hysteric paroxysm. In this last disease, however, the pulse assumes every variety both in strength and quick- ness ; but the constitutions which each affects are very different, and the previous indisposition of the stomach, the attack commencing Avith flatulence, the neck swell- ing, the absence of either a fulness or redness in the face, Avhich occurs when carus proceeds from over dis- tended vessels, or a peculiar sinking in the features, when from narcotic vapours, sufficiently distinguish the complaint. In an hysteric fit the countenance is little altered. Nearly the same symptoms distinguish carus from syncope; to which we may add, that the latter, if com- mon, cannot easily be mistaken; if a single occurrence, the cause will point out its nature. The distinction of hydrocephalus is not so easy. In the early state of irri- tation the disease does not resemble carus : in its latter period, the strabismus, and the slow pulse, sufficiently point out Avater in the head. Yet there are cases where neither occurs, and where even the pupil dilates and contracts. The history of the complaint must then come in aid, and little difficulty will arise. If Ave suppose an error, no great harm can result; and, in doubtful cases, the practitioner should act as if it Avere carus. A more important consideration is, Avhether carus be idiopathic or symptomatic. It is often a symptom only of disordered stomach; and, as we have remarked, it CAR 355 CAR >.s a symptom of fevers. In the whole course of medi- cal practice, we know no case of greater difficulty than the distinction of complaints affecting the head and the stomach with respect to the primary affection. After a long practice, we are often deceived; nor can any precise limits be draAvn. Every case is peculiar to it- self; and the practitioner can only be assisted by an at- tentive examination of the origin and progress of the complaint, the effects of remedies, and the various juvantia and laedentia of the dietetic kind. Even the apparently pathognomic symptom of a noise in the ears is, in elderly persons, more frequently the effect of weakness than of over distended vessels. When a complaint of this kind occurs in fevers, it is, as we have hinted, a dangerous symptom ; and it then seldom arises from over distended vessels, but from weakness. In slow fevers, however, Avhich approach insidiously, this symptom unexpectedly comes on ; and all the evacuants, with every method of rousing the patient, are employed, till the powers of life, at once ex- hausted, yield. We may repeat the metaphor formerly employed, which the young eager practitioner should constantly keep in mind: a gentle gale may animate the flame which a violent wind will extinguish. An attack of apparent carus, or even of its increased degree approaching apoplexy, often happens in young and strong persons from long exposure to the sun. In such cases we have seen leeches, blisters, and the Avhole train of evacuants, employed Avith little success. The disease is in fact a less degree of the coup de soleil; and moderately Avarm stimulants, with tonics, and, above all, rest, Avith patience, are only adequate to the relief. Its immediate cause is obscure; but, what- ever it may be, we are not yet in a condition to ex- plain it. Various preliminary facts must be previously stated. Narcotic poisons and effluvia are more common causes'of carus than of apoplexy. These also require a stimulating plan. Cold water dashed on the surface, oxygenous gas injected into the lungs, volatile spirits applied to the nose, and stimulating cataplasms to the feet, are all necessary. In other respects the treatment does not essentially differ from that of apoplexy. CARO'TA. See Daucus. CAROTIDE'jE ARTE'RIjE. The carotid ar- teries ; from xxpx, the head, or xxpos, sleep; since, when the current of blood is diminished through these ves- sels, stupor folloAvs. From the fore part of the curvature of the aorta, just before the trachea, the right subclavian and the carotid mostly arise in one common trunk, Avhich runs upwards a little Avay, and then divides. The left carotid rises singly, and runs upwards on the side of the trachea. Both these carotids run up as high as the side of the larynx, even to the upper part of the thyroid cartilage, before they give off one branch, and there they divide into the external andTinternal: the latter goes to the in- side of the cranium ; the former, which is the largest, gives branches to all the external parts of the head. The external carotid is anterior, the internal is poste- rior ; the external situated more inward and nearer the larynx. It is the smallest, runs insensibly outward be- tween the external angle of the lower jaw and the pa- rotid gland, which it supplies as it passes; afterwards it ascends on the fore side of the ear, and ends in the temples. It sends off the gutturalis superior, sublin- gualis, maxillaria inferior, maxillaria externa, &c. The internal carotid leaving the general trunk is, at first, a little incurvated. It is situated a little more backward than the external, and generally runs up, without any ramification, as high as the loAver orifice of the great canal of the apophysis petrosa of the os temporis: it enters this orifice, and the cranium, through an irregular aperture in the sphenoidal bone; and, except one branch, which goes to the eye, it is wholly spent upon the brain. See Winslow's Anatomy. CA'RPASUS, (so named srxpx ro xxpov zroi?io~xt> be- cause it makes the person who eats it appear as if he Avas asleep). An herb, the juice of which Avas for- merly called opocarpason, opocarpathon, or opocalpason: according to Galen, it resembles myrrh; but is esteemed highly poisonous. It is not certainly knoAvn Avhat it is ; yet Bruce thought he had found it in a species of acacia, called sassa, which is not poisonous. It differs little from the mimosa Nilotica. CA'RPATA. See Cataputia minor. CARPA'THICUM. From the fresh cones of the trees Avhich yield the common turpentine is distilled a fine essential oil, said to be carpdthicum, or Germanis ileum. CARPERITA'RIA. See Barbarea. CARPE'SIUM, (from xxpvos, fruit). This is an aromatic vegetable; it is often mentioned by the an- cients, and is probably the carpesiu7n cernuum Lin. Sp. PI. 1203. CAR'PHOS. See Fif.num Gilecum. CA'RPHUS, (from xaptpy, a straw). In Hippocrates it signifies a straAv, a mote, or any small substance. It also signifies a small pustule, for the cure of \vhich iEtius, Tetrab. i. recommends rubbing them Avith dried seeds of the herb mercury. CA'RPIA, (from carpo, to pluck off, as lint is from linen cloth). See Carbasus. CA'RPIO, (from carpo, to seize; so called because of its voraciousness). Called also carpa, cyprinus. The carp. Fish of this kind fed in rivers are better than those fed in ponds; and of these the largest and fullest are the best. They live on herbs, slime, and the smaller fishes. They are nutritive, but not highly flavoured, and the fat is indigestible. The head is the finest part of the fish; and of the head, the tongue is the most delicate. CARPOBA'LSAMUM, from xxp?ros, fruit, and PxXtz.ia.ov, balsam). It is the fruit of the tree that yields the balm of Gilead. See Balsamum. CARPOLO'GIA, (from carpo, to pluck, or pull gently). A delirious motion of the hands; as when a patient seems to be gathering something from off the bed clothes, which yet is imperfectly performed, be- cause of the trembling which affects them. It is usually a fatal symptom in fevers. CA'RPOS. (Greek.) See Fructus and Semen. CA'RPUS. Kxp7r&; a Greek primitive, a avrist, called by the ancients brachiale. It consists of eight bones; viz. the os scaphoides, lunare, cuneiforme, pisi- forme, trapezium, trapezoides magnum, and uneiforme. The first three make an oblong head, by which they are articulated to the lower extremity of the bones of the fore arm by arthrodia. The articulation of these three bones, with the bones of the inferior row, is such Zz 2 CAR 356 CAR as allows of motion, especially backAvard and forward, to Avhich the arthrodia of the os magnum with the sca- phoides and lunare greatly contribute. The trapezium on the one side, the pisiforme and cuneiforme on the other, being raised above the rest of the bones of the carpus, make a sort of arch for the secure passage of the flexors of the fingers; and the transverse ligament being extended from one side of the arch to the other, binds them down to their proper place. Lyserus gave the eight bones of the wrist their respective names. The four bones of the second row are all in a line, the first being articulated with the thumb, and the rest with the metacarpus. These bones are very spongy. See Win- slow's Anatomy. CA'RTHAMUS, (from the Arabic term kartham). Bastard saffron. Called also cnicus; crocus Sara- cenicus; carthp.rn.um officinarum; carduus sativus, saf- fron flower; carthamus tinctorius Lin. Sp. PI. 1162. Nat. order cynarocephali of Jussieu. It agrees with the thistle in most of its characters, but its seeds are desti- tute of doAvn. The leaves are oval and pointed : on the tops grow scaly heads, with saffron coloured fistulous floAvers; these are folloAvedby smooth white seeds, of an oblong roundish shape, yet with four sensible corners remarkably heavy, so as to sink in water. This plant is annual, a native of Egypt, and culti- vated in other places on account of its floAvers, which are used in dyeing. It does not arrive at much perfec- tion in England. The seeds have an unctuous sAveetish taste, Avhich on chewing are acrid and disagreeable. With water they form an emulsion by trituration; and to spirit they give out a little nauseous, acrid matter. They are cathartic in doses of one or two drachms.; supposed also to be diuretic and expectorant, particularly useful in humoral asthma, and similar complaints. The flowers are diffi- cultly distinguished by the eye from true saffron, Avhen they are well prepared; but they have neither its smell nor taste. They give to spirit of Avine a deep saffron tincture, and to Avater a paler yellow. After the yelloAV matter is extracted by Avater, the floAvers appear of a red colour, and communicate to spirit of AArine a deep red. Some have the art of preparing the seeds of melons and of cucumbers, so as to resemble the excoriated seeds of bastard saffron; but the genuine seeds are not so Avhite as the artificial. The carthamus lanatus is considered in France as a febrifuge and sudorific. (See Carduus and Atrac- tylis). The carthamus gummiferus of naturalists is the atractylis gummifera of Linnaeus. Its juice is milky, and it concretes in the form of a gum. CARTHUSIA'NUS PU'LVIS, (from the Carthu- sia7i 7no7iks, Avho were the inventors). See Antimo- stum. CARTILAGINO'SUM, (from cartilago, a carti- lage). See Patella. CARTILAGO, (quasi cartilago, from carnis, the genitive of caro, flesh). A substance betAveen muscu- lar flesh and bone. A cartilage or gristle, called also chondros. Dr. Hunter defines it to be a smooth, so- lid, diaphanous, elastic, insensible, inorganic substance. He observes, that in the fresh subject it appears uni- form, and without any visible fibres; when cut in any direction, its surface appears smoothj like wax or glue. On a cartilage there is no periosteum; but it* place is supplied by a similar membrane, styled the perichondrium. Cartilages are the least affected by pres- sure of all animal substances, while the body is living: their substance is firm and dense, and their texture so fine, that, Avhen cut, they appear only like a very stiff jelly. Cartilages are distinguished into three kinds : First, such as supply the place of a bone in an adult, as the trachea; secondly, such as supply the place of bones in young subjects, as epiphyses; and, thirdly, such as are common to the fetus and adult, and are expanded on the extremities of articulating joints. Bones, it is supposed, are only cartilages, into which the calcareous phosphat has been secreted; and, when nitric acid has dissolved the latter, the shape of the bone is thought to be preserved by its cartilaginous substance. This, hoAvever, is not correct, as we have already shoAvn; and the matter Avhich remains after solution is rather membranous, Avith a portion of gelatine attached to the membranes. Cartilages differ greatly from bone. They are inso- luble in cold Avater; but they yield to the Avater at a boiling heat, forming a jelly, and at last a glue. Yet, even to cold water, they impart a small.proportion of gelatine, Avhich becomes sour. The jelly procured by boiling water becomes first sour, and then putrid, but not in a high degree; and the animal matter pro- cured by distillation is much less than from the same bulk of muscular, or almost any other animal, sub- stance. The articulating cartilages cannot be injected to their middle solid part, though the vessels of its membrane are easily filled. The cartilages are supposed to be sup- plied Avith nerves, but they are too minute to be visibly demonstrated. The uses of the articulating cartilages are, first, to prevent abrasion, as without them the continual attri- tion of the bones against each other's surface must have destroyed them; secondly, by their elasticity, they break the force of collision ; thirdly, they serve as indo- lent bodies, to admit of motion and friction without pain. They sometimes answer the purpose of ligaments, oc- casionally of bones. A disease never affects the cartilages primarily. They are incapable of exfoliation; but when diseased from some preceding disorder of the bone, the Avhole is generally affected, and the cohesion between the cartilage and the bone in the joint being less than be- tAveen the parts of the cartilage itself, causes it to sepa- rate from the bone. If a part of the cartilage is destroy- ed, it is never restored. CA'RUI and CA'RUM, also called carvi, cuminum pratense, caros; carawaies. It is the carum carvi Lin. Sp. PI. 378. Nat. order umbellifere. It is a native of the northern climes ; cultivated in gardens with us; but by chance found Avild, and is a biennial plant. Its roots and leaves are esculent. The seeds are Avarm and carminative; have an aro- matic smell, a warm penetrating taste, and are* given in powder from 9j. to 3*j. They dispel Avind, are cor- dial, stomachic, and assist the digestive poAvers; re- commended in dy spepsia, flatulencies, and some hyste- rical and hypochondriacal affections. Carui seeds ex- cite the discharge of saliva, and are said to be emmena- gogue. They are used in palsies: the oil is supposed CAR 357 C A R to be advantageous in tooth ach. In the complaints of children, they are boiled with advantage among the laxative ingredients of clysters. Custom even retains them in those of adults. They differ only from anise- seeds in the peculiarity of their odour. An extract made from a tincture, with rectified spirit, retains all the virtue of the seeds. After infusion in Avater, spirits extract a strong tincture; watery in- fusions are strongest to the smell, and spirituous ones to the taste. When distilled in Avater, all their aroma rises. They afford an essential oil, which is a warm carminative, and given in doses from one to five drops: and there is also a spirit drawn from the seeds. Spiritus ca- rui is made by adding half a pound of bruised carui seeds to a gallon of proof spirit, with a little water to avoid empyreuma, and distilling off a gallon. It has been used as a stomachic; but, by such medicines, the pernicious habit of drinking drams is often incautiously introduced. CARU'NCULA. A caruncle. This word is a diminutive from caro, flesh. A caruncle is a small piece of flesh, or an excrescence that hath the appear- ance of flesh. Thus there are the caruncule lachry- males in the corners of the eyes; the caruncule myrti- formes, which are at the entrance into the vagina, formed, or rather discovered, by the rupture of the hymen (see Hymen); thepapillares caruncule of the kidneys; and a caruncle of the urethra at the orifice, Avhich opens from the vesiculae seminales; besides many others, all which are the productions of nature. The uvula is sometimes called caruncula. Morbid excrescences of flesh are called caruncles, as well as small portions of a fleshy substance sometimes discharged in a dysentery by stool, or in diseases of the urinary passages by urine. Excrescences in the urethra arise from its ulcerated or excoriated sides, by sharp corroding matter lodging there: these are often mistaken for the stone, or occa- sion nephritic symptoms, but are owing to a stricture in the urethra. In this case, when the urine is discharged, it passes from the urethra divided into two or more streams, sometimes only with pain, and in drops; but the only certain proof is, passing a probe or bougie up the urethra, until the obstruction is met with; and if any is found on this side the valve, at the entrance of the bladder, there is reason to suspect caruncles to be the cause. They are cured by the bougie. Bell's Surgery, vol. ii. p. 188. Caru'ncula lachrymalis, is situated between the internal angle of the eye lids and the ball of the eye; it is a small reddish oblong,substance, and hath the appearance of being fleshy, though it is thought to be glandular. The ancients call it glandula lachri/7nalis, also glandula i7inominala. It serves to prevent the in- ternal edges of the lids at that part from coming into contact with one another; and the orifices of the la- chrymal points are kept open, so that the tears pass freely through them into the sac. CARU'NCULjE MYRTirO'RMES, (from myr- tus, a myrtle, and forma, a likeness, because they are like the myrtle berry). They are several small knots or protuberances at the entrance of the vagina; they aic the remains of the ruptured hymen, and, Avhen large, have been taken for cancers. CARUNCULO'SA ISCHURIA. A suppression of urine, from caruncles in the urethra. See Ischurlv, 4th species. CA'RVA. See Cassia lignea. CA'RYA, a Avalnut, (from xxpx, the head, because it is round like the head). See Juglans. CA'RYCE, or CARYCIA. Galen says it is a costly food prepared by the Lydians. Varinus supposes it to be thus called, because it Avas black like the boiled Avalnuts; from xxpvov, the walnut. CARYE'DON, (from xxpvx, a 7iut). See Alphi- tidon. CA'RYL. See Corallodendron. CARYO'CES. A Portuguese name for the fruit of the Guinea palm tree. See also Ady. CARYOCOSTI'NUM ELECT, (from xxpvov, cary- ophillus, and xoe-livos, composed of costus, so named from its ingredients). See Scammonium. CA'RYON. A nut. (From xxpx, the head, from its rotundity.) This word is applied to all such fruit as inclose someAvhat eatable Avithin a hard shell. Plu- tarch says that the ancients called the walnut caryon, because it induces a heaviness and stupidity of spirits; probably derived nxpx to xxpov, from its causing sleep. See Caros. Ca'ryon basi'licon. See Juglans. Ca'ryon heracleo'ticon. A small nut, as a hazle nut or filbert; from Heraclea, in Pontus, whence it Avas brought into Greece. Ca'ryon le'pton. A small nut, as filberts, or hazle nuts; from Xe7rjos, small. CARYOPHYLLA'TA: also herba Benedicta,cary- oph. vulgaris, ga7~yophilla, jana7/iunda, avens, herb bennet. It is called caryophyllata, from caryophillus, because its smell resembles that of clove July flowers. Geum urbanum Lin. Sp. PI. 716. Nat. order rosacee. It is perennial, grows wild in woods and hedges, and is found in flower the greatest part of the summer. The root is gently styptic, corroborant, and stoma- chic; hath a moderately austere aromatic taste, a plea- sant smell, especially in the spring, and when produced on dry warm soils. It has been said to be astringent, vulnerary, and tonic; to cure intermittents Avhere bark has failed. Indeed, it is strongly astringent with some aroma, when recently raised in the spring, and from a dry soil. There is great reason to doubt its efficacy in intermittents, as the experiments of the SAvedish physi- cians contradict those of the Danes and the Germans, who are the great advocates for this medicine. It gives its aroma chiefly to spirits, and its astringent matter to water or to spirit. In distillation with water it affords a small quantity of an agreeable concrete oily matter; and the remaining decoction, if inspissated by evapo- ration, is moderately astringent. Lewis's Mat. Med. Cullen's Mat. Med. CARYOPHY LLATUM A'LCOHOL. See Ca- ries. CARYOPHY'LLI AROMA'TICI, (from xxpvov, a nut, QvXXov, a leaf, and xpoyM, odour). The aroma- tic cloves ; called also garyophyllus, hinka, and clous. It is the unripe fruit, or rather the cups of the unopened flowers, of a tree which grows in the Molucca Islands, of the natural order of the myrtles. In shape, it re- sembles a short thick square nail, of a rusty colour, in- clining to black: in the middle of each clove are found CAR 358 CAR a stylus or stamina, Avith their apices; at the larger end shoot out from the four angles, four little points, like a star, in the middle of Avhich is a round ball of a lighter colour than the rest, composed of four small scales or leaves, which seem to be the unexpanded petala of the flower. The tree is the caryophyllus aromaticus Ian. Sp. PI. 735. It, indeed, seems evidently to belong to the class icosa7idria; and modern botanists are said by Dr. Woodville, though we know not on Avhat authority, to refer it to the genus eugenia. The clove tree is one of those whose flower is produced above the rudiments of the fruit: the ripe fruit, sometimes brought to Eng- land under the name of anthophyllus, or antophyllon, marked on the top with the remains of the floAver, is about the size and shape of an olive, and contains, un- der a thin blackish shell, one or two hard kernels of the same colour, which hath a deep longitudinal seam on the side, composed each of two sinuous lobes; but this fruit is less aromatic than the immature flower. The cloves are said to be cured by exposing them to smoke, and afterwards drying them in the sun. The largest, heaviest, most brittle, and darkest co- loured, are the best, and those which feel oily Avhen pressed. Another mark of their goodness is, Avhen, on piercing them with a needle, a little liquid matter, like oil, oozes out. Those that are of a light brown colour have had their oil extracted. Cloves have a strong but agreeable smell, a bitterish hot pungent taste; arc one of the hottest, and most ' pungent and acrid, of the aromatic class; and have all the virtues ascribed to aromatics in general. When good, they have these qualities in a great degree, and almost burn the throat when swallowed. They are remarka- bly disposed to imbibe humidity; and, when robbed of their active parts, and afterwards mixed with fresh cloves, they regain from them a considerable share both of taste and smell. The Dutch extract the oil from them, and then mix them with others, from Avhich it hath not been separated; but their dryness, less pungent odour, and pale colour, discover the fraud. The Dutch also preserve the fruit Avith sugar, Avhich they eat in their voyage, to stimulate the stomach and prevent scurvy. Rectified spirit of wine takes up all the virtue of cloves: an extract from this spirituous tincture amounts to nearly one-third of the cloves used in preparing it, and retains nearly their whole virtue. Infused in Avater, they give out to it more of their smell than to spirit, but not so much of their taste. Distilled with water, they give over, very slowly,about one-sixth of their weight of essential oil, at first yellow, and afterwards a reddish brown; but if the fire is very moderate, its colour is pale: it sinks in Avater, is mild, and not very pungent; but the only way to have it genu- ine is to distil it ourselves. The Dutch oil is very acrid, and contains near half its weight of an insipid expressed oil. It is probable, that, from an admixture of the resinous part of cloves, this sophisticated oil re- ceives both its acrimony and high colour; or, as fresh cloves are said to yield a high coloured fragrant thick oil upon expression, it may be, that the common oil of cloves, brought from the spice islands, is no other than this oil diluted with an insipid one. In Holland, the oil is distilled by holding the cloves in a moistened cloth over the fumes of hot water. Heat is applied over them; and the oil, dropping through the water, sinks to the bottom. If the oil of cloves is adulterated with an insipid ex- pressed oil, it is discovered by dropping a little into al- cohol; and, on shaking them, the genuine oil mixes Avith the spirit, and the insipid oil, separating, is dis- covered. Cloves are considered to act as poAverful stimulants to the muscular fibres; and, in some cases of atonic gout and paralysis, may supersede most others of the aromatic class. In stomach and chlorotic complaints, they are often of considerable service. Though cloves poAverfully excite the vital powers, they produce no serous discharges, and are accused of inducing consti- pation. In humoral asthmas they are said to be use- ful, and the oil rapidly cures the tooth ach. Its use as a dondiment is well known. Both the spice and oil are used as correctors of some of our officinal compositions. The Dutch join it with bark and cream of tartar, in ob- stinate agues. TAventy cloves are added in poAvder to half an ounce of each of the other, and 5 ss. is given every third or fourth hour. In dyspepsia, also against flatulence, and as a vehicle to other medicines, 3 ij. of cloves are infused in half a pint of boiling water. The dose, one ounce and an half, or two ounces. The oil of cloves is made into an agreeable draught by mixing it with a proper quantity of gum arabic, and then Avith Avater. See Neumann's Chem. Works. LeAvis's Mat. Med. Cullen's Mat. Med. Caryophy'lli sua'vis odo'ris, 8cc. See Canella alba. CARYOPHYLLO'IDES CORTEX CARYO- PHI'LLON PLI'NII, (from xxpvoQvXXov, caryophyllus, and eihs, likeness, from their resemblance to the July floAver). See Cassia caryophyllata. CARYOPHI'LLUS RU'BER, from xxpvov, a nut, and vXXov, a leaf; so called because it smells like the leaves of the Indian nut or clove tree). Hence it is a name applied to many plants of the pink and July Aoav- er kind. Gillyfloaver; also called tunica, vetonica, betonica coronariu, curyophillus hortensis, clove July flower; dianthus caryophyllus Lin. Sp. PI. 587. It is Avell known in our gardens, is perennial, and said to be a native of Italy. There are many varieties; but those employed for medicinal use are of a deep crimson colour, and an agreeable aromatic smell, some- what resembling that of the spice; and this odour is not very soon dissipated. These flowers are esteemed moderately cardiac, diu- retic, and sudorific; but they are chiefly used in the form of a syrup, for the beauty of their colour. The London college directs the following syrup from these flowers. Take of fresh clove July floAvers, Avith their heels cut off, two pounds; of boiling distilled water, six pints: macerate the flowers in the water for twelve hours in a glass vessel; and in the liquid, strained, dissolve as much double refined sugar as is required to make a syrup. It should be observed, that as the beauty of the colour is a principal quality of this syrup, no pressure of the flowers is to be admitted. In St. Thomas's hospital a syrup is made from the aromatic clove, coloured with cochineal. See Lewis's Mat. Med. CAS 359 CAS CARYOPHY'LLUS AROMA'TICUS AMERI- CA'NUS. See Piper jamaicensis. Caryophy'llus horte'nsis. See Caryophillus ru- ber. CARYOPHY'LLUS in'dicus. See Anthelmia. Caryophy'llus vu'lgaris. See Caryophillata. CARYO'TI, (from xxpvov, a nut). See Dactylus PALMULA. CAS GA'NGYTHREB. See Verbena. CA'SAMUM. See Arthanita. CASCARI'LLA. Cascarilla. The Spaniards ap- ply this word to the Peruvian bark, as we apply the word bark to distinguish the same material. It is a diminutive of cascara, the Spanish word for bark or shell; but is applied by us to a peculiar bark, very different from the Peruvian. See Thuris cortex. CA'SCHU. See Terra Japonica. CA'SEUS, (from the Arabic term casah, milk). Cheese. When old, it is called paletyrus. Aristaeus, a pupil of Chiron, is said to have first discovered the art of making it. The ancients were well acquainted with the methods of coagulating milk; and for this pur- pose they boiled it, mixed'it with vinegar, infused the branches of the fig tree in it, or added salt with sour milk. The curd of milk is more or less dense, according as the whey is more or less perfectly separated from it. Its cohesion is never considerable; but the chief art of making cheese consists in separating as perfectly as possible the whey, for a very small proportion of mois- ture accelerates fermentation and putrefaction. Curd or cheese is an albuminous substance, not un- like the white of an egg, or the coagulum of the blood. It dissolves in alkalis, but most perfectly in the caustic mineral alkali; and from its solution a volatile alkaline smell arises. The vitriolic and nitrous acids dissolve it; the marine acid less readily. In hot water it hardens; and cold has no effect on it. If the cheese is good, it melts easily : if poor, it becomes crisp and horny. By distillation, the water which first arises is nearly taste- less, but soon putrefies. In a greater heat the cheese blisters, and yields hydrogenous and carbonated gas, with some ammonia, and a heavy stinking oil. Its ashes contain phosphat of lime and calcareous earth. The curd of goat and cow's milk is solid and elastic; that of the ass and mare less solid; that of the sheep and women almost or entirely fluid. It is a common opi- nion, that old cheese digests every thing, yet is left un- digested itself; but this is without a proper foundation. New cheese digests with difficulty, and when old is acrid and hot. Cheese made from the milk of sheep digests sooner than that from cows, but it is less nou- rishing; that from the milk of goats sooner than either, but is the least nourishing. In general, it is a kind of food fit only for the laborious, or those whose organs of digestion are strong. See Galen de Alim. Facult. Dr. Cullen, in his Materia Medica, a-o1. i. gives a very minute account of cheese, and tells us " the caseous or coagulable part of milk contains certainly a great, if not the greatest part of the nourishment Avhich milk affords, and is in itself the more nourishing the more it is united Avith the oily parts. When the coagulum has the whey taken from it, it becomes a more nutritious substance than the milk it Avas taken from, but will probably be of more difficult digestion. Cheese in its dried state, when made from milk pre- viously deprived of its cream, may be still nutritious, though of difficult digestion ; but made of entire milk must be more nourishing, and of easier digestion; and made of entire milk, with a portion of cream taken from other milk added to it, will be still more nourish- ing, but hardly of less easy digestion, as the oil every where interposed between the parts of the gluten must render its adhesion less firm ; and if cheese is made of cream alone, that will be certainly the most nutritious, and of the easiest digestion." But cheese is not only made of cows' milk alone, but also of the milk of ewes and goats, and often of a por- tion of the two latter added to cows' milk. In all these cases, as the milk of ewes and cows contains a larger portion of the oily and caseous parts, so in proportion as these are employed the cheese becomes more nutri- tious, but at the same time often occasions inconve- nience from its richness. As cheese is employed not only Avhen recent and fresh, but also under A^arious degrees of corruption, so it acquires new qualities ; and, according to the degree of corruption, it becomes more acrid and stimulant, partly by the acrimony thus acquired, and partly by the great number of insects that are very constantly gene- rated in that state. It can then hardly be taken in such a quantity as to be considered as alimentary; and its effects as a condiment influencing the digestion of other food are difficult to explain, though they are commonly admitted. When toasted, it is certainly not easily di- gested by Aveak stomachs; as a portion of the oil is se- parated, and the coagulum rendered horny. In general, cheese, as an aliment, is, as we have re- marked, adapted to the healthy, the strong, and labo- rious. The coagulum always contains a sufficient de- gree of moisture to approach-the putrid state, Avhich is prevented from advancing rapidly, by the close com- pression it experiences. Yet, as a medicinal dietetic, it is often useful, even in debilitated stomachs. In those where acid abounds, good cheese is particularly serviceable; and in cases of flatulence it often relieves. It has been recommended as a diet in leucorrhcea; and we can perceive some connection between this com- plaint and an acid stomach, since absorbents have been recommended for its relief: as a condiment it is well knoAvn, and it has been properly said, that cheese' di- gests every thing but itself; in other Avords, though undigestible, yet by its stimulus, or its antacid power, it contributes to the digestion of the various heteroge- neous substances of a modern luxurious dinner, since a redundant acid is its most frequent consequence. It may be of use to know, that soft cheese relieves that unpleasing sensation often the consequence of an acid, Avhich we express by the teeth being an-edg'e. With respect to its component parts, cheese chiefly differs from the excess or defect of its oily part. The opposite examples are the cream cheeses of Bath, and the scald-milk cheese of the West. In the former, cream is added, and it is of course in a larger propor- tion than from the milk which nature offers. The con- sequence is, that compression is inadmissible; the acid fermentation soon comes on, increased fluidity is the consequence, and from that state it rapidly hastens to CAS 360 CAS putrefaction. The Bath cheese is nutritious, and Ave think easy of digestion. The Stilton cheese is not very different; and the Cheshire, the Gloucestershire, and the BridgcAvater, follow in the order. Each is more oily and nutritious than its successor: each in the inverse order is more stimulating and indigestible, and still more so the farther the putrefactive process is ad- vanced. On the opposite side, the scald-milk cheese contains the curd almost wholly without the oil, Avhich is artifi- cially separated by heating the milk to a degree just below the boiling point. It is hard and indigestible; but Ave may add, that this only is the cheese proper for cements. From its dryness, it does not readily putrefy ; though when putrid it is scarcely more indigestible than in its most perfect state. The Roquefort cheese is soft, mild,- and pleasant. The peculiar excellence of this cheese, from M. Chap- tal's description, consists in checking the fermentation Avhen it has reached a given point; for if neglected, it contracts a disagreeably sour taste. The milk of goats and sheep are only employed. The Swiss cheese de- rives its excellence from a similar management. It is cellular; and the cavities are filled with whey, which is in its passage from the acid to the putrid state. The cheese is also rich, and the peculiar poignancy of this whey renders it such a favourite with the epicure. The smell Avhen toasted is so much heightened as to be ge- nerally unpleasing, except to the sensualist.—But we cannot enlarge this disquisition: these details belong rather to the economical science than to medicine. See Lac CA'SHOW. See Terra Japonica. CA'SIA, i. e. Cassia, (from the Arabic term katsia, and this from katsa, to tear off). Cassia; so called from the act of stripping the bark from the tree. CASMINA'RIS, CA'SMUNAR. See Cassummu- niar. C. B. An abbreviation for Caspar Bauhine. C. B. PIN. Caspar Bauhine's Pinax. C. B. MATTH. Casp. Bau. in Matthiolum. C. B. PROD. Casp. Bauh. Prodromus Theatri bo- tanici. CA'SSA, (from the Arabic term katsa). See Thorax. CA'SSADA. (Indian). Called also cacavi, cassave, pain de Madagascar, ricinos minor, maniot, yucca, 7na- niiba, aipi, aipi7na coxera, aipipoca, janipha, jatropha 7na7iihot Lin. Sp. PI. 1429. Nat. order tithymeloides of Jussieu, nearly related to the crotons. This plant grows in the Avarmer parts of the western world. Its root, which is only used, is called yucca; by the Mexicans quantica7notli; and Avhen prepared into a flour, cassavi. Names for the preparations of the root, in order to make it into bread, are various. See Mandiba. This plant, which is a native, or at least a denizen, of three quarters of the world, is one of the most ad- vantageous gifts of Providence to mankind. It grows in a dry, and in many respects an useless, soil; it is nei- ther injured by seasons nor insects, and the roots of different varieties are fit for use at every period. It is nutritious, and, to those accustomed to the diet, plea- sant, though to the European it is insipid. The plant is poisonous; but the poison consists in a volatile oil, which is easily separated by heat, and its congeneres afford us tAvo medicines of peculiar utility, the cascarilla and the castor oil, both however from plants poison- ous in some parts. The poison of the cassada root is a Avhite milky fluid, highly deleterious. It is found to act as a sedative on the nervous system; for the substance is apparently unchanged, and neither inflammation nor erosion can be discovered in the stomach. Among the varieties cultivated, those which have a tinge of red or violet are most common and most high- ly esteemed. The cassada, when dried, will keep fif- teen years with little change: and Aublet tells us, that ten pounds are sufficient for fifteen days' provision. On adding Avater, it sAvells considerably. The liquor that is pressed from this plant is called 7nanipuera ; the root macerated in water until it is soft is called 7na7idiopiba; of the sediment of this is made a finer flour, called vipeba by the Brasilians, and by the Portuguese farinhafresca ; the undried dressed meal, farinha relada. The soft mandihoca is called puba : when dried over the fire, or in the sun, it is called carima ; and of this good bread is made, which is called musam, or angu, or enfonde. The root of the bitter cassada is poisonous when raw: however, it may be deprived of its noxious qualities, which reside in the juice, by heat. Cassada bread is made therefore both of the bitter and sAveet,by Avashing and scraping the roots clean, grating them into a tub or trough, and squeezing out the juice by strong pressure through a hair bag ; the thinner part of which is eva- porated, and the remainder dried over the fire in a hot stone bason, and afterwards made into cakes. It also makes puddings equal to millet. The small bits which have escaped the grater, and the clods not passing through the sieve, are dried in the stove after the flour is roasted; then pounded in a mor- tar to a fine powder, of which is made soup. It is like- wise used for making a kind of coarse cassada, which is roasted till almost burnt: this, fermented with me- lasses and West-India potatoes, forms an intoxicating liquor, a favourite drink of the natives, called ouycou. With this liquor the poorer inhabitants and Avorkmen are often" intoxicated. It is of a red colour, strong, nourishing, and refreshing; to which the inhabitants are soon and easily accustomed as beer. Of the cassada are made emulsions, ptisans, 8cc. Avhich are used in consumptions, dysenteries, fevers, faintings, against poisons and haemorrhages, both in- ternal and external. The scrapings of fresh bitter cassada are successfully applied to ill-disposed ulcers. The fluid pressed from the cassada contains an ex- tremely fine faecula or starch, of the most beautiful white colour, which, like the starch of Avheat, crackles between the fingers—an adventitious quality in the lat- ter, depending, it is said, on spirits of Avine employed in the manufacture. The cassada starch is used in the preparation of the most delicate dishes; indeed in every art where Ave employ the finest flour. From the cassada, mixed with potatoes, by fermenta- tion, the Americans prepare the vicou : it is an agree- able acid liquor, equally pleasant and wholesome. If the juice of a variety of the jatropha, the cachiri, is boiled with rasped potatoes and sugar, and then fer- mented, a pleasing liquor resembling perry is produced. By a similar method, a kind of white Avine (paya) or CAS 361 CAS cyder (voua-pay a) is manufactured. In these processes, the roots of the cassada suffer a degree of decomposi- tion, probably from fermentation, since they are al- lowed to remain till they are covered with a purple mould. The cassada, boiled with pimento till it ac- quires the consistence of a conserve, is used as a con- diment, and said to be highly agreeable in a variety of sauces. When the cassada is heated over the fire to separate the poisonous oil, it is usually made into cakes; but it is sometimes broken into small grains, and is then sup- posed to be the tapioca. The juice of roucou is an antidote to the poison of this plant. Raii Hist. Encyclop. Britannica. CASSA'LE VU'LNUS. A term signifying a Avound in the breast: (from the Arabian Avord cassa, a breast). CA'SSAMUM. The fruit of the balsam tree. CASSA'TUM, (from xxa-o-x, a harlot; so called from being debilitated by too frequent meretricious commerce). Weak, spiritless; blood that is grumous, and hinders the passage of the circulating blood. It is a word of Paracelsus. CA'SSAVE, CA'SSAVI. See Cassada. CA'SSE, eau de, or eau de casse-lune'tte. It is snoAV water distilled from the floAvers of the cyanus. CA'SSIA. See Casia, and also Senna Alexan- drina. Ca'ssia alata, Lin. Sp. PI. 541. The leaves of this plant are bitter, nauseous in their taste, and supposed to be cathartic. The decoction is recommended in herpes. Ca'ssia cane'lla. See Cassia lignea. Ca'ssia caryophylla'ta, called also piper tavasci, caryophillus aromaticus fructu rotundo, garyophillon Plinii, amomum, clove berry tree, sweet scented Jamaica pepper tree. The bark is called cortex ca- ryophylloides, clove bark, and cassie cortex, cassia bark. Myrtus caryophyllata Lin Sp. PI. 675. The bark is produced in Jamaica, Cuba, and other of the West Indian islands. It is rolled like cinnamon, but is rather thinner, rougher on the outside, and of a dark brown colour. Cassia bark is Avarm and aromatic, resembles the smell of cloves, though weaker, and mixt Avith the flavour of cinnamon; agreeing with cloves in the solubility and volatility of its active principles. Spirit of Avine takes up all its aroma, but carries very little of it in distillation. Water takes up its smell, though imperfectly its taste; and, distilled Avith water, a small portion of an essential oil arises, Avhich resem- bles that of cloves, but is more pungent. A similar bark is brought from the East Indies, un- der the name of culiltawan or culilawan, a compound Malabarian word, which is translated into the Latin by cortex caryophylloides, or clove bark. That distin- guished in Europe by the name of culilawan is thicker than the other, and more of a cinnamon colour, but scarcely differs in smell or taste. The carabacium of Baglivi is probably not very different, and supposed to be a species of laurus. Rumphius observes, that the outer and inner barks of different parts of the tree differ in colour and taste from one another; Avhence, probably, the differences observed in those brought under differ- ent names into Europe. The unripe fruit is the Jamaica pepper. See Piper Jamaicense. vol. I. Ca'ssia fistula'ris, called also cassia 7iigra, cassia solutiva, vel purgatrix, chaiarxambar, canna, fistula, purging cassia. Cassia fistula Lin. Sp. PI. 540. The Alexandrian purging cassia. The cassia fistula is the hard woody cylindrical pod of a tree called pudding pipe tree, Avhich resembles the walnut tree: it grows spontaneously in Egypt and the Avarmer part of the East Indies, and hath been from thence introduced into the West, and is brought to us from the Brasils. The pods are about an inch in dia- meter, and a foot or more in length; externally of a dark brown colour, somewhat wrinkled, Avith a large seam running the Avhole length upon one side, and an- other, less visible, on the opposite side, internally of a pale yellowish colour, divided by thin transverse woody- plates, in a number of little cells, containing each a flat- tish oval seed, with a soft black pulp. The pulp is called by some 7nedulla ; cassia cribra- tra ; cassie atramentum, extractum, and fios ; by others, wild honey, because of its sAveet taste, which is fol- loAved by an ungrateful kind of acrimony; that from the East Indies has a more agreeable sweetness and less acrimony than the West Indian kind. The best pulp is of a shining black colour, sweet taste, with a slight degree of acidity. The oriental pods are also smaller, smoother, and thinner rinded than the occidental, and its pulp is more shining and of a deeper colour. The dry pods, in which the seed rattles, are generally rejected; but Neu- mann thinks that they are scarcely worse than the other, as their humidity only is wasted, and it is thus secured from being mouldy or sour. The best sort, if gathered before it is fully ripe, grows mouldy, and becomes sour or harsh. The pulp of cassia dissolves very readily in water, whether it is moist or dry, but not so readily in spirit of wine. It is usually extracted by boiling the bruised pods in water, and evaporating the strained solution to a proper consistence: the exhaling vapour carries no- thing off. The pulp soon turns sour, so that it should be only extracted in small quantities. Cassia was first used by the Arabians. Where irri- tating purges would injure, it may be safely employed: in doses of a few drachms it is generally laxative, and particularly useful in costive habits and inflammatory cases. According to Geoffroy, it is peculiarly beneficial in those tensions of the belly Avhich attend an imprudent use of antimonials: as a cathartic, two ounces are re- quired, so that it is seldom used; and, indeed, at present it is rarely given by itself, except to children, or pregnant delicate women. The pulp of prunes is recommended to supply its place, as almost equally pleasant and safe. It is sometimes quickened by stronger purgatives, or Avith tartrited antimony, which it decomposes; so that four grains or more of emetic tartar may be taken in a decoction of cassia by those, who, without it, can scarce- ly bear one quarter of the dose. It is supposed to en- hance the purgative virtue of manna: a mixture of half an ounce of cassia with tAvo drachms of manna, is said to purge more than three times the quantity of cassia by itself, or than a yet greater quantity of manna Avhen alone. Cassia, if repeatedly taken, is said to tinge the urine of a yellow, green, or brown colour, according to the quantity given. Bergius, however, informs us, that an 3 A CAS 362 CAS ounce was taken for three successive mornings Avithout such effect. The London college directs the following prepara- tion: Electudrium e Cassia.—Take of syrup of roses, the pulp of cassia, fresh extracted, of each half a pound; of manna, two ounces; of the pulp of tamarinds, one ounce. Beat the manna, and, with a slow fire, dissolve it in the syrup; then add the other ingredients; con- tinue the heat; and reduce the whole to a proper con- sistence. This electuary was formerly called diacassia: the ta- marinds render the taste of it very agreeable, and do not subject it to turn sour. Two or three drachms will prove gently laxative. See Lewis's Mat. Med. Neu- mann's Chemical Works. Cullen's Mat. Med. Ca'ssia lig'nea; called also cassia lignea Malabar- ica, xylo-cassia, canella Malabarica et Javensis, karva, canella Cubana, arbor Jucadice, cassia canella, canel- lifera Malabarica, cortex crassior, cina?no7num Mala- baricum, carva, calihacha, and by the ancients canela, WILD CINNAMON TREE, MALABAR CINNAMON TREE, Ol" cassia lignea tree. The leaves of this tree are, by way of eminence, called Folium, which see. The bark is called cassia lignea, and is brought from the East Indies. This tree is of the cinnamon kind. It is the laurus cassia Lin. Sp. PI. 528; the cassia, or wild cinnamon tree. Curtis, in his Catalogue of Medicinal Plants, in the London Botanic Garden, calls it laurus Malabathrum. This bark (the best species of which are styled daphnitis) resembles cinnamon in appearance, but is distinguish- able by its breaking short or smooth, while the fracture of cinnamon is fibrous : and by cheAving, when the cas- sia becomes mucilaginous, but the cinnamon austere and dry. It resembles cinnamon in flavour, but is weaker: it contains a mucilage, of which cinnamon does not sensibly partake; if poAvdered, and boiled in water, the Avater becomes glutinous, so as to concrete, on cool- ing, into a jelly. Of the bark, choose that which is small, purplish, easily broken, fragrant, pungent, sweet- ish, and mucilaginous when chewed. Spirit of wine extracts the aroma, and water extracts the mucilage. By distillation in Avater it yields a small portion of oil, Avhich differs not from that of cinnamon; and if care is taken in distilling it with Avater, no differ- ence can be discovered from what it produces, and that which is draAvn from true cinnamon; but if too much heat is continued at the end of the operation, it occa- sions an empyreumatic flavour, because of the mucilage, which is very apt to burn. As a cordial, it is equal to cinnamon, if twice the quantity is allowed for a dose; but to astringent powers it has no pretension. See Neumann's Chem. Works. Lewis's Mat. Med. Cul- len's Mat. Med. Ca'ssia poe'tica lobe'llii, cassia Latinorum, cassia lignea Monspeliensium, and cassia Monspeliensium. See Osyris. Ca'ssia li'gnea Jamaice'nsis. See Canella alba. Ca'ssi.e atrame'ntum et extractum. See Cassia fistularis. Ca'ssia co'rtex. See Cassia caryophyllata. CASSIA'NA. See Cassine. CA'SSIBOR. See Coriandrum. CA'SSIDA, (from its resemblance to cassis, a hood; or helmet); Lysimachia galcriculata; Scutellaria gale- riculata Lin. Sp. PI. 835. Hooded loose strife. Lysimachia cjeru'lea galericulata, or gratiola cerulea, (from Lysimachus, the inventor). Hooded willoav herb. Dr. Turner says it was called tertianaria, from its use in intermitting fevers; it is bitter, stinks like gar- lic, but is never used. CA'SSIDBOTT. See Coriandrum. CA'SSINA, CA'SSINE; also called alaternoides Africana lauri serrate folio, Apalachine gallis, herba cassiana, alaternus. Ilex cassine Lin. Sp. PI. 181. Nat. order dumosa. It grows in Carolina; the leaves re- semble those of senna, blackish Avhen dried, shining in the upper part, and green underneath, Avith a bitter taste, and an aromatic smell. There are two sorts, and, according to Dale, they are the third and fourth species of alaternus. Miller calls the cassine vera Floridano- rum, the South sea tea tree; and the Paragua, the cassio berry bush. Some call the Paraguay, or South sea tea, by the name of Bartholomew's herb. It groAvs near the sea. The trade for this tea is chiefly at Santa Fe, whither it is brought by the river Plata: there are two sorts, the yerba de palos, and a finer and a better sort, called yerba de camini. It is most proba- ble that the yerba de ca/nini is the Paraguay, or South sea tea, and the yerba de palos is our cassio berry bush. The leaves of the cassine are considered as stomachic and stimulant. They are sometimes used as expec- torants; and, when fresh, are emetic. Miller's Diet. CA'SSOB. See Alcali. CASSOLE'TA. A kind of humid suffumigation described by Marcellus. CA'SSONADA. See Saccharum. CA'SSU. See Acajaiba. CASSUMMU'NIAR, called also bengalle Indorumt rysagon, and casminar. The root brought from the East Indies in irregular slices is tuberous, an inch or more thick, marked on the surface with circles or joints like the galangal: it is brown on the outside, and of a dusky yellow within. We have no certain account of the plant from which it is taken. This root was introduced by Marloe as a medicine of uncommon efficacy in nervous diseases; at present it is used as a stomachic, but not so generally as it seems to deserve. It is Avarm and aromatic, slightly bitter, in smell resembling ginger, or zedoary, from which it dif- fers in being milder. Spirit of wine extracts all its virtue; and, if the tincture is evaporated, it remains in the extract. Lewis's Mat. Med. CASSU'TA, (from the Arabic term kesut). See Cuscuta. CASTANEA. Chestnuts, (from Castana, a city in Thessaly from whence they were brought). Called also lopima, mota, glans Jovis Theophrasti, Jupiter's acorn, and Sardinian acorn. Fagus Castanea Lin. Sp. PI. 1416. The coat between the kernel and shell is astringent; the kernel is indigestible, and supposed to be astringent; but if roasted and mixed with honey, it is commended for coughs and spitting of blood. See Aliment. Cast'anea. Fl'ore al'bo, &c. See Coffea CAS 363 CAS Casta'nea equi'na. Horse chestnut. See Hip- rOCASTANUM. Casta'nea ca'stjoe. See Terra Japonica. CASTLE-LEOD WATERS. This mineral Avater is found at Castlc-Leod, in Ross-shire : and at this place a spring of strong sulphureous water has been in great repute for many years. Dr. D. Monro, in his analysis, found a gallon to contain about 59 grains of solid mat- ter ; viz. of absorbent earth If grain; of selenite 261 grains; of saline matter 30-| grains ; the greatest part of which is true Glauber's salt, mixed with a little sul- phur, and probably a very small portion of marine bittern. This water is said to be sensibly diuretic, and sometimes to increase perspiration. It increases the appetite, and sits light on the stomach; sometimes oc- casioning a little headach, but of no long duration, nor to any great degree. Dr. Mackenzie has directed people with various complaints to drink these Avaters; and observes, that cutaneous eruptions have been cleared by their use, the herpes removed, the erysipelas re- ceived benefit, and foul ulcers cured. Dr. Monro asserts, that many of those cutaneous disorders called scorbutic have been removed by their means, and that they cure the itch. As this Avater contains but a small portion of purging salt, and does not operate by stool, all these virtues are very incredible, and are probably the offspring of fancy or superstition. To render them really useful, some purging salt may be occasionally added to the first glass that is taken in the morning; and if equal parts of this and sea water be mixed, they Avill form a purging sulphureous Avater, similar to that of Harrowgate. See Monro, vol. ii. Medical and Phar- maceutical Chemistry. CASTOR, (quasi yxo-gur, from yxtrreg, the belly, because of the largeness of his belly ; or from castrando, because he is said to bite off his testicles, as the supposed object of his hunters). The Beaver, also called fiber, and canis p07iticus. Castoreum russi- cum, materia, in folliculo prope anum sito, collecta. Pharmacop. Lond. Russian castor, from the castor fiber Lin. Systema Naturae. It is an amphibious qua- druped, inhabiting some parts of Prussia, Poland, Russia, and Germany; but the greatest quantities are found in Canada. In the inguinal region of this ani- mal are found four bags, of an oval shape, a large and a small one on each side; in the two large ones is con- tained a softish, greyish yellow, or light brown sub- stance, which in a Avarm dry air grows by degrees hard and brittle, and of a darker and browner colour; this is the castor used in medicine. The tAvo smaller bags have a smell much like that of the larger, but contain a softer and more unctuous matter of but little Value. On cutting these bags, when dry, and brought into the shops, they are found full of a brittle friable sub- stance, of a broAvnish red colour, interspersed with fine membranes and fibres, intimately interwoven. Neumann asserts that the best comes from Prussia; all other Avriters say from Russia, and it is in hard round bags: an inferior moister sort comes from Dant- zic. The worst is from New England, which is in thin long bags. The Russian castor hath a strong but not agreeable smell; the taste is pungent and bitter; the other sorts are weaker and more ungrateful. Castor is ranked among antispasmodics, and is cer- tainly, on many occasions, a powerful one. It has been useful almost in every case requiring such reme- dies, Avhen given in doses of from 10 to 30 grains. In sIoav nervous fevers it takes off the oppression of the precordia, which is often a very troublesome symp- tom. It is by no means a stimulant, but seems rather to relieve by a sedative power. From this it is proba- bly useful in stomach complaints: and if it be an em- menagogue, as authors have supposed, it must be in the hysteric and nervous habits, Avhere the discharge has been repressed from spasm in consequence of a fright, or any similar cause. It has been styled also, Avithout sufficient foundation, an aphrodisiac; but its quality of correcting the uneasy irritation of opium in those with whom that medicine disagrees, is an effect more firmly established. It is used in spasms and con- vulsions of every kind, in the flatulent colic, and in typhus. Joined with camphor, Ave have found it pe- culiarly useful near the conclusion of the more purely nervous fevers. Rondeletius seems to have first made the distinction between these bags or glands of the beaver and his tes- ticles, the part supposed to contain the castor. Alb. Seba remarks, that the Siberian castor is the best, and in succession, the Norwegian, the Swedish, the Polish, and the Canadian. But from whatever coun- try it comes, that which is from a full-grown beaver, hath a fetid, disagreeable smell, an acrid biting taste, a brownish colour, and a friable texture, is the best. It is adulterated Avith dried blood, gum ammoniacum, or galbanum, mixed with a little of the powder of castor, and some quantity of the fat of the beaver. But to detect the fraud, we may remark that the genuine follicules arise from one common source; that the matter contained in them is of a firm consistence, and too bulky to be introduced in their natural state : the smell is not so strong as the genuine. It is, indeed, sometimes difficult to distinguish the false from the genuine; but the sophistication is undoubted, when the membranes, pellicles, and fibres, do not appear inter- mixed with the castor. This drug does not keep well in powder. Rectified spirit, proof spirit, and water, by the help of a little heat, extract its Avhole virtue. Rectified spirit takes up the less ungrateful parts, and water the more nau- seous. Proof spirit acts equally, though with some . difficulty, on both; the sp. ammon. compositus is an excellent menstruum, and in many cases improves its virtues. The London college directs the following Tinctura Castorei. Take of Russia castor, two ounces; of proof spirit of wine, a quart: digest for ten days without heat, and then strain. Dose 3L to 3 hi. Heat only extracts the grosser part more plentifully than a cold maceration, and proof more than a rectified spirit. If it should be wanted to act more suddenly, the tincture of the Edinb. New Dispensatory, 1789, is preferable. R. Castorei Russici §i. asafoetida ^ss. sp. sal ammoniac vinos. it>i. digere per sex dies. Ca'stor. See Cataputia major. CASTRA'TIO, (from castro, to castrate). Cas- tration. This operation, called also celotomia or- 3 A 2 CAT 364 C A T chotomia, is performed Avhen the testicle is scirrhous or cancerous. When the testicle suppurates, it is only treated as a common abscess. Mr. Barnard says, that out of a hundred patients that he castrated, only three Avere living three years after: and that when, after the operation, the wound heals nearly, and not com- pletely, it commonly proves mortal. Some of the most eminent practitioners observe, that when a scirrh- ous is extirpated, it is apt to return like a cancer in the breast. But if the testicle must be extracted, first examine whether or not the spermatic cord is free. Should it not be so, the operation is useless. If not diseased, it must be laid bare, tied, and cut; after which all the diseased part of the scrotum must be dissected. If the tumour is large, or if it adheres to the skin, an oval in- cision must be made, begun a little above the tumour, for the better convenience of tying the vessel. Mr. Gooch (Cases, vol. 2.) first slits the sheath of the cord with the point of a knife, then opens it fur- ther with a small pair of crooked scissors, by which method the vessel is fairly discovered, and easily taken up with a crooked needle and ligature. He adds, that if the whole spermatic cord be tied, the consequences are disagreeable, or perhaps fatal: he, therefore, after dissecting the sheath, secures only the artery, and thus an haemorrhage is prevented, and the usual conse- quences of tying the whole cord avoided. Dr. Hunter long since advised to secure the artery, and leave the rest of the cord; and, indeed, he suggests a sufficient security though the artery should be left untied ; though if it is to be cut close to the ring, he advises to tie it before cutting, that it may not retract too suddenly, and prove troublesome by its discharge. Perhaps the scrotal arteries should be secured previous to the ope- ration. After it, the patient should be kept perfectly quiet, and the wound healed, if sufficient integuments can be saved by the first intention. See Sharpe's Ope- rations. Le Dran's Operations, and his 74th Obs. Heister's Surgery. Bell's Surgery, vol. i. p. 520. CASTRA'TUS, (from castro, to castrate). In botany it means having the filament without the anthera, or part Avhich contains the dust of impregnation. In medicine, those unhappy beings Avho, to preserve the voice from the changes produced by puberty, are thus mutilated in early infancy. In the East, the same operation is prac- tised to qualify them as safe guardians of the women. CASTRE'NSIS. See Dysenteria. CA'SUS, (from cado, to fall out, or occur). This word signifies the same as symptoma ; but sometimes any thing fortuitous or spontaneous; or a fall from an eminence. In Paracelsus it signifies a present distem- per, as well as an entire history of a disease. CATA'BALAM. See Ambalam. CATABLE'MA,(from xx]x£xXXu, to place round). The outermost fillet which secures the rest of the band- age ; also fimbria. Y\\nnoerates,secu7idumGalenum. CATACHLO'OS, (from xxlx, and #Ao(*«, to make green). Galen styles it * a very green colour.' It is applied to stools; and then catachola, very bilious, will be synonymous. CATACHRI'STON, (from xxlx%?iu, to anoint). \ medicine applied by way of unction. CATACHY'SIS, (from xxlxxXeu, to pour out). An affusion. CATACLA'SIS, (from xxlxxXxu, to break or dis- tort) . Galen explains it to be a distortion of the eye- lids. Vogel defines it to be a spasmodic occlusion of the eye. CATACLETS, subclaatcle. According to Galen it is the first small rib of the thorax; from xxlx, below, xXeis, clavis, the clavicle. CATACLI'NES, (from xxlxxXiva, to lie down). See Clinicus. CATACLY'SMA. See Enema. CATACLY'SMUS, (from the same). Embroca- tion. Coelius Aurelianus also interprets it by illisiones aquarum, dashings of water. CATACONE'SIS, (from xxlxxovxu, to irrigate). Ir- rigation by a plentiful affusion of liquor on some part of the body. CAT A'CORES, (from xxlxxpevvvfti, to supersatu- rate). Full, abundant; and when applied to stools, it means that they are purely or intensely bilious. Hip- pocrates uses it in both these senses. CATAGE'MU. See Gambogia. CATAGLY'PHE, (from yXvQu, to cut in wood or metal). An excavation, hole, or pit. Hippocrates uses this word, De Art. et de Morb. CATA'GMA, (from xxlx, and xyu, to break). A fracture. See Fractura. Galen says,' a solution of the bone is called catagma, and elcos is a solution of the continuity of the flesh ; that when it happens to a carti- lage it hath no name, though Hippocrates calls it ca- tagma. See Alphitedon. CATAGMA'TICA, (from xxlxywyu, xxra, contra, xywpi, frango). Remedies proper for cementing broken bones, or to promote a callus. CATAGO'GE, (from xxlxyu, deduco.) In Hippo- crates' Epid. lib. vii. it means a region, and its circum- jacent part. v CATALE'NTIA. See Epilepsia. CATALE'PSIS, catalepsy, (from xxlxXx^Qxvu, to seize, or interrupt). It is also called catoche, cato- chus congelatio ; and by Hippocrates, aphonia ; by An- tigenes, anaudia ; by Coelius Aurelianus, apprehensio, oppressio ; also apoplexia cataleptica, detentio, encata- lepsis, comprehensio. The word catalepsis hath many significations, as perception, or the knowledge of a thing; the reten- tion of the breath, as Avhen a person strains at stool; a retention of any humour which ought to be eva- cuated; an interruption of the blood in the vessels by a bandage, and the disease Avhich is the subject of this article. The catoche is sometimes supposed to be the coma vigil; but most writers mean by it the cata- lepsy. This disorder, with the carus, may be ranked among the species of apoplexy. Dr. Cullen considers it as such, and adds the following remark: ' I never saw any catalepsy but what was counterfeited; and the same has been seen by others. Therefore from the dis- ease being seldom seen, differently described, and often altogether feigned, I know not in what place to fix it with certainty; but, as I am persuaded in general it does not differ from apoplexy, I have therefore placed it under that head,' viz. apoplexia cataleptica, when the muscles are contracted upon being moved by external force. Its seat seems to be in the back part of the brain, from the symptoms of the disease, and the CAT 365 CAT observations made on dissecting those Avho die of it. Indeed its subjects, and, perhaps, the symptoms, do not essentially differ from chorea, since the tonic and clonic spasms originate from the same or similar causes; and chorea we shall find to be truly apoplectic. Women of a melancholy habit and a very active imagination are most subject to it, especially if exposed to bad weather in cold climates after being heated. The immediate cause of this and other spasmodic diseases, is an irregular distribution of the vital influ- ence from debility. The predisposing cause is an irri- table system; and the exciting suppressed perspiration, or a disordered stomach : noxious vapours, and bad smells, have been accused, but, Ave suspect, without sufficient foundation. This disorder rarely occurs : the fits generally seize the patient at intervals, and last usually a few minutes, though sometimes they continue for some hours or days. It is rarely preceded by any signs that indicate its ap- proach ; in a few instances a stiffness in the neck, or a dull pain in the head, has ushered in the fit. In the disorder the patient is without sense or motion, con- tinuing in the posture in which the fit attacked him, until a recovery from it: the limbs are moveable by another person; but, however they are disposed, the patient never alters their position until the paroxysm is at an end. He neither sees, hears, nor feels, Avhat- ever methods may be used to excite the sensations. He swallows greedily all that is given him; the coun- tenance becomes florid ; the eyes are open, seemingly fixed upon some object; at the close of the fit he fetches a deep sigh, and then recovers. Other symptoms at- tend different patients, or the same at different times, such as tears dropping from the eyes, grinding of the teeth, &c. but the above are the most general. Care must be taken not to confound a catalepsy with a tetanus: the latter begins with a stiffness of the neck, Avhich gradually extends to every muscle, and every limb is immoveably rigid. If this disease proceeds from passions, the danger is not so great as when suppressed accustomed evacua- tions, or a foul stomach, are the causes : from sup- pressed evacuations it is mostly fatal. In general the cure will be similar to that of the apoplexy. The in- dication in the fit is, to relax the spasmodic stricture; and, out of the fit, to remove the material or secondary causes, which contribute to the production of the con- striction. In the fit, pungent acid spirits, such as the acetic acid, or the strongest wine vinegar, may be applied to the nose. Forestus strongly recommends antispasmodic oils to be rubbed on the nape of the neck, and on the back part of the head after shaving it. Strong stimu- lating clysters may be injected, if the anus is not too much constricted to admit them. Bleeding is commended, if the face is very red and turgid; but, the heat and strength of the patient will best determine the propriety of this operation. Blisters, though recommended, seem not so eligible an applica- tion as sinapisms to the feet. Two or three spoonfuls of the following mixture may be given at proper inter- vals, either during the fit, or in its absence. R. Gum ass. foetid. 3 ij. aq. puleg. § iv. sp. ammoniae foetid, and tinct. valer. vol. 111 ss. m. The fit is gene- rally transitory, and never fatal. In the absence of the fit, the remedies Avill be indi- cated by the remote causes. The boAvels should, in every instance, be kept regularly and freely open. If, however, fears or other passions of the mind are the causes, medicines cannot be expected effectually to re- lieve ; but, in such cases, a change of air, travelling, diverting company, Sec. are to be insisted on. Elec- tricity has been recommended, and cures from its em- ployment have been recorded. The metallic tonics have also been recommended, particularly the copper and the zinc, though seemingly from no real trials. The catalepsy sometimes ends in a melancholy, epi- lepsy, or fatal apoplexy. See Coelius Aurelianus, Acut. ii. x. Hoffman. British Magazine for March, 1800, and the following numbers. Journal des Savans, Jan. 1776. Histoire de l'Academie des Sciences, 1738 ; and Memoires pour 1742. CATALO'NGAY. The plant that bears the faba sancti Ignatii. CATA'LYSIS, (from xxlxXvu, to dissolve, or de- stroy). It signifies a paralysis, or such a resolution as happens before the death of the patient; also that dis- solution which constitutes death. CATAME'NIA, (from xxlx, secundum, according to, and t*.nv, mensis, the month). See Menses. CATANA'NCE. See Cichorium. CATANTLE'MA, (from xxlxvlxxu, to draw, or pout- water upon). A kind of lotion by infusion in water. Moschion de Morbis Mulierum. CATANTLE'SIS, (from the same). A lotion with hot water, expressed out of sponges, recommended by Marcellus Empiricus against irritable running ulcers of the head. CATAPA'SMA, CATAPA'STUM, (from **?*- jrxo-s-u, to sprinkle upon). The ancient Greek physi- cians meant by this term any dry poAvder, to be sprinkled on the body; called also conspersio, epipas- ton, pas7na, sympasmata, aspersio, aspergines; their various uses may be seen in Paulus of Egina, lib. vii. cap. xiii. Powders valued for their grateful smell Avere called diapasms; and these Avere sometimes added to the drink. Oribasius shows from Antyllus, that e7npas- mata were used in order to restrain sweat, or any other evacuation by the pores; or for exciting an itching. Catapasms, varied according to the intention of the physician, were sprinkled on ulcers; but diapasms were prepared for the sake of their scent, and were ap- plied to the arm pits, and the inside of the thighs. Coel. Aurel. in Morb. Acut. lib. ii. cap. xxxviii. says, that sympasmata were such powders as, being endowed Avith an acrid quality, were sprinkled on the body to procure heat. CATAPA'SMUS. A term used by Ccel. Aurelia- nus, probably by mistake, for some other Avord. It im- plies, according to him, a rubbing of the posterior part of the shoulders and neck downwards. CATAP'ELTES, (from xxlx, against, and -xexln, a shield,) a grenado, or battery : it signifies also the me- dicine Avhich heals the wounds and bruises made by such an instrument. CATAPHI'SMA. A thick poultice of meal and herbs. CATA'PHORA, (from xxlxQtpu, which, among other significations, implies to render sleepy). A pre- CAT 366 CAT ternatural propensity to sleep. Sec Caros. Galen calls a coma by this name. Cata'phora co'ma, i. e. Apoplexia. Cata'phora hydrocepha'lica, i.e. Apoplexia serosa. See Hydrocephalus. CATAPHRA'CTA, (from xxlxtppxr™, to fortify). See Quadriga. CATAPLA'SMA, a poultice, (from xxlxnXxrtru, illino, to spread like a plaster,) also malagma, epipasma, epiplasma. Cataplasms take their name sometimes from the part to which .they are applied, or effects they produce, so are called anacollema, and frontale, when any topical application of this sort is laid upon the fore- head ; but the former Avere always made of agglutinants. They were styled epicarpia, and pericarpia, Avhen ap- plied to the wrists ; epispastica, when the external re- medies only inflamed the skin ; vesicatoria, when it oc- casioned blisterings ; and sinapismata, when mustard chiefly composed them, and the consequences were irritation, redness, itching, and tumour, in the parts to which they are applied! See Blisters. These kind of applications are softer and more easy than plasters or ointments. They are formed of some vegetable substances, and applied of such a consistence as neither to adhere nor run: they are also more use- ful when the heat is to be preserved, or its access pre- vented. See Caloric When designed to relax, or to promote suppuration, they should be applied warm. Their warmth and moisture contribute to this purpose. The proper heat, when applied warm, is that only which excites a plea- sant sensation ; for great heat prevents the relaxation for which they are applied. (See Balneum.) They should be renewed as often as they cool. For relaxing and suppurating, none excel the white bread poultice, made with the crumb of an old loaf, a sufficient quantity of milk to boil the bread in until it is soft, and a little oil, to prevent the poultice from drying and sticking to the skin, and, perhaps, to retain the heat longer than the bread and milk alone would do. The meal of lint- seed is often employed, as it contains the oil intimately united with the farina. To preserve the heat longer, the poultice, when applied, may be covered with a strong ox's bladder. "When designed to repel, they should be applied cold, and ought to be renewed as oft as they become warm : a proper composition for this end is a mixture of oat- meal and vinegar. Epithems are also a kind of cata- plasms. The emollient poultice is made by boiling half a pound of the crumb of bread with one ounce of white soap in a sufficient quantity of cow's milk, to reduce the whole to a proper consistence. Amongst the poor, the bran from wheat may be used instead of bread, adding a small quantity of oil or lard to it. The discutient poultice is made with barley meal, six ounces; the leaves of hemlock fresh gathered and bruised, two ounces; crude sal ammoniac, half an ounce; vinegar enough to give the Avhole a proper consistence. These ingredients should be mixed with- out heat, and applied cold. Catapla'sma efferve'scens. Stir into a strong in- fusion of malt as much oatmeal as will make it of a proper consistence, then add a spoonful of yeast, and mix them well together. By this mode, fixed air is ap- plied to ulcers, cancers, and other locd affections re- quiring poAverful antiseptic remedies. In the applica- tion, room must be left by the bandages sufficient to permit its expansion, Avhich, from the fermentation, will be considerable, or the bandages must be carefully watched, and occasionally slackened. Catapla'sma alu'minis. See Coagulum aluminis. Catapla'sma ace'ti. See Stremma. There are a variety of other cataplasms, all which will be found un- der the respective ingredients from whence they are denominated; as, catapla'sma ro's^e, cu'mini, 8cc. See Rosa, Cuminum, &c. CATAPLE'XIS, (from xxlx7rX*)rcru, to strike). A sudden stupefaction, or deprivation of sensation in any of the members or organs. CATAPO'SIS, (from xxIxtivu, to swallow down). According to Aretaeus it signifies the instruments of deglutition. Hence, also, CATAPO'TIUM, (from the same). A pill. See PlLULA. CATAPSY'XIS, (from xxlx-^v%a, to refrigerate). A coldness Avithout shivering, either universal or of some particular part. A chillness ; or, as Vogel de- fines it, an uneasy sense of cold in a muscular or cuta- neous part. CATAPTO'SIS, (from xxIxttikIu, to fall down). It implies such a falling doAvn as happens in apoplexies; or the spontaneous falling down of a paralytic limb, ex- pressed often by decidentia. CATAPULT'ARUM, Aqua. See Arquebusade. It is the same as Catapeltes. CATAPU'TIA. Spurge, (from xxlxirvSa, or the Italian term cacapuzza, to have an ill favour). Under this name are ranked the Cataputia major ; called also palma Christi, alkerva, ficus infernalis, pentadactylon, granadilla Peruviana, ricinus vulgaris, ag7ius castus; kiki,ricinus Americanus, nha77ibu guacu of Piso, cherva 7najor; common palma Christi, great spurge, Mexico seed, castor; ricinus communis Lin. Sp. PI. 430. It is of the natural order of tricocca, and nearly allied to the croton and jatropha. The order of Jussieu is the tithymaloides. This plant sometimes rises in one year to the height of twenty feet, and is spread into many branches; the leaves expand like a hand, Avith the fingers a little sepa- rated : the flowers are small and in bunches. On the body of the plant there are clusters of rough triangular husks, each containing three speckled seeds about the size of small kidney beans, and in their shells are Avhite kernels of a sweet, oily, and sometimes of a nauseous, taste. These seeds are called grana ragiwn, and were used by Hippocrates, and perhaps before him. If taken in sub- stance they are acrid, and purge violently ; but the oil expressed from them acts gently, though generally with effect. The leaves, when beat and boiled in milk to the consistence of a poultice, are poAverful suppurants, used for dressing blisters, and applied to the tinea of children. The seeds are externally variegated with black and Avhitish streaks, resembling both in shape and colour the insect called ricinus, the tick, whence the name C A T 367 CAT ricinus is given to the plant. The oil is the most valu- able part, and is obtained both by expression and de- coction; the latter is preferred as more mild in its operation. This oil is knoAvn by the names of ol. ricini, alkerva, ol. palma Christi, oleum cicinum kerva, oil of agnus castus, and castor oil. The Greeks call it Atywliov eXxiov, oleum JEgyptium. This oil operates soon after its exhibition, often in two or three_ hours: it seldom gripes, or gives more than two or three stools. It is particularly suited to the cure of costiveness and of spasmodic colic. It is not heating or irritating to the rectum, and conse- quently well suited to cases of haemorrhoids; besides its easily operating as a purge, it is of peculiar use in bili- ous constitutions, in febrile disorders of the same kind; and, by joining it Avith proper cordials, may be used in the low and putrid fevers. Its efficacy exceeds all other kind of purging medicines in calculous complaints, and in all such cases as require the boAvels to be moved, and yet forbid the use of powerful stimulants. In colics, without addition, it is seldom sufficiently active; and even in fevers, as it does not greatly excite the action of the muscular fibres of the intestines, it often passes over collected scybala. See Cathartics. To children it may be given in the manner of an oleo saccharum. Gooch, in his Medical Observations, commends the folloAving method of administering it to adults, and assures us, that tAvo or three spoonfuls, taken occasionally at bed time, keep the boAvels solu- ble, even Avhen the bleeding piles attend. A larger dose, or the above more frequently repeated, is sufficient for a purge on any occasion. R. Ol. ricini ^ i. ss. vitel. ovi parum, probe contritis adde sensim aq. menth. pip. et aq. cinnam. aa. 3 ij- syr. rosae, § ss. m. In the colic, a table spoonful of this oil may be mixed with a little peppermint Avater, and repeated every half hour, or every hour, until it promotes the desired eva- cuation. If the stomach rejects it, the irritability of this organ, should the necessity of a discharge not be urgent, may be previously corrected by opium. In fevers it is cooling and laxative; but in the lower kind of fevers it requires the addition of an aromatic. In the yellow fever of the West Indies it is very useful. When the belly is already too lax from acrid bile, this oil sheaths the acrimony, and thus restrains the exces- sive discharge; in dysenteries it relieves by a similar power. If the symptoms of nephritic complaints and the properties of this oil are considered, its use in those complaints will be obvious, for it purges in small quan- tities, Avithout irritation; it is cooling, and allays febrile heat; it corrects acrimony, and prevents the cohesion of calculous concretions. In gonorrhoeas, the fluor albus, the constipation peculiar to studious and seden- tary persons, &c. this oil is of singular efficacy. The more resinous purgatives often leave costiveness, but the castor oil, it is said, after little use, acts even in less doses. The best method of preventing sickness or nausea, which it sometimes occasions, is to mix one part of tincture of senna to three parts of the oil. In this state the oil is less nauseous to the taste, and sits more easy on the stomach. It is sometimes taken in coffee, sometimes in mutton broth; frequently in an emulsion, mixed by means of the yolk of an egg, with some spirituous Avater, or while swimming on pepper- mint Avater. The dose is a table spoonful, or § ss; but some require double the quantity. Where the oil is rejected, the seeds may be carefully separated from their shells and the inner white membrane, and formed into an emulsion, as an agreeable substitute for the oil. The oil of a pale colour, limpid, and rather inclining to a greenish cast, almost insipid to the taste, with but little smell, and of a thickish consistence, is the best. See Lewis's Mat. Med. Lond. Med. Obs. and Inq. vol. ii. Canvane's Diss, on the Ol. Palmae Christi. Med. Mus. vol. iii. Cullen's Mat. Medica. Catapu'tia mi'nor. Garden spurge. Also called lathyris major, and tithymalus latifolius. All the spurges are acrid : the milky juice, in which their virtue lies, is caustic and cathartic; the root, or bark, prepared by infusion in vinegar, hath been given in the dose of a drachm; three or four of the leaves purge strongly; the milky juice is said to destroy Avarts; but none of this tribe are noAv used, because of their excessive acrimony. Under this article may be ranked the three following, viz. Ricinoi'des (from ricinus, the tick, and eihs, forma ; from its likeness to that reptile). The Barbadoes nut; jatropha curcas Lin. Sp. PI. 1429. Also called pineus purgans, pinhones Indici, carcas nux Barbaden- sis, faba purgatrix, carpata, chiviquilenga, ricinus Americanus major semine nigro, 7nundu bignacu. The fruit is oval shaped like a walnut, and contains oblong black seeds. The tree is a native of America, and also of the East Indies; it grows to a considerable size. The seeds are extremely acrid, and afford an oil that purges, but is rarely used, on account of its activity. AVELLANA CATHARTICA, Or PURGATRIX. The PURG- ING nut. Jatropha 7nultifida Lin. Sp. PI. 1429. The tree is a native of America and the West Indies; and grows to a considerable size. Its fruit is oval shaped, containing roundish, and somewhat triangular, brown- ish seeds, Avhich have but little acrimony, and taste like almonds, but yet operate briskly by vomit and stool. Gra'na ti'glia. Croton tiglium Lin. Sp. PI. 1426. The Molucca grains, so called because they were first brought from the Molucca islands. They are also called croton, and pinus Indica nucleo purgante. The tree is a native of America and the East Indies; the fruit is roundish, containing dark greyish seeds; shaped nearly like those of the palma Christi. They are in- tensely hot and acrid, operate with a degree of virulence both upward and downward; and of the four sorts above mentioned, this is the most active. One drachm of the oil is a strong dose. The wood and leaves of the above five trees and plants are strong cathartics. Hermann says, that the wood of the tiglia, called panava, or pavana, operates violently when fresh,-but when long kept is sudorific. CATARA'CTA. A cataract, (from xxlxpxtrru, to mingle together, or put. out of order; because the sense of vision is confounded if not destroyed). Dr. Cullen places it as a species of caligo, and names it ca- ligo (lentis) ob maculum opacum pone pupillam; and observes, that he cannot agree with Sauvages, that a cataract should be of a different genus from caligo; and leaves it to the judgment of others to determine CAT 368 C A T Avhether he has been right in changing the character of caligo, and placing cataract as its species. A cataract is an opacity of the crystalline humour of the eye, Avhich stops the rays of light from passing to the retina, and preventing vision. Dr. Hunter attri- butes the disease to an inflammation in the coat of the crystalline humour; but M. de St. Yves seems to inti- mate that the crystalline humour is itself affected. Hippocrates called it glaucosis. Galen, hypochysis, and hypochyma; the Arabians, gutta opaca; others, macula oculorum. Celsus, suffusio. It sometimes has the term affusio applied to it; and yXxvxuo-is, or yXxvxufMt., which Galen and most of the ancients say is a dryness or concretion of the crystalline humour. iEtius thinks it a change of the crystalline humour to a sky colour, with a dryness and concretion. More modern authors think that the principal difference be- twixt a cataract and a glauco7na is, that in the latter the crystalline humour becomes hard, and of a sky co- lour (glauci coloris) ; and in the former it is soft. But the idea of cataract is now totally cleared from all that confusion in which it was usually involved ; it is uni- versally allowed to be an opacity of the crystalline lens, or its capsule. M. de St. Yves divides the cataract into the true, doubtful, and false. The true is when the crystalline humour hath lost its transparency: and the species are, when it is soft; Avhen hard; and when purulent. The doubtful are those cases in which the success of the operation is as uncertain as the use of topical re- medies. Of this there are four sorts : a membranous and a filamentous cataract; cataracts from external in- juries ; and from a defect of the membrane which co- vers the bottom of the socket in the vitreous humour. The first and third of these he subdivides again, each into three kinds, as he endeavours to be minute, as Avell as full, in his description of this disorder. The false are those in which the remedies afford no relief further than to palliate pains, or to remove de- formity; and these he divides into the glaucoma, and the shaking cataract. All these minute divisions seem little regarded in present practice; but yet some useful hints will be de- rived by a perusal of this author. When a cataract begins, the patient at first com- plains of a dimness of his sight; and on a careful ex- amination of the eye, a whiteness is perceived very deep in it: on examining the eye at distant periods of time, its opacity becomes more and more manifest to the observer, and the patient very sensibly loses the advan- tages of seeing. The progress of a cataract is usually very sIoav. 1 No medicines are capable of removing this disorder of the eye; but it is sometimes relieved by copious, general, or topical evacuations; sometimes by small doses of muriated mercury, long continued*; by draw- ing electrical sparks, or even by dropping a little of the tincture of opium at night into the eye; in short, by every means of increasing the action of the smaller vessels. The sight, hoAvever, can only be restored by an operation. Sauvages enumerates no less than five species, and of the cataracta vera six varieties. He tells us, that iavo patients were cured by the internal use of the hyos- cyamus : one of the species which he inserts under the title of membranacea is very doubtful. He says, that it was discovered by Lower on horses, and arises from a mucus exuding from the margin of the pupil, or uvea, which concretes sometimes into a membrane that ob- structs the pupil; but whether this membranous cata- ract exists in the human species, he thinks uncertain, notwithstanding it has sometimes been suspected. See Sauvages Nosologia Methodica, vol. ii. p. 723. Mr. Sharpe gives it as a general rule for proceeding to the operation, when the cataract is entirely opaque; adding, that sometimes they are of a proper consistence for the operation before they become opaque; but for- bids the attempt while the patients can perceive any thing. Cataracts are of different colours; the pearl coloured, and those that appear like burnished iron, arc thought capable of enduring the needle ; the Avhite are supposed to be milky; the green and yelloAV are horny, and incurable; the black cataract Mr. Sharpe thinks is the gutta serena. The yellow cataract often adheres to the iris, so as to be incurable. When a gutta serena attends, the opera- tion will not relieve. There is little to be expected from the operation Avhen the size of the diseased eye is either diminished or increased ; when, previously to the appearance of any obfuscation, the sight AA'as defective; Avhen in a strong light, of which, from the appearance of the cataract, the patient must be seemingly sensible, no contraction of the iris takes place. The methods of operating are different- By the first and oldest plan, the thickened crystalline was depressed beloAV the vitreous humour; and it was styled couching, from coucher, to lie down. In the second, the crystal- line is extracted. Before and after the operation, a due regard must be paid to the state of the patient's constitution; and such means are generally advised, as will keep it somewhat beloAV its natural vigour, if otherwise in health. When no objection to the operation attends, Mr. Sharpe commends the following method for depressing the cataract. " Place the patient in a convenient light, and a suitable height; put a pillow behind his back, that his body may bend forward, and the head approach near to the operator; then inclining the head a little backAvards upon the breast of the assistant, and covering the other eye, so as to prevent its rolling, let the as- sistant lift tip the superior eye lid, and the operator de- press a little the inferior one: this done, strike the needle through the tunica conjunctiva, somewhat less than one-tenth of an inch from the cornea, even with the middle of the pupil, into the posterior chamber, and gently endeavour to depress the cataract with the flat surface of it. If, after it is dislodged, it rises again, though not with much elasticity, it must again and again be pushed down. If it is membranous, after the dis- charge of the fluid, the pellicle must be more broken and depressed. If it is uniformly fluid, or exceedingly elastic, we must not continue to endanger a terrible in- flammation by a vain attempt to succeed. " After the operation, treat it as an ophthalmy; and a collyrium, of one part rectified spirit of wine, and ten parts of lukewarm water, will be as proper an ap- plication as any." Mr. Daviel has the honour of having discovered the method of extracting the crystalline humour, but M. C A T 369 C A T de St. Yves practised it about sixty years before him. When the crystalline lens had passed through the pupil into the anterior chamber of the eye, both Mery and Petit extracted it; for then the depression is imprac- ticable. When this mode of relief is employed, the folloAving method is recommended. Pass your knife through the cornea into the anterior chamber of the eye, about a line before the iris; for if it is not inserted there, the iris will perhaps be wound- ed : if you go too far on the cornea, the knife may pass between its lamina, and so not perforate into the cham- ber. After puncturing into the chamber, guide your knife, Avith the flat side perpendicular to the eye, through the aqueous humour horizontally, (being careful not to wound the iris,) and thrust it out at the opposite side and situation of the cornea to those in which you insert it; turning its edge obliquely and perpendicularly outwards, make an incision rather through the inferior half of the cornea; then lifting up the superior part of it, the crystalline humour will burst its capsule and drop out: but if it should stick at its exit through the Avound, it shows that the capsula of the crystalline is not broken, on which you must puncture it with the knife, and then it will drop: but if the disease is in the aranea, or the capsule of the crystalline, you must extract it also with the forceps. With respect to the nature of this disorder, or the state of the crystalline lens, whatever improvements have been made within the present century respecting its disordered state, many difficulties still attend. Mr. Pott observes, that, until about the year 1720, neither the state, nature, nor seat of this disease, was truly known, at least not to those who practised surgery. Accident, he adds, first proved it to be a distemper of the crystalline lens, and to be in general confined to it. Heister is the first Avriter who leads to any just idea on the subject. Mr. Pott seems to be the first Avho explains the true state of the crystalline humour, when a cataract is formed. He says, that the idea of a beginning or imperfect cataract being soft, and that of a mature or perfect cataract being hard, is erroneous; at least for the most part: that the natural sound transparent crystalline is very far from being uniform in its consistence through its whole sub- stance; its external part is much softer, and more ge-" latinous than its internal, Avhich, therefore, although equally transparent, may be said to form a kind of nucleus, and is always of a much firmer texture. He adds, if this known difference of consistence between the external and internal parts of the crystalline was duly attended to, it would solve many of the appear- ances in cataracts, which, for Avant of such atten- tion, are either not at all or imperfectly understood. Among other phenomena, it would account for the very different colour which the different parts of the same cataract frequently bear; and which hath fur- nished the wildest conjectures. From this sound and natural state it is capable of several morbid alterations; it is capable of being dissolved, or of becoming a fluid, without losing rny thing of its transparency. It hath been supposed, by very able anatomists, that the hu- man crystalline has sometimes between its surface and its capsula, a small quantity of fine pellucid lymph, and consequently that there is no immediate connection be- tween the body and its investing membrane. In many VOL. I. beasts, as Avell as fishes, this is knoAvn to be the case; but Avhether it be so in the human eye is not very easy to be knoAvn during life; though it sometimes hap- pens from disease: that is, the whole crystalline is dissolved into a fluid, which still preserves its tran- sparency; and this seems to form Avhat is called the black cataract, which is a species of the gutta serena. Mr. Pott goes on to observe, that the crystalline humour is capable of being dissolved into an appa- rently uniform fluid of a gelatinous consistence, which will be more or less opake through the whole of it: it sometimes becomes opake while it undergoes a partial dissolution, which leaves or renders its differ- ent parts of very different degrees of consistence; and it now and then, though very rarely, becomes opake through its Avhole substance, and yet preserves its natural degree of firmness. From this variety of al- teration, Avhich the crystalline humour is capable of undergoing, proceeds that variety of appearance which our ancestors have called so many different kinds of cataracts. The idea of beginning cataracts being soft, and hardening as they become more perfect, hath had an unfortunate influence on practice. When the cry- % stalline humour becomes softer than it should be, it is certainly distempered, and unfit for perfect vision, whether it be opake or not; but that this softened lens Avill ever be harder Ave have no more reason to think than Ave have evidences that an opacity is a proof of its induration. The most fluid cataracts are as opake as the most firm ones. If the early or unripe state be supposed an improper one for the operation, and that the patient must wait for a later or ripe one; it then becomes a matter of consideration, Avhether the patient shall or shall not continue blind for a very uncertain space of time, or perhaps be ever relieved. Besides the body of the crystalline lens, its capsula or investing membrane may be the seat of the disease; it may be- come opake, while its contents are clear and duly tran- sparent. This may happen after the operation for de- pressing a harder cataract, or for discharging a softer one. When the capsula is the seat of the disease, and it takes place after depressing or extracting the crystal- line lens, it sometimes vanishes in a few Aveeks, but occasionally requires an operation. Respecting the operation of couching, Mr. Pott ob- serves, that as in some instances the cataract remains ahvays fluid, so in others it becomes instantly in- durated ; Avhence it follows, that there is no point of time for which we should wait; but at any time when, on other accounts, the object is a proper one, the sur- geon may proceed. Previous to the operation, it is right to know the circumstances Avhich render it likely or unlikely to succeed. That it may succeed, the crys- talline humour should be opake, and all the other parts of the eye capable of performing their functions; the eye should be of its natural size: Avhen, Avith the cataract, the globe of the eye is manifestly enlarged, the patient is incapable of perceiving light, or distin- guishing betAvixt light and darkness, in such a case, the operation must be omitted. The pupil ought to be capable of contracting and dilating. It hath been ge- nerally supposed, that when the pupil is immoveable it is useless to perform the operation, which is not in every instance true: the operation certainly should not be performed if the pupil is immoveable from a para- 3 B C A T 370 C A T lysis of the part, nor if it adheres to the crystalline; as In these cases we could not operate Avith any success : but if it is immoveable, or almost so, from a disten- tion of the crystalline humour, (Avhich Mr. Pott thinks sometimes happens,) the operation may be performed : in these cases, hoAvever, on a very nice examination, the pupil will be found to have a very small degree of motion. The patient ought always to be able to dis- tinguish light from darkness, and a Avhite from a black body; if he is not, though you remove the cataract from the pupil, yet the retina is incapable of perform- ing its office. In the folloAving instances, success is hardly to be expected by either.couching or extracting the crystalline body; viz. when the diseased crystalline is somewhat of the colour of brass, or of a bright yel- low, or of a copper colour; the pupil being generally found immoveable, and the whole eye enlarged. When all the parts of the eye are enlarged, or Avhen the crys- talline protrudes through the pupil, the case is not proper for the operation. Those who undertake to perform either operation Avill, undoubtedly, have availed themselves of all the in- formation given by the best Avriters on these subjects ; and to those who wish for fuller directions, the sub- joined writers are those from Avhom the whole of Avhat art hath taught will be received. See Celsus, Paulus Aetius, St. Yves on the Disor- ders of the Eyes, Heister's Surgery, Sharp's Opera- tions, Med. Mus. vol. ii. p. 157, &c. and 412. vol. iii. p. 1. Warner and Pott on the Cataract. Bell's Sur- gery, vol. iii. p. 394. Medical Obs. and Inq. vol. vi. p. 250. Wallis's Nosology of the Eyes, p. 197, &c. lidinb. Med. Comment, vol. v. p. 275. White's Sur- gery, p. 236. Catara'cta ni'gra. See Amaurosis. CATA'RIA, cat mint, (from catus, a cat; because ihey arc fond of it). See Mentha cataria. CATARRHA'LIS FE'BRIS AMPHEMERI'NA, (from catarrhus, because this fever is accompanied Avith, or proceeds from, a catarrh). The catarrhal fever, or continual quotidian of the ancients. It begins in the evening, Avith a shivering and a coldness of the skin and extreme parts, costiveness, frequent de- sire of making water, but the urine is small in quantity; weakness of the head, universal languor, a capricious and irregular appetite, thirst, difficulty of sAvallowing, stimulus on the larynx, a heat in the nostrils and fauces, attended Avith sneezing, and a weight in the breast. ToAvards night, heat, and a quicker, fuller pulse; cough, Avith a defluxion of rheum, a heat in the fauces, unquiet sleep, sweating in the morning, and at length a total loss of appetite. In the forenoon there is generally a remission, and it thus appears of the quotidian type. The cause is a fever, Avith inflammation on the mem- brane of the nostrils, throat, and bronchiae, occasioning the secretion of a sharp, acrid serum, Avhich irritates every part of this membrane, and sometimes the oeso- phagus, stomach, and intestines ; a cough, hoarseness, spitting of a viscid matter, sneezing, a defluxion on the lungs, nausea, and colic followed by a salutary flux, are often the consequences. Women, children, and weakly men, are its chief subjects. It is most frequent in spring and autumn, or in very variable seasons. After a few days, a catarrh comes on; and as soon as its discharge appears at the nose, the symptoms of the fever go off: sometimes, indeed, a copious perspiration relieves, and at others a large discharge, thrown up from the lungs; or, perhaps, a diarrhoea proves the natural means of cure. If Ave do not wait for these, we must relieve the fever by the more common means of emetics and ca- thartics, and thus supersede the deposition on the lungs. In fact, from the neglect only of these more general remedies it becomes a catarrhal fever. If these are neglected, the remedies are the same as in catarrh. See Catarrhus. CATARRHE'UMA, (from xxrxppeu, to flow from). See Catarrhus. CATARRHEXIS, (from xxrxppnywu, to pour out).. A violent and copious eruption or effusion. Ce.tarr- hexis, xoiXms, is a copious evacuation from the belly, and sometimes even alone it has the same signification. In Vogel's Nosology it is defined a discharge of pure blood from the belly. CATARRHCE'CUS, (from xxrx'ppea, to flow from). A Avord applied to diseases proceeding from distillations of an acrid fluid. CATARRHO'PA PHY'MATA, (from xxrxppeKu, to tend downwards, and , scari- fico). Scarification ; and, according to Dioscorides, a deeper scarification than common, Avhich is necessary in gangrene and sphacelus. CATASTA'GMOS,CATASTALA'GMOS,(from ttx£u, to distil). These are names which the Greeks, in the time of Celsus, employed for distillatio. CATASTA'LTICUM, (from o-reXXu, xxlxo-reXXu, to restrain). It signifies styptic, astringent, and is some- times termed castalticum. CATA'TASIS, (from xxlxmva, to extend). In Hip- pocrates, it means the extension of a fractured limb, or a dislocated one, in order to replace it; as well as the actual replacing it in a proper situation. CATA'XA. Both Aetius and Actuarius express by this Avord raAV silk, or silk before it is dyed. CATE'E. See Acajaiba. CA'TE, and CA'TECHU, (from kate, a tree, and chu, a juice, in the Japanese language). See Terra Japonica. CATEIA'DION, (from xxlx, and eix, a blade of grass). A long instrument which was introduced into the nostrils, in order to provoke an haemorrhage in the cure of the head-ach. It is mentioned by Aretaeus. It xvas thus called, either because the instrument had at the end a blade of grass, or Avas made like a blade of grass for the purpose. -' CATELLO'RUM, o'leum, (from catulus, a whelp). It is olive oil in which young Avhelps have been boiled until their flesh separates from the bones; after which are added thyme, marjoram, &c. The Avhole stands to- gether in the sun, and then the oil is strained for use. See Ph. Paris. CATE'LLUS CINERE'US: so called from itshead being like that of a dog. A cupel or test. See Cu- pel la. CATE'VALA. Common Aloe. See Aloe hepa- tica. CATIITRESIS, (from xxlx, and x,?eu, to take away). The subtraction of a part of the body by any- kind of evacuation, called also detractio. CATIIiERE'TICA, (from xlpeu, to take away). Re- medics Avhich consume superfluous flesh. See Cor- RODENTIA. CATHA'RMA, (from xx6xi^u, to purge). The ex- crements purged off from any part of the body. CATHA'RMOS, (from the same). Purgation by medicines, and the cure of a disorder by superstitious remedies. CATHA'RSIS, (from the same). A discharge from the uterus, bladder, or intestines, excited either by na- ture or art. CATHAR'TICA, (from xxexipu, to purge). This word is generally used as expressive of purging medi- cines ; but it implies emetics in ancient authors also. In this place, hoAvever, we must adopt the common language, and speak of purgatives only; a class of me- dicines of great variety and singular utility. By phar- maceutical authors, they are divided into lenitives, purgatives, and drastics; and by therapeutical writers, into those that act by increasing the evacuations, in consequence of the stimulus applied ,to the excretory- ducts of the different glands, and those that increase the action of the intestines themselves. There are others that act by exciting a commotion in the system, in consequence of their poisonous nature ;'and these show deleterious effects, immediately on their introduc- tion, by exciting vomiting. Of this kind are the gutta gamba, the seeds of some species of the croton and jatropha, the tobacco, probably the colocynth, and others. Another division, now almost obsolete, is that into phlegmagogues, cholagogues and hydragogues; purgatives that evacuate phlegm, bile, or water: these very nearly correspond to the lenitives, purgatives, and drastics. With the first, often styled minoratives, ec- coprotics have been confounded, but improperly. The last are certainly mild in their operation ; but this is not always OAving to their moderate stimulus, but often to their Avant of solubility in the first passages, in conse- quence of Avhich they act on the rectum only, since they reach that part with little change. Thus sulphur and aloes are eccoprotics, and even the gutta gamba is an ingredient in that recommended by Dr. Fordyce, as the other parts of the formula are not very soluble. We shall therefore follow the pharmaceutical division just mentioned, and then add a few remarks on the eccoprotics. Lenitives chiefly act by increasing the watery or mu- cous discharges from the glands, and comprehend all the phlegmagogues af the ancient pharmaceutists. The mildest of this class are the vegetables and the acid fruits. Of the vegetable lenitives, the oleraceae are the principal; and of the acid fruits, the tamarinds, the apples, and the prunes. It is doubtful whether the hesperideae (oranges and lemons), the senticosae (strawberries, raspberries, grapes, gooseberries, &c), are cathartic, except in con- siderable quantities. They seem to be directed rather to the urinary organs; though in some constitutions, CAT 375 CAT from idiosyncrasy, probably, they operate as cathartics. All the neutral salts, except the ammoniacal, are in a greater or less degree laxative. To.these must be add- ed the supertartrite of the vegetable alkali, viz. the crystals of tartar. The saccharine vegetable substances belong also to the lenitives; as the pulp of the cassia, manna, and, what, with a little latitude, may be referred to the same rank, honey. The vegetable oils are all slightly cathartic; but we use only the olive and the castor oil. Sulphur, from the little change it expe- riences in the stomach and small intestines, is a cathar- tic of a similar nature; and to this class phosphorus is added: but, until some safer mode of exhibition is adopted, Ave Avould not advise this substance to be em- ployed. The bitters, the gall of animals, the foetid gums, the various balsams, the guaiacum and the myrrh, appear to be occasionally, in a slight but per- manent degree, laxative ; though not usually arranged in this class. The guaiacum, indeed, is often more active; but this seems frequently to depend rather on idiosyncrasy than a real cathartic power. The foetid gums are excellent vehicles for eccoprotics. Lenitives, in general, very slightly stimulate the in- testines, but seem chiefly to act by increasing the se- cretions from the glands, whose ducts open into the intestinal canal. They do not increase the heat of the body nor the pulse. They give little uneasiness in the stomach, except from their bulk; and this is chiefly obvious in the saccharine lenitives, and sometimes in the oily. They discharge copious watery faeces; but by no means the substances hardened in the cells of the colon. In many instances, they even lessen heat; and as eccoprotics, unbruised mustard seed, or a clove of garlic, is swallowed, Avithout producing any sensible irritation. The saline lenitives excite thirst; and this may be readily gratified, as Avann diluting liquors as- sist their operation. Purgatives are more active, excite the action of the muscular fibres of the intestines, and are consequently better adapted to remove the more hardened faeces. Of these there is a considerable variety. The leading distinction is, into those which are astringent, or have no such power. The former are preferred, from their strengthening rather than weakening the bowels. They are supposed, however, to leave a disposition to cos- tiveness; but, while the appearance of astringency leads to a suspicion of this effect, we find little foundation for its existence. All the cathartics, except, perhaps, the saline and oily, render the intestines less irritable; since vessels, stimulated to discharge an unusual quan- tity of fluids in a given time, sink afterwards into a comparatively torpid state; and, indeed, Avhen the cir- culating mass is drained of any considerable proportion of its fluids, all the secretions are for a time lessened, until the loss is repaired. But while we cannot deny some subsequent astringent effect to rhubarb, for in- stance, we cannot admit of its strengthening the bowels by the same power. We have found no effect of this kind, and the continuance of small doses has appeared to be only eccoprotic. When the bowels have been Aveak'.ned by inflammation, or diarrhoea, it has seemed injurious from its acrimony. This, former practition- ers tacitly alloAyed, by toasting it; which they thought increased its astringency, but really only lessened its cathartic effect. The distinction between lenitives or drastics, and laxatives, is by no means easy; since by diminishing or increasing the dose of the last, they may, Avith some propriety, be considered as belonging to the first or se- cond class. This inconvenience, however, attends all natural arrangements; but, in our enumeration of the different medicines, we shall folloAV them very nearly in the order of their activity. As laxatives, Ave employ- the sena (cassia sena); ipe- cacuanha (callicocca ipecacuanha) in decoction; the polypody root and myrobolans (polypodium vulgaris et emblica); the damask rose leaves (rosa damascena); rhubarb (rheum palmatum); purging flax (linum ca- tharticum); broo7n (spartium scoparium); mechoacanna (convolvulus mechoacanna); buckthorn berries (rham- nus catharticus); jalap (convolvulus jalapa); rattle- snake root (polygala seneka); celandine root (chelido- nium majus); black alder (rhamnus frangula); scam- mony (convolvulus scammonia); common and dwarf elder, inner bark (sambucus nigra et ebulus). From the mineral kingdom laxative cathartics are, James's powder, calomel, and phosphat of silver. These substances act with greater or less acrimony; and those tOAvards the end of the list are often highly acrid. Many others might be enumerated, which are found in the writers on the Materia Medica, and Avhich occur in their places in this dictionary. From these before him, however, the practitioner may have a suffi- cient choice. In general, these laxatives excite colic, and sometimes prove emetic: they frequently stimulate the system, increase the heat and the pulse; but, on the other hand, they are active and effectual evacuants. If an opiate has previously produced some relaxation in the cells of the colon, they will bring aAvay the most hardened, long retained scybala. In cases of fever, however, these are often only evacuated when the re- laxation is produced by the solution of the disease. Mild purgatives will, in those cases, discharge what had escaped the action of the most violent. The former part of this list contains the chologogues of the ancients. The drastics are the gamboge (stalagmitis of Koenig); wild cucumber (momordica elaterium); bitter cucumber (cucumis colocynthis); black and white hellebore (helle- borus niger, and veratrum album); sea colewort (bras- sica marina, soldanella pharmaceut.); resin of jalap, nitrat of silver, and various mercurials and antimo- nials, q. v. These drastics act with great violence, generally dis- order the stomach and the whole system in a consi- derable- degree, and sometimes inflame the intestines. These, and some of the more active-medicines of the former group, Avere chiefly used by the ancients, for the milder laxatives Avere introduced by the Arabians, and occasioned the numerous cautions respecting the use of purgative medicines. From this circumstance also, and from the use of mercurials as laxatives, the supposed necessity of confinement to a warm room ap-. parently arose. This measure may be dictated by con- venience; but certainly Avarm air, and a horizontal posture, retard or lessen the operation of laxatives. The narcotic cathartics remain, Avhich disorder the senses, produce stupefaction, and seem to act as ca- thartics, by the general commotion that they produce. We think these effects in some measure follow the use of the gutta gamba, the colocynth, the hellebores, a£d CAT 376 CAT some of the other drastics, when first introduced into the stomach. They often occasion sickness, faintness, and cold sweats; but the cathartics more decidedly se- dative are the tobacco (nicotiana tabacum), the foxglove (digitalis purpurea), and the lactuca virosa. One effect of the drastics, which we deferred mentioning till we had introduced this last group, is the discharge of wa- ter from the cavity of the peritoneum, the chest, and the cellular substance. This effect seems to arise from the sedative power of the remedies. In this moment of total relaxation every bond of union is removed, even the inosculation of the maternal and foetal parts of the placenta, every form of obstruction recedes: the secre- tory organs yield, not from the action of the remedy increasing the excitement, but from the temporary so- lution of the tonic power. We have little to add to what we have already said of eccoprotics. A mild vegetable diet is the safest and the best. Aloes, combined either with the foetid gums or soap, is highly useful, chiefly from its very slow de- composition in the small intestines. Sulphur is equally convenient, from the same cause. The sea water and the purging mineral waters are also highly useful, Avhen they can be conveniently taken. Rhubarb we have found too irritating, unless combined with soap; and a sufficient quantity of the latter renders the bulk incon- venient. We have generally added a small proportion of the scammony, to render it more active. Aloes is by far more useful; and though it sometimes produces piles, yet, in the forms above mentioned, we have not expe- rienced this inconvenience. Dr. Fordyce, in an ex- cellent paper " on the combination of medicines," recommends a compound eccoprotic, Avhich he thinks of superior efficacy to any other. It consists of five parts of aloes, three of sagapenum, tAvo of gamboge, and one of distilled oil of camomile. Tavo parts of gum arabic are employed to give it a consistence, and the whole is made into a mass with the syrupus a spina cervina. From six to ten grains are a dose; and it is said to operate Avithout sickness or griping. We shall resume this subject under the article of combi- nation of medicines, and shall then speak of the advantages derived from the union of different pur- gatives. One other class of purgatives remains, viz. what are styled, by some late authors, " the mechanical;" con- sisting chiefly of watery liquors. These act by their bulk, which is the chief stimulus of every hollow mus- cle. The utility of a large bulk of fluids is particularly conspicuous in clysters, where a pint and a half of milk and water will procure a motion, often more readily than the most active purgative administered in the same manner. We speak, however, of these mechani- cal cathartics, chiefly to notice the effects of dilution in increasing the power of the neutral salts. If an ounce is the proper dose in two ounces of Avater, two thirds Avill be sufficient in half a pint; and perhaps one half in a pint. This fact, before alluded to, solves the difficulty felt in accounting for the purgative power of some mineral waters, in which the proportion of salts is inconsiderable. In describing the effects and the use of cathartics, in- stead of explaining them in the way of some therapeu- tical authors, a capite ad calcem, we shall first speak of their more immediate effects; and, from them, trace the more remote and distant. We shall after- wards enumerate those diseases in which they are chiefly indicated, and in which they are most essen- tially useful. The first and most obvious effect of purgatives is the discharge of the contents of the abdomen. The intes- tines are subject to various accumulations of hardened faeces, undigested matter, or inspissated mucus. These substances impede not only the passage of the fresh nutriment, but prevent the absorption of the newly- formed chyle, and occasion general languor and debi- lity. Laxatives, as we have said, also stimulate the orifices of the excretory ducts, and promote the circu- lation through the vessels of the glands. This is a very important effect, and renders these medicines useful in a variety of complaints.- By the evacuation of the contents of the intestines, ' it may be supposed that cathartics would relieve the stomach, and promote, in every instance, the discharge of its contents: but this effect is not constantly pro- duced; and where a viscid mucus has accumulated, its weight carries it to the bottom of the larger curva- ture of that organ, and it is rarely discharged Avithout the assistance of an emetic. The complaints of the stomach, supposed to be relieved by cathartics, are more often accumulations in the duodenum. When the intestines are loaded, and particularly the small intestines, some pressure is made on the descend- ing aorta, and the blood is determined in larger pro- portions to the ascending branches, occasioning pain in the head, languor, and general uneasiness. These symptoms cathartics commonly relieve; and, by taking off the pressure from the descending aorta, facilitat- ing the circulation through the glands of the chylo- poietic viscera, and thus increasing the circulation in its branches, cathartics become the most useful reme- dies in diseases of the head. The efficacy of cathartics as evacuants of particular fluids, which seem chiefly to depend on the solu- bility of the medicine, merits our attention. The saline and other lenitives act immediately on passing into the intestinal canal, and stimulate not only the excretories of the liver and pancreas, but of the mucous glands in the neighbourhood; and it is this class of cathartics on which we chiefly depend for the evacuation of bile. By some accident, rhubarb has been considered as the chief evacuant of this secreted fluid; but we have never found it peculiarly adapted for this indication, except Avhen combined Avith soap. Indeed the stimulus of rhubarb on the internal surface of the canal is so considerable, that even when it has passed the entrance of the ductus communis, the irrita- tion may be communicated to it. Irritation is always readily conveyed along the surface of mucous mem- branes ; for we find a stone in the pelvis of the kidney sometimes convey a peculiar sensation at the extremity of the glans penis. The active cathartics alone stimulate sufficiently the muscular fibres of the colon; so as to evacuate the con- tents of its cells: and for this purpose calomel is the most effectual. Jalap, a medicine of considerable utility, seems also to combine a power of assisting the watery secretions; and thus becomes a serviceable ad- dition to the lenitives, when employed Avith this view. Rhubarb seems also particularly useful in evacuating C A T 377 C AT the contents of the larger intestines. On the rectum, Sulphur and aloes seem to act exclusively; and the one is supposed to relieve, as the other .is to induce, the haemorrhoids. The evacuation of the contents of the rectum is, ho-wever, in general, more properly trusted to clysters. The importance of this discharge is con- siderable in relicvingany inflammatory diseases of the uterus or vesica urinaria; and, "as injections reach so nearly the affected part, opiates are thus advantage- ously administered. * But this is from our present subject. The diseases in which cathartics are advantageously employed arc numerous. We' have detailed the ad- vantages arising from the evacuation of the contents' of the boAvels; and it will be obvious, that, in every case oi dyspepsia, of bilious accumulations, and worms, they must be of essential utility. For the discharge of worms, and the mucus which fonns their nidus, the most sti- mulating cathartics are requisite. For dyspepsia the eccoprotics; and for bilious accumulations the laxa- tives, and of these rhubarb and calomel, are the most useful. The infarctions of the different viscera require the constant use of cathartics; since, from the steady and frequently repeated stimulus to their excretories, Ave promote a more active circulation through their sub- stance. Dissection discovers various indurations in different organs, whose excretories open into the abdo- men ; but we can distinctly ascertain the existence of one only during life, viz. infarctions of the liver. The small doses of calomel, which give a general activity to the circulation, are.greatly assisted by the regularly re- peated stimulus of gentle laxatives ; and, indeed," with- out these, would be of little service. When no symptom leads to the suspicion of disease in any one organ, a general cachectic habit renders laxatives almost indis- pensable : indeed, in every instance of this kind they are highly useful. When the mesenteric glands arc affected, we can scarcely style the lactealsjheir excre- tory ducts ; yet the stimulus of cathartics on their ori- - fices is highly useful. We shall find reason to conclude, that all the infarctions of conglobate glands are owing to a Avant of irritability in these vessels; and the disease is not only relieved by the stimulus of the cathartic, but probably by the absorption of those found to be most useful, viz. sea Avater, and the purging mineral waters. The latter are frequently the most effectual also in in- farctions of the liver; and, when joined with a chaly- beate, Avhich, as Ave have said, is supposed to prevent the debilitating effects of purging, have been greatly celebrated. Cheltenham Avater is the most fashionable of this kind.- In diseases of the head, from the effects of cathartics just mentioned, Ave may expect the greatest advantages; and Ave find from experience, that they chiefly relieve every accumulation on the cerebrum. In every case of apoplexy,, chr'us, and lethargy, cathartics are remedies of peculiar- utility; and, in the course of our labours, we shall find many diseases connected with such accu- mulations that have not been suspected to originate from this source. The great utility of cathartics is, however, conspicu- ous in febrile diseases. We cannot explain the founda- tion of the advantages derived from them at present; but can only observe, that in every fever the balance of VOL. I. the circulation is apparently destroyed; that in some cases the liver, in others the head, often both organs, suffer from accumulation. Cathartics relieve both; and, in checking fever on its first formation, seem to be the most useful remedies. Emetics have had the chief credit in destroying fever in the bud; but, unless suc- ceeded by, or accompanied with, laxatives, they have failed, or performed their office imperfectly. During the whole course of febrile diseases, a regular, and very often an active, discharge from the bowels is necessary : and stools, so far from weakening, add to the strength of the patient. Care, however, must be taken that the discharges be actually feculent. We have known the motions numerous without relief: they have been found only mucous evacuations from the rectum. They have been reported to be copious; but, on examination, have appeared to be only water scarcely coloured. Even wlien motions have appeared most decidedly feculent at the conclusion of the fever, some matter has been seemingly retained; since discharges of peculiar foetor and putridity have accompanied or followed the crisis. Qn this account the lenitives, though often recom- mended, have not appeared to us the best form of ca- thartics in this country. In warmer climates, where the bile is highly acrid and stimulating, lenitives only- are admissible; since laxatives would add to a stimulus already in excess. We now make this distinction, but would subjoin a caution in the words of Baglivi, when he apologizes for a practice which might be suitable only in his own situation : " Romae ago et Romano in aere." It may be asked, are laxatives so peculiarly useful in every epidemic ? We dare not say so; for Ave have found some truly asthenic fevers in which they have appeared to have effects highly debilitating. The in- stances have, however, been very few ; and, in general, on the appearance of every epidemic, the practitioner mu'st cautiously examine its nature in every point. He will, however, err most seldom in examining the effects of laxatives if he tries them to some extent. t He can soon check his career; and, in the very earliest stages, they scarcely ever are injurious. We must, however, in a future article, point out the fevers Avhich are less adapted to this remedy. To pursue the particular kinds of fevers in which cathartics are most useful, we must first remark that bilious accumulations are particularly conspicuous in intermittents; and from hence arose the anxiety of former physicians to bring the fever to a regular inter- mission, previous to the exhibition of the bark. In fact, the end really attained was, by previous evacua- tions, to prevent accumulations in the liver, Avhich the bark might still further impact; nor have we a doubt that the accusation, formerly brought against this remedy, of its producing the tumours styled ague cakes, may have had some foundation. It has been alleged, that these tumours were more common be- fore the introduction of the bark than since. This. indeed, we believe ; >but the cause Avas the long cor- tinuation of the disease Avithout the use of any ac- tive remedy. In remittents, diseases of a similar nature, the same remedy is useful; and of continued fevers, it is chiefly employed in the mflamtnatory fever, to cool by the dis- charge from the exhibition of lenitives; and in bilious 3 C C AT 378 CAT fevers,, to clear the liver from the accumulations Avith which that organ is oppressed. In the more common epide7nics, styled putrid, or nervous, there appear to be accumulations in the liver and the head. We are told by medical authors to prevent costiveness; but we have only succeeded when we have carried the evacuation further. On these subjects Ave must again enlarge In the topical inflammations, cathartics are less gene- rally useful. In phrenitis, indeed, they are essential remedies; but, in pneumonia, often injurious. In an- gina they are not singularly beneficial; and, in gastritis, often inadmissible. In enteritis they are of the greatest importance; and, on their management in this disease, the cure almost wholly depends. In nephritis ,and peri- tonitis, lenitives are remedies of importance; and, in cystitis, laxative clysters are highly useful. In the exanthemata, also, laxatives are employed with much discrimination. The boAvels and skin, as we have said, alternate in their discharge; and, cutis sic- citas, alvi laxitas, is an axiom tAvo thousand years old. By purging, therefore, Ave may ahvays moderate a cu- taneous eruption ; we may sometimes prevent it: and, whenever previous fever threatens a copious eruption of small pox, next to cool air, active laxatives are the most effectual remedies. In measles we have found nothing prevent so effectually the peripneumonic symp- toms as a loose belly: and, from one instance, have suspected that purging may be carried to a greater de- gree than has yet been practised. The child was ten- der and delicate, with apprehension of weak lungs; the peripneumonic symptoms violent. The cathartics were urged Avith unusual activity ; the disease was mitigated, and the recovery unusually rapid. The instance is, however, a single one. In erysipelas and scarlatina we know not that cathartics have been urged, or that they have been urged with success. In gout we have said they are injurious: in rheumatism they are inconvenient. Yet we have thought the doses of calomel, in an active form, have been useful as laxatives. In hamorrhages of the brain the most active laxatives are useful; but here their benefits seem in this order to end: in the other haemorrhages, the mildest lenitives only are employed Avith advantage, to cool rather than to evacuate. In various diseases, arranged by Dr. Cullen under the class neuroses, laxatives are highly useful. In all comata, even though not febrile, they are essential. In the spasmi they are apparently less beneficial; but, in warm countries, these often arise from acrid bile, and the trismus infantum is well knoAvn to be owing to this cause. The chorea, too, as Ave shall soon find, is greatly benefited, often effectually cured, by active cathartics. In colic, cholera, and diarrhea, laxatives are appropriate remedies; but particularly useful in the first: in the tAvo last the discharge requires only to be regulated,' sometimes to be rendered more effectual. In the Avhole of the class vesania, cathartics in differ- ent forms and degrees are necessary; and, in the ca- chexies, particularly in tabes mesenterica, Ave have al- ready remarked their utility. On the subject of dropsy we have nothing to add to the Observations under the articles Ascites and Anasarca, q. v. The manuscript of the foregoing article was sent to the printer before we had an opportunity of perusing Dr. Hamilton's " Observations on the Utility and Ad- ministration of Purgative Medicines." It gave us great pleasure to see this confirmation of our opinions, drawn also from the sick bed, by a gentleman Avith whom Ave Avere once personally"acquainted, and Avhose abilities we highly respected. JTe recommends purga- tives in chlorosis, chorea, chronic diseases, haemateme- sis, marasmus, scarlatina, and typhus. Under the se- parate respective articles Ave shall more particularly attend to his observations: our opinions, in general, are before the reader. With scarlatina, he speaks of its frequent concomi- tant, the ulcerated sore throat. The peculiar disease which we have described under the article Angina gangrenosa is scarcely, if at all, knoAvn in Edinburgh; at least, in the course of five years, we never saw it: and, in the lectures of Dr. Cullen and Dr. Gregory, this kind of sore throat Avas spoken of so indiscrimi- nately, as if they were little acquainted Avith the com- plaint. In the ulcerated throat as it appears in Eng- land, purgatives are certainly not admissible; and Ave have seldom found them very advantageous in scarla- tina. Dr. Hamilton means by purgatives what we have called laxatives, but administers them in separate doses. CATHAR'TICUS, sal, (from xxSxigu, to purge)* Called also amarus sal, magnesia vit7-iolata, Ebshamen- s£s, and Epsomensis sal. Purging salt, Epsom salt, and English salt- This salt was first obtained from the mineral water at Epsom : it was afterwards separat- ed from the brine which remains after the crystallization of common salt, and the latter is noAv in general use. It is composed of the vitriolic acid and magnesia; differ- ing from the natron vitriolatum, which has a mineral alkaline salt for its basis. The first is often sold for the latter; but they are distinguished by adding any alka- line salt to a solution of the former, Avhen the earth will be precipitated. It is with this salt that the purging mineral Avaters are frequently impregnated, and to which they often owe their virtue. It hath a bitter taste, is soluble in less than twice its weight of water, shoots into long prismatic crystals, liquifies and bubbles in a moderate heat, emit- ting a quantity of aqueous vapours; it changes to a white spongy mass, which is more bitter than the ori- ginal salt. If this salt is dissolved in Avater and crystallized afresh, it concretes into a larger kind of crystals,. which resemble the purging salt usually called Glau- ber's. It has a nauseous bitter taste; is a gentle purga- tive, operating in general with ease and safety, yet with a sufficient efficacy, and quickly finishing its operation. Two or three drachms, dissolved in a pint of water, ope- rate ,more powerfully and easily than a larger quantity in three or four ounces. Its passing off hastily, and not exciting the action of the intestinal fibres, seem to be its principal imperfections. In small doses often repeated it promotes the secretions in general, and proves an excellent aperient in many chronical disor- ders. It seldom occasions gripes or sickness, like re- sinous purges. If the patient keep warm, small doses will excite perspiration; if cool, they pass off by urine. As a purge, from an ounce to an ounce and a half is a full dose, which, Avhen dissolved in a quart of water Avith a drachm of mace or of cardamom seeds previously C A T 379 CAT infused in it, sits easy on the stomach. See LeAvis's Mat. Med. Neumann's Chem. Works. Catha'rticus Hispanicus sal. It is produced near Madrid from some springs: it is neutral, and agrees with the natron vitriolatum, or Glauber's salt. Its ope- ration is very gentle. Catha'rticus Glaube'ri sal. See Glauberi sal. CATHE'DRA, (from xxBi^o^xt, to sit). See Anus. CATHE'STECOS. See Di^eta. CATHETERI'SMUS, (from xxhle?, catheterus). The introduction of the catheter into the bladder; an appellation given by P. ./Egineta to this operation, which is required in the following cases. 1. When a stone lies internally on the neck of the bladder, and stops the discharge of the urine. 2. When a preternatural weakness of the bladder hinders the urine from being discharged in the usual manner; and when other remedies fail, which often happens in women weakened with labour, or Avhen the head of the child presses on the urethra. 3. When, by long retention of urine, the bladder is so distended and weakened as not to be able to dis- charge itsxontents. 4. When mucus, blood, pus, or other matter, sticks in the neck of the bladder, from ulcers, or wounds of the kidneys, or from discharges of bloody urine. 5. When the urethra, or the neck of the bladder, is contracted or obstructed; but'in this case bougies are preferred"; or Avhen the prostate is scirrhous and pre- vents the passage of the urine. 6. In the last months of pregnancy it is sometimes useful to introduce the catheter, to draw off the urine, as the AAreight of the uterus obstructs its"discharge. 7. When a prolapsus uteri produces an ischury. 8. When a liquor is to be injected into the bladder; in which case a bladder, or an elastic bottle, may be filled with the liquor to be injected, fastened to the catheter, and, by gentle pressure, conveyed through It is easy .to introduce the catheter into the female bladder, since the direction of the urethra is nearly straight; but in males there is some difficulty. Heister directs the man to lie on his back, and the operator to take the penis in his left hand, as he stands on the pa- tient's left side, reclining the penis towards the navel; then he is to introduce the catheter, with its concave part to the belly, into the urethra, so far as the os pubis ; and so thrusting it under the symphysis of those bones, and moving the hands gently outwards, forces it into the bladder. If the catheter is too small, it is the more apt to stop in the corrugations and foldings of the urethra, Avhich often occur in elderly men. Dr. Hunter adds, that some impediments areoften met Avith at the caput gallinaginis, in which case he advises to draw the ca- theter a little back, and press the end of the catheter a little higher, and then it will slip in; but he cautions against using any force. If a difficulty is still found, he advises the operator to put a finger into the anus, at the same time draAV the perinaeum forward, and therewith endeavour to assist the catheter in its intro- duction. Mr. Ware, in a paper expressly Avritten on this sub- ject, says, " The mode in which I pass the instrument is as folloAvs: being first thoroughly oiled, I introduce it into the urethra, with its convex part uppermost, and carry it as far as it will pass Avithout using force ; then I turn it slowly round, so as to bring its concave side uppermost; and in doing this, I make a large sweep Avith the handle of the instrument, and at the same time keep my attention fixed steadily on its apex, or inner termination, which I take particular care neither to retract, nor to remove from its first line of direction. When the catheter is turned, it must still be pressed onward, and its handle at the same time gently de- pressed : by this method it .will be made to enter the bladder." The catheter made use of by Mr. Ware is twelve inches long, which is more than an inch above the or- dinary length; and the curvature larger than common, as represented in the plate he has annexed; and with which he has succeeded often, where others of a differ- ent size and curvature had failed. Those catheters are the best that are made Avith small holes at their ends, instead of long rhomboidal aper- tures. In the , following cases this instrument cannot be used: 1. When the neck of the bladder is greatly inflamed, for then the urethra is much contracted, and force in this case AA-ould endanger a sphacelus. 2. When a ca- runcle, cicatrix, or hard tubercle, obstructs the passage. 3. In old men, sometimes from the stricture shrinking, or from Avrinkles in the urethra. 4. From the disten- tion of the spongy substance of the urethra Avith blood. 5. From a scirrhosity or preternatural tumour of the prostate gland. 6. From a stone lodged in the neck of the bladder. 7. When the uterus is remarkably pro- minent and pendulous over the ossa pubis, the neck of the bladder, then forming an angle Avith the, body of the bladder, hinders the passage of the catheter. 8. When the uterus is retroverted, in Avhich state it drags the bladder upwards and backwards. CATHETE'RUS. Ca'theter, (from xx6te/x.<, to thrust into). Also called auliscos, fistula. It is a long crooked tube introduced through the urethra into the bladder, when solid for the discovery of a stone, or when holloAv to occasion a flow of urine if suppressed. The Latins call it fistula: and it had the epithet aenea from the matter of which it Avas formed. It is the name also for bougie, which see. CATHIDRU'SIS, (from xxBifyva, to place together). See Fractura and Catimia. CATHI'MIA. In the Spagyric language signifies subterraneous mineral veins; concretions in. the fur- nace of gold and silver; and soot that adheres to the walls in burning brass. It is, in fact, cadmia disguised by bad spelling. See Lithargyrum. CATHO'LCEUS, (from xxlx, and oXxeu, to draw over). An oblong fillet which came over the Avhole bandage of the head, called periscepastrum, or the sling with six heads. See Fascia. CATHO'LICON. A general or universal medicine, formerly supposed to purge off all bad humours, (from xxrx, through, and oXov, the whole): sometimes termed diacatholicon, or the universal purge. It Avas an elec- tuary which Nicolaus prescribed, as a purge suited to carry off all kinds of humours. CATHY'PNIA, from w®~, sleep). A profound sleep. 3 C 2 C AU 380 C A U CA'TIAS, CA'TIUS,(from xxStvfu, dimitto, to place in). An incision knife, formerly used to extract a dead foetus, and for opening an abscess in the uterus. CATI'LLIA. The weight of nine ounces. CA'TINUM ALU'MEN. See Clavellati Ci- neres. CATI'SCHON, (from xxnr%u, to retain). One who is costive, or not easily purged. CATIXIS, (from xx\ i%iv,per rectamviam). On the same side. In inflammation of the liver, a crisis of blood is discharged from the nose by tlje right nostril; and in inflammation of the spleen by the left. It hath long been supposed that nature endeavours with more vigour, and more certain success, to free herself by passages on the side of the disease. CATOCATHA'RTICA, (from xxrx, downwards, and xx6xipu, purgo). , See Cathartica. CA'TOCHE, and CATOCHUS, (from xxleX*>, to detai7i). See Catalepsis, Caros, and Tetanus. CATOCHI'TES,(from xxle%u, to retain). A stone found in Corsica, which Pliny says attracts and retains the hand when laid upon it. CATO'DON, (from xxtu, below, and «. CATULO'TICA, (from xx\aXoa,to cicatrise,) impro- perly catalotica. Medicines that cicatrise wounds. CA'TULUS. In zoology it is a puppy. See Canis. In botany it is a catkin. See Amentacei flores. CATU-TRI'PALI. See Piper longum. CAU'CALIS, (from xxvxiov, a cup, so named from the shape of its flower). Bastard parsley, called also echinophora tertia, lappula Canaria,pseudoselinum, a7ithriscus, daucus annuus 7ninor, hedge parsley. It has generally red flowers, and possesses the common qualities of the garden parsley. See Apium hor- TENSE. CAUCALOI'DES, (from xxvxxXis, and tih^s, like- 7igss). A name of the patella, in Moschion de Morb. Mulieb. so called from its likeness to the flower of the caucalis. CAU'DA. jEtius, in his Tetrab. 4. serm. 4. ch. 103. says, that in some women a fleshy substance arises from the os uteri, and fills the vagina. Sometimes it protu- berates Avithout the lips of the pudenda, like the tail of some animal. If this substance ever existed, it must have been enlarged clitoris, or, if a disease, a polypus. In order to extirpate it, he advises to extend it Avith a forceps, and then cut it off; after Avhich it must be dressed with lint dipped in rough wine. It is also a name of the os coccygis. Cau'da equi'na. In anatomy the medulla spinalis ends about the first or second lumbar vertebra, and there forms itself into many branches, Avhich receive all together the name cauda equina, from being like a horse's tail. From the loins downwarcts the holes in the vertebrae are somewhat lower than the origin of the nerves that pass through them ; hence it is of imports ance, Avhen any disorder arises from an injury of any of the nerves below the first and second lumbar vertebra, to advert to this circumstance; and, as at the first or second vertebra of the loins the cauda equina begins, so, in tracing the source of all the nerves below these parts, this is their origin. See Lumbares. Cau'da muris. A species of ranunculus. See also Myosurus. Cau'da porci'na. See Reucedanum. Cau'da vu'lpis rubicu'ndi. A preparation of lead. CAUDA'TIO, (from cauda, a tail,) an elongation of the clitoris. See Cauda. CAUDE'X. The trunk of a tree, or that part of a plant which lies betAvixt the root and the branches. According to Linnaeus, Avhen a seed germinates, the caudex descendens terminates in roots, the ascendens in branches and leaves. CAULE'DON, (because it breaks like xxvX<&>, a stalk). A species of fracture, when the bone is broken transversely so as not to cohere. CAULI'AS, (from xxvXos, a stalk). An epithet for that juice of the asafoetida plant which flows from the stalk, by way of distinction from that Avhich Aoavs from the root, and is called-pi^ixs, rizias. Its stalk is styled caulos. CAU'LIS, and CAU'LOS, (from kalah, a Chaldean term). The stalk. See Caudex. It is a name also for both the penis and vagina ; and in corn and. grass it is called the blade. It is a name for a cabbage or coleAvort. See Brassica sativa. Cau'lis flo'rida. See Cauliflower. CAULO'DES, (from *«&a«s, cabbage). See Bras- sica. CAU'MA, (from xxiu, to burn). The heat of the atmosphere; or of the body in a fever. CAU'NGA. SeeARECA. CAU'SA. (Latin.) A cause. Causation, among metaphysicians and logicians, is a subject of peculiar - difficulty and of some danger ; since, in pursuing the reasoning Avithout due attention, some of the best men have advanced nearer the confines of infidelity than they have suspected; and mankind, ever prone to cen- sure, have caught with eagerness at little errors, and pursued the author with the acrimony which crimes only merited. As logical disquisitions can have no place in this work, Ave shall fortunately escape the quick- sands, though we may encounter whirlpools, on the op- posite shore. Dr. Wallis, in his Avork on Health and Diseases, and in the last edition of this Dictionary, seemed to plume himself on establishing certainty from his disquisitions on this subject, in a science for- merly conjectural; yet a more confused farrago, of rea- soning, with scarcely a clear determinate idc?., never C AU 381 C A I occurred. Disputes, hoAvever, are still less Avithin our province, and particularly Avith our predecessors. To ascertain the nature and degree of causation re- specting diseases, Ave must first enquire what a dis- ease is; and "we shall so far' anticipate that article by saying, {hat a disease is that condition of the human body, in Avhich thenactions of life and health -proper to it- are not performed, or performed imperfectly. According.to this definition, the disease consists in the disordered or impeded functions; and these form, in our views, its essence. By these it is defined; by these distinguished. Authors formerly, and often at present, suppose that the disease consists in the injury which disorders or impedes the functions : thus what they con- sider as the disease is, strictly speaking, only the im- mediate cause. The difference is, indeed, merely verbal; and, Avhen established, eitherplan may with equal reason be supported. If, however, it be necessary.to speak of diseases as characterised by fixed indisputed marks, it must be established on a securer basis than the fluc- tuating systems of pathology. In this way the real disease, like the unknown quantity of the algebraist, is uncertain ; but as it has distinguishing properties and a peculiar appellation, every end is attained. Since a disease supposes a change of the body from a sound state discriminated by a given concourse of symptoms, these symptoms are the effect of that change; and the change itself the effect of a given power by whose influence it exists. Whatever, then, it be by whose influence the disease exists, is its cause. In medicine, also, it is not necessary that the cause be active, though logicians scarcely admit any other: pri- vation, as will be seen, is a frequent cause of corporeal changes, and often a source of disease; as depriving a muscle of a portion of its nervous power, occasions vio- lent convulsions. The minute difference of causes in the Avorks of many pathologists, would lead to pompous trifling, and Avould disgrace a science which should be distinguished by its utility alone. The first important distinction of causes is into internal and external. The former im- plies some defect previously rooted in the body be- fore it breaks out into a disease, or before it becomes conspicuous by evident symptoms. To such a state, though really a morbid change, Gaubius himself, who considers what Ave would style the immediate cause as the disease, will not allow, that appellation. External causes are, improper djet, inclement weather, sudden changes of temperature, or, indeed, whatever affects the body from without. These have been styled evident causes ; and even the most empirical systems admit the utility of enquiries into them. Internal causes form the seminium morbi, the predisposition to disease ; and such is the state of the human frame, that no constitution can be pronounced free from predisposition. There is, in svery one, some Aveak organ which requires only an exciting cause to .blow the spark into a flame. Thus a vomica is brought to a suppuration by an accidental cold, Avhich would never otherwise have occasioned* any inconvenience. This internal cause, which is often styled causa npotiytiiiiitiy or predisponent, is roused to action by what is styled the exciting cause, causa irpoxxrxpxrlxt!, sometimes pccasio, or occasional cause. This is generally external, though not necessarily so, as Ave shall soon find. In general, neither of these causes alone Avill produce a disease, but the concurrence of both is required. If there is no predisposition, the occasional cause is harmless: without the occasio, a predisposition may exist for years harmless. These causes have been styled, in conjunction, prin- cipia morborum, and the logical meaning of principium may be understood from Sauvages' Definition of a Cause, adopted, if we recollect rightly, from Wolfius; " Causa est, illtid ex quo intelligitur alterius actualis existentia, unde discrepat a principio, ex .quo non actualitas sed tafltum possibilitas-intelligitur," What authors have styled the disease, or Avhat the more correct pathologists of the present day call the proximate cause, viz. the morbid laesion, alone merits the appellation of a cause. " That only," observes Gau- bius, " deserves the name of a physical cause, Avhich so constitutes the disease that, Avhen present, the disease exists; Avhile it remains, the disease remains; Avhen changed or removed, the disease is equally altered or destroyed." The lax use of the term cams? among phy- sicians has occasioned much ridicule on the art, which should have been directed against its unskilful profes- sors : and causesjwithout effects; effects without causes; opposite effects from the same cause; or the same effect from opposite cau»es; have not been uncommonly as- signed, and furnished a foundation for numerous sneers. The English reader need not look further for examples than Tristram Shandy and Hudibras. We, have spoken of the body only, Avithout mention- ing the mind. We Avell knovv their mutual influence; but have yet to learn, Avhether disease may consist merely in mental injury, Qr, indeed, Avhether morbid motions can originate from mind. The mental prin- ciple, Avhich regulates the whole system, has been already spoken of. -Its tranquillity and passions may be considered, as its health and diseases. These, however, are transitory, but they affect for a time the body. Joy and exultation have raised the mental poAvers so high that they have sunk from exhausted excitability; and the depressing passions, by lowering the irritability, have produced visceral obstructions, and every symptom of cachexy. But whatever may have been the mental source, the effect is continued from disease of body. The mental disease may be*aflfcviated or removed; the bodily remains; nor in any instance, whatever tempo- rary relief may arise from soothing consolation, can the disease be removed Avithout bodily remedies. In body, however, as in mind, the remote causes may cease to act without any change in the disease. When it is once produced, their presence or absence occasions little alteration. A. person, for instance, affected by fever from _ marsh miasmata, may be removed to the healthiest situation Avithout any change of his com- plaint ; and the cold that produced rheumatism may be removed with little-relief of his disorder. This, as we have said, is-not the case with the proximate cause: it commences, continues, and ends, Avith the disease. Another circumstance respecting- causes demands our attention. We have'explained two kinds of remote causes; but betAveen these and the proximate there are many intermediate steps. There is, as Ave have formerly said, a series of causes and effects before the morbid lesion takes place. Thus, in the common cause of dropsy ebriety, Ave see that the tone of the stomach is originally destroyed. This Avant of irrita- C AU 382 C A V bility is communicated to the liver; infarctions take place; the returning blood to the vena portae is checked in its progress; the exhalant arteries have more than their proportion of fluids; and exhalation is increased beyond what the absorbents can convey, which also seem to experience the same defective irritability. In this series there is no predisponent cause; and which is the remote cause of the disease, the diminished tone of the stomach, the infarctions of the liver, the ob- struction of the vena portae, or increased exhalation? Yet medical authors give with confidence remote and proximate causes, though the former are often Various, and the latter frequently unknown. In short, in every science there is too much jargon, and too many pre- tensions to a knoAvledge that we cannot, which pro- bably Ave never shall, possess." We just now cited the cause of dropsy with a parti- cular design: it was to adduce it as an instance, that predisponent causes, seminia morbi, do not always occur. The same occasional causes will produce the disease in the best constitution; as a fall from a house will bring on haemoptoe in the person Avhose lungs are most sound. To return, then; the proximate, or the continent, cause merits our chief regard, as it alone furnishes indi- cations of cure. This is, however, often uncertain, and in many cases unknown. If debility furnish the lead- ing- clue to explain the plienomena of fever, Ave can scarcely explain its operation or connection with every symptom; nor can Ave say Avhy, when its cause is removed, the effect should not cease. In the disease just mentioned, dropsy, Ave can scarcely in any instance see the particular cause of the increased exhalation or diminished absorption; nor, as Ave have found, can we rest on either any clear discriminated indications of cure. We must, therefore, often collect rules from experi- ence, and connect them with the more obvious causes and the more certain changes in the constitution Avhen deviating from the hoalty state. CAU'SIS, (from xxtu, uro, to bum). See Ambusta. CAUSO'DES FE'BRIS, (from xx,u, to burn). See Febris ardens. *' > CAUSO'MA, (from the same). In Hippocrates signifies a burning heat And inflammation. CAU'STICA. Caustics, (from xxtu, to burn). See ESCHAROTICA. CAU'STICUM AMERICA'NUM. See Ceva- DILLA. Cau'sticum commu'ne fo'rtius. Ph. Lond. The common stronger caustic of the London college, called now calx cum ka'li, is made by adding five pounds four ounces of quick lime, to water of pure kali, sixteen pounds. The water of pure kali is re- duced by boiling to a fourth part; and the lime reduced to a powder by the affusion of water gradually added. It must be kept in a vessel close stopped. For the mode of application see Escharotica. Cau'sticum luna're. See Argentum. Cau'sticum opIa'tum. Opiated caustic. R. Calcis cum kali puro 3 ij- opii pulverisati 3 ss. saponis mollis q. s. commisceantur calx cum kali puro, et onium, et in pastam cum sapone molli formentur. This is used in the radical cure of an hydrocele, by fonn- ing, of adhesive plaster spread on leather of several thick- nesses, a circular aperture adapted to the loAver and an- terior part of the tumour, in which the paste is intro- duced. This is to continue for about eight hours, about Avhich time it will, without much pains, pene- trate doAvn to the tunica vaginalis. Afterwards apply poultices till the eschar sloughs : then the water is eva- cuated, and the cure completed. This is Mr. Else's mode at St. Thomas's Hospital. CAU'SUS, (from xxiu, uro, to burn). See Ardens febris and Dipsas. CAUTE'RIUM, (from xxtu, to burn). A cautery, either actual or potential. See Escharotica. Caut&rium Pote7itidle Ph. Edinb. The potential cautery of the Edinburgh Dispensary. Take of Russian potash and quick lime, of each equal parts; of spring water three times the quantity of the whole; macerate them for two days, occasionally stirring them ; then filter the ley, and evaporate it to dryness; put the dry mass into a crucible, and urge it Avith a strong fire till it flows like oil; then pour it out upon a flat plate made hot, and while the matter continues soft cut it into pieces of a proper size and figure, and keep them in glasses closely stopped. This is also called lapis septicas. It is a strong and sudden caustic, but it deliquesces too soon in the air, and runs beyond its proper bounds; indeed, the sudden- ness of its action depends on its disposition to liquefy.' But this inconvenience is avoided in the calx cum kali puro. Ph. Lond. 17-88. CA'VA VE'NA. The principal vein, Avhich re- ceives the refluent blood, and conveys it to the heart, is thus named, from its size. The vena cava is generally described as being two; Viz. the ascending and the descending; the right auri- cle receives them both, one at its upper, the other at its lower part. The superior vena cava receives the blood principally from the thorax, head, and upper extremities, Avith a very small proportion from the parts below the diaphragm. The inferior vena cava receives the blood principally from the abdomen and loAver extremities, and very lit- tle from the parts above the diaphragm. The ancients called the vena cava superior, the vena cava ascendens ; and the vena cava inferior, vena cava descendens. According to Winslow, who is extremely accurate in his description of the blood vessels, the superior vena cava runs down to the right auricle of the heart, almost in a direct course, for about two fingers' breadth within the pericardium, on the right side of the aorta, but a little more anteriorly. Above the pericardium, it runs doAvn from the cartilage of the first true rib, and a little higher than the curvature of the aorta; here it receives two branches, viz. the right and left subcla- vian veins. The trunk of this upper vena cava, above the pericardium, to the just named bifurcation, receives anteriorly the vena mediastina, pericardia, diaphrag- matica superior, thymica, mammaria. interna, and trachealis. All these are called dextrae. Their fel- lows on the other side are called sinistrae; they do not fall into the trunk of the vena cava, but into the left subclavian vein. Posteriorly, a little above the pericar- dium, the trunk of the vena cava receives a capital branch, called vena azygos. It runs down by the ver- C ED 383 CED tebrae dorsi, almost to the diaphragm, composed of the greatest part of the venae intercostales and lumbares su- periores. Hardly a quarter of an inch of one side of the vena ca- va inferior is contained in the pericardium; from thence it immediately perforates the diaphragm, receiving the venae diaphragmaticae inferiores, or phrenicae: it passes behind the liver, through the great sinus of that viscus, from which'it receives venae hepaticae. In this course it inclines towards the spina dorsi and aorta inferior, the trunk and ramifications of which it accompanies all the way to the os sacrum, the arteria cceliaca and the two mesentericae excepted. Arrived at the os sacrum, the two iliacae unite to form its trunk, joined by the hy- pogastricae, and some other branches distributed into the pelvis. Under the ligamentum Fallopii they take the name of crurales, each of which receives the blood from the lower extremities. CA'VAN, dicta Tho'ra pa'rou. See Cajan. CAVE'RNA, (from cavus, hollow). A cavern. See also Pudendum muliebre. CAVIA'RIUM, (from caviar). It is the pickled roe of the sturgeon. CAVI'CULA, and CAVI'LLA, (from cavus). See Astragalus, and also Cuneiforme os. CA'VITAS INNOMINA'TA,(from the same). See Auricula. CAYENNE, CA'YAN. See Piper Indicum. CAYU'TANA LU'ZONIS. See Fagara ma- jor. CA'ZABI. See Cassada. CEANO'THOS, (from xeei xyuOev, because it pricks at the extreme parts). See Carduus HjEMOrrhoi- DALIS. CEANO'THUS. See Celastus inermis. CEA'SMA, (from xex£u, to split, or divide). A fis- sure or fragment. CEBIPl'RA Brasiliensibus. (Indian.) Guacu, or Miri. A tree which grows in Brasil. Its bark is bitter and astringent, and the decoction is employed in baths and fomentations for the relief of pains in the limbs, diseases from cold, tumours of the feet and belly, itch, and other cutaneous diseases. It is figured by Mar- grave in his plants of Brasil, p. 100, but its botanical place has not been ascertained. CE'CIS, (from xvxtu, to spring). A gall of the oak. So called because it springs suddenly from the oak. See Gall.k. - CECRY'PHALOS, (from xpwlu, to hide). The net in which women confined their hair (Hippocrates). It is also applied to one of the stomachs of ruminating animals. See Abomasum. CE'DMA, (from xehtu, to disperse)'. See Puden- dagra. CE'DRA, Esse'ntia de. See Bergamotte. - CEDREL^E'UM, (from xeS'pos, the cedar tree, and iXxiov, oleum). ,Oil of cedar. See Cedria. CEDRE'LATE. According to Bellonius, this word is derived from eXxni, the fir tree, and xetyos, the cedar, because it grows like the fir. Among botanists it sig- nifies that species of cedar which is said to exceed all other trees in size. CE'DRIA, (from xe^pos, the cedar tree). It is called the pitch and the resin of the great cedar tree, and it is the crude tears of the cedar, ft has been supposed different from the cedrium, or oil of cedar, Avhich is more fluid; but, by writers in general, it is called cedria, cedrium, and cedrelaum. Gorraeus and Pliny observe, that the great cedar yields a pitch called cedria, to which Galen gives the same appellation Avith many others. Salamasius says, that the Arabians call the oil of cedar ketran, or alketran; and we, by a corruption of that word, give the name of cedrium to the pitch which is used for ships. Though the. Greeks confound cedrelaum with cedria, they are not the same ; for the cedria is the pitch, or resin', that distils from the cedar tree; and the cedrelaeum is an oil obtained from the pitch or resin, and which swims above it in boiling, and is collected with wool. Dioscorides remarks, that the best cedria is thick, pellucid, and of a nauseous smell; when poured out it does not spread, but collects in drops, and preserves dead bodies from putrefaction: it does not, however, appear to be really known what the cedrium is. CEDRI'NUM LI'GNUM. See Juniperinum. Cedri'num vi'num. Cedar > wine. Take thin pieces of wood, just cut from the tree, while the fruit is on it, and expose them to the sun, or a fire, to ob- tain their juice by exudation. A pint of this juice is mixed with six pints of Avine. After standing for tAvo months they are decanted into another vessel, and ex- posed for some time to the. sun. The wine is then fit for use. In the same manner are prepared Avines from juniper, pine, cypress, bay, and the wood of some other trees. All these wines are heating, diuretic, and astringent; the bay wine is particularly so. Cedar wine is also prepared by mixing half a pound of the bruised berries with six pints of must. The whole placed in the sun for forty days, and is then proper for drinking. Cedrinum is a name for the composition of wax and resin used for ships. See Cedria. CE'DRIS. See Cedrus. CEDRI'TES, is wine in which the resin that distils from cedar trees has been steeped. CE'DRIUM. See Cedria, and Pix liquida. CE'DRO and CEDROME'LA, (from xefys and (MjXov, an apple). See Citreum. CEDRONE'LLA, (from xeSpos, because it is pro- duced by a sort of cedar tree). See Melissa. CEDRO'STIS, (from xetyos\ because it smells like the cedar).- See Bryonia alba. CE'DRUS, (from Kedron, a valley where it grew in great abundance,) cedrus conifera foliis laricis, cedrus Libani, cedrus magna, larix orientalis. The pinus cedrus Lin. Sp. PI. 1420. The great cedar of Libanus. Nat. order conifera. It is referred by Tournefort to the genus meleza, and by Jussieu to the juniperus. Modern botanists cannot find cedar trees that agree with the scriptural description of their loftiness; but this tree, according to the similitude of the Psalmist, spreads its branches very extensively. Maundrel, in his travels, says he measured the trunks of some old cedar trees, and found one to be twelve yards in cir- cumference, and thirty-seven yards in the spread of its boughs. Its native spot seems to be Mount Libanus, Avhere it grows in a dry, stony soil; but even here its numbers Avere diminishing. RaAvolf, in 1574, found CEL 384 CEL only-tAventy six, with no young ones; Maundrel, 100 years afterwards, could discover but 16: there Avere, however, many young ones. Pocock also found a great number of young thriving cedars on the moun- tain, j The cedar of Lebanon is an evergreen coniferous tree, with very narrow, stiff, sharp pointed leaves, standing several together in tufts. Its fruit is called cedris. It is a native of the bleak snowy mountains of Syria, and is not as yet become common in England. As a medicine, it differs very little from the virtues of the fir tree. Its smell is considerably more agreeable, and the resinous juice extracted from the trunk of the cedar tree, by incisions, is more disposed to concrete into a solid brittle mass than that-from the fir-tree; nor does the matter Avhich distils from the cedar'tree lose much of its finer parts hi drying: even boiling Avater does not easily carry off the flavour of cedar Avood. By distilling the>wood with Avater, a" small quantity of essential oil is obtained, which congeals ih a mode- rate degree of cold. The decoction, in the still, affords an extract by evaporation, which-smells considerably of the wood, and is in taste bitterish and saline. In the saline nature of this extract, this wood differs from all the resinous ones that have-been examined. Margraff says, that the saline part which crystallized in the ex- tract was common salt. The wood of the cedar is very incorruptible, though it is not probable that cedar wood formed the roof of the temple of Apollo at.Utica, supposed to have re- mained with little change for 2000 years. The fra- grance of the Avood drives avvay moths; and, internally, the productions of the cedar and the junipers differ little from the turpentines. See Juniperus. Ce'drus cupressi, juniperus Lycia Lin. Sp. PI. 1471. »' It is a shrub with yelloAV floAvers, and fleshy leaves, placed four together, like those of cypress. The floAvers are followed by a round fruit like a mulberry in taste and smell, and of a purple colour Avhen ripe. "In this fruit are three or four seeds, which smell like resin. Until this tree is three or four years old, its on]y dis- tinction from the jdniper bush is, that its leaves are softer and shorter. , It groAvs in many of the southern parts of Europe. Its medicinal qualities are like those of juniper. Dale informs us of another species which he found in Carolina, and Avhich affords a gum so like the true olibanum, that, Avhen mixed, they cannot be separated. Hence he concludes, .that this is the tree that affords the olibanum. It is probably the juniperus thurifera Lin. Sp. PI. 1471: Ce'drus America'nus. See Thuya. Ce'drus bacci'fera, sabina. Juniperus sabin.aL.in. Sp. PI. 1472. See Sabina. Ce'drus ce'es. See Crinones. Ce'drus phceni'cia, called also thuya Massiliensium, juniperus e Goa, cedrus e Goa, sabina Goensiq, and juni- perus Coroliniana. A variety probably of pinus cedrus. Its virtues are similar to those of juniper. * ' CELA'STRUS, (from xeXx, a dart or pole, Avhich it represents). Ceanothus Americanus Lin. Sp. PI. 284. Some noted Indians depend more on this than on the lobelia for the cure of syphilis, and use it in the same manner as the Lobelia, Avhich see. If the disorder is exceedingly virulent, they mix some of the roots of the rubils occidentalis Lin. PI. 706, with it. CE'LE. JS-yXv, a tumour, (from xsXeu to swell out,) the protusion of a soft part; a rupture. CEXLERI ITALO'RUM. A corruption of selinmn, (Ital.). See Apium. CELLU'L^ MASTOI'DEX, (a dim, of cella, a scell). These are very irregular cavities in the substance. of the mastoid apophysis, which communicate Avith each other, and have a common opening towards the inside, -,, and a little above the posterior edge of the orbicular •/ groove. These cells are lined by a fine membrane, which is partly a continuation of the periosteuA of the tympanum, and partly seems to be glandular, like a * kind of membrana pituitaria. The mastoid opening is opposite to the small opening of the Eustachian tube, but a little higher. See Auditus. CELLULO'SA MEMBRA'NA. The cellular membrane. It is called tela cellulosa, panniculus adi*.. posus; me7nbrana adiposa, pinguedinosa, et reticularis; - in French, tissue cellulaire, tissue muqueux■, aftd I'organe 'cellulaire. This membrane is of the greatest extent, and of the utmost consequence in the human structure; for it connects and penetrates into every part; indeed it seems to be the very constituent of most, if not all, the parts that are called the solids in our bodies. Ex- periments prove that all membranes, without excep- tion, and the vessels, Avhich are holloAV membranes, the parenchymatous substance of the viscera, ligaments, - and a great part of the bones, either are or have been cellular texture. The cellular membrane, when com- pacted in different degrees of density, forms these solids. Air introduced under the skin diffuses itself through all the surface of the body, penetrates into the interstices of the muscles ; and Haller asserts, that even the vitreous humour of the eye hath received the flatus of an emphysema. ; Some describe the cellular membrane not as one, but as a congeries of many membranous lamina joined irre- gularly to each other at different distances, so as to form numerous interstices of different capacities, and which communicate with each other. These interstices they call cellulae,andthe substance made up of them cellular substance. It is generally and properly considered as of two kinds, viz. reticular and adipose; and the latter is de- scribed as a connection of fibres, forming, by their different directions, cells for the lodgment of oil or fat. In some parts its substance is merely a net work of slender fibres,^ which give it ductility and looseness; for instance, under the skin of the penis and scrotum. In other parts it is more or less loaded Avith oil, and is less porous or spongy in its substance, as under the skin of the buttocks, and in the soles of the feet. Dr. Hunter uses the term cellular as the generical name, and the names reticular and adipose for expressing the two species. He also observes, that the reticular part is evidently dispersed through the whole body, except, perhaps, in the substance olrVthe bones, of the brain, and in the humours of the eye; that it is found in a much greater degree in the belly of muscles than in the tendons, in which it is scarcely discerned. He is ' also of opinion that the adipose membrane is composed of two kinds of cells; viz. the reticular, Avhich com- municate Avith each other; and adipose, which are di- CEL 385 C E IS stinct, and are the reservoirs of the animal oil, or a white granulated matter, capable only of being fused, by heat; the cells of which are called sacculi adiposi. He urges, as a proof of his opinion, that the Avater in an anasarca goes downward while we are in an erect posture, but the oil does not. The oil is supposed to be secreted by the small arteries, and occasionally absorbed into the circulation. Dr. Hunter thinks that wherever -there is fat in the human body, there is a particular glandular apparatus superadded to the re- ticular membrane, consisting of vesicles, or bags, for lodging the animal oil, as well as vessels fitted for its secretion. Whether or no the cellular membrane be the basis of all the organized and vascular parts of our frame, Dr. Hunter hath proved that the most simple parts of it are vascular; that the callus, which unites broken bones, is itself bone, and also vascular; that the morbid adhe- sions, between different adjacent parts, are vascular, and that a cicatrix in the skin is vascular. He infers from hence, that all our solids are organized; and that, whether lengthened or renewed, they shoot in a vas- cular form. But here he speaks of the visible parts. We suspect, however, that the importance of this con- necting reticular texture has been greatly exaggerated. We see in it nothing but connecting threads, which any condensed glutinous substance forms; and, if the cells communicate through the whole body, it is no more than may be expected from the union of differ- ent separate organs. If these are united in one part, they are separated in another; and Ave can easily see that by some passage all may communicate. It has been said, that membranes are formed of this substance. We know that, Avhen condensed, it will assume a membraneous appearance; but we have no evidence of it in any case possessing nerves or organi- zation, like Avhat we may style pr'anordial membranes. The effused gluten, between the pleura and lungs, as- sumes this form; but we cannot say that this is an or- ganized substance. The cellular texture never appears to be vascular: even in a state of inflammation it is never sensible. It is the seat of an abscess, but is not itself inflamed. Nerves pass through it, but are never lost on it. The former editors of this work have suggested, that it may be formed from the coats of the nerves; but these are never deposited except at their minutest extremities, where the nervous poAver acts with its peculiar functions. This never occurs in the cellular substance, except of the muscles; and it Avould be a gratuitous assertion, that such Avas the origin of the cellular substance in muscular flesh, when, in every other part of the body, no such source could be traced. In fact, Ave see in every part of the cellular substance only hardened gluten, Avithout either a nerv- ous or glandular apparatus. Whether the adipose membrane differs in its structure we doubt. There is some reason to think so: but we must remember that, if one part of the cellular substance be filled, the sur- rounding membrane is thickened; and this will account for the retention of the fat in those cells where it is de- posited. Among the uses of this membrane, the fol- loAving are sufficiently obvious. 1. It fills up interstices, and gives an agreeable con- tour to the body. VOL. I. 2. It is a cushion to defend against pressure, hence it is of a thicker composition in infants. 3. It connects the parts of the body, but so as to ad- mit of a sliding motion between them. 4. In some parts of the body it serves as a bed for more tender organs; as in the orbit and scrotum, as well as a reservoir for animal oil. This membrane is the seat of abscesses, the leuco- phlegmatia, emphysema, anasarca. In a consumption it is shrunk up so as to be hardly visible; in an anasarca its oily contents are all destroyed; and-in an emphyse- ma almost its minutest parts are rendered visible. On this article, see Avhat Dr. Hunter says in the Lond. Med. Obs. and Inq. vol. ii. p. 26, &c. Haller's Physiology; Malpighius on the Cellular Membrane; Dr. Shebbear in his Theory and Practice of Physic; also Recherches sur le Tissu Muqueux, ou l'Organe Cellulaire, par Mons. Theoph. de Bordeu. Cellulo'sa tu'nica Ru'yschii. See Intesti- na. CELOTO'MIA, (from xjjAjj, hernia, and np.vu, to cut). See Castratio and Hernia. CE'LSA. It means the beating of the life, or of the life's blood; and is a barbarous term of Paracelsus. CE'LTIS. A celsitate,from its height. See Lotus arbor. CEMENTA'TIO. See Cojmentum and Corro- sio. CEMENTE'RIUM. See Aludel. CE'NCHR AMIS, (from xey%%os, millet). See Ficus SATIVA. CE'NCHRIUS, a species of herpes, called, from its resembling xey&pos, millet. See Herpes, Bell's Spec. 3d. CENCHROS. Millet, (from xey&vos, dry; be- cause it is a very dry seed). See Millium. These seeds are also called cenchrcides; and,. in Hippo- crates, Ave find the words xeyxpxethes imputes, miliary sweats. CENEANGI'A, (from xeve^ vacuus, inanis, and xyyos,vas,) is an emptiness of vessels from abstinence. It is sometimes thought to mean, primarily, a spon- taneous evacuation of blood from the vessels; and, consequently, that which is artificial may be meant by this term. In some dissections the vessels have been found remarkably empty; but this appearance has not been connected Avith any concourse of symptoms. CENEO'NES, the flanks, from xeves, emptu. CENI'GDAM and CENI'PLAM, and CENT'GO- TAM and CENI'POLAM. The name of an instru- ment anciently used for opening the head in epilepsies. CENIOTE'MIUM. A purging remedy, formerly used in the venereal disease, supposed to be mercu- rial. CENO'SIS, (from xevos, empty). Evacuation. Ce- nosis imports a general evacuation; catharsis the evacua- tion of a particular humour Avhich offends Avith respect to quality, and almost exclusively from the alimentary CENTAU'REA BENEDI'CTA. See Carduu, benedictus. Centa'urea centau'reum. See Rhaponticum vul- gare. CENTAURIOI'DES. See Gratiola. 3 D CEN 386 CEP CENTAU'RIUM, (from xevlxvpos, a centaur). This herb is called centaury, because it Avas feigned that Chiron, the centaur, cured Avith it Hercules' foot, which had been wounded Avith a poisoned arrow. It is also called Chironi.v. Centau'rium ma'gnum, ma'jus. See Rhaponticum VULGARE. Centau'hium mi'nus, or lesser centaury. It is the ge7itiana centaurium Lin. Sp. PI. 332. Nat. order ro- tacea. It is annual, grows Avild in dry pastures, and among corn. It floAvers in July; and is sometimes called the febrifugia. The leaves and tops are pure bitters, having scarcely any smell or flavour, and agree Avith the gentian root. The seeds are bitter, but the petals of the flowers and roots are almost insipid. The flowery tops are the parts chiefly useful. Its active parts are readily dissolved by water, or rectified spirit of wine. Water takes up with the bit- ter an insipid mucilage; but spirit, the bitter part only. The Avatery extract is consequently more in quantity, and less bitter; and the spirituous less, but more bitter. Cartheuser says, that one ounce of the herb yields about half an ounce of the watery extract, and scarcely two scruples of the spirituous. The centaury is justly esteemed to be the most efficacious bitter of our indi- genous medicinal plants; and has been recommended as equal or superior to gentian. Dr. Cullen observes that, though the extract of this plant is said to be less agreeable than that of gentian, he can find no difference, and thinks that, as cheaper, it is preferable. It is considered as strengthening and stomachic; and, as out of the body centaury manifests an equal degree of antiseptic power with gentian, similar medical effects are ascribed to it. It is given in atony, dyspepsia, and jaundice. The flowery tops are infused as tea, and a tea cupful administered three or four times a day: but they may be taken in powders, or the decoction in- spissated into an extract like Avormwood. See Neu- mann's Chem. Works. Lewis's and Cullen's Mat. Med. CENTIMO'RBIA, (from centum, a hundred, and morbus, a disease; so called because it Avas supposed capable of curing a great number of diseases). See NUMMULARIA. CENTINE'RVIA, (from centum, and nervus,' a string; so called from the many ribs upon its leaves). See Plantago. CENTINO'DIA, or CENTINODIUM, (from cen- tian, and 7iodus, a knot; so called from its many knots or joints). See Polygonum. CENTI'PEDES, (from centum, and pes, a foot). See Aselli. CENTRA'TIO, (from centrwn, a centre). The de- generating of a saline principle, and contracting a cor- rosive and ulcerating quality. Hence centrum salis is said to be the principle and cause of ulcers. Para- rclsus* CE'NTRE PHRENI'QUE. See Diaphragma. CE'NTRION, (from xevrpov, a spur). An epithet for a plaster mentioned by Galen, calculated against stitches in the side. CENTRUM, in chemistry, is the principal residence, foundation, or source of any thing; in medicine, that part in Avhich its virtue resides; in anatomy the middle point of some parts. Ce'ntrum nerve'um. The tendinous part of the diaphragm, which hath a triangular appearance: it is called also centrum tendinosum. Ce'ntrum ova'le. Vieussens first gave this appel- lation to a part of the corpus callosum. It is convex, and of the form of the cerebrum. See Cerebrum. CENTU'NCULUS,(from cento, a quilt or mattrass, Avhich Avas formerly made of this herb). See Alsine, and Gnaphalium. CE'PA, (from xenos, a wool card; from the likeness of its root; or capitis magnitudine, from the size of its head). The onion. Allium cepa Lin. cromyon, et agrumina. Nat. order liliacee. The common onion is a plant too Avell knoAvn to need any description of its botanical character. It is chiefly cultivated for culinary uses: its root affords a large proportion of alimentary matter, particularly Avhen boiled, as it shows by some sweetness and a large pro- portion of mucilage, when its acrimony is exhaled. In its fresh state it is acrid and stimulating. In bilious dispositions it produces flatulence, thirst, and headach; but in cold and phlegmatic temperaments is warming, attenuant, and promotes both expectoration and urine. It is powerfully antiseptic, and, if applied to tumours, promotes suppuration. The root is the most active part; but it loses much of its virtue by drying. Distilled with water, all its flavour and acrimony arise. The active matter is much more volatile than that of garlic, but in other respects they agree, though the onion is much weaker, less acrid, and more mucilaginous. Onions have a greater effect than any other alka- lescent plant in dissolving gravelly concretions. The expressed juice has been serviceable in deafness (see Allium). Neumann remarks, that the characteristic principle of this root is its essential oil, though it can- not be collected in a separate state. See Lewis's Mat. Med. or Neumann's Chem. Works. Cullen's Mat. Med. CEPJL'A. A small species of onion, which used to be esteemed for sallads in spring, but is not noAv re- garded. See Becabunga. CEPHALCE'A, (from xeQxXv, head). A long con- tinued pain in the head. See Cephalalgia. CEPHALALGIA, CEPHALA'GIA,(from xe, the head, and xXyos, pain). The headach. It is also named cephale, cephaloponia, and homonopagia. It is sometimes used to signify a dull pain of the head, of a "short duration; but most frequently it is the ap- pellation of pain in the head in general, without re- gard to circumstances, and is sometimes acute, and sometimes chronical. When mild it is called cepha- lalgia; when inveterate, cephalea. When one side of the head only is affected, it takes the name of he- micrania, 7nigrana, hemipagia, and megrim: in one of the temples only it is entitled crotaphos; and that which is fixed to a point, generally in the crown of the head, is distinguished by the name of clavas hystericus: q. v. The nervous membranes of the head are the general seats of its pains, as the pericranium, the skin, dura mater, the membrane which covers the sinus in the os CEP 387 CEP frontis, 8cc. This complaint is considered as symp- tomatic by Dr. Cullen; but as an idiopathic affection by other nosological writers. See Vogel, Sagar, Lin- naeus, Macbride. Sauvages places it under his seventh class dolores, and second order dolores capitis; of which the cephalalgia and cephalaa form tAvo distinct genera. See Nosologia Methodica, vol. ii. p. 49. Undoubtedly pain of the head is often symptomatic; yet, as in many cases it is impossible to ascertain the disease of which it is a symptom, and in some is uncon- nected Avith any other complaint, it must be often con- sidered as idiopathic. When we explain the arrange- ment of diseases, Ave shall find it difficult to avoid an order, at least, of dolores; and under this head cepha- lalgia must be arranged. If we vvere already to antici- pate definitions, Avhich we have cautiously avoided, Ave would say that it is a pain confined to the forehead and occiput, unconnected in every instance Avith the bones of the face, except when periodical. In this way it is at once distinguished from the tic doloureux (the dolor crucians faciei of Fothergill), diseases of the teeth, of the different antra, and of the eyes. In this view, headach is a disease of the brain when idiopathic; and, though a symptom of apoplexy, of mania, and other diseases, yet, when alone and uncom- bined, when the series of symptoms which distinguishes these diseases is absent, and headach alone present, it must certainly be considered as of itself a disorder. As such, Ave find it produced by extraneous bodies pressing on the brain. These have been bony frag- ments, separated from the internal table of the scull, irritating the brain, while the accident that occasioned their separation Avas, at a distant period, unknown or unobserved. In some cases no such accident seems to have occurred; and the cause, only discovered by dis- section, is unknown. The irritating bone has, in some instances, not been separated; but, has sprouted from the internal table of the skull in the form of an exos- tosis. This seems to be the cause of the obstinate head- achs arising from an old neglected venereal complaint; headachs which we have sometimes seen terminating in epilepsy. The falx has been found to be bony, Avith- out producing headach ; and, on the contrary, the me- ninges of the brain have been discovered in a thickened state after headachs the most violent. In the last case it is probable that the thickening of the membranes was OAving to chronic inflammation; and that the latter occasioned the pain. The pineal gland has been sometimes found hard, and filled Avith stony concre- tions, which seem to have been the cause of obstinate headachs; and Dr. Blane has found a tumour in the situation of this gland occasion the disease, as Avell as aneurisms of those branches of the carotids that sur- round the sella turcica. The distinction of these cases is very difficult: the pain is not always constant. In some instances it is violent only when the circulation is greatly accelerated ; in others it occurs irregularly, Avithout any obvious cause for its exacerbations. We have not mentioned the worms generated in the brain, recorded by Schenkius, as this author's narratives are more often wonderful than probable; and abscess in the brain more often produces lethargy and coma, than cephalalgia. It may be doubted Avhether other causes do not some- times produce pain in the head, Avhich are still less easily traced. Accumulation of Avater often occasions uneasiness and symptoms of irritation, before those of compression come on. The peculiar kind of circulation through the brain; viz. the collection of the venous blood in sinuses, greatly favours accumulation, and may be a cause of pain. We hear also of a spasmodic con- traction of the meninges; and the idea has been sup- ported by a peculiar feel, as if the bram Avas grasped by a strong hand. Yet Ave cannot admit of the contraction of a membrane in Avhich no muscular fibres are dis- coverable, and the sudden distention of their vessels may produce the peculiar sensation just mentioned. We find also cases of mania and idiotism, Avhere vio- lent pain preceded the irregular exertion or extinction of the mental powers, in which the brain has been found unusually dry, or peculiarly soft. We know not the cause of these changes; nor can we trace the connec- tion of their effects; yet, as they have been causes of pain, we may suppose that, in some obstinate cases, they may produce this symptom without proceeding to similar distressing terminations. There is at times a morbid sensibility, the concomitant often of genius, which predisposes to, or causes, this disease. It seems as if the man of genius suffers from the same source that gives him the superiority to the rest of mankind. In such a constitution, as in inflammations of the skin, of the eye, or ear, a fly may excite pain; a ray of light, or the slightest sound, be more pungent than the mid- day sun, or the explosion of a mine. We shall mention haemicrania as an idiopathic pain of the head, though by some authors it is referred to intermittents; by others to rheumatism. We mean to treat of it, however, more particularly under its OAvn appellation. On a review of these causes of idiopathic headach, Ave must regret that the source of so feAv cases is dis- coverable, and that we have scarcely appropriate reme- dies for any of those which we can ascertain. In ge- neral, in every instance, the necessity for keeping the bowels free, must be obvious from Avhat we have said under the article of Cathartics. A drain also from the head, by a perpetual blister on the vertex, to the bone of the neck, or behind the ears, must be equally so. Avoiding accumulations and flatulencies in the stomach, for the reasons formerly assigned (see Ca- thartics), must be advantageous. Emetics are often advised for this purpose; but they are doubtful reme- dies, as they determine so powerfully during their ac- tion to the head. Yet Ave suspect that they are not in- jurious, since their inconvenience is transitory, and their beneficial effects durable; and Ave shall find them pecu- liarly useful in symptomatic headachs. As a remedy for flatulence, the fetid gums will probably be useful, even in idiopathic cephalalgia; and, if joined Avith aloes, will be more serviceable. From the effects of camphor in fevers, we suspect that it may be useful in headach; and Avith nitre we have often employed it with advantage. It is a too common practice to cut oft' the hair, partly because it is supposed to keep the head Avarm, and partly that cold applications may be more conveniently employed. This practice has not, hoAvever, the sanction of long experience; nor is it supported by reason. Each hah is a vegetable, nour- ished by a bulbous root, supplied by numerous blood vessels. These, though small, from their number 3P3 CEP 388 CEP convey no inconsiderable quantity of fluids; and as the external and internal carotids arise from a common trunk and anastomose in some of their branches, what- ever cause increases the circulation in the former must lessen it in the latter. The author of this article suf- fered for many years an irregularly returning paroxysm of headach, for which he could assign no cause; but at last discovered'that it frequently returned after shav- ing the head. He suffered his hair to groAv, and from that time it gradually lessened in violence, in duration, and the frequency of its return. From being a com- plaint highly serious, and beginning to affect the me- mory, its returns are now rare, and never so violent as to unfit him for any exertion of body or mind. Among the means of lessening the force of the cir- culation in the head, we should, perhaps, have mentioned more early, the use of slight occasional bleedings; the application of leeches or cupping glasses. They are all occasionally useful. In such cases, too, the temporal artery has been sometimes opened with the best effect. The diet in those subject to headach should be light, tooling, and moderate in quantity: the usual drink, water, Avith a moderate quantity of the Avine most suita- ble to the constitution. The white wine is generally preferable. The mind should be kept calm; all the more violent exciting passions avoided; the exercise moderate, and never in the heat of a summer day, or under a Avarm sun. The apartment should be large; the sleeping room lofty and well ventilated; the head raised high on the pillow. In short, every thing that accelerates the circulation, or determines the blood to the head, should be carefully avoided. Symptomatic headach is a disease of so many or- gans, that it is impossible to " fix the variable Proteus by any chain." Headach attends fevers of almost every kind; and, when the infinite variety of forms of fevers are considered, so many must there be of cepha- lalgia, as a symptom of this complaint only. Every ob- struction in the boAvels, every accumulation of sordes, or indigestible matter in the stomach, produces the same disease : every obstruction to the regular evacua- tion of any gland, particularly those of the surface, has a similar consequence; every nervous affection, either from excessive excitability or exhaustion. Are Ave then to be surprised at its frequent occurrence ? Is it not Avonderful that the head is ever free from pain ? But to be more particular. The sympathy between the head and stomach has been so generally observed, it is the subject of such constant experience, that to enlarge on it would be su- perfluous. We have already observed how difficult it is to ascertain the organ primarily affected. The ap- prehension of increasing any effusion in the brain, has made the distinction an object of peculiar anxiety ; but Ave are confident in saying, that, in the doubtful cases, no hazard attends the exhibition of an emetic : Ave must repeat, the inconvenience is temporary, the advantages durable. We urge this with more force, as, with the experience of near forty years, avc find the decision difficult and precarious : the tyro, without a suspicion of the difficulty, by the exhibition of an emetic has succeeded. If to this we add that headach is one of the first symptoms of fever, this plan has additional re- commendation. It must be followed by a cathartic; and, unless great Aveakness forbid, this cathartic must be an active one: the foundation of its use has been already explained. In this Avay headach, Avhether idiopathic or symptomatic, will be usually relieved. If relieved only, and congestion in the head is obvious from heavy or inflamed eyes, languor and listlessness, a blister is no equivocal remedy, whatever may be the cause. Headach, if a symptom of slow or obstructed boAV- els, is to be relieved in the same Avay by an emetic and laxative, but chiefly by the latter; and, in these circum- stances, a moderate discharge, steadily continued, is more useful than temporary active purging. Eccopro- tics are chiefly useful; and they should be long persisted in. The choice of the medicine must be determined by the causes. If the fault be in the biliary secretion, the purging mineral waters, soap, sometimes assisted by rhubarb, or neutral salts Avith the occasional use of calomel, will be useful. If a torpor of the intestines occasion the disease, the rhubarb, the aloes, and even the colocynth, will be necessary, as less active medi- cines will have little effect; if mucus involving worms, calomel, rhubarb, resin of jalap, and even gutta gamba. We doubt, however, Avhether Avorms be so frequent a cause of headach as has been supposed. The hydro- cephalus was not long since styled a worm fever; and the early symptoms of irritation, accompanied by pain in the head, were attributed to these animals. Yet, as all accumulations in the bowels may occasion headach, those from worms must not be hastily rejected. An obstruction connected with the boAvels has been a very general cause of this complaint, we mean the suppression of the haernorrhoidal discharge. In the whole circle of practical medicine, we know no question so intricate and difficultly explained as the connection of the haernorrhoidal discharge with the general health; or rather, perhaps, the supposed connection, as stated by the German physicians. We have not found, from our oavii observation, this connection; but the experience of ages must not be overlooked, or contemptuously disre- garded. The haemorrhoids were considered, at a cer- tain period of life, as essential to the male, as the cata- menia to the female, health: their appearance was hailed as a salutary omen, their disappearance dreaded as a dangerous symptom. To this subject we must return: Ave can only noAV say, that we have not found this dis- charge necessary, except when established as an habit- ual one. We have found its repulsion injurious, and indeed so is that of every habitual discharge. Yet there is evidently some connection between the state of the rectum and the general health; for the fistula, or an abscess in ano, often relieves hectic symptoms; and, to check or stop the discharge, is often injurious, and ge- nerally fatal. It Avas supposed, that as the veins of the abdomen centered in the vena portae, the depletion of these Avould lessen an obstructed circulation in the liver. But the haernorrhoidal veins do not form a part of the vena portae, and this system is of course untenable. The inconvenience that arises, must consequently be attributed to the suppression of an evacuation, and par- ticularly to that of a discharge, Avhich increases the cir- culation in the descending aorta. The consequence, as Ave have already shown, must be a greater determination , to the ascending. Another defect constantly attended Avith headach is that of the catamenia, whether they have not appeared CEP 389 C E P ©rbeen suppressed. The chlorosis Ave shall soon notice, but it must be under the disadvantage of not having con- sidered the cause of menstruation. We should have explained this subject under catamenia but were un- willing to disturb the former arrangement too rashly, as it involved such numerous references. If plethora or spasm obstruct the menses, the disease of the head is obviously accounted for : if Aveakness or inanition ren- der this discharge insufficient, the effect is not so easily explained. The complaint is, however, attended with general debility; every discharge is equally suppressed, and an irregular balance of the circulation is the conse- quence. With the greatest weakness, Avith a com- plexion which shows that the red globules, that index of tone and general health, are deficient, the head is loaded, and haemorrhages from the nose are not un- common. A similar complaint with headach often occurs in boys about the age of puberty. In these dis- eases, active cathartics, particularly those whose activity is exerted on the rectum, are the chief remedies, though in chlorosis, tonics must be also employed. Repelled fluids from the surface produce very con- stantly symptomatic cephalalgia. The simplest case of this kind is coldness of the feet; but damp cold wea- ther, with an easterly wind, will in many constitutions bring it on. Partial colds produce rather fever or rheu- matism; but in both the head is usually affected. A more severe cause of this kind is the repulsion of acrid matter from the surface, by the application of astringent washes to herpes, or tetter; by saturnine or mercurial applications as cosmetics: from these the head generally suffers, though the mischief is often more extensive, and apoplexy, cachexy, slow fever or epilepsies, are frequent consequences. Repelled gout is a still more serious cause. See Arthritis. There are causes of headach that act more mechanic- ally. Whatever, for instance, retards the current of the blood in the sinuses of the brain, or the veins which convey the blood from the head, will produce it. Of this kind are various tumours, particularly of the con- globate glands, polypi, exostosis, &c. Whatever pre- vents the free evacuation of the right auricle and ven- tricle, contributes to retard the motion of the blood in the veins, which discharge their contents on this side of the heart. More externally, rheumatic pains in the muscles of the head sometimes resemble so strikingly cephalalgia as to be mistaken for it. We have not mentioned the mental causes, anxiety, fear, suspense, and grief; for these seldom produce the complaint until the body or, in general, the stomach is affected. The cephalalgia of students is often a nerv- ous affection merely. Whatever be the action of the nervous fibres in intellectual operations, its excess is often a cause of pain; though, in many instances, the cephalalgia of students is connected with obstructions of the boAvels, and very often with increased determination to the head. The hysteric cephalalgia partakes of this nervous cause, particularly when the" pain feels as if a nail Avas fixed in the brain, from hence called the clavus hystericus. But to this subject Ave must return Avhen Ave treat of hysteria. Authors have endeavoured to distinguish by the par- ticular kinds of pain Avhich of these causes may have produced it, but language fails in describing the differ- ent feelings, and their variety. An external soreness, points out an external cause; and, Avhen the remote causes are attended to, we may, Avith little difficulty, ascertain the real nature of the complaint, and the prac- tice will, of course, be obvious. Where the causes are beyond our reach, the disease may be mitigated, by attending to the directions given for relieving idio- pathic headach. Though the cure of these species of headachs de- pends on their causes, and we have given, in general, the outline, which will be filled up in treating of the diseases themselves, Ave may here add a few of the re- medies which give immediate relief. One of these is bathing the feet in tepid water, rubbing them Avith flour of mustard, and keeping up a general circulation to the surface by flannel next to the skin. The effects of a blister we have already mentioned; but the aqua ammoniae, or ether, applied to the nostrils or the fore- head by the palm of the hand, often produce instan- taneous relief, which authors have explained in the folloAving manner: A branch from the fifth pair of nerves is spread on the membrane that lines the nostrils, and another branch from the same passes through the foramen su- percili, and spreads on the teguments of the forehead ; hence, Avhen pain is in the eyeball and forehead, a heat is perceived in the nostrils; and benefit may be expected from external means, if applied to the mem- brana narium and to the forehead : alternate pressure near the superciliary holes of the frontal bones will also relieve. Cephalalgia catarrha'lis. See Catarrhus. Cephala'lgia inflammato'ria. See Phremhs. Cephalalgia he'rba. See Verbena. Cephalalgia spasmo'dica. The sick head- ach. Though this afflictive malady scarcely differs from the symptomatic headach, arising from the sto- mach, yet, from respect to Dr. Fothergill, Avho first called our attention to it, we shall speak more parti- cularly on the subject. He observes, that it is not the complaint of any particular age, sex, constitution, or season, but it is incident to all. The sedentary, in- active, relaxed, and incautious respecting diet, are the most exposed to it. The patients, he observes, generally awake early in the morning with a headach, which seldom affects the whole head, but one particular part of it, most com- monly the forehead; over one frequently, sometimes over both eyes. It is occasionally fixed about the upper part of the parietal bone, of one side only; sometimes the occiput is the part affected; or it darts from one place to another. From the time it commences until it wholly ceases, it'is in different degrees. With this is joined more or less of sickness, which in some is scarcely sufficient, Avithout assistance, to provoke vo- miting, though in others this operation is easily excited, If this pain happens, as is most common, early in the morning, before any meal is taken, then phlegm only is throAvn up, unless the straining be severe, when some bile folloAVS. In this case the disease soon begins to abate, leaving a soreness about the head, a squeam- ishness at the stomach, and a general uneasiness, which induces the patient to wish for repose. Perhaps, after a short sleep, he recovers perfectly, debilitated only by CEP 390 C E P his sufferings. The duration of this conflict differs in different persons; in some it goes off in two or three hours; in others it continues twenty-four hours or longer, and with a violence scarcely to be endured, when the least light or noise produces most excruciat- ing pain. In young persons it most commonly goes off soon ; if it continues to harass them many years, as it sometimes happens, the fit is of longer duration, and leaves the Avhole system in so Aveak a condition as is not soon recovered. Its returns are very irregular; some suffer from it every two or three days, some in two or three weeks, others in as many months, or yet more seldom. Those who use but a little exercise, and are inattentive to their diet, are the greatest sufferers; costive habits are the most exposed to it; and habitual laxity of the bowels coming on has removed this com- plaint. The disease is spasmodic ; it attacks after digestion is performed, Avhen the bile is supposed to have acquired its full activity, undiluted by fresh supplies of liquid: from numerous circumstances it appears to proceed from the stomach. For the most part it proceeds from inattention to diet, either in re- spect to kind or quantity, or both; and without exact conformity to rule in this respect, medicine proves ineffectual. Butter, pepper, or other spices, meat pies, rich baked puddings, drinking strong liquors, with a very free use of malt liquors, are sup- posed to produce it. Quantity as Avell as quality of diet is to be considered. Bile, if very acrid or bitter, is a frequenf cause, unless in habits where the bile will purge, and these are rarely affected by this disease. An emetic, or mild cathartic, and some time after it an anodyne, will carry off" the complaint; but, as we have said, the fits will return after irregular and uncer- tain intervals. If disposed to costiveness, the belly should be kept open, by a regularly repeated laxative; and rhubarb, or aloes, is preferable to the saline pur- gatives. If acid abounds in the stomach, small .doses of stomach bitters, with a little alkaline salt, or a cha- lybeate, once or twice a day, may be given; but in general, soap and pil. aloes cum myrrha, or magnesia and rhubarb, in small doses, daily continued, will often prove effectual. The folloAving eccoprotic is highly useful: R. aloes succotorin. 3i. rad. rhab. et rati. glycyrrhiz. incis. aa. 3 ss. infunde in aq. calcis ^ viij. colaturae adde tinct. lavend. 1 ss. m. cap. cochl. i. ij. vel. iij. pro ne nata. This disease is not the effect of any sudden and ac- cidental cause, but" of reiterated errors in diet, or in conduct, which, by weakening the organs of digestion, and othenvise disordering the animal func- tions, occasion frequent accumulations of indigested matter, and require a steady perseverance in the use of medicines. This change cannot be effected speedily; a patient observance of proper regimen, in respect both to medicine and diet, is necessary. The former ought, therefore, to be so contrived as to be taken Avithout disgust for several weeks together, and to be repeated at proper distances, till the digestion is rightly per- formed, and the bile properly secreted and discharged. Unless the Avhole plan of diet, both in kind and quan- tity, accord Avith medical prescription, the benefits will be proportionally diminished. It demands atten- tion to observe the just medium, and no less resolution to keep steadily to the directions enjoined, particularly in respect to quantity. This must vary in different constitutions; but the first sensation of satiety is the surest proof of the meal having attained its proper limits. These patients are often subject to false appe- tite, a craving that does not arise from the demands of health, but from the morbid irritability of the stomach, which prompts them to eat more, and more frequently than nature requires, by which their sufferings are increased, and the disease gains ground. See Dr. Fothergill's Works, 4to. edit. p. 597, &c. Medical Observations and Inquiries, vol. vi. p. 103, &c. CEPHALA'RTICA, (from xepxXv, caput, and xgnZp, to 7nake clear). Medicines that purge the head. CEPHA'LEA JUVENUM. The headach that often attends youth at the approach of puberty. CEPHA'LICA, cephalics, (from xetpxXv, the head, also capitalia,) remedies against disorders of the head. Dr. Cullen says, " however frequently era-' ployed, such a general meaning is sufficient to show the absolute impropriety of the term. It has been pro- posed to limit it to such medicines as have the power of increasing the energy of the brain and the activity of the nervous system. But in this manner it has been applied without any proper distinction and precision; and till this can be done, the term would be better laid aside." In general, authors mean by cephalics, cor- dials, and whatever promotes a free circulation of the blood through the brain. In general, cool applications are useful cephalics, when inflammation prevails; but the ether, and the spirit of ammonia, as Ave have just observed, are more frequently useful. The old pharmaceutical works are full of formulae under this title, to be applied as capitones, frontals, or in other forms, which modern practice wholly disregards. The medicines were generally of the stimulant kind. The herbals are equally full of medicines, Avhich clear, which purge, which fortify the brain, under the name of cephalics. Perhaps err- hines and sialogogues may have some effect in promot- ing a discharge; but these act on more general prin- ciples. The chief cephalics retained in some of the lists of the older authors are, the betony, the valerian, the lavender, the abrotanum, and the vanilloes. Cepha'lica policis. A branch from the cepha- lica vena, sent off from about the lower extremity of the radius, running superficially between the thumb and the metacarpus. Cepha'lica tinctu'ra, of a former edition of the Edinburgh Dispensatory, consisted of four ounces of wild valerian root, finely powdered; one ounce of Virginian snake root, poAvdered; half an ounce of the tops of rosemary ; and six pints of Avhite French wine; digested for three days, and then strained off. If to this were added two ounces of senna, one ounce of black hellebore, and two pints of French white wine, the cephalica tinctura purgans is formed. It is noAv totally disregarded, though it may be useful as a nervous or antispasmodic medicine; particularly in those nervous complaints connected with fullness of the vessels of the head. Cepha'lica ve'na. The cephalic vein, called also capitis vena: because the head was supposed to be relieved by taking blood from it. It does not attend CER 391 CER any particular artery; it comes over the shoulder be- tAveen the pectoral and deltoid muscles, and runs down the back part of the arm ; when it arrives at, or a little below, the bending of the fore arm, it divides into tAvo, below the outer, as the basilic does below the inner, condyle of the os humeri. The inner of the two branches of the cephalic vein is called mediana cephalica, and is the safest to bleed in. It is a branch from the axil- lary vein. CEPHA'LICUS. PuLvis. See Asarum. CE'PHALINE, (from xeQxX*, the head). See Lin- gua. CE'PHALITIS, (from the same). See Phrenitis. CEPHALOI'DES, (from xtQxXy, and eihs, likeness). Shaped like a head, or having a head. It is applied to plants which are called Capitate, q. v. CEPHALONO'SOS, (from xepxXv, a head, and tor®', a disease). This term is applied to a fever par- ticularly affecting the head, and is frequent in Hungary. See Amphemerina Hungarica. CEPHALO PHARYNG^US, (from xepxXv, the head, and the Morello cher- ry. Cera'sus ri/bra, sati'va, or Angli'ca ; common RED CHERRY. Cera'sus ni'gra, also cirasus major, black cherry. CERA'TIA, CERA'TIUM, and CERA'TONIA, (from xepxs, a horn, Avhich its fruit is supposed to re- semble). See Siliqua dulcis. Cera'tia diphy'llus. See Courbaril. CERATTTIS, (from xepxs, a horn). See Unicornu. CERATO-CE'PHALUS, (from xepxs, cornuf and xe, caput; from the horn-like appearance of its top). See Acmella and Bidens. Cerato-glo'ssi, (from xegxs, a horn, and yXuo-o-x, a tongue ; muscles so named from their shape and inser- tion into the tongue). See Hyo-glossus. Cerato hyoidje'us, (from the os hyoides). See Styo-hyoides. Cerato-pharynge'us ma'jor et mi'nor. See Hyo- PHARYNGEUS. CERATOI'DES, (from xegxjos, the genitive case of xepxs, a horn). See Cornea. CERATOMALA'GMA, (from *^«5, wax, and fAxXyxftx, a mixture). See Ceratum. CERA'TUM, from cera, wax). Cerate; called also CereljEum (which see), ceroma, ceronium, cera- tum, cerato7nalagma. Cerates chiefly differ from plas- ters in consistence, being a softer kind of plaster, or harder kind of ointment. Their consistence is very convenient: when mercury is made up in plasters, a sufficient quantity is not absorbed from them to produce any very certain effect; but in a cerate it is resolvent and discutient, and when thus applied to venereal tophi and nodes, they often yield to it. The general rule for cerate is, eight parts of oil, fat, or juices, four of wax, and one or two of powder: or three ounces of oil, half an ounce of wax, and two or three drachms of powder. The London college directs the ceratum hlbwn to be made, of olive oil, four ounces by measure; of Avhite wax, two ounces in weight; of spermaceti, half an ounce in Aveight: these must be melted and stirred to- gether till the cerate is quite cold. Cera'tum antimo'nii vi'trum. See Antimonium. Cera'tum lytha'rgyri. See Lithargyrum. Cera'tum hydra'rgyri mtra'ti. See Mercur. PR-SCIPIT. RUB. CER 393 CER Cera'tum me'llis. See Mel. Cera'tum citri'num.—Take of the ointment of yel- low resin, half a pound; of yelloAV wax, one ounce: melt them together. Ph. Lond. 1788. Cera'tum ru'brum. Red cerate. Take yelloAV wax, and sheep's suet, of each two pounds: red sul- phurated quicksilver, fifteen grains: yelloAV resin, tAvo ounces. Melt the resin, wax, and suet together, and aftenvards add the sulphurated quicksilver; this is a cheap cerate for external dressings. Cera'tum epulo'ticum. See Calaminaris lapis. Cera'tum litha'rgyri aceta'ti. SeeLYTHARGYiuM. Cera'tum sapo'nis. See Sapo. Cera'tum cantha'rides, et hydrargyri. Cerate of Spanish fly. See Cantharides, and argentum vivum. CERAUNO-CHRY'SOS, (from xep*vve<, thunder, and xpVT°Si aurum; so called from the violence of its explosion when heated). See Aurum fulminans, un- der Aurum. CE'RBERUS TRI'CEPS. A powder composed of three capital active ingredients. See Scammonii pulv. composit. under Scammonium. CE'RCHNOS, and CE'RCHNON, (from *ee%t», to wheeze). SccRhenchos. CERCHO'DES, (from the same). See Dasys. CE'RCIS, (from xepxts, a pestle for a mortar, or spoke for a wheel). See Siliquastrum and Radius. CERCO'SIS, xepxuo-ts,(from xepxos,a tail). A disease of the clitoris, when it is enlarged and hangs like a tail from the vagina. See Clitoris. CE'REA, (from cera, wax). See Cerumen auris. CEREA'LIA, (from ceres, corn). All sorts of corn of which bread is made. The Greeks use the word demetrias in the same sense. Not to enlarge too far the article of bread, we referred to this part of our work a short view of the comparative qualities of different corn employed as its basis. The eerealia, strictly speaking, are the barley (hordeum distichum Lin.) ; the rye (secale sereale); millet (panicum miliaceum) ; the oat (avena sativa); Avheat (triticum hybernum); rice (oryza sativa); and maize (zea, 7nays). To these are sometimes added the buck wheat, from different spe- cies of fagopyrum; Guinea corn (holchus sorgum); flote fescue grass, or manna seeds (festuca fiuitans); and the lotus, described by Mungo Park, (rhamnus lotus). These different eerealia are set down nearly in the order of their nutritious qualities, beginning with the least nourishing ; and, as these perhaps depend on the proportion of oil, their ascescency, and the easy evolu- tion of their saccharine principle, are not very different. The buck wheat, the Guinea corn, the manna seeds, and those of the lotus, are truly saccharine. See Ali- ment, and the different articles under their proper terms : Farinacea and Bread. « CEREBE'LLUM, and CERE'BRUM, (a dim. of cerebrum,) as it were, the little brain ; called also epencranis parencephalis encranion. " The cerebrum and cerebellwn together are often called cerebellum, when the brain is spoken of in small animals, as birds, pigs, &c. " The cerebellum is flattened, and convex on its upper and lower part; its greatest extent is from side to side. VOL. I. It is situated under the posterior lobes of the cerebrum, and divided into two lobes by a small process of the dura mater, which is a continuation of the falx running in its direction. It is covered by the pia mater like the cerebrum ; but the lobuli of the cerebellum differ from those of the cerebrum, mostly lying horizontal. It hath no convolutions like the cerebrum, but it hath curved parallel lines described on its surface by the pia mater, and is of a darker colour than the cerebrum. It is com- posed of a-cortical substance, and a medullary part like the cerebrum, but disposed in a more regular manner; and a perpendicular section of it hath a beautiful ap- pearance, ramified like a tree, called vita arbor, the trunks of which form the pedunculi of the cerebellum. On the back part of the isthmus Avhich joins the cere- brum and cerebellum we see four eminences; the two upper are called nates or glutie, and the two lower testes or didymi. Before these the aqueduct runs down into the fourth ventricle, the medullary covering of which is called valvula magna Sylvii. The fourth ven- tricle is placed betAveen the cerebellum and the medulla oblongata." " Ce'rebrum, (quasi carabrum, a xxpx, caput). The brain, called encephalus: see also episph^eria. Meta- phorically called emporium (a Latin term for a market town), because it is the seat of all rational and sensitive transactions. Its structure and use are not so fully known as some other parts of the body, and different authors consider it in various manners. However, ac- cording to the observations of those most famed for their accuracy in anatomical enquiries, its general struc- ture is thus described. " The whole mass of brain is divided into cerebrum and cerebellum. It consists of two substances, viz. one cortical or cineritious; the other medullary. The first is of an ash colour, the second is white, and of a firmer texture: they both are vascular, but the cortical is more so than the medullary, from whence the nerves proceed. When the two hemispheres of the cerebrum, each side of the falx being called an hemisphere, arc removed, a white part, called corpus callosum, running from one hemisphere to the other, appears. The centrum ovale is the appearance of a particular section of it. The anterior ventricles are two oblong bodies placed one on each side the corpus callosum, with a partition betAveen them, called the septum lucidum, which is a continuation of the medullary substance of the cor- pus callosum. There is commonly much water in these ventricles, in those Avho die of disorders in their heads, as in the epilepsy, hydrocephalus, &c. but naturally they only contain about two drachms. In Avatery heads the fluid is always found in the cerebrum only; the ce- rebellum never hath any share in it. Each ventricle at the posterior part throws back an appendage, which makes a cavity in the posterior lobe of the cerebrum. Below the septum lucidum appears the fornix, or lyra, with the corpora fimbriata, narrow at the ante- rior extremity, where it rises by a double basis called its crura, Avhich follow the track of the ventricle; in each ventricle are eminences of a cineritious colour, called corpora striata. The plexus choroides, call- ed also reticularis, or retiformis, is a plexus of vessels Avhich folloAV the sweep of the ventricle: it is formed by the vessels of the pia mater; it is parth collected in 3E CKR 394 CER two loose fasciculi, which lie one in each lateral ven- tricle, and partly expanded over the neighbouring parts, and covering in a particular manner the thalami nervo- rum opticorum, glandula pinealis, and other ad- jacent parts, both of the cerebrum and cerebellum, to all which it adheres. The parts of this plexus, which are in the ventricles, contain some very small glands, which are considerably increased in some diseases. After the fornix is removed, we see a large plexus of vessels, particularly Galen's great vein, which go to form the toucular Herophilli, or fourth sinus, called also lecheneo i, and, by Herophillus, lenos. It is a sinus formed by tne meeting of the sinuses of the dura mater. Under the plexus, before the united thalami nervorum opticorum, is a hole on each side called the anus and the vulva; the latter goes to the infundibulum, the former to the aqueduct and third ventricle. The thalami nervorum opticorum are Avhite externally, and grey within, and are little eminences from Avhence the optic nerves arise. The third ventricle is very small; it runs back under the tAvo thalami, between them and the medulla oblongata. The pinealis glan- dula, pineal gland, called also conarium, conoides et conoides corpus, from its cone like form; and turbinata, covered by the plexus choroides, and situated on the sella turcica of the os sphenoides, is a little greyish body, the size of a pea: it lies just a little before Avhere the transverse and longitudinal processes meet, where the vessels go to form the torcular. It is covered by the pia mater, and is connected by a little bone to each thalamus nervi optici. " Numberless experiments prove, that the nerves are necessary to life; and that when the brain, or medulla spinalis, is much injured, life is at an end, or at least health : yet no part of the brain being injured, imme- diate death may ensue from different causes, though an Injury of the 7nedulla oblongata is so instantly fatal. " Behind the infundibulum called pelvis, is seen the CORPORA ALBICANTIA, Or GLANDUL.S WlLLISII. " Two glands are said to be in the brain, viz. the su- perior or glandula pinealis ; and the inferior or glandula pituitaria, Avhich see. They have the external appear- ance of glands, but as to their being such is not cer- tainly known. " The cerebrum fills all the upper portion of the ca- \ity of the cranium, or the portion Avhich lies above the transverse septum; each lateral half is divided into three eminences, called lobes; one anterior, one middle, and one posterior. " The blood vessels which supply the cerebrum, ce- rebellum, and medulla oblongata, come partly from the carotid, and partly from the vertebral, arteries. The veins of the cerebrum and cerebellum may, in general, "be looked on as branches not only of the longitudinal sinus of the dura mater, and of the two great lateral sinuses, but also of all the inferior sinuses of this mem- brane, in all Avhich the veins terminate by different trunks." " Plain truth," it is observed, " needs no floAvers of speech," and Ave long hesitated Avhether this simple, ■this bald, unornamented description might not pass as plain sound science. If we could only add to it specu- lation, yet when this is the mode, a dictionary, which is to give the very body of the time its form and pressure, must admit of speculation. As the room it employed Avas but small, and as it contained a text which might prevent repetition, we have, therefore, preserved it, and shall add the commentary. A brain is the distinction of the more perfect animah. and its proportional bulk is the criterion of more per- fect intellectual faculties. With a diminished brain, animals dwindle in the scale of intellect; and Camper's facial line, Avhich marks the varying boundary between the most perfect human form and the'meanest animal Avhich possesses this distinguishing organ, depends on the bulk of the cerebrum. This is the part originally created; and the integuments, whether bony or mem- branous, are adapted to its primordial shape. When the head is opened, and the tense dura mater removed (vide in verbo), Ave perceive a bluish white mass, formed apparently of vermicular convolutions, variegated Avith vessels of a deeper blue. This mass is divided into two hemispheres, which fill the upper part of the head, and form the projection of the forehead. Be- tAveen the hemispheres passes a membrane, called the falx ; because, when separated, it resembles a scythe or reaping hook; and these are united below the falx by a white substance, firmer than the brain, which has been just styled corpus callosum. This hard substance is continued downwards, and divides two ventricles; but as it is there thinner, it has obtained the name of sep- tum lucidum. This corpus callosum, continued back- Avard, connects the cerebrum and cerebellum ; and as when cut through in a horizontal direction it appears of an oval shape, it has been called the centrum ovale. When the base of a skull is examined, it appears to have numerous projections and depressions, adapted to the cavities or reliefs of the brain which rests on it. Behind are two spherical cavities, which contain the cerebellum ; and between them is a hole, through which the medulla spinalis passes out, or, according to modern speculators, enters. We need not enlarge further on these projections, as our predecessors have given their ap- pellations, except to add, that the pineal gland seated in the midst, on a kind of throne, the sella turcica of the sphaenoidal bone, the only part to which no other corresponds, has been styled the seat of the soul. Less eccentric observers have supposed it to be a conglobate gland; but as Ave have found it the seat of calculous concretions, we must consider it as a secretory organ, whatever fluid it may furnish. To this subject, how- ever, we shall return. When the brain is examined more nearly we find a very thin membrane, called the pia mater, Avhich ac- companies the convolutions, and sinks into the inter- stices. This membrane, Avhich will be afterwards de- scribed, conveys the blood vessels to the cineritious part of the cerebrum, and is itself covered Avith a cobAveb- like membrane, Avhich, hoAvever, does not follow it into the sulci, called tunica arachnoides. When we cut into the substance of the brain, we shall find for a little space within a broAvn substance, called, without any strict accuracy, the cineritious portion; which follows all the sulci of the convolutions, terminating in lines or rounded points, as directed by these. To this portion the medulla is united, and neither encroach on the other, but in the angles of the sulci: the depth of the cineritious portion is generally uniform. The colour is derived from very minute bloodvessels; for, strictly speaking, the medullary part suffers vessels only to pass CER 395 C E R through it. Those apparently dispersed on it, form such conspicuous streaks, as prevent us from thinking that the medulla contributes any thing further than a support: there is certainly no such minute distribution as generally attends any glandular apparatus, or distin- guishes any organ destined for an important purpose. This cineritious portion is certainly designed for an office of the greatest consequence; for we shall find that whatever be the proportion of the brain, it is al- ways present, and by no means in the ratio of the me- dulla; and in parts where seemingly additional nervous power is required, in the course of the nerves, adven- titious ash coloured matter is observed. In the sub- stance of the brain, striae of a cineritious hue are found; and some projections wholly consist of it, with different tints, Avhile others contain this matter surrounded with, instead of containing, the medullary substance. Near the origin of each pair of nerves we are in- formed that a brown substance is observable; and in the cerebellum, confessedly the most important part of the contents of the skull, it penetrates so deeply as to form by much the larger portion of it. Nature, also, seems to have supplied it with its blood, by means so refined as to prevent almost the possibility of its being Avholly destitute; for not only does it receive arteries from the external surface, but other vessels pass through the base of the skull and penetrate the medullary sub- stance to prevent any deficiency from accident. It is these arteries only, in our opinion, which we see in the medulla. It has been doubted whether the whole of this substance is vascular: the minutest injections do not penetrate every part; nor, perhaps, were the Avhole vascular, could this be expected. The medullary substance is a pulpy mass; though probably, could our sight be sufficiently assisted, Ave should find it fibrous, since this structure appears where the nerves are sent off, when they assume their coat from the pia mater. Various communications are ob- servable in the medulla, from the front to the hinder part, and from side to side. In a negro the medulla is yellowish, and sometimes a blackish yellow, though in the European of a pure white. In the former the yel- Ioav hue disappears by the access of the air. The cor- pora striata, and the thalami nervorum opticorum, which are in an European of a flesh colour, approaching a cineritious, are in the negro of a dusky brown, like the bark of a tree. The ventricles of the brain are four in number. Two are on each side of an oblong form, projecting in what are styled horns; and it seems as if the medulla, growing more dense in the corpus callosum and septum luci- dum, had proportionally contracted, leaving these cavi- ties. In health they are probably distended by an halitus; but after death their parietes collapse, and a small portion of fluid is only discoverable. Two, as we have said, are on each side; the third is more forward and in front, below the fornix, or that portion of the medulla which forms the base, and in part, the sides of the lateral ventricles. It. is a sulcus or slit of very in- considerable dimensions, and scarcely merits the name of a cavity, but from it passes a canal of soft cineritious matter, styled the infundibulum, to the pineal gland. The fourth ventricle is in a perpendicular direction, anterior to the cerebellum. It is probable that all the ventricles communicate. Dr. Monro has, Avith much anxiety as a discovery of importance, claimed the ho- nour of having first described an opening between the lateral ventricles, and consequently a communication between the three former. Yet it seems that this com- munication which we have ourselves often traced, is not always found. When we contemplate the ventricles, we seem to think that, like the chambers in the Egyptian pyramid, they are so disproportioned to the bulk that they can probably be of little advantage, and seem, as Ave have hinted, to be accidental. A more attentive examina^ tion, however, sIioavs the fallacy of this conclusion; and they appear formed by design, and Avith a judgment so subtle or refined, as to elude our research. The pia mater from the basis of the skull, is conveyed as a lining round the parietes of each; and if the cineritious mat- ter is an important organ, the pia mater, from Avhich it originates, must be equally so. Again: the base of the brain is diversified by numerous projections, evi- dently designed to increase the surface, and afford a larger scope for the cineritious matter which Ave find iii different parts, and chiefly about the origin of the nerves, which spring from the base. This cineritious substance is also found.in many parts of the different ventricles; and in these too, we find plexuses of vessels so minutely- convoluted, as probably to subserve some important purpose. Let us add, that any suppuration or any dis- order on the base of the brain, soon produces the most alarming and fatal symptoms; while some spoonfulls of the medullary substance of the hemispheres may be discharged from a Avound, without apparent injury to the intellectual faculties. We forgot to mention thai the commissural, the medullary cords, Avhich unite the different parts of the brain, are by far more common at the base of the skull than in any other part; nor is a circumstance Avholly to be overlooked, that the infundi- bulum, Avhich passes from the ventricles, terminates in the pineal gland: an organ probably of considerable importance, though its office is yet unknOAvn. The in- fundibulum is not indeed hollow through its whole length, yet it'seems to be occasionally so, as some au- thors have described the aperture as continued to the gland. Its uniform direction, and the small space occu- pied by the loosely textured medulla, seem to shoAv the probability of some communication. Anatomists have described, with great precision, all the minuter projections, cavities scarcely discernible, medullary cords of connection (commissurae), and nu- merous sulci. To follow them would be useless; for this Avork is not designed to teach the minuter branches of anatomy, and the reader may think that Ave have already been unnecessarily minute. Yet Ave thought it right to give a particular outline of the anatomy of the brain; and we think we have not trespassed in descrip- tions Avhich will not admit of some application. The projecting and upper parts of the skull are filled Avith the two hemispheres of the cerebrum which rest on a membrane, a prolongation of the dura mater, styled tentorium. Below it is the cerebellum, whose connec- tions we shall next describe. From each side of the brain, near the middle, medullary processes arise; and passing dowmvards and backwards, form what are styled the crura cerebri: these unite at an acute angle, and form what is styled the pons varolii or tuber annu- lare. From hence, what are styled the crura cerebelli 3 E 2 CER 396 CER arise; or to the tuber they descend. A prolongation of the latter forms the medulla oblongata; which, when it escapes from the head, is styled the medulla spinalis. In the whole of this part of the brain, the striated or cineritious matter is freely united with the medullary; and at the union of the crura there are some protuber- ances, which, from their shape and colour, have ob- tained the names of corpora pyramidalia and olivaria. As an appendage to the system of the brain, or rather as a detached nervous apparatus of considerable im- portance, we shall shortly describe the course and forma- tion of the great sympathetic or intercostal nerve ; the brain of the vital and involuntary motions, its succeda- neum in the lower classes of animals, and, indeed, in human monsters Avhere the brain is absent. The great intercostal is styled a portion of the sixth pair of nerves, another portion of which is distributed to the muscles of the eye. It is, however, more properly a nerve from the medulla spinalis, and is sent rather to the brain, than proceeds from it. This we collect from the parts to Avhich it is distributed being wholly inde- pendent of the will; and from the nerve between the neck, and that part where the nerves of the muscles of the eye are sent off, being larger than that between the brain and the same point. This almost insulated, nearly independent, nervous system, is connected with the brain, not only by this branch, but by a slight twig frorn the fifth pair; but its substance is formed by branches from all the different vertebrae. As soon as it appears in the neck it forms a ganglion, a medullary enlargement, in which the different filaments are inter- mixed, Avith generally the addition of some cineritious substance. In the neck only, there are three of these ganglia, to which nerves from almost every vetebra can be traced. In the chest it receives additional nerves, forming several smaller ganglia. From hence it escapes with the aorta, and reaches the sacrum; forming, with the branches from the spinal marrow of that part, other ganglia. It then turns inward ; and at the hollow of the os coccygis, meets its fellow from the opposite side, which has traced the same course with similar addi- tions. When not united in a hard body like a ganglion, smaller nerves are often intermixed, and form, by their mutual decussation, a net Avork. In these a similar in- terchange of fibres seemingly takes place; and, in the course of the intercostal nerve through the trunk, nine distinguished plexuses have been described. To illus- trate the advantages of this arrangement, we may now, though not in its proper place, remark that if an organ essential to life Avas supplied by one nerve, any injury to that, either in its origin or course, would be fatal. If, by uniting in a ganglion or a plexus with another nerve the fibres of both are intermixed, the injury to one nerve would be attended only with half the injury to the function of the organ, but the chance of injury Avould be increased in the same proportion. If, then, fifty nerves are mixed, the chances of injury are aug- mented, but the real injury to the organ is very in- considerable. In this way has nature guarded those organs on Avhich life depends; and we see that animal life may exist with a very small brain, or without any. But, after a perfect animal has existed, such is the con- nection of excitability through the whole nervous sys- tem, that, independent of the loss of blood, the destruc- tion of the brain must destroy the excitability in the nerves. It may be diminished to a very inconsidera- ble degree; and, by the arrangement described, life may for a time be continued till the cause is re- moved. The great sympathetic nerve is also the connecting link, between the two parts of which the human body consists. All our organs are doubled; and one half may be diseased or dead, with a partial injury only to the vital organs; and, in the first case, if the brain is not affected, without any apparent inconvenience to the unaffected parts. The great sympathetic, Ave shall find, supplies, in a great degree, the lungs, the heart, the stomach and intestines, the urinary and genital organs. The action of these, it must be obvious, are too important to be entrusted to the influence of one or several nerves: they must be raised above common accident: and, above all, must be independent of the will. Such is the substance of the descriptions of the most correct anatomists; and Ave should now proceed to consider the functions of this organ, if Ave did not find it necessary to attend to the doctrines of an author who has begun to excite considerable attention on the con- tinent; we mean Dr. Gall of Vienna. Dr. Gall has published no account of his system, and the substance must be collected from the reports of his pupils. We have now before us two, the one by Dr. Arnemann, and the other by M. Boisjames (Journal de Physique, vol. 55.), in which there is a view of the cranium, where the different organs are distinctly marked. Our chief object, at present, is his account of the brain and me- dulla spinalis. We laid the foundation for this explanation very early, by inserting the arrangement of the animal king- dom by M. Virey (see Animal). In this scheme, animals are distinguished as possessing a cerebral and intercostal, or sympathetic system : an intercostal sys- tem alone; or separate nerves with nervous molecules only. Dr. Gall considers the lower classes of animals as possessing nervous filaments only; the next, a spinal marrow; the superior animals possess a double spinal marrow; and the more perfect, a brain. In this lsst class, the spinal marroAV, he thinks, exclusively forms the brain, and all the other nerves. The eight pair of nerves, supposed to arise from the brain, are derived, therefore, by Dr. Gall, from the spinal marrow, and seem to become a part of the brain before they are sent off in separate bundles. In this rank, the first are the nervus accessorius, and nervus occulo motorius; the common ganglion of Avhich is supposed to be the corpus olivare, at the upper part of the medulla oblon- gata. Nearer the centre of the medulla are the nerves of the cerebellum; those medullary processes formerly supposed to be sent from the latter to the former: the ganglion of these is a substance situated in the body of the cerebellum, called, by anatomists, corpus ciliare. The corpora pyramidalia, which Ave have mentioned as protuberances on the medulla oblongata, are sup- posed, by Dr. Gall, to be the origin of the cerebrum; for he expressly remarks, that the size of the hemi- spheres is always proportional to that of the pyramidal bodies. The ganglia of the pyramids are the pons varolii; and a part we omitted to mention, the gan- glion cerebri, near the fossa sylvii. These nervous CER 397 C E R strings are distinctly marked at the base of the skull by gyrating lines. As eight pair of nerves, according to Gall, are de- rived from the spinal marrow, they are styled " enter- ing nerves;" but there are some minute nervous fila- ments, returning from the brain, which he calls " re- trograde nerves." These, he thinks, arise from the cortical substance which surrounds the ends of the first species of entering nerves. They unite in their course towards the spinal marrow, and increase in bulk, with- out passing through any ganglia. These nerves, in his opinion, form commissurae. Thus the commissurae of the retrograde acoustic nerve is situated under and be- hind the pons varolii; that of the olfactory nerve between the ganglion belonging to these nerves ; that of the re- trograde nerves of the cerebellum in the pons varolii itself. The commissurae of the retrograde nerves of the cerebellum are the corpus callosum, the commissura anterior of the lobe of the brain, near the optic nerves, continued in the septum lucidum, 8cc. Through the very middle of the spinal marrow, to a raphe or seam on the top of the corpus callosum, a very delicate medul- lary substance is observed to ascend, which Dr. Gall considers as the uniting medium of the double system of organs in the animal machine; an office we have assigned to the great intercostal. It will be obvious on examining this system, that little difference can arise in any disquisition respecting the functions of the brain, whether it be derived from the spinal marrow or the contrary; and, ascending from the more simple structure, we may as well suppose a cerebral organ added, as, in descending, to view the lower animals deprived of it. The brain, we find, is not essential to animal life; for the nerves subservient to it are derived from another source; and it is certain, that a Avound in the spinal marrow is more fatal than one in the brain. The functions of the latter, as Ave have seen, may be destroyed, while those of the former remain. So far, perhaps, the balance may be said to turn in favour of Dr. Gall. The brain, however, is the chief seat of the intellectual functions; and this is acknowledged by our author, since, in his " Organ- ology" he has assigned to its different parts various pas- sions and propensities. We have already admitted his chief position, that the shape of the cerebrum and cere- bellum determine that of the skull; and, as he has found (or thinks he has found) certain projections con- nected in man and different animals, with different pro- pensities or passions, he has denominated these their seat. He seems to have carried this enquiry to a considerable extent; and his collection of skulls, or casts, is said to be numerous and highly curious, as they belonged to characters the most notorious, of very different de- scriptions. On a careful examination and consideration of this system, we cannot think it wholly fanciful, though fancy seems often to predominate. But this is from our present subject. We shall return, however, to Dr. Gall's system, with some notice of that of Lavater, under the article Craniology. We must not conclude this descriptive part of the cerebrum, without some notice of the enquiries of Camper. This very accurate anatomist examined, with peculiar and discriminated attention, the skulls of dif- ferent races of mankind; and found that the facial line, viz. the direction of a ruler applied to the lips and fore- head, distinguished the more perfect and beautiful forms, from those confessedly less generally pleasing. The line of the faces of the ancient heads formed, with a horizontal line, an angle of 100°; beyond that is the deformity of the hydrocephalus; between it and 70° the usual European forms: a less angle than 70° marks the Calmuc, the negro, the ape, the dog, and the woodcock, in succession. In the last the angle is almost wholly lost. When we trace the forms of the different races of mankind in the natural history of man, Ave shall enlarge on this subject. It is only ne- cessary at present to observe, that the direction of the facial line is marked by the projections of the hemi- spheres of the cerebrum, and the situation of the fora- men occipitale. These distinguish the more perfect races; and, indeed, mankind, from its nearest resem- blance, the ape. The functions of the brain are so singular and im- portant, that every art has been employed to trace its structure and component parts. When the knife of the anatomist had exhausted its dexterity, injections and microscopical observations came in aid. The cineri- tious matter, we have said, is vascular; but we added that the whole could not be injected. Some authors have thought that the Avhole has been filled; but this is not probable, nor supported by the experiments of the most accurate anatomists. Veins are traced from it, and their contents are conveyed to the sinuses. The parts not injected have been supposed, from micro- scopical observations, to be follicles; and small globu- lar bodies have been discovered. But these are seen in almost every fluid of the human body, particularly in mucilaginous ones, and lead to no important conse- quence. The hemispheres of the cerebrum are chiefly mucilaginous; but as we approach the basis of the skull, a fibrous texture is more conspicuous : and, if the brain be macerated in acids, this fibrous structure can be traced further into its substance than by mere anatomi- cal investigation. When the brain is boiled in oil, it assumes a granulated appearance. The refinements of modern chemistry have also tor- tured this substance with as little profit. We recollect only the labours of M. Thouret, in the 38th volume of the Journal de Physique, p. 329, and M. Fourcroy's, in the 16th of the Annales de Chimie. The brain they found somewhat heavier than water; and conse- quently, a person at rest in a horizontal position in water, swims indeed, but with the head lower than the surface. A small proportion of saline matter was discovered by M. Fourcroy, but scarcely T^, part of the whole; and it consisted of phosphat of lime, of soda, and ammonia. In other respects the brain seemed essentially to differ from the other solid parts. It cer- tainly contained little animal matter, and consisted chiefly of albumen; but the latter differed from that of the human body in general, or was changed in its pro- perties by the mixture of another substance, whose nature has not been ascertained. It certainly is not an oily matter, and the brain is not a saponaceous substance. We strongly suspect that it contains sulphur; but much room remains for further investigation. M. Thouret considers it as analogous to spermaceti; and it is singular that, when kept from the air, it for a long time experiences little change. After having detailed every important circumstance CER 398 CER relative to this very peculiar organ, Ave have not found a single property to assist us in explaining its functions. If Ave examine its changes from disease, Ave shall find no further assistance. In maniacal persons it is found sometimes hard and dry; in idiots, soft and mucilagi- nous. Occasionally an abscess appears at the basis, and sometimes the pineal gland is suppurated, or filled Avith calculous concretions. Although Ave think, with some authors of high credit, that the brain is ahvays organi- cally affected Avhen any violent and permanent injury of its functions has preceded, yet there is no given change, from any particular series of symptoms. Dissection does not teach us any indication to pursue; nor would the powers, Avhich we possess, probably enable us to fulfil them, if they were pointed out. We must, therefore, consider the brain as the material organ of an immaterial principle, intimately united with it during life, and forming with it one distinct, inseparable Avhole. When we speak then of the ac- tions and functions of the brain, we speak of it only as the instrument; nor can we after this declara- tion be misunderstood. Though Ave may sometimes employ the language of materialism, we consider the materialist, in general, as a weak, uninformed philo- sopher, and should deprecate being confounded with the herd. The best physiologists suppose the brain to be fibrous; and when Gall calls it a membrane, he means no more. Fibres are conspicuous at its base, and in its prolongations, the nerves. These chords convey im- pressions of different kinds to the brain, in a manner which has occasioned many disputes. It Avas for a long time supposed that the brain was a gland which secreted a fine fluid, conveyed through the minute fibres of the nerves, which conducted to their origin the impressions received at their extremities ; but the great tenuity of such a fluid, its rapid motions, and, above all, the little probability of the nervous fibres be- ing hollow, rendered this system highly improbable. Yet, that the brain was a gland appeared to be a con- clusion, obvious from its structure, its large supply of blood vessels, and their very minute convolutions. These facts appeared to Dr. Cullen in so striking a light, that, while he considered the nerves as vehicles of a very fine fluid, which was the cause of sensation and motion, he supposed that the brain secreted the nutritious particles designed to repair accidental losses, either from absorption or accidents; and that these were conveyed along the surfaces of the nerves. The improvements in electricity, and more lately in Gal- vanism, have given a different appearance to this ques- tion, Avhich Avill soon claim our attention more par- ticularly. We shall only at present state what we consider to be the nature and properties of the nervous poAver. It is probable that in each nervous fibril, an elastic fluid is inherent, forming, from the first moment of animation, a part of it; differing, however, according to the state of the constitution, in power, in mobility, and, perhaps, in other qualities. Of this fluid the nerves are conductors; and they are surrounded in their course by non-conducting membranes; while the same membrane lines every part of the brain, and is carried into the deepest cavities, guarding with parti- cular attention the slightest aperture. In this vieAV the sanguiferous vessels are chiefly useful in nourishing this medullary substance; and they appear to be necessary also in adapting the nerves to their office; for when the circulation is greatly increased, the sensibility is more acute; and when it languishes, or is destroyed, the nervous energy soon shares the same fate. This fluid must be necessarily an elastic one; and impressions are apparently conveyed through it by vi- brations. It does not follow from hence, that the nerves vibrate like musical chords; or that, in every the slightest motion, a portion is conveyed from the brain. The elasticity of the fluid is proved by the momentary- continuance of the impression after the cause is re- moved ; and vibration is a term employed in many branches of philosophy as a means of communicating motion, Avithout any very distinct application. If avc touch an object Avith a stick, or with a metallic rod, Ave perceive through it the impression, and, in a general way, the nature of the substance. The impression must be conveyed by something; and Avhatever, that some- thing is, it may as well convey impressions through the nerves as through the rod. But, through the nerves only can it affect the brain, and produce an idea, or some change in the brain, or its fluid connected with the nature of the object, and which conveys to the mind some peculiar and discriminated impression Avhich it afterwards retains. We have offered these opinions, not indeed essen- tially different from those taught by Dr. Cullen, be- cause it enlarges our sphere of language, and enables us more clearly to convey our own opinions. It is im- material to the purpose whether this vieAV be ultimately correct: it is sufficient that it meets all the phenomena already known, and carries us to the confines of im- materiality; of which we can have no idea, while the organs which convey ideas are material. We know of no ideas that are innate : all are derived from sensible objects; and even in dreams, when the mind seems to sport uncontrouled, the distorted, and often apparently new, images, will be found only heterogeneous com- pounds of sensible ideas formerly received. We can now, then, speak more fully of the functions of the brain, the seat of intellect, the receptacle of our ideas, and the scene of all the intellectual operations. Animal life, as we have said, is confined to the in- tercostal system, perhaps to the cerebellum; which, we own, appears to us rather an appendage to the medulla spinalis than to the cerebrum. The most striking function of the brain is volition; and this, the great source of all our voluntary motions, is, Ave believe, ahvays excited by sensation, though often by sensations wholly unperceived or unattended to. It is singular that we will the end only: the means are directed by mind, or in some cases by a necessary con- nection. In sneezing, in coughing, and yaAvning, vo- lition appears imperfectly, if at all, exerted; and the motions excited appear to arise from a connection of nerves, though the means are directed with great preci- sion to the end. The great intellectual principle which pervades every intellectual function, the association of ideas, is also carried on in the brain; and it is this principle which seems to require that the receptacle of our ideas should be so large and extensive. We mean not to revive the old system of material vestiges as the effect of im- CER 399 C E R pression, and the sensible prototypes of our ideas; but it involves no contradiction to suppose, that a nervous fibre, Avhose mobility has been once excited, will more readily yield to the same stimulus, Avhen repeated in a less degree; and ideas once connected will, by the same increased mobility, be excited by any impression, men- tal or corporeal, on the neighbouring parts, as the voice involuntarily pursues the air which another has begun to sing. The variety of distinct impressions communi- cated to the mind through the medium of the nerves, necessarily, therefore, requires an extended bulk of the common sensorium; and, though a part of the cere- brum may be occasionally destroyed Avithout apparent injury to any function, Ave need only reflect how feAv and simple are the ideas of the greater number of man- kind, compared with those of Bacon, Newton, Boyle, or Locke. Yet we see, after a partial compression of the brain, some of the powers of mind greatly Aveak- ened; and it is singular that these powers are chiefly such as are concerned in succession, and consequently association ; as in counting numbers, or pursuing any successive train of ideas. It has been doubted, whether the mind can of itself commence a train of thought wholly new, or excite ideas different from those received through the senses. We have, as already observed, never been able to dis- cover any such in all the wanderings of a morbidly excited imagination, all the reveries of fancy, all the eccentric images in dreams or low delirium: yet the mind can voluntarily again raise ideas formerly im- pressed ; and this faculty is styled reminiscence, or me- mory : a power which is greatly assisted by association. Though we consider mind as an immaterial princi- ple, yet, as its instrument is the brain, the state of mind must often appear to partake of the diseases of the body: and the restoration of mind equally follows the returning health of body. The reason is, that we do not see the mind act but through the medium of the corporeal organs; and every agent will be powerful in proportion to the power of his means. We, therefore, in considering the effects of astringents, referred the change in the state of the nervous fluid to that of the solid; and so again in mental diseases we shall en- deavour to shoAV the connection of mental powers with the same fluid. In some instances the change is so sudden, that the fluid itself must be primarily affected, as in the attack of fevers ; and the mind is weakened in proportion. This did not escape Shakspeare, Avho has described the effects of an ague fit with the spirit of a poet, and the precision of a philosopher. Speaking of Caesar, Cassius says, " He had a fever Avhen he was in Spain; And, when the fit was on him, I did mark How lie did shake ! 'Tis true, this god did shake : His coward lips did from their colour fly: And that same eye, whose bend doth awe the world, Did lose its lustre I did hear him groan ; Aye ; and that tongue of his, that bade the Romans Mark him, and write his speeches in their books, • Alas !' it cried,' Give me some drink, Titinius,' As a sick girl." This sudden change in the nervous energy, as evi- dent in fevers, and in breathing noxious vapours, has been styled by Dr. Cullen "collapse;" and we shall adopt the term more from shortness than any desire of connecting it Avith any real alteration, or as referring to any theory. Yet, as Ave knoAV no instance in nature of a sensible fluid circulating Avith the rapidity of the nervous; and as we do knoAV that a poAver not obvious to our senses, which possesses some of its peculiar properties, really exists, we perceive no theoretical te- merity in adopting its terms. It extends, as we have said, the bounds of language; and facts expressed in this language may be without violence transferred to any other, when future discoveries may extend our knowledge of this mysterious power, Avhose cause Ave know not, but whose influence is general and exten- sive. To penetrate further into the regions of metaphysics is not suitable to our present object. What we have noAv introduced, Ave shall have occasion hereafter to ap- ply. We shall conclude this article with some more particular account of the circulation through the brain than the pages of Dr. Motherby and his associate have supplied. To connect the whole, a little repetition is unavoidable. The course of the carotid arteries has been already explained; and the peculiarity in the circulation chiefly relates to the venous system. The veins are large and tortuous, unconnected Avith cellular substance, without valves; freely anastomosing, and terminating in reser- voirs rather than in large trunks. The apparent great object of this apparatus is to confine a certain portion of blood in the head ; and, at the risk of a morbid accu- mulation, to prevent the source of the nerves from wanting at any time a supply. Even respiration, as we shall find, contributes to the same purpose. The mode in which the veins open into the sinuses confirm the same principle. We are informed by Vicq d'Azyr that they open in a direction opposite to the current of blood; and, though the universality of this distribution has been doubted, it is admitted that they very frequently penetrate obliquely through the coats of the sinus, as the ureters into the bladder; or that little valves occasionally cover their apertures ; a struc- ture which produces the same effects,. Where the veins penetrate the dura mater, this mem- brane and the pia mater are united by a fatty substance, Avhich has been mistaken for the glands of Pacconius ; but these are in the cavity of the longitudinal sinus, and act still further as valves, to save the arteries from the danger of being exhausted ; since these glands are placed at the entrance of the vein into the sinus. The course of the smaller veins is circuitous, and with dif- ficulty explained Avithout numerous plates. We shall not attempt a description, for it admits of no application. The arteries in the plexus choroides, Avhich are peculiarly minute and tortuous, probably have an im- portant office, which Ave cannot even conjecture. The veins are large Avhich arise from them, and some are peculiarly conspicuous. The great central vein of the brain is styled, from Galen, Avho first described it, vena Galeni. From nearly the centre of the brain, this vein collecting all the blood, enters the fourth sinus, Avhere it receives the blood from the inferior longitu- dinal sinus. But to be more distinct, Ave shall begin Avith the latter. The great longitudinal sinus commences near the root of the nose, and runs backAvard close to the skttfh CER 400 C E R over the head, in the direction of the sagittal suture. The vena Galeni, running backAvard, forms the chord of this arc. At nearly two thirds from the front, to the occipital bone in this chord, the inferior longitudi- nal sinus descends to meet it, forming the fourth sinus. It descends in a curved line, not concentric with, or parallel to, the great longitudinal sinus, but nearly in the same direction; and in the prolongation of this chord, where it meets the longitudinal sinus near the occipital bone, the left and right lateral sinuses branch off, terminating in their respective jugulars, after a ho- rizontal course of some length. Nearly at the fore part of the base of the skull, be- low where the vena Galeni assumes a distinguished bulk, there are some other sinuses, irregular in their shape, and tortuous in their course, which terminate also in the jugulars. The great sinus is formed by the splitting of the la- minae of the dura mater, and as the separation is.more distant above, the cavity of the sinus is triangular ; the inferior lesser sinus runs along the edge of the falx, without any peculiar form; but the fourth sinus, which is continued along the tentorium, by the joint action of this membrane and the falx, is also draAvn into a triangular shape. The other sinuses are apparently enlarged tortuous veins, which we need not particularly mention. It is obvious from this description, that nature anxi- ously retains a portion of blood in the head, even at the risk, as we have said, of accidental accumulation. But she has not incurred this danger, without attempts to lessen or relieve it. Though the longitudinal and the occipital sinuses are bound by the dura mater and tentorium, the rest are free, and admit of dilatation. At the point of meeting the angle of the occipital bone, they are so closely tied down, that the ancients sup- posed the blood in this part subjected to a peculiar pres- sure, and the point of union was styled the torcular Herophili, from its discoverer. The inferior sinuses, however, have no such restrictions; and they commu- nicate by veins, styled the emmissariae of Santorinus, which communicate also with the external veins. Vicq. d'Azyr informs us, that those sinuses which lie near the orbits and ethmoidal bone, the orbitar and carvenous, anastomose by a number of small veins with the hinder veins of the nose; so that the advan- tages of critical haemorrhages from the nose in reliev- ing acute fevers where the head is affected, will be suf- ficiently obvious. But, though authors have described the emissaries of Santorinus with particular care as the source of relief in apoplexies, and similar disorders arising from accumulation, their bulk is by no means equal to this office; and they seem chiefly useful in preventing partial compression, from the too great ful- ness of any particular sinus. The uses of the sinuses have been differently ex- plained by former authors; and these cavities have been supposed reservoirs, to prevent any sudden inter- ruption in the blood through the vena cava to the heart from pressing too strongly on the tender medullary or- gan. If this were, however, the case, they are adapted very imperfectly for the purpose, since they are closely tied doAvn Avhere dilatation might be safely alloAved; and Avithout any restriction in the base of the skull where their compression must necessarily be injurious. If it be true that the nervous fibres require an active circu- lation for the support of their excitement, it must be an object of the highest importance that the arteries of the brain should not be suddenly emptied, or frequently liable to the accidents that may occasion it. This pur- pose the sinuses answer very completely; and, as we shall find, that during inspiration the course of the blood in the upper vena cava is obstructed, this func- tion Avill appear to be an assistant in the same office. See Winslow's Anatomy ; Haller's Physiology ; Wil- lis' Anatome Cerebri; Vicq. d'Azyr on Brain, and his Memoirs in the Academy of Sciences for 1781; Mala- carne Encephalotomia Nuova; Monro on the Nervous System. Ce'rebrum elonga'tum. See Medulla spina- lis. CEREBRI AFFE'CTIO SPASMO'DICO-EC- STATICA. See Apoplexia. Ce'rebri compre'ssio, and concussio. Compres- sion of the brain : (from con, and premo, Po press to- gether; and con, and quatio, to shake together). This often happens from external injuries, and gene- rally attended with giddiness, dimness of sight, coma, loss of voluntary motion, vomiting, an apoplectic.ster- tor in breathing, convulsive tremors in different mus- cles, a dilated state of the pupil of the eye, even when exposed to a clear light; paralysis of different parts, especially of the side of the body opposite to that part of the head which has been injured; involuntary evacua- tion of the urine and faeces; an oppressed, and, in many cases, an irregular, pulse; and when the violence done to the head has been considerable, it is commonly attended with a discharge of blood from the nose, eyes, and ears. Some of the milder of these symptoms, such as vertigo, stupefaction, and a temporary loss of sensi- bility, are frequently induced by slight blows on the head; and as they often appear to be more the conse- quence of a shock, or concussion given to the sub- stance of the brain, than of compression induced upon it, so they soon commonly disappear, either by the effects of rest alone, or some other gentle means. (See Concussio.) But when any of the other symptoms take place, such as convulsive tremors, dilatation of the pupils, involuntary passage of the urine and faeces, and especially Avhen much blood is discharged from the mouth, nose, eyes, and ears, it is almost certain that much violence has been done to the brain, and that compression in some part is induced. In fine, a com- pression of the brain may be brought on by Avhatever contributes to diminish the cavity of the cranium, or increase its contents in any considerable degree: hence fractures, attended with depression of any part of its bones, forcible introduction of any extraneous body through both tables of the skull, the effusion of blood, serum, pus, or any other matter, the thickening of the bones of the head produced by lues venerea, collection of water in the ventricles, or other parts of the brain, may occasion this disease. For the cure of which see Concussio ; Fractura cranii ; Depressio, Extrava- satio, Hydrocephalus; also Bell's Surgery, vol. iii. p. 132, &c. Ce'rebri ba'sis. See Palatum. Ce'rebri ga'lea. See Cranium. CEREFO'LIUM, a corruption of Ch.erophyllum. See CoeLiFonuM, and Ch\ebefolium. CER 401 CER Cerefo'lium hispa'nicum. See Myrrhis. CEREFO'LIUM SYLVE'STRE. See CHjEROPHYLLUM SYL- VESTRE. CERELjE'UM, (from xepos, wax, and eXxiov, oleum). See Cervtum et Oleum cer;e, under Cera. CEREVI'SIA AMA'RA, and ANTISCORBU'TI- CA,(from Ceres,) as all ales are made of corn. See Alla. Cerevi'sije catapla'sma. Into the grounds of strong beer stir as much oat meal as will make it of a suitable consistence. This is sometimes employed as a stimu- lant, and antiseptic to mortified parts. CE'RIA, or CE'RLE, (from cereus, soft taper). See T.enijE. CE'RION, xepiov, a honey comb, (from xepos, wax). oCC \cHOR CERI'TUS, or CERRI'TUS, (from Ceres,) the dis- ease arising from malt liquors. CE'RNUUS, (from cernuo, to fall with the face downwards). In botany it means bent doAvmvards, drooping, hanging down its head. CERO'MA, et CERO'NIUM. See Ceratum. CEROPI'SSUS, (from xepos, wax, and 7rto-Fx,pitch). Also called dropax, dropacis7nus. A plaster of pitch and Avax. It was usual to spread it on cloth or leather, and to apply it to some part of the body, then to pull it off again and apply it afresh, frequently reneAving the application and removal, to induce a redness on the part and attract the fluids Avhich nourish it. To render this plaster the more efficacious, acrimonious poAvderswerc added to it. This dropax was also used to make hair fall off, or to pull it off from any part. But the ingredients for the dropaces Avere pitch, oil, bitumen, galbanum, and other stimulants. CERO'TUM, (from xepos, wax). See Ceratum. CE'RRO, (from xepxs, cornu, because its Avood is hard like horn). See Phellodrys. CERUMEN AU'RIS, (from cera, wax). The avax in the ears. The Latins call it cerea, auriu7n sordes, and marmorata aurium, cypsele, cypselis,fugile. It in- viscates, and retains insects, and prevents their hurting the membrana tympani. It is a yelloAV, oily, bitter, and viscid fluid, which is inspissated by stagnation, softens by heat, and evaporates in a Avhite smoke, Avhose odour resembles that of burning fat. By a continuance of the heat, it melts, SAvells, groAvs dark, and emits an am- moniacal and empyreumatic odour. It mixes Avith Avater, forming an emulsion, Avhich, on putrefaction taking place, deposits white flakes. Alcohol dissolves more than half; and, when evaporated, a deep coloured substance remains, nearly resembling the resin of bile. What the alcohol does not dissolve appears to be albu- men, Avhich, Avhen burnt, leaves marks of soda and phosphat of lime. jEther dissolves it, but the solution is less coloured; so that, added to these ingredients, it seems to contain a peculiar colouring principle. It is separated from the glands in the part of the ear in Avhich it is found. It is fluid A\dien first discharged, but soon thickens by stagnation. Wax, under some circum- stances, occasions deafness. See Surditas. CERU'SSA. So called because it was a pigment made by dissolving lead in vinegar, and formed of the consistence of Avax ; hence xepos, xepoeis, xepoetrc-x,—unde xepve-o-x. See Plumbum. Ceru'ssa antimo'nii. See Antimonium. vol. I. CERVA'RIA, and CERVA'RIA NI'GRA, (from cervus, a stag, because deer are fond of it). See Laserpitium vulgatius, et oreoselixum. CE'RVI SPI'NA. See Rhamnus. CERVICA'LES, belonging to the neck, (from cer- vix, the neck,) the nerves Avhich pass through the ver- tebrae of the neck. The first cervical 7ierve throAvs out a considerable branch to the occiput; supporting, in some degree, the ' idea of Gall: it joins the ninth pair from the brain, to form the first cervical' ganglion of the intercostal. The second cervical nerve hath a very remarkable plexus; it sends out a very considerable nerve to tin occiput, as well as the first. It sends off three branches behind the sterno mastoideus, Avhere they are entangled with the accessorius Willisii. The first branch, going upAvard and backAvard, becomes cutaneous on the pos- terior parts of the temporal and parietal bones. The second goes upAvard, and a little forAvard under the sterno mastoideus, and throAvs branches to the parotid gland, to the lobe, and to the posterior side of the ear. The third goes horizontally fonvard to the neck, and there becomes a cutaneous nerve, Avhich is sometimes pricked in opening the external jugular vein. The third cervical nerve goes doAvmvards by a number of filaments tOAvards the shoulders, and produces the phrenic nerve, which runs towards the thorax, before the anterior portion of the scalenus, betAveen the sub- clavian artery and vein, contiguous to the trunk of the par vagum; passes doAvn before the root of the lungs, folloAvs the pericardium, and branches out in the dia- phragm. That on the right is shorter than that on the left, as the latter goes round the apex of the heart. The four inferior pairs, since a similar nerve arises on both sides, are larger than those already named. Their main trunk, with the first nerve of the back, passes betAveen the portions of the scalenus over the first rib, into the axilla, where they produce six trunks, Avhich go to the upper extremities. In their Avay thither they detach branches to all the arteries. The first of these six branches is the humera'lis, Avhich folloAvs the course of the artery of that name, round the head of the os humeri. The second is the cuta'neus, Avhich runs doAvn the ■ inside of the arm, and goes into the fore arm, just where Ave open the basilic vein, and is often Avounded. The third is called the musculo cuta'ni.lSj and is larger. If rises pretty high, and throAvs branches into the coraco brachiaeus, through Avhich the trunk passes obliquely ; it is then covered by the biceps, and, passing- through between the brachiaeus and biceps, it sends off' several branches, and lies on the outside of the tendon of the last mentioned muscle, Avhere Ave commonly bleed in the median cephalic vein. The fourth is called cubita'lis, or ulna'ris, the uhiar nerve; it follows the course of the artery, but passes gradually backwards, and gets behind the inner condyle of the os humeri, betwixt Avhich and the ole- cranon it passes to the fore arm. A little above the carpus it divides into an anterior and posterior branch, Avhich goes to the palm, the back of the hand, and fin- gers. See, under Cubitalis, Cheselden's account. The fifth branch, called media nis, the median nerve, passes doAvn contiguous to the brachial artery, and, accompanying the vessel, goes to the fore arm C E R 402 CER and to the palm of the hand, thence to the thumb and fingers. The sixth branch, called the radia'lis, radial nerve, passes down the inside of the arm, and then backwards betAveen the brachiaeus externus, and the short heads of the biceps externus, attended by the artery. When it hath got round, it runs doAvn; and, at the head of the radius, it gives off a cutaneous branch, which goes to the thumb and fingers on the back of the hand, whilst the main trunk passes round the head of the radius through the supinator radii brevis, and goes betAvixt the radius and ulna, to be lost in the extensor digitorum communis, and the muscles of the carpus and thumb. Cervica'les arte'ri^e. The arteries of the NECK. The cervical artery rises from the subclavian on its upper side, and is presently afteiwvards divided into tAvo, Avhich sometimes come out separately, and at others by a small common trunk ; the anterior goes to the ante- rior muscles which move the neck and head, the poste- rior to the scalenus, trapezius, &x. The anterior cervicalis, running behind the carotid of the same side, is distributed to the musculus coraco- hyoidaeus, mastoidaeus, cutaneus, sterno-hyoidaeus, and sterno-thyroidaeus, to the jugular gland, and aspera ar- teria; the muscles of the pharynx, bronchia, oesopha- gus, and to the anterior muscles, which move the neck and head. This artery has been observed to send out the intercostalis superior. The posterior cervicalis arises sometimes a little after the vertebralis, and sometimes from that artery. It passes under the transverse apophysis of the last ver- tebra of the neck, and from thence runs up backAvard, in a Avinding course, on the vertebral muscles of the neck, and then returns in the same manner. It com- municates with a descending branch of the occipital ar- tery, and with another of the vertebral, about the se- cond vertebra. It is distributed to the musculi scaleni, angularis scapulae, and trapezius, and to the jugular glands and integuments. Cervica'les vexje. The cervical veins. They are branches from the upper external jugular veins,or from the vertebral veins: they spread in the vertebral muscles- of the neck, and communicate with the hu- meralis and occipitalis. Cervica'lis desce'ndens, do'rsi. See Sacro lum- HARIS ACCESSORIUS. CERVICA'RIA, (from cervix, the neck, so named because it was supposed to be efficacious in disorders of the neck and throat). Bell flower, or campa- nula. The floAver consists of one petal or floAver leaf, shaped like a bell: before it is blown it is of a pentagonal figure, and Avhen fully opened it is cut into five seg- ments at the top. The summit of the pedicle is ex- panded into an ovary, whose apex is crowned with a monophyllous quinquifid calyx, divided into five long segments. The seed vessel is for the most part divided into three cells, each having a hole at the bottom, by Avhich the seed is emitted. Campanula esculenta. Small or garden rampion. Campanula rapmiculus Lin. Sp. PI. 232. The roots are used in salads. Medium, viola Mariana Lin. Sp. PI. 236. Syrian bell flower. Trachclium, (from rpxx*>Xos, the throat,) ca/npdnuia vulgarior major. Great throat wort, aud Can- terbury bells. Campanula trachelium Lin. Sp. PI. 235. The root is very moderately astringent. CERVI'CUL.E SPI'RITUS, (from cervus, a stag). Rulandus gives this appellation to the-spirit of the bone of a stag's heart. CE'RVIX. Usually confined to the back part of the neck; hence derived by some from curvus, crooked; but, by others, quasi cerebri via, as the road leading to the brain; also collu'm, the neck. This is applied figuratively to different parts ; and there is the cervix vesice, uteri, ossis. (See Vesica, Uterus, and Pro- cessus). But, in its general acceptation, it means that part of the body situated betwixt the head and breast. The neck is divided into the anterior part or throat, and the posterior or nape. It contains the larynx, apart of the trachea arteria, the pharynx, part of the oesopha- gus, the musculi cutanei, sterno-mastoidaei, sterno- hyoidaei, hyo-thyroides, coraco-hyoidaei, splenius, corn- plexus, the musculi vertebrales, which lie upon the first seven vertebrae, and a portion of the medulla spinalis. The arteries which go to the neck, are the arteriae carotides externae, et internae, vertebrales, et cervicales. The veins are, the venae jugulares externae et internae, cervicales, et vertebrales. The nerves are, the portio dura of the auditory nerves, the eighth, ninth, and tenth pair, the seven cervical pairs, and the nervi sympathetici maximi. A contraction of the neck to one side is among the disorders to which it is subject. Tulpius calls this contraction caput obstipum ; but it is a species of con- tractura: he hath removed this disorder in those who had exceeded their twentieth year, and were born with it: others have had the same success. This disorder is usually described under the title of the wry neck. It proceeds from burns, a stricture in the skin, a relaxation of some of the muscles in the neck on one side, or a contraction of them on the other; but the most common cause is a contraction of the mastoid or sterno-mastoid muscle only. If it depends on a paralysis on" one side, the cure must depend on that of the disease: if from inflam- mation, external blisters and stimulants are employed. In general, emollients on the contracted part, and sti- mulants on the opposite, afford the most probable means of relief. Electrical sparks, drawn from the re- laxed side, are also often useful; and the contracted muscle should be kept at its full extent of distention, by a bandage keeping the head steady in the opposite direction. If these remedies fail, tAvo or three incisions trans- versely through the skin, Avhere it is contracted, may be made. If the cause is from several muscles being contracted, the cure will be more difficult; but if there is a contraction of the mastoid muscle only, or, as called by some, the sterno-mastoid muscle, the cure is effected by dividing it. In this operation, Mr. Sharpe directs us " to make a transverse incision through the skin and fat, some- thing broader than the muscle, and not above half an inch from the clavicle; then passing the probed razor with care underneath the muscle, draw it out, and cut the muscle. After the incision is made, the wound is CET 403 C 11 A to be filled with dry lint, and ahvays dressed so as to prevent the extremities of the muscles from re-uniting; to which end they are to be separated from each other as much as possible, by the assistance of a supporting bandage for the head during the Avhole time of the cure, which Avill generally be about a month." Mr. Pott directs to cut through the muscle as near the middle as may be, taking care not to wound the carotid artery, nor the jugular vein. Dr. Hunter pre- fers making the incision near the sternum : he says, that at the lower part of the muscle it is best to perform this operation, because, there, the cellular membrane is not in any great proportion. Mr. Sheldon advises us not to use the razor above named, as we may en- danger cutting the carotid artery, the jugular vein, and the eighth pair of nerves. He prefers the incision knife, to cut gently in a transverse direction; in that case the fibres will fly from the edge of the knife, and, with a moderate attention, the dangers just mentioned will be avoided. See Bell's Surgery, vol. iv. p. 366. White's Surgery, p. 387. CE'RVUS,(from xepxs, cornu; so called because of the exuberance of its horns). The stag, hart, or male of the red deer. The flesh of these animals, until they are three years old, is excellent. The bone of the stag's heart, called crux cei-vi, from its shape being that of a cross, is only the tendons of the muscles of its heart hardened. This bone, as it is called, should be very Avhite. Balls are formed in their stomachs from the hairs which they sAvalloAv when licking themselves. These balls are called elaiphopila. See Capra Alpixa. The tears of a stag are the sordes collected in the inner angles of the eye, resembling wax. This matter hath many virtues ridiculously attributed to it, and is given in doses of three or four grains. Ce'rvus da'ma. See Dama. Cer'vus mi'xor America'nus bezoa'rticus. The deer Avhich produces the West Indian bezoar, q. v. Ce'rvus odora'tus. See Moschus. Ce'rvus rangi'fer. The rein deer, called by some authors tarandus, and machlis. It is an animal very com- mon in all the northern regions, of the shape of a stag, but its body is thicker, and its Ayhole make much more robust and strong. It is of great use as a beast of car- riage to the Laplanders, and almost all the northern nations. Scheffer alleges, from Tornaeus, that though •a cloven footed animal, and plainly of the deer kind, it does not cheAV the cud; but this is wholly disbelieved by the more accurate naturalists. Its horns and hoofs have been said to be of use in spasmodic affections. CESTRE'US. See Mugilis. CESTRI'TES VINUM,(from xe?l?ov,betony). Wine impregnated withbetony. CE'STRUM, (from xee-lgx, a dart; so called either from the shape of its floAArers, Avhich resemble a dart, or because it was used to extract the broken ends of darts from wounds). See Betonica. CETA'CEUS,(from cete,a whale). Cetaceous fishes are very large, bring forth a perfect animal instead of spawn : like viviparous animals, they respire by means of lungs, and nourish their young Avith milk. CE'TE, (from the Chaldaean Avord kota). This term is usually applied to the spermaceti whale; physcter macrocephalus Lin. See Spermaceti. CE'TERACH. See Asplenium. CE'TUS. See Cete. The whale. There arc many kinds of this fish; but the two principal are the Greenland whale : also called balena vulgaris, balena major, musculus; according to Pliny, 7nysticetus: the Greenland, or black whale. The spermaceti whale is the physeter macrocephalus. It is from the upper jaAV that whale bone is taken, and from no other part of this fish. Besides this bone, its only produce is its oil, used for burning in lamps, but of no use in medicine. In Paris, they have tAvo sorts of whale oil: the best is called huile de grande baye: it is made from the blubber immediately after it is taken out of the fish, and is not so offensive in smell as that from Holland, Avhich is melted down after their arrival. The latter also called cachalot, catodon, from having teeth only in the loAver jaw, balena macrocephala, trompa, byaris, occa. The spermaceti avhale does not afford any whale bone; but its teeth are ivory. From its body it yields a finer oil than that from the Greenland spe- cies ; as Avell as Spermaceti, q. v. CEVADI'LLA, (from cevada, barley, Spanish). Called also sebadilla, sabadilla, causticum Americanum, hordeum causticum, canis intersector. Indian caustic: barley. Veratrum sabadilla, not included in the Spe- cies Plantarum. It is the seed vessel of a Mexican plant; like a barley ear, but Avith seeds not exceeding the size of lintseed. They are reckoned the strongest of the vegetable caustics. Monardes says, that for de- stroying vermin, and as a corrosive for some kinds of ulcers, they are equally effectual with the actual cau- tery. Dale thinks the capsula of the seed only is used: the taste is, hoAvever, bitter and acrid ; in quality highly drastic, and poAverfully anthelmintic. It is also diuretic and emetic. The dose to a child from tAvo to four years old, is two grains; from hence to eight, five grains; from eight to tAvelve, ten grains. CE'VIL. See Ludus Helmontu, CHA'A. See Thea. CHACARI'LLA. See Thuris cortex. CHiEREFO'LIUM, CHiEROPHY'LLUM, (from #«/£&/, to rejoce, and QvXXov, foliu7n, a leaf, so called from the abundance of its leaves). Called also cerefo- lium, gingidium; common chervil. It is the scandix cerefoliu7n Lin. Sp. PI. 368. It is an umbelliferous plant, with Avinged leaves, like those of parsley, pro- ducing smooth long seeds, shaped like a bird's beak; a native of the southern parts of Europe, soAvn annually in our gardens, and slightly aromattic, aperient, and diuretic, differing not from parsley- in its medical vir- tues. Distilled with Avater, it affords a small quantity of essential oil. ChjErefolium sylve'stre pere'nxe cicu'tje fo'lio, Cicuta7-ia, vulgaris, 7nyrrhis sylvestris, cxrefolium syl- vestre -, aatld cicely; coav weed. Cherophyllum sylvestre Lin. Sp. PI. 369. The roots are poisonous, causing difficulty of breathing, torpor, and delirium. The roots resemble parsnips, and are called by the coun- try people madnips. The leaves resemble those of hem- lock. CHAIARXA'MBAR. See Cassia fistularis. CHAI'TA. Properly the name of quadrupeds; but RufusEphesius expresses by it the hair of the hind head. CHA'LAPA. See Jalapa. CHALA'SIS, (from #«*««, to relax). Sec Relax- a no. 3F 2 C H A 404 C H A CH ALA'STIC A MEDIC AME'NTA, (from the same). Relaxing medicines. CHALA'ZE, and CHALA'ZIA, (from x***fri, hail stones; grandines lupe). This name is given to a Avhite knotty string at each end of an egg, formed of a plexus of the fibres of the membranes, by which the yolk and the Avhite are connected: it is sometimes called arquatum. It is also a -species of the hordeolum. Stye, stian, or stithe, a moveable, hard, Avhite, encysted tumour on the margin of the eye lid, resembling a hail stone; and differs from the crithe, another species, only in being moveable. It continues long, and proceeds slowly, and is often merely an enlargement of one of the sebaceous glands in consequence of obstruction; but occasionally of a more solid consistence. Some- times it may be dispersed with the unguentum cceru- leum fortius, and Avith a feAv roses of calomel. If they fail to relieve, make an incision through the skin which covers them, and dissect the tumour clearly out, or touch the skin over them Avith caustic, until the Avhole is wasted. See St. Yves on the Disorders of the Eye. Bell's Surgery, vol. iii. p. 264. Nos. Meth. Ocul. of Dr. Wallis, p. 4. CHALBA'NE. See Galbanum. CHALCA'NTHUM, (from ##a*o?, brass, and xvios, a flower). Flowers of brass. See Vitriolum. CHALCEDO'NIUS, is the name of a medicine, which Galen directs to be used in disorders of the ears. Also a species of onyx stone brought from Chalcedon. CHALCI'TIS, (from ##Axes, brass). The native is said to be a vitriolic mineral, containing copper and iron, of a copperish colour. As it cannot be procured, Dr. Alston thinks that its best succedaneum is the chalcitis officinarum. See Vitrioli colcothar, and Vitriolum viride. CHALCOI'DEUM, Os. The os cuneiforme of the 'arsus. See Cuneiforme os. CHA'LCOS. Sec Ms. CHA'LCUTE. Burnt brass. See Ms ustum. CHALICRA'TON. Wine and avater, (from #<*a„ the elder). See Ebulus. CHAMjEBA'LANOS, (from #«/**> and pxXxxns, a nut). See Orobus. CHAM-E'BATOS, (from xxftttt, and pxivu, to go; so called from its creeping along the ground). Sec RuBUS A'ULGARIS. CHAM^ECE'DRYS, (from x*!**^ and xtfyos, cedar). See Arbrotanum fcemineum. CHAMjECE'RASUS, (from x*!**1* and xepxa-es, cherry tree). See Caprifolium. CHAM-ECI'SSUS, (from x*/**'* and xittos, ivy). See Hedera terrestris. CHAMiECI'STUS, (from ^«f*«;,and xve-les, cystus). Panax chironium, consolida aurea; cistus helianthemum Lin. Sp. PI. 744. Little or dwarf cistus, or sun- flower. It is vulnerary, and is supposed to make a good gargle in diseases of the throat. CHAM^ECLE'MA, (from xw^h and xXe.ux, ivy). See Hedera Terrestris. CHAMjEDA'PHNE, (from x*."xh and Ae?i9, the laurel). See Laureola mas. CHAMjE'DRYS, (from XW'' and J]pv«, the oak). Germander. Chamadrys 7>ii7ior repens; vulgaris. Also called quercula calamandrina, trissago; chamc- drops P. .Eginetae and Oribasii. Small germander, and English treacle. It is the teucrium chamadrys Lin. Sp. PI. 790. Creeping germander. The chamaedrys is a small, creeping, shrubby plant, Avith square stalks, small, stiff, oval leaves, notched from the middle to the extremity, like those of the oak tree, set in pairs at the joints, and purplish labi- ated flowers, set thick together, wanting the upper lip. It groAvs Avild in France, Germany, and SAvitzerland. It is sometimes found wild in England, but is generally raised by culture in gardens. It floAvers in June and July. The leaves and tops are slightly bitter and aroma'tic ; and esteemed mildly aperient and corroborant. They have been held in esteem in uterine and rheumatic com- plaints; in intermittent fevers; scrofulous affections, and other chronic complaints. At present, however, they are little used. The best time for gathering this herb is when the seeds are formed, and the tops are then preferable to the leaves. When dry, the dose is from 5 ss- to r> i- Either water or spirit Avill extract their virtue; but the watery infusion is more bitter. This plant is an ingredient in the noted powder, called from the duke of Portland, of Avhich we add the original receipt. Take of the roots of round birthwort and gentian, the tops and leaves of small germander, lesser centaury, and ground pine, of each equal parts: poAvder them all together. Of this poAvder a drachm must be taken, in any convenient liquor, every morning, fasting, for three months; then tAvo scruples for three months; and, after that, half a drachm for six months: and, to conclude the process, half a drachm every other day for a year. -Etius calls a poAvder similar to this, antidotes ex duobus cen- taurea generibus; Coelius Aurelianus,. diacentaurion. Experience, in general, hath tended to lessen the credit of this composition, Avhich hath little more than its an- tiquity to support the character Avith Avhich it Avas lately raised. It differs but little from the diacentaureon of Cpelius Aurelianus, the pulvis principis Mirandolae, climax vel scala sacra, and others, of which an account is given in the Lond. Med. Obs. and Inq. vol. vi. p. 126, where also the origin of the duke of Portland's powder is traced back to these boasted remedies. We C II A 405 C H A need not add on this subject to our former observations on bitters, and on the gout cordial. See Amara, and Arthritis. Cham^'drys in'cana mari'tima. See Marum Sy- RIACUM. Cham^e'drys frute'scens. See Teucrium. ChAM^e'dRYSFRUTICO'SASYLVE'sTRISMELi'sSjEFO'lIO. See Salvia sylvestris. Cham^'drys palustris al'bium redo'lens. See SCORDIUM. Cham^e'drys spu'ria angu'stifolia, vel LATIFOLIA. See Veronica. Cham^e'drys. A name of a species of caryophyllata, galled avens. CHAM^LLjE'A, CHAMEL-E'A, (from xW', on the ground, and eXxix, the olive-tree). Widow-wail. Daphne Alpina Lin. Sp. PI. 510. A shrub, Avith leaves like the olive-tree. The juice is a poAverful hydra- gogue and cathartic, but much milder than mezereon, and many other plants Avhich belong to the same genus. If it is applied to the pubes and abdomen of dropsical patients, no medicine is said to be more effectual in promoting urine. See Laureola Fcemina. CHAM-ELEA'GNUS, (from ^«^«<,.and eXxtxyvos, the wild olive). See Myrtus Brabantica. CHAM,ELEMA, (from £*fwc<, and xXeptx, ivy). See Hedera terrestris. CHAMiELE'ON, (from xcttA-xh humi, and Xeuv, lion ; that is, dwarf lion). A lizard, supposed to be capable of changing its colour at pleasure. It is also the name given to some thistles from the variety and uncertainty of their colour, and to some metallic preparations from the same variety. Cham^ele'on albus, &c. See Carduus pinea and CARLINA. Chamjele'on ve'rum. See Cnicus. CHAMJLLEUCE, (from x*f**h and Xevxy,) the herb colt's foot. See Tussilago. CHAMjELI'NUM, (from x»l*»h and Xivov, flax). See Linum catharticum. Cham^li'num vu'lgare. See Knawel. CHAM-EME'LUM, (from xw>> and f*.eXov,an ap- ple ; because it grows on the ground, and has the smell of an apple). Camomile. Galen calls it euanthemon. It is corruptly named ca7nomilla. The folloAving are the most common species. Chamjeme'lum no'bile. Cham. Romanum leucan- themum odoratius, vel odoratissimum repens ; by Dios- corides, chrysocallia ; common camomile. It is the anthemis nobilis Lin. Sp. Plant. 1260. Nat. order com- posite radiate. It is found wild in moist pasture grounds in many parts of England, but is commonly cultivated in gar- dens. It flowers in July, August, and the folloAving summer months; and the seeds come to perfection at the time of floAvering. The leaves and flowers have a strong, though not ungrateful smell, and bitter taste. The floAvers are more aromatic and bitter than the leaves and the stalks ; the yelloAV disk is by far the strongest. The smell and taste are both improved by careful drying, and they lose very little by long keep- ing. These floAvers are found to consist of a bitter ex- tractive part, and an essential oil. The former is the Ionic, and the latter the carminative portion. The floAvers only are used internally : they are bitter, carminative, anodyne, antispasmodic ; of particular use in cold flatulent colics, especially if joined with aroma- tics ; in nephritic, hysteric, hypochondriac, and other spasmodic disorders. The vomiting of breeding Avo- men, and the after-pains of parturition, are greatly re- lieved by them; and it has been idly supposed that they Avill prevent the accession of puerperal fever, -and pro- mote the uterine discharges. In agues, from half a drachm to 3 i. of the poAvder is given every two or three hours during the intermission; but as this quantity is apt to run off' by the boAvels, it is usually joined to an opiate or astringent. The camomile is useful in spas- modic colics, and also in the dysentery, from its lax- ative poAver; but in diarrhoea it has been found hurtful. In fevers of the low and irregular kind, attended Avith visceral obstructions, especially Avhen too nearly allied to continual fevers to admit of the bark, the camomile is assisted by a mixture of fixed alkaline salts, and other corroborating medicines. A warm infusion, from two to three ounces, taken twice a day, has been ef- ficacious in relieving pains of the stomach. In much larger quantity, it excites vomiting, and promotes the operation of emetics ; for which purposes it is fre- quently given. In general, camomile floAvers possess in a very great degree all the virtues of bitters (see Amara), rendered more effectual by the warmth of the bitter oil, Avhile, from the total absence of the astringent principle, they are of considerable service in pulmonic affections. They seem superior in most respects to the quassia, the columbo, to the angustura bark, and perhaps the myrrh ; yielding perhaps only to the columbo, Avhere bile abounds in the stomach. If it proves purgative, the best addition is the extract of the logAvood. Externally, the flowers are used in the de- coction for fomentation, and are also an ingredient in the decoction for clysters. The dose may be from gr. x. to 3 i- of the dry pow- der ; of the fresh juice from the whole herb, from one to six ounces, Avhich, if taken just before the paroxysm of agues, is said to be effectual in a feAv doses. This juice is supposed to be peculiarly useful in strangury, asthmas, jaundice, and dropsies. Camomile floAvers yield their virtue to water and to spirit: the dry floAvers make a more agreeable infusion than those that are fresh or neAvly dried; and the most grateful is Avhen cold water only is used. Distilled with water, they impregnate it strongly; and, from the flowers, a small proportion of essential oil may be thus obtained. This oil is of a yelloAvish colour, and possesses all the virtues of the flowers in an eminent degree. Externally, this herb is discutient and antiseptic ; but the floAvers possess the greatest degree of these quali- ties. Dr. Pringle says, that their antiseptic power is 120 times greater than that of sea salt. A green oil is prepared from the herb, while it is fresh, in April and May at furthest, by boiling it Avith olive oil until the leaves are almost crisped: but as boil- ing dissipates the most efficacious part of the herb, the best method is to steep the floAvers cold in the oil, and to strain it off as it is Avanted. Extrdctum Chamameli. Extract of Camomile, is prepared by boiling the floAvers in distilled water, C II A 406 C II A pressing and straining the decoction. When the faeces have subsided, the decoction is evaporated in a water- bath saturated Avith sea salt, to a consistence proper for making pills. Lond. Pharm. 1788. This extract is remarkably antiseptic, according to the experiments of Sir John Pringle; and in doses of one or two scruples, either given by itself, or added to other remedies, proves highly beneficial in flatulence, indigestion, and pains of the stomach and bowels. In the same manner have the college of physicians of London ordered the extract of broom tops, gentian, black hellebore, liquor- ice, rue, and savine, to be made. But if the extract of this flower is obtained from a spirituous tincture, it retains much of its flavour, as avcII as its bitter taste. Lewis's and Cullen's Mat. Med. Cham^eme'lum vulga're, leucanthemum Dioscoridis; common wild corn, or dog's camomile. It is the ma- tricaria chamomilla Lin. Sp. PI. 1256. It is upright,an- nual, and groAvs wild in corn fields. In France, and other countries on the continent, its floAvers are used indiscriminately with the other species, but they are weaker and more disagreeable. The oil obtained from this species, by distillation, is of a fine blue colour, but the air soon changes it to a yelloAV. Cham.,eme'lum flo're ple'no, called also chameme- lum nobile flore multiplici, and double camomile. An- themis nobilis var. p. They are produced by culture, and differ in their flowers from the Roman camomile above described in being double, or having several rows of the Avhite petals, and the thick disk proportionably smaller. Sometimes the disk is filled with the petals. The single and the double flowered sorts are often used indiscriminately: their leaves differ very little; but as the active parts chiefly reside in the disk or tu- bular part of the florets, which in the single flowers are largest, the latter are generally preferred. The single sort affords most oil. ChamjEme'lum fcetidum, called also cynanthemis, cotula fcetida, anthemis cotula Lin. Sp. PI. 1261. Stinking camomile, maiths, and May-weed. It is annual, growing in Avaste ground^ and amongst corn. It is more upright than the other species; its leaves are finer, and floAvers closer. In its qualities it differs greatly from the three pre- ceding. Its smell is disagreeable; its flowers are al- most insipid, but the leaves have a strong, acrid, harsh taste. It has been esteemed strongly sudorific. Dr. Brown Langrish gives an account of a decoction of this plant, recommended by a gypsey, throAving a person af- fected with a rheumatism into a profuse sweat, and cur- ing him of the disease. Chamjeme'lum Canarie'nse. The leucanthemum Canariense. ChrysanthemumfrutescensfAn. Sp.P1.1251. Cham^me'lum chrysa'nthemum. See Buphthal- MUM GERMANICUM. CHAMjEME'SPILUS, (from x*H-*<, on the ground, and [x,so~iriXvs, a medlar). See Aria. CHAM-EMO'RUS, (from #«/«,«», and fjuopex, moros, a mulberry tree). Called also cha7ne-rubus foliis ribis Anglica, rubus palustris humilis, vaccinium Lancas- trense, rubus Alpinus humilis Anglicus. Rubus cha7na- morus Lin. Sp. PI. 708. Cloud-berry, and knot-berry. It is a shrub Avhich groAvs on boggy mountains in England, and more northern regions; the leaves re- semble those of the malloAv or of the currant tree; the fruit is like the raspberry; when ripe it is sweet, tart, and of a yellowish red. It ripens in July and August. When ripe and boiled, without any addition, to the con- sistence of a pulp, it Avill not soon spoil, if closely co- vered in pots ; and, as an antiscorbutic, far excels the scurvy grass, and vegetables of that tribe in common use. The chamemorus JVorwegia is a variety of the same species. Raii Hist. CHAM.EPEU'CE,(froni£*/etf*(, and zrtt/jcj?, the pine tree). See Camphorata. CHAM^PITUI'NUM VI'NUM. It is wine in which the bruised green leaves of the chamaepitys have been infused. CHAMJE'PITYS, CHAMjEPITY'S MAS, (from Xxy.xi, and tciIos, the pine tree.) Arthetica vel arthre- tica, ajuga, abiga ; iva arthritica. Dioscorides says, that it Avas called holocyron in Pontus, Ionia in Athens, and sideritis in Eubcea. Common ground-pine. It is the teucrium chamapitys Lin. Sp. PI. 787. It is a Ioav hairy creeping plant, with square stalks, whitish clammy leaves, cut deeply into three narroAV segments, set in pairs at the joints, and yellow labiated floAvers Avithout pedicles, and wanting the upper lip. It is annual, grows wild in sandy and chalky grounds in some parts of England ; flowers in July and August, and has a long slender fibrous root. The leaves are moderately bitter, of a resinous but not disagreeable smell, approaching in this respect, as in their external form, to those of the pine tree. They are aperient, stimulant, and corroborant; are commend- ed in palsies, rheumatisms, gout, and uterine obstruc- tions; are attenuating and diuretic, and in general of si- milar virtues with the chamaedrys,but more active from an admixture of an essential oil similar to turpentine. They yield their virtue to water, but somewhat more fully to spirit: on distillation with water, a very small portion of essential oil is obtained, resembling that from turpentine. An infusion of the dried herb in white Avine is the best preparation, but the dried leaves may be taken to a drachm for a dose. They are an in- gredient in the pulvis ad rheumatismum. See Chamje- drys. Cham^'pitys moscha'ta, also called iva moschata Monspeliensium; chamapytis anthyllis. TeucriU7niva Lin. Sp. PI. 787. French ground-pine. It is Aveaker, but of similar virtues. See Chama- pitys. CHAMiE'PLION. A name in Oribasius for the Erysimum, which see. CHAMjERAPHANUM, (from x*V<*h on the ground, and px, on the ground, and pohhvhov, the rose laurel). See ^Igole- thron. CHAM.ERU'BUS, (from x*Pxh and rubus, the bra7nble). See Chamemorus. CHAMvESPA'RTIUM, (from *w«m, and rxagrm, Spanish broom). Geniste'lla. See Genista tinc- TORIA. C H A 407 C H A CHAM.ESY'CE, (from x^*1* and c"J"t"» afiS tree). Sec Pepliox. CHA'MBROCH. See Trifolium. CHA'MOIS. See Capra Alpina. CHAMOMI'LLA. See Chamemelum. CHA'MPACAM. (Indian.) A large tall tree in the East Indies, which bears fragrant floAvers twice a year, and not iruit until it is advanced in age. Ray thinks it is the champaca of Bontius. Michelia champaca Lin. Sp. PI. 756. The dried root of its bark is an emmena- gogue : the floAvers are reckoned cordial. CHA'NCRE, a canker, (French); called also ca- roli. The ancients called such ulcers on these parts caries pudendorum. The small irritable pustules Avhich have obtained this appellation do not appear at any certain period after the application of the virus; sometimes they form in less than twenty-four hours; at others not before six weeks; but most frequently from four to ten days, and are at first seldom larger than a millet seed. They occasionally make their appearance over all the parts of generation, and, in some instances, even on the contiguous parts, as on the scrotum, all over the penis, and on the lowest region of the abdomen. They may indeed form on all the soft parts of the body ; but they are most frequently seated on the glans penis, and on the prepuce, near to its connection Avith the glands; often about the fraenum, and in some instances on the very point of the glans, and even within the verge of the urethra; here, as well as near the fraenum, they prove ahvays very trouble- some, and more difficult to cure than in other parts of the penis. The colour, quantity, and consistence of the matter, are exceedingly variable. It is usually of a dirty yellow green colour, often tinged with red. Sores of this kind are sometimes of a simple innocent nature, and Ihey usually heal in the course of a short time, merely by being kept clean; whilst they will gradually become worse, if they are venereal, should mercury not be employed, or if they are not treated with es- charotic or astringent applications. A real venereal chancre is seldom so large at the first as the base of a split pea, and the edges of the sore are elevated, some- Avhat hard and painful: still, in some few instances, Ave observe a slight superficial ulceration, not attended with either pain or hardness, and which, by the consequences alone, Ave find to be venereal. In general, however, such sores are not venereal, and the want of hardness and of painful irritability are the chief distinctions. There are other chancres, which become suddenly elevated into extensive vesications, containing a clear lymph, but more frequently tinged with blood; from this livid appearance, these chancres are judged of a more dangerous nature than others; but the colour de- pends entirely on the blood being mixed Avith the se- rum; and on their contents being discharged, the parts beneath appear clean, the surface is only excoriated, without being affected in any other manner. In wo- men, chancres exactly resemble those in men, and oc- cur chiefly on the internal parts of the labia pudendi, nymphae, clitoris, and the entrance of the vagina and urethra; but seldom or never within either of these passages. If a chancre is seated in the urethra, it may be mis- taken for a gonorrhoea, but may be distinguished by the smallness of the discharge, the pain during erection being in the extremity of the penis, or a particular spot in the urethra, but principally by examining Avith the touch of a probe or bougie whether it is callous or not. In almost every instance, however, a chancre never occurs in the urethra, except it'..be Avithin the reach of the sight, often of the touch. When a venereal chancre, distinguished by its ap- pearance, its hardness, and its painful irritability, oc- curs, it is seemingly the first object to crush the disease in its bud. It has been indeed doubted Avhether in that state absorption takes place; but we need not dis- cuss the question, since no prudent practitioner would agree to omit internal remedies; and in the inquiry into the previous symptoms, the appearance of a chancre leads most decisively to the use of internal mercurials. If, indeed, after exposure to infection, an ulceration appear, it is most probably only a local affection; and a cure might be effected by a very superficial dressing; yet as we have no means of being certainly safe, the cure of even the slightest chancre should never be trusted to external remedies. In every case of ulcerated chancre not attended with much inflammation, after wiping the sores as clean as possible, let them be sprin- kled Avell with the hydrargyrus nitratus ruber, finely powdered, and pledgets of any common ointment applied over it; and after two or three dressings, the ulcer will be generally clean, and nearly healed. Finely powdered calomel will be equally effectual, and the application is said to give a pleasing glowing warmth. The free use of the lunar caustic is recommended highly in the cure of this complaint, and particularly in its incipient state: it effectually cures, by destroying the diseased parts, Avhich soon become clean, and heal as quickly as sores proceeding from any other cause, and of the same magnitude. In general they are sel- dom troublesome but from the pain, and the great doubt is whether they should be suffered to remain as an index of the effects of mercury internally, or de- stroyed as local disease by a caustic. We have no doubt of advising the latter, since in a part where the circulation is languid, they may not be readily affected by internal mercurials, and we have equally certain guides of the necessary extent of a mercurial course. See Astruc on the Venereal Disease, or Chapman's Abridgment of Astruc, Heister's Surgery, Lond. Med. Trans, p. 337 ; and particularly Hunter and Bell on the Venereal Disease. CHAO'VA. The Egyptian name for coffee. See COFFEA. CHA'RABE, (from charaba, Arab). See Succi- NUM. CHARA'CIAS, (from x«?«Sj, a bulwark, or fence). An epithet given to some plants Avhich require support, as the vine, &c. CHARA'CTER, (from xxPttT0'u> to engrave.) In botany and nosology it is that assemblage of marks by which the species of plants or diseases are distinguished from each other. Character signifies also an hereditary disposition to some particular disease. In chemistry it is a mark importing a particular sub- stance; or it is a sign invented to represent the princi- pal substances and operations in a concise manner. CHARA'NTIA. See Momordica. CHA'RDONE. See Cinara spinosa. C HE 408 CHE CHARISTOLO'CHIA, (from %*pis,joy, and A«#/«, the flux of women after child-birth.) So called from its usefulness to women in child-birth. See Artemisia. CHA'RME, CHA'RMIS, the name of a cordial an- tidote mentioned by Galen. CHARO'NIUS, (from Charon, the boatman of the Styx, surrounded by noxious vapours.) Charonian. An epithet for caves, some of Avhich are in Italy, where the air is loaded with deleterious vapours. CHA'RTA VIRGI'NEA. So called from its like- ness to a piece of fine paper. See Amnion. CH'ARTREUX, Po'udre de, invented by some friar of the Carthusian order. See Antimonium. CHA'SME, x^Wi (from %xivu, to gape.) See Os- (Ttatio. Hence, in English, a chasm. CHA'TE. See Cucumis jEgyptia. CHAULIODO'NTA, (from ^«wa««, to throw out, and o£ov, a tooth.) So the Greeks call those animals Avhose teeth grow to a great length out of their mouths, as the boar and the elephant. CIIE'DROPA, (quasi xe'Pi manus, tyeTra, colligo.) V general term for all sorts of corn and pulse, because they are collected by the hand. CHEILOCA'CE, (from #£<*«?, a lip, and xxxov, an evil.) The lip-evil. A swelling of the lips. See Caxcrum oris, andLABRi-suLCiUM. CHEIME'TLON, (from x^'P", winter.) See Per- nio. CHEI'MIA, (from the same.) Cold, shivering. CHEIRA'PSIA, (from xe'P> the hand, and x7rlop.xi, to touch.) Scratching. CIIE'IRI. So named from the likeness of its blos- soms to the fingers of the hand; called also leucoiu7n luteum, viola lutea, common yelloav wall-floaver. Cheiranthus cheiri Lin. Sp. PI. 924. The stalks are woody and brittle; the leaves oblong, narroAv, sharp pointed, smooth, and of a dark green colour; the floAvers numerous, yellow, tetrapetalous, open successively on the tops, are followed by a long slender pod, containing reddish flat seeds. It grows Avild on old walls and among rubbish, and flowers in April and May. The flowers have an agreeable smell, but to the taste are nauseously bitter and pungent. Water takes up all their active matter; but no essential oil is obtained by distillation, though in this Avay a water is obtained that possesses much of the flavour of these floAvers. They are reckoned among the nervines, deobstruents, diure- tics, and antiparalytics. CHEIRIA'TER, (from xilh a hand, and ixrgos, a physician.) A surgeon ; called also chirurgus. Hence cheiridticus, a term appropriated to chirurgical reme- dies and operations. V. Chirurgia. CHEIRI'SMA, (from xt'P1^,°fAXh to labour with the hand.) Handling, or a manual operation. CHEIRI'XIS. Surgery. CHEIRONO'MlA,(from xitP°'">l*'luito exercise with the hands.) Chironomia. An exercise mentioned by Hippocrates, Avhich consists of peculiar gesticula- tions of the hands. CHEIRUR'GUS, (from xtihmanus-> and e^yov,opus.) See Cheiriater. CHE'LA, (from #£», to take.) A forked probe mentioned by Plippocrates for extracting a polypus from the nose. In Rufus Ephesius it is the extremities of the cilia; but most commonly it is used for claws, particularly of crabs. It also signifies fissures in the heels, feet, or pudenda. CHEL. CANC. PULV. C. See Cancer fluvia- T1LIS. CHELI'DON, (from Trxpx n> xt'*1™ xhiv, because it chatters Avith its lips or bill.) The savalloav. Also the IioIIoav at the bend of the arm, from its shape. CHELIDO'NIA, (from xe'^c*i the swallow, be- cause SAvallows are said to open the eyes of their young by it; or because it blossoms about the time in Avhich these birds appear.) The greater and lesser ce- landines. See Chelidonium majus. CHELIDO'NIUM. See Brionia alba. Chelido'ntum ma'jus, papaver corniculatum lu- teum, tetter-avort, and great celandine. Che- lidonium majus Lin. Sp. PI. 723. This plant hath longish leaves, divided to the rib into roundish and indented portions, of Avhich those at the extremities are the largest, of a bright green colour On the upper side, of a bluish green underneath, full of a gold coloured juice, as are likewise the stalks; from the bosoms of the leaves issue long pedicles, bearing clusters of tetrapetalous yelloAV flowers, which are followed by broAvnish pods, containing flattish shining black seeds; the root is thick at the top, Avith a number of fibres at the bottom, externally brownish, internally of a deep yellowish red or a saffron colour: it is perennial, groAvs Avild in hedges and shady places; floAvers in May and June. The leaves and roots have a faint unpleasing smell, and to the taste are bitter and acrid; they give out their active matter to spirit and to water: the pungency they possess is not of the volatile kind, for hardly any of it rises in distillation; yet it is lessened by drying the plant, and inspissating infusions of it. Drying wholly, dissipates its smell. It is aperient, diuretic, and useful in the jaundice, Avhen not accompanied with inflammatory symptoms. The fresh juice is used to destroy Avarts and films in the eyes; but for this latter purpose it is diluted with milk. Of the dried root from 3 ss. to 5 i- is a dose; of the fresh root infused in wine or in water the dose may be about 5 ss. The decoction of the fresh root is used in dropsy, cachexy, and cutaneous complaints. Chelido'nium mi'nus, called also scrophularia minor, flcaria minor, chelidonia rotundifolia 7ninor, cUrsuma, hamorrhoidalis herba, ranunculus vernus, pilewort, and lesser celandine. Ranunculus flcaria Lin. Sp.Pl. 774. It is a small plant, Avith roundish smooth shining green leaves, set on long pedicles; and slender pro- cumbent stalks, bearing bright gold coloured solitary flowers of eight or nine petals Avhich stand in three leaved cups, and are followed by clusters of naked seeds; the root consists of slender fibres, Avith a number of tu- bercles or little knobs. It is perennial, grows wild in hedges and moist meadows, and floAvers in April. The leaves are antiscorbutic, but are Avithout smell, and have very little taste, though on chewing a slight pungency is perceived. The roots are reckoned a spe- cific, if beat into cataplasms and applied to the piles; they yield a large portion of mucilaginous matter to Avater, are supposed to be diuretic, and to clear the skin C II E 409 CHE oftettery eruptions. Raii Synop. et Hist. Othonna has been supposed to be the juice of celandine. CHELO'NE. A tortoise. It also imports a part of a surgical machine mentioned by Oribasius. An in- strument to make a gradual extension of any fractured limb, in which motion it resembles the sloAvness of XeXuw, a tortoise. A plant also whose crest resembles a tortoise shell. CHELO'NION. A hump back; so called from its resemblance to the shell of ££A»vjj, a tortdise. ' CHELTENHAM WATER. This arises from a spring near Cheltenham in Gloucestershire ; and is one of the most celebrated purging waters in England. When taken from the fountain, it is clear and co- lourless, but somewhat brisk; has a saline, bitterish, chalybeate taste; it strikes a vivid purple colour immediately on being mixed with an infusion of galls. Its heats is in summer from 53° to 59°, when the medium heat of the atmosphere was nearly 15° higher. When exposed to the air in an open glass vessel, it throws up a quantity of air bubbles, becomes turbid, and loses its brisk chalybeate taste and property of tinging an infusion of galls. On evaporation it is found to contain a calcareous earth, mixed with ochre, and a purging salt. In one gallon were found by Dr. Short 74 grains of calcareous earth mixed with ochre, and 673 grains of a purging salt. In the second experiment, 42 and 580; in the third, 70 and 622 respectively. Dr. Rutty found 36 grains of earth, 494 of salt, which was7 composed of vitriolated magnesia, and a small quantity of sea salt. Dr. Lucas, 4 grains of iron, 181£ grains of calcareous earth, mixed with a small portion of selenites, 362£ of salt of the nature of Epsom, but drier and finer. Dr. A. Fothergill found 480 grains of Glauber and Epsom salts, 5 grains of sea salt, 25 of magnesia, and 40 of selenite; together 550 of solid contents. The upper, or King's Avell, was discovered by the accidental sinking of a well after the king's resi- dence there, by his command. The temperature of this water at eight in the morning, the beginning of August, Avas 54°. Its specific gravity was, at that temperature, 1059; and it boiled at 214£, Avhen the barometer Avas at 29.60. Its sensible qualities Avere not very different from the other springs. It certainly contains a larger proportion of salts than the water usually employed; and the analysis of Dr. Jameson discovered the folloAV- ing contents : viz. sulphat of soda, 490 grains; sulphat of magnesia, 310 3 muriat of soda, 40 ; sulphat of lime, 38; carbonat of lime and magnesia, 34: in all 912 grains of salts, estimated in their crystallized state in a wine gallon of the water. This Avell seems to contain neither sulphur nor steel. The principal diseases, for which the Cheltenham Avater is employed, are bilious; and to the Chelten- ham Avells resort those who from indolence, luxurious indulgences, a long residence in tropical climates, or other causes, labour under cachexy from a diseased, ge- nerally a scirrhous, liver. It is this state of the biliary system which is chiefly adapted for these waters; and they very successfully assist a mercurial course. In overflowings of bile also, particularly where this fluid regurgitates into the stomach, occasioning headach and sickness, it assists in discharging it regularly. In the first instance, the steel seemingly counteracts its debili- vol. 1. tating poAver; and in the latter, the carbonic acid gas prevents it from producing vomiting. In gout the Cheltenham water is also occasionally re- commended ; and the cooling tendency of the salts is supposed to be counteracted by the stimulus of the steel: yet, perhaps, it is chiefly adapted to those cases of gout connected Avith complaints of the liver; in reality, to the broken constitution, Avhich is the cause of both. In all stomach complaints, in hypochondriasis, and chlorosis, it is said to be useful; and, probably, may be so, though there are apparently other medicines better adapted to them. In jaundice, in scorbutic eruptions of different kinds, in scrofula, and the diseases connected with it, this Avater is useful. In inflammatory asthma, in amenorrhcea and leucorrhoea, in haemorrhoids, and nephritic complaints, in short, wherever constant cool- ing laxatives are necessary, this mineral water has been employed; but in many of these diseases it is not su- perior to sea Avater, and in some perhaps inferior. As a purge, this water is drank from one to three pints; though in general from half a pint to a quart is sufficient. It operates with great ease. CHE'LYS, (from x(Xv*i a shell). See Pectus. CHELY'SCION, (from xeXv$>tne breast). A short dry cough. CHE'MA. Blancard says it is a certain measure mentioned by the Greek physicians, supposed to contain two small spoonfuls; the Athenians had one of two drachms, and another of three. CHE'MIA, vel CHI'MIA, (from the Arabic term chamiah, from chamah, to burn). Chemistry. Among the Greeks it was called xt>Fuee'> Zef^etu> and Xvt^eiot\ the last of which hath been generally folloAved by the later writers on this subject, though the most approved editors and other learned men have preferred the former. The modern Greeks write xtf**"*- It is also called archimdgia and pyrotechnia. Though this branch of the science of nature is Avell knoAvn, the definition of chemistry has occasioned many discussions and tedious controversies. The first great object is to distinguish it from natural philosophy, a task Avhich few authors have successfully performed; and we are on this account tempted to select the discri- minating description of the Abbe Haiiy, in the ablest system of natural philosophy yet published. " When Ave consider," observes this author, " the ge- neral and permanent properties of bodies, or Avhen the changes that these bodies undergo are slight, and they return to their former state, after the cause has ceased to act; Avhen, also, the laAvs which determine the reciprocal actions of the same bodies are propagated to distances more or less considerable; the results of our observations are still within the confines of natural philosophy. But Avhen the phenomena depend on the ultimate action Avhich the molecules exert on each other, at distances almost infinitely small, by virtue of which the mole- cules separate to unite again in a different order, form- ing neAV combinations, Avith neAV properties, the study of the phenomena belongs to chemistry." We seldom indulge ourselves with quoting the Avords of an author but for some particular object. This dis- tinction, truly judicious and scientific, avc consider as one of those positions on Avhich Ave'can securely rest, and to Avhich we may have occasion to rctV . At pre- 3 G CHE 410 CHE sent it serves only to introduce, and as a foundation for, a more precise definition of chemistry than any former author has offered. We shall consider chemistry, there- fore, as comprehending the science of the mutual actions of the smaller particles of matter, either in decompos- ing natural bodies or producing neAV compounds. In this view, fire, electricity, and Galvanism, are its in- struments only, and become the objects of chemistry when they enter into the composition of bodies; and in this vieAV, also, the human body is a philosophical and chemical machine, though chiefly chemical. It some- times partakes of both, in as much as its operations are carried on between particles at an indefinitely minute distance, but not always occasioning decomposition or new compounds with different properties. Were we to treat of the history of chemical arts, we should be carried back to a very remote era: were we to speak of chemistry as a science, our history would scarcely yet have a beginning. Chemical arts do not imply chemical science; and we shall consequently overlook the fancies of those, who see in common oper- ations the rudiments of what has since been so advan- tageously developed ; Avho admire, for instance, the ingenuity of those ancient artists who could be so far instructed as to produce a scarlet dye, when they Avere in reality ignorant of such a colour. The Egyptians, who have had the honour of invent- ing every science, probably without the accurate know- ledge of any one, have appeared to claim chemistry as peculiarly their own. Plutarch tells us, that Egypt is called £aj|t*E'«e, from its earth, like the black of the eye; but the name is more probably derived from Ham, as it is called by the psalmist Al-chami. The error arising from this name was fostered by the neAV Platonists, who forged works under the names of Hermes, &c. as those of the ancient Egyptians. Yet to these new Platonists we are perhaps indebted for many valuable facts. They were the first visionaries who aimed at changing the meaner metals to gold, a pursuit with which the disco- very of an universal medicine was very early connected ; and from them it was conveyed to the Arabians, by whom it was taught to Europeans. Themistius, the peripatetic, in the fourth century, and .Eneas of Gaza, in the fifth, speak of these attempts; the former in his 1 Oratio ad Valentinum,' the latter in his Dialogue en- titled ' Theophrastus.' With themand with the Ara- bians the art remained; nor did it reach Europe till after the capture of Constantinople, for the name was unknown to the Grecians of Europe till the time of Julius Firmi- i us, who lived under Constantine the Great. The Arabians applied this new science to medicine, though not to any considerable extent. Their practice Avas mild and timid; and had any more active medicine been discovered, it is not probable, from their general conduct, that they would have been its patrons. The works of Geber, Rhazes, Avicenna, and Mesue, have reached us; and from them, were not our limits con- fined, we might trace very accurately the state of me- dicinal chemistry at that time. It is enough to remark, that it added little to the powers of medicine, though someAvhat to the convenience of the practitioner. We speak not noAV of the neAV medicines which they intro- duced. In Europe, the art of making gold filled the minds of the chemists, or rather alchymists, to Avhich they joined an almost equal anxiety to discover the universal medi- cine. This was sometimes supposed to be the same, sometimes a similar preparation; and as the former art depended, in their opinion, on the employment of mer- cury and antimony, many preparations of these metals must have occurred, and we can trace some of them at this time to these whimsical unintelligible works. Even among the alchymists, however, Ave perceive traces of sounder minds and more solid judgments mixed with their reveries; and the names of Albert von Bollstaedt, Roger Bacon, Raymond Lully, Albertus Magnus, Ar- nold of Villenuova, the Isaacs of Holland, and Basil Valentine (though probably not his true name), merit peculiar distinction. They mixed indeed the fancies, the superstitions, and the unintelligible language of the alchymists with their descriptions; but they discovered and detailed, often Avith precision, many valuable and important facts. The writings of Lully and Arnold, however, seldom merit the commendations Avhich we have bestOAved; and perhaps the praise of any portion of perspicuity might have been more limited. They were all of the thirteenth or fourteenth centuries. The folly, the madness, and the wickedness of the alchymists, for their conduct at different times merited each title, continued without any considerable change. They Avorked in secret; and collected facts which were to supply at a future period the more rational chemists, but had little influence on the practice of medicine till the period of Paracelsus. This visionary of the sixteenth century burnt in solemn state the writings of Galen and his followers, professing to cure all diseases by che- mical medicines alone. He Avas equally depraved in his moral, as he was insolent and ignorant in his medical, character. His precepts were generally dictated in fits of intoxication; and he oAvned to one of his favoured disciples, that he could not maintain his credit in any place above a year. He died in his forty-seventh year, boasting of having the poAver of prolonging his life to an indefinite period. From the mysticism of his language, many parts of Avhich Dr. Motherby and his associate had preserved, and some specimens we have, perhaps with too great facility, retained, it will appear that little can be learnt from his works, Avhich however, have been collected by his disciples in two volumes folio. He was succeeded in this path by Van Helmont, equally visionary as an alchymist, and more so in adopting the fancy of sympathetic medicine; but a man of talents, of observation, and, out of these departments, not without judgment. To Van Helmont, though nearly at the dis- tance of a century from Paracelsus, and to Crollius, we owe the labours of Paracelsus in a more intelligible form ; and Ave are certainly indebted to him for the in- vention or preservation of some very valuable chemical preparations. The original of Crollius appeared at Frankfort, in 1609, and was translated into English in 1670. Glauber, Kunkel, Kircher, and Conringius, were diligent and experienced chemists, who added greatly to the stock of facts, and to Avhom Ave are still indebted. Chemistry, hoAvever, continued to be only a collec- tion of detached facts, without any bond of connection, without any principle of union; nor, until the period of Becher and Stahl, did it assume the semblance of a CHE 411 CHE science. Becher died, like Paracelsus, at the age of forty-seven; but he had collected the various operations of chemistry, and united them by general principles: one of these was the supposition of phlogiston, which has only of late been, with reluctance, abandoned. Stahl, a man of singular talents, of an imagination lively and eccentric, but who wrote Avith a logical precision almost unexampled, assumed gratuitously the existence of this principle; and connected also, chiefly by its means, the numerous isolated facts of Avhich chemistry then consisted. His cotemporary, Hoffman, applied this science, with more stvtdied care, to medicine, and col- lected, Avith great anxiety, the labours of the more in- telligent chemists Avho preceded or were cotemporaries Avith him. As a medical chemist, Hoffman merits the highest commendation: he was patient, industrious, and honest. He was, hoAvever, too eager, certainly too credulous. About the same period, with superior tal- ents and similar faults, our own Boyle laboured in this vineyard; but, while we blame their credulity, Ave must make alloAvance for the splendour of numerous and surprising phenomena, which dazzled the imagination, and led the judgment captive. It was a new Avorld, and what they believed was scarcely more extraordinary than Avhat they saw. To pursue the subject of medical chemistry, our chief object, we shall next mention the celebrated Boerhaave, who detailed, very advantageously, what former chemists had discovered, and added the result of many years un- remitted industry. He unveiled the mysteries of the art, by employing the language of learning and philoso- phy unmixed Avith metaphor and an assumed obscurity. Probably, no author promoted, more successfully, the progress of chemistry, or applied it more advantageously to medicine; and he advanced it by these means rather than by splendid discoveries. After him folloAved Dr. Cullen, who, probably, brought to this science those ex- tensive systematic views which distinguished him in every other. But the cold reserve of his descendants, their apparent indifference to his fame, repress all com- munication. We knoAv only that his lectures were re- ceived Avith great approbation, and that his chemical knoAvledge was directed to medicinal improvements. To him Ave are indebted for the more general use, at least, if not the introduction, of some of the more ac- tive metallic preparations. Dr. Black folloAved his steps ; and, though he pursued chemistry rather as an inde- pendent science, he seldom lost sight of its application to medicine. In following the systematic authors, Ave have hastened too rapidly in our way. From the time of Boerhaave to the doAvnfal of Becher and Stahl's boasted principle, numerous Avere the authors who improved this science. \mong the Germans, Areu7nann, Pott, Cramer, Car- theuser, Margraaf, Spielman, De Born, Plenck, Scheele, and Gren; in Holland, Ingenhouz and Van Mons; in France, the Geoffroys, Reaumur, Du Hamel, Hellot; the two Rouelles, Homberg, Macquer, Bau7ne, Sage, D'Arcet, and De Morveau; In Italy, Scopoli, Fontana, Liandriani, Cavallo, Volta, and Spalanzani; in England, Hales, Mayow, Lewis, Priestley, Black, Higgins, and Nicholson; in Sweden, Brandt, Wallerius, Cronstedt, Rinman, Scheffer, Gahn, and Bergman. Those who have applied more particularly chemistry to medicine * e marked by italics., The early dawn of chemical improvements may be traced, in England, to the period of MayoAv, Hales. Kirwan, and Black, of the old school; from Priestley and Cavendish of the new. Gahn and Bergman, Sage and De Morveau, Scopoli and Spallanzani, are on the confines of each system, and may belong to both. The experiments of Hales and MayoAv had been forgotten, Avhen Black elicited the first spark, Avhich was to dazzle Avith the flame it excited. This embryo, if not ne- glected, scarcely treated Avith a parent's fondness, Avas cherished by Cavendish and Priestley; and the result was the splendid discovery of the composition of Avater; the existence and properties of many, permanently elastic, gases. Lavoisier, De la Place, Berthollet, and Fourcroy, folloAved; and from this period the distin- guished chemists of every country have resigned the visionary phlogiston, and joined in adopting the pneu- matic system. Priestley died an infidel; Gren but half converted. Kirwan and Black joined Avith apparent reluctance, after patient inquiry and full conviction, what is styled the antiphlogistic system. The revolu- tion is noAv, Ave believe, complete: it is not heresy, but reformation. The French chemists, not content with this splen- did improvement, of Avhich, indeed, they could not claim the honour, though they have made numerous ad- ditions, scarcely less valuable, perhaps, than the first discoveries of Black and Cavendish, have changed, in consequence of the establishment of the pneumatic system, the Avhole language of chemistry. They have thus attempted to make it exclusively their own. This vanity, so common in their nation, might excite a smile as harmless; and from the merits, on the whole, of the new nomenclature, command approbation, Avere it not from some serious inconveniences that -will be found to result. At this time, the language of both sects is common, and little inconvenience is experienced ; but, except to the experienced chemist, the labours of Pott, of Neumann, of Margraaf, Macquer, Baume, &c. will be soon lost. Their language Avill no longer convey ideas; and experiments, most truly important and valuable, will be almost on a footing Avith Egyptian hie- roglyphics. There is one remedy for this evil, which is the unmerciful pillage of French authors from their predecessors; and, as usual, the stolen goods are marked with the characteristics of their present oAvners, to con- ceal the depredations. This, however, is not sufficient: juvat integros accedere fontes; and, unfortunately, the streams are polluted. Various are the changes Ave have Avitnessed to adapt former facts to the theory of the moment. We would strenuously advise the stu- dent, therefore, to study the language of both sects; and the lately published lectures of Dr. Black are ad- mirably adapted for this purpose. Mr. Nicholson's Elements also, published when the new theory Avas not fairly established, contains the explanation of the phe- nomena according to each system, and Avill ansAver the same purpose, though the neAV theory has received con- siderable improvement since the period of their publi- cation. Chemistry, so far as it relates to medicine, has been hitherto employed in the composition of medicines. In this branch, hoAvever, previous to the introduction of pneumatic chemistry, much Avas empirical and hetero- geneous; ingredients, destructive of each other's powers, CHE 412 CHE .vere ignorantly or inconsiderately accumulated. It was the object to heap a great variety of medicines in one formula, that should one fail, another might suc- ceed: forgetting that, though the imagination was boundless, the stomach Avas limited; and that, when the number of ingredients was increased, the dose of each was inconsiderable. In chemical formulae, the error Avas greater from the union of heterogeneous sub- stances; and, Avhere the ingredient was retained, its utility Avasnot understood. A striking instance of this kind was the chalybeate oxide in the preparation of the corrosive sublimate, Avhich furnished the pure air that distinguishes this preparation. In the former case we have refined, perhaps, too far, as we shall show in the article of Combination of medicines. In the latter, Ave have not been equally rash, yet we suspect Ave have often erred. In the articles, Argentum vivum, and Antimonium, Ave have shown that the more simple modern preparations are different, in some respects, from those of the ancients. Chemistry, however, which first led the pharmaceutist from the path, will contribute to his recovering it. In another branch, chemistry was seemingly misem- ployed; we mean in investigating the powers of medi- cines. The older chemists employed fire, almost ex- clusively ; and vegetable remedies, the most opposite in their nature, yielded nearly the same products. Even bread, we are informed by Mr. Boyle, will produce, by distillation, the most acrid deleterious oil. In fact, in these destructiveprocesses, new combinations are form- ed; and, as the principia proxima of vegetable sub- stances are nearly the same, it is not surprising that the products in their reunion, after separation, should be similar. Modern chemistry employs less violent means, and neAV compounds are not so frequently produced. By these more gentle means, also, the analysis of mine- ral waters is much more accurate and satisfactory. This science has, however, since the discovery of neAV %-ases, been very successfully employed in investigating ;he nature of the animal solids and fluids. A new era may be thus marked in our chemical physiology. They Avere not neglected by the French chemists, particu- larly the Rouelles, Homberg, and others; but we have nnly of late Avitnessed the happy results of more accu- rate, more scientific investigation. Since the period of Plenck, Avhose Hydrology is still an excellent work, Ave have received considerable satisfaction from Berthollet, fourcroy, Vauquelin, Pearson, Hatchett, and many chemists of the neAV school. To teach chemistry cannot be our object; we must treat of it as the handmaid, the assistant, of physic and the physician, and the chief details must be sought in the different articles. Yet, perhaps, we may here, with advantage, sketch the outline of the science; point out the mutual dependencies of each part, and supply what omissions may have already occurred. We must, how- i-ver, speak chiefly of medical chemistry; for we anxi- ously wish to avoid stepping beyond the line of medi- cine, and to render this dictionary strictly, and, as far as possible, exclusively a medical one. In teaching chemistry, modern authors have begun Avith elements, and proceeded to their compounds. We thus soar, perhaps, too far above common comprehen- sions, and certainly beyond the youthful intellect. We shall prefer thedivisionof Dr.Black,originally thatofDr. Cullen; and divide the objects of chemistry into salts, earths, inflammables, metals, and Avaters, adding the airs, vegetable and animal substances. We obtain, however, the bases of every body most pure in the form of air, so that we shall premise a short abstract of the properties of the different gases. Of caloric we have already spoken: of light, as a chemical principle, we knoAv little, and still less of its real influence in the ani- mal economy; yet, under that article, we shall add a few observations on the subject not wholly uninteresting. Under the article Air, in the First Part, we have mentioned the general properties of the different kinds of this invisible fluid, as Avell as of the medical proper- ties of each species. We must noAV speak of air chiefly in a chemical view; and though, perhaps, in this and some other parts of the present article, we may seem to deviate from our professed intentions of confining our- selves to medical chemistry, such is the rapid progress of the science, and so much closer is its connection Avith physiology advancing, that, even while we are Avritingwhat may at first appear irrelevant, will become of the greatest importance. We speak first of oxygenous gas as the least com- pounded form of air; and though, as we have said, the aerial form is the purest in which the different bases can be represented, yet it is doubtful whether this gas has any basis, and whether it is not strictly and purely caloric. It combines, under different degrees of tem- perature with all the gases or their bases, with inflam- mables and with metals, but not with earths or alkalis. The temperature required for the union is different; and Avhen it is in so high a degree as to dissipate the body in vapour, inflammation, strictly so called, is pro- duced. By the French chemists, the union of oxygen Avith different bodies is styled combustion, but in a loose, and, we think, an unscientific sense. This gas constitutes 0.22 of atmospheric air, and its specific gravity is 0.00135. Oxygen combines Avith bodies in different propor- tions. With nitrogen, it forms atmospheric air: in larger proportions, successively, nitrous, nitric oxide, and nitric acid. With hydrogen, water: and, as has lately been rendered probable, in a larger proportion, muriatic acid. With carbon, it forms plumbago, char- coal, gaseous oxide of carbon, carbonic acid, and carbo- nic acid gas. With sulphur, oxide of sulphur, sul- phureous and sulphuric acid. With phosphorus, oxide of phosphorus, phosphorous, and phosphoric acid. With carbon and hydrogen, it forms Avhat are styled the hy- drocarbonats and the vegetable acids; and, Avith the addition also of nitrogen, it forms animal substances. Oxygen unites with metals, forming what fonner che- mists styled calces, now oxides. From these it is sepa- rated by phosphoric salts, and, indeed, by animal sub- stances of every kind: a fact of importance in explaining the action of oxygenated remedies. It is separated also from almost every compound by light: a circum- stance to which Ave shall return in that article. Mtrogenous or azotic gas constitutes 0.78 of our at- mosphere, and may afford the portion that Ave breathe with peculiar pleasure, and by which the process, styled animalization, may be chiefly assisted; it is probably ab- sorbed in respiration. Its specific gravity is 0.00115, and some very delicate vegetable blues are rendered green by it. Vegetation, respiration, and combustion, are at once CHE 413 CHE checked by this gas when unmixed; and azote is the distinction of animal substances. It constitutes, with oxygen, nitrous acid, and is the chief ingredient in am- monia. It refuses to unite with water, and dissolves phosphorus and carbon in small quantities. With oxygen it forms atmospheric air, and in succes- sion nitrous oxide, nitrous gas, and nitric acid; with hydrogen, ammonia; with sulphur and phosphorus, sulphurated and phosphorated nitrogen gas. With car- bon, nitrogen, and oxygen, it forms animal substances; should the oxygen be in excess, the result is animal acids. With the proportion of oxygen, which forms nitrous oxide, viz. 37 of oxygen and 33 of nitrogen, it will support flame, and suffers no diminution when mixed Avith oxygen gas. It does not change even the most delicate vegetable colours, for in this state it recedes from its alkalinity, nor does it combine with alkalis. With atmospheric air, it is highly grateful when breathed, which supports the idea formerly hazarded/ that azote, so far as it can be safely introduced, is pleas- ing and salutary. Water absorbs one half the bulk of nitrous oxide. The nitrous gas contains 44 parts of oxygen, but does not change vegetable colours. Its specific gravity is 0.001343. It forms, Avith oxygen, nitric acid, and water absorbs 0.118 of its bulk. It supports neither vegetation nor respiration, and only in a few instances combustion. Hydrogen gas, the inflammable air of Priestley, is very light, for its specific gravity is only 0.000094. It is highly inflammable, and burns when oxygenous gas or atmospheric air is contiguous ; or detonates, Avhen mixed with them, on the application of a burning body. It extinguishes flame, and will not support respiration. It dissolves sulphur, forming hepatic gas; and united with phosphorus and carbon, it forms gases highly fetid. Hydrogen, with oxygen, forms Avater; with a less proportion it has been lately thought to produce muriatic acid; Avith nitrogen, ammonia; with sulphur and phos- phorus, hepatic air and sulphurated hydrogen. With carbon and oxygen it produces the hydrocarbonates and vegetable substances; with carbon, nitrogen, and oxy- gen, animal substances and animal acids. Water is composed of 14.42 of hydrogen, to 85.58 of oxygen; ammonia of four parts of nitrogen, and one of hydro- gen. Carbonic acid gas was formerly known by the name of fixed air, and its discovery was the germ of the whole of pneumatic chemistry. Its basis, carbon, in its purest form, is the diamond; and 17.88 of carbon with 82.12 of oxygen, forms the gas. It is the chief basis of vegetable, though it occurs also in animal substances. With oxygen and iron it forms plumbago, and with a larger proportion, successively, charcoal and gaseous oxide of carbone; with metals, Avhat are styled, in the neAV language, carburets. With oxygen and hydrogen, it forms the hydrocarbonates, alcohol, ether, oils, wax, re- sins, camphor, starch, sugar, jelly, tanin, and all the va- riety of vegetable acids, with the mucous, laccic and se- baeic acids. With nitrogen, oxygen, and carbon, it forms the various gums and resins, cork, gelatin, albumen, fibrin, urea; the prussic, zoonic, uric, and amnic acids. Common charcoal of wood contains 36.14 of oxygen the gaseous oxide of carbone, 74.11 of oxygen. Salts are either acid or alkaline. The acid salts, or acids, are mineral, vegetable, and animal; though various acids are not exclusively confined to the class in which they are arranged. The mineral acids, or those usually styled so, are three, the vitriolic, the nitrous, and the muriatic ; but the succinic, the boracic, and several others, have an equal claim to the title, as they are the productions of, or at least found in, the mineral kingdom. These acids unite with alkalis, earths, and metallic oxides so com- pletely, that in the new compound, the properties of the component parts are wholly lost; while some of the weaker acids, particularly the carbonic acid gas, leave often an alkaline, urinous taste. These acids, like all others, owe their acidity to the oxygen they contain, united to separate bases, which give their peculiar pro- perties ; but this oxygen may be in excess, and the acid has then been styled oxygenated, or the particle (oxy) is added. The French chemists distinguish the acids with an excess of oxygen, by terminating their respec- tive appellations with ic, as sulphureous and sulphuric. Their general properties have been already detailed. The vitriolic acid is diffused so generally, as to be styled the universal acid; but many others can now dis- pute this honour, particularly the carbonic. In medi- cine it is of the highest importance, since, independent of its tonic powers when uncombined, its union with alkalis and metals furnishes a variety of useful remedies. Its basis is sulphur, and, from its apparent viscidity, it has been styled oleum sulphuris. When sulphur is in- flamed, the oxygen is supplied by the atmosphere; and for this purpose it Avas formerly burnt under a bell, from Avhose sides it streamed into a receptacle below. It is now usually prepared in close vessels; and the oxygen is supplied by the addition of nitre, whose acid is in this operation decomposed. Vitriolic acid will crystallize at 3° below 0 of Reau- mur. With ice it produces an increased cold; with water considerable heat. With alkalis it forms the sul- phat of potash, formerly the vitriolated tartar, the sul- phat of soda (Glauber's salt), and the sulphat of ammo- nia (Glauber's secret ammoniacal salt). The sulphat of potash is soluble in about sixteen parts of water, at 60° of Fahrenheit, which Ave shall af- terwards call cold water, and five parts of boiling Avater. It is the least soluble salt, and on this account inconve- nient in its exhibition, as it requires so much fluid. One hundred grains contain 30.21 of acid; 64.61 of alkali; and 5.18 of water. The sulphat of potash, of commerce, is the residuum after distilling nitrous acid, separated from nitre by means of the vitriolic. In ex- temporaneous prescription, it is only decomposed by barytes or any of its preparations. In some circum- stances the nitric acid will displace the vitriolic; but this is of little importance to our subject, Avhich is not strictly chemical. Mr. Chaptal found this salt in the analysis of tobacco. The sulphat of soda is soluble in three parts of cold water, and in an equal weight of boiling water. It contains a large quantity of water entangled in its cry- stals, Avhich occasions it to swell and effervesce Avhen heated: 100 grains contain 14 of acid, 22 of alkali, and 64 of water. It is found in the ;ashes of the tamarix gallica ; but the salt of commerce is the residuum, after preparing the muriatic acid. It is decomposed by pot- CHE 414 CHE ash, baritic salts, the muriat of potash, the acetite of soda, muriated lime, lime water, nitrated silver, acetat- ed and nitrated mercury, and acetite of lead. The sulphat of ammonia is seldom, if ever, used in medicine. It is produced chiefly by decomposing earthy or metallic salts with volatile alkali, and by the decomposition of nitric, muriatic, or carbonated ammo- niacal salts by sulphuric acid. In extemporaneous prescription, fixed alkalis, barytes, and lime, the nitric and muriatic acids must be avoided in the same for- mula. The basis of the nitrous acid is the nitrogen, Avhich, with different portions of oxygen, forms nitrous oxide, nitrous gas, nitrous and nitric acids. The nitrous acid is brown, volatile, and suffocating. It assumes succes- sively a blue, green, and yellow colour, by the addition of water; and in a state of vapour is absorbed by wa- ter, oil, and sulphuric acid. It consists of about three parts of oxygen, and one of nitrogen. The nitric acid consists of four parts of oxygen to one of nitrogen; is liquid, colourless, and transparent, but corrosive, tinging the skin of a yellow colour. It produces heat when mixed with water, and is deprived of a part of its oxy- gen by light; Avhile the suffocating fumes of the nitrous acid are destroyed or suppressed by keeping it in the dark. When concentrated, it inflames oils, sulphurated hydrogen, and iron filings. The same effect is pro- duced on zink, bismuth, and tin, when poured on them in a state of fusion. It oxygenizes all metals, muci- lages, &c. and is itself decomposed. This facility in yielding its oxygen, which is seemingly separated by the animal fluids, and is certainly so by the phosphoric salts with Avhich they abound, has rendered it an useful remedy where oxygenation is required. Its utility in curing syphilis is not indeed established by extensive experience; but it evidently prevents the disease from growing worse, when from Aveakness, inclement wea- ther, or accidental circumstances, mercurials cannot be persisted in. From the chemical composition of nitrous acid, its resemblance to atmospheric air is obvious, and by the air it is evidently formed. In many places, particularly in India, South America, and Spain, nitre requires only lixiviation and purification. In France and other coun- tries, its formation is assisted by animal putrefaction, vegetable fermentation, and the rubbish of old walls, containing a calcareous substance. It is not easy to say what particular office either part of the process serves. It seems designed chiefly to adapt the mass for the ab- sorption of the ingredients of the atmosphere, for these are only requisite to form the acid. The alkali is sup- posed to be the product of the vegetable fermentation. This is, however, improbable; and we strongly suspect that it arises from the calcareous matter, as we shall soon consider. It is in the form of nitre that this acid is offered to our notice; in the language of modern chemistry, nitrat of potash. As it occurs from the hand of nature, it is far from pure. A large proportion has often, as might be expected, a calcareous basis; and sea salt generally forms a portion of it. We find nitre also in many plants, particularly the parietaria and bugloss; in fact, in all those whose extracts are liable to ferment. We need not enlarge on the methods of purifying nitre. Wc receive it in the form of a neutral, crystallized in prismatic octoedrons, terminated by dihedral summits. It is fusible on ignited coals, and its acid is decomposed. It does not deliquesce, but dissolves in seven parts of cold water, and its own weight of boiling: 100 grains of the crystals are usually said to contain 30 of acid, 63 of alkali, and 7 of Avater. This salt is cooling, and highly useful in all inflammatory diseases, those of the bladder sometimes excepted. Nitre is decomposed by alum, Epsom salt, tartar, spirit of vitriol, vitriol of zinc, copper, and iron. From the usual laws of affinity, it should be decomposed by Glauber's salt; but this takes place only in a slight degree, and at a temperature of 32°. Its chief utility in the arts for the process of making guripowder is well known. It is the principal ingredient also in fulminating powder; but even mo- dern fancy has not yet enrolled this among the articles of the materia medica. Nitrat of soda is styled cubic, quadrangular, and rhomboidal nitre, from the form of its crystals, Avhich, however, are not cubic, but rhomboidal. It is somewhat more bitter than common nitre, and grows moist in the air. Cold and boiling Avater equally dissolve about two parts of the salt: 100 grains contain, it is said, 28.80 of acid, 50.09 of alkali, and 21.11 of water; but by others the proportions assigned are very different, and Tromsdorff thinks that 100 grains contain 43 of acid, 32 of alkali, and 25 of Avater. It is generally the pro- duct of art, though it has been suspected in some mi- neral waters. We know not that it has been used in medicine; but should it be employed, the prescriber should recollect that it may be decomposed by potash, alum, Epsom salt, vitriolic acid, and the vitriols. Nitrat of ammonia is the production of art, and its crystals are described as resembling needles; the taste is cooling, but it has been little attended to, and has neve r been employed in medicine. The marine acid has hitherto resisted every attempt to ascertain the nature of its basis. Yet, from some Gal- vanic experiments, it is suspected that it may be water; and this acid is only water with a diminished proportion of oxygen. We shall first describe this acid and its pro- perties in the common way. When pure, it is colourless ; but has generally a yel- loAvish hue, and exhales white suffocating fumes. It is lighter than either of the other acids ; but its most dis- tinguishing property is the very great change it expe- riences from an excess of oxygen. Though this be un- doubtedly the principle of acidity, yet when added to the muriatic acid in an over proportion, its volatility is increased, its acidity and power of attraction for alkalis weakened, and instead of reddening vegetable colours, it destroys them. It is procured from common salt by the addition of sulphuric acid, when it assumes a ga- seous form; and in this state has been recommended for destroying infection, and purifying infected rooms. As these fumes are very suffocating, the vapour of the ni- tric acid has been preferred; and the discovery of each has occasioned a controversy which perhaps might have been spared, and which we must afterwards more par- ticularly notice, though we shall not pretend to decide the dispute. The most delicate test of the presence of muriatic acid is the nitrate of silver ; for the metal Avhen united with the muriatic acid is insoluble, but the oxygenated acid occasions no precipitation; so that if any doubt CHE 415 CHE arises, the acid should be previously exposed to the light, which separates in every instance the oxygen. The oxygenated acid forms, with different bases, ful- minating powders, Avhose detonation is extremely vio- lent, and takes place on trituration only, without heat. The use of the oxy-muriatic acid in bleaching is well known; and in its union with alkalis it furnished the active ingredient of De Morveau's box, which, on open- ing, diffuses round the person who holds it a pure at- mosphere, which destroys infection. The ingredients are now altered. See Contagion. The experiments lately alluded to are, hoAvever, too striking to be wholly passed over, since they offer such a clear simple view of the different operations of na- ture as will greatly elucidate many unaccountable phe- nomena. In attempting to ascertain the basis of this acid, even Berthollet erred, and Mr. Lambe was misled by a remote analogy; nor some months since should we "fiave given a more favourable account of Girtanner's hypothesis, who derived it from hydrogen. On the 23d of April, 1805, Mr. W. Peel of Cambridge, an- nounced, in the Philosophical Magazine, his discovery of muriat of soda from the decomposition of Avater by the Galvanic apparatus. In June he repeated his com- munication, and mentions his having formed water from its elements to repeat the experiment; but this water, from a little inaccuracy in the proportions, being acidulous, he neutralized the acid with lime, and dis- tilled it. But, after the Galvanic process, he found muriat of potash. By a singular coincidence, about the same time Pac- chioni of Pisa made a similar discovery. His letter is dated the 9th of May, sixteen days only later than Mr. Peel's, and both speak of recent discoveries. Pacchioni's apparatus is not described; and at the first glance it excites a suspicion that he procured oxygen only in the decomposition of the Avater, while others have obtained, exclusively, hydrogen; but as both are ingredients of water, evolved separately on different sides of the pile, this occasions little difficulty. On separating the oxygen, he found the gold wire dissolved, and the oxygenated muriatic acid evidently produced. Water then is hy- drogen, with its full proportion, perhaps, of oxygen. When the proportion of the latter is diminished, it be- comes oxymuriatic acid; and, Avhen still further, the common muriatic acid. Mr. Henry has repeated these experiments Avith some success, but suggests a source of fallacy, Avhich leads us at least to hesitate. We shall have frequent opportunities of resuming the subject in different parts of the Avork, as in the articles Muriatic acid, Muriats, and Sea salt, when we shall give whatever the labours of chemists have added to the stock. Even Avhile this sheet was passing through the press, we find in the Journal de Physique, vol. lxi. some experiments instituted by the Galvanic Society at Paris, which throAv considerable doubts on the supposed dis- covery. Muriat of potash has been styled the febrifuge salt of Sylvius, and, from one process by which it was pre- pared, the regenerated marine salt. Its crystals are cubic, but not regular; its taste pungent and bitter; and it dissolves in three times its weight of cold Avater. It is supposed by some authors to contain 29.68 of acid, 63.47 of alkali, and 6.85 of Avater. It is found occasion- ally in sea water, and in some mineral Avaters; but, Avhen wanted as a medicine, which scarcely ever happens, it is prepared by art. Muriat of soda is the common salt so generally dif- fused not only in the earth, but by the ocean, of Avhich it constitutes the chief ingredient. Should the suspi- cions just stated be confirmed, its source will be well understood: at present it is unknown. There is every reason, however, to suppose, that all the fossile muriat of soda has been deposited from an ocean Avhich once covered the highest continents, perhaps the Avhole globe, when the principal inhabitants Avere fish, and Avhere ani- mals, noAV knoAvn only from their debris, Avere the ty- rants of this Avatery Avorld. Common salt is highly necessary to the health of men and many other animals; it is a condiment most congenial to their constitution, and though some are, from necessity, obliged to live without it, yet all find its advantages when it can be procured. In America, animals from a vast distance repair to those regions where the salt effloresces on the surface, Avhich they " lick" Avith great avidity, and the spots are distinguished by this appellation. Common salt is pungent, with a slight bitterness. It dissolves equally in cold and hot water, in a little more than twice its weight of the menstruum: 100 grains have been said to contain 33.3 of acid, 50 of alkali, and 16.7 of Avater. Its crystals are usually- cubical, but they seem to be sometimes octoedral. It scarcely ever forms an article of extemporaneous prescription, except in the form of sea Avater. Barytes, lead, and sometimes iron, seem to decompose this salt, and are employed to sepa- rate the soda for the artist; but could have no extem- poraneous effect in mixture, were it even necessary to combine them in a medicine. Vitriolic and nitric acids are, apparently, the only instances from which any in- convenience could arise. Potash Avould, however, have a similar effect; and some metalline salts, particularly nitrat of silver, Avould decompose it; but these are not likely to meet in a prescription. Muriat of ammonia Avas originally prepared in Egypt from the dung of camels, and is met with in commerce in round cakes, concave on one sideband convex above, from the shape of the glasses into which it is sublimed. When in conical masses, it is debased by other salts, particularly earthy ones. Its taste is acrid and pungent, with a flavour not very distant from the urinous alka- line. It dissolves in about three times its weight of cold, and about an equal Aveight of boiling, water; and, during its solution, produces nearly 32° of cold. Its crystals are four or six sided pyramids, generally aggre- gated in a plumose form, and it is said to consist of 42.75 of acid, 25 of ammonia, and 32.25 of Avater. It is not often used internally, yet Ave shall find that it is more commonly useful than has been supposed. Ex- ternally it is often employed; but, as it is decomposed by the sulphuric and nitric acids, by barytes, potash, soda, strontia, and lime, as Avell as by different salts composed of these acids or their bases, and by some metalline salts, the practitioner should be very careful of the ingredients Avith Avhich he joins this salt. It is soluble in little more than four parts of alcohol. These are the acids which chiefly claimed the atten- tion of chemists within the last tAventy years. An acid from vegetables Avas indeed well knoAvn, and it seemed to be varied in its forms and its properties; but modern chemistry has only ascertained their different C H E 416 CHE sources, and their distinguishing affinities. We find also in the animal system a variety of peculiar acids which claim our attention, and in both vegetables and animals there are various substances denominated oxides, which, with the addition of oxygen, assume acid properties. These we shall not consider in the present article, unless they have become peculiar objects of our attention, by having been introduced into the practice of medicine. The principal vegetable acid is the acetous, knoAvn chiefly in common life by the appellation of vinegar; but nature offers us also that of lemons (the citric), of apples (the malic), that of galls (the gallic), that of acetosella (the oxalic), that of benzoin (the benzoic), that of tartar (the tartarous), and that of borax (the bo- racic acid, or sedative salt). With a little exertion we separate from cork, the suberic ; from camphor, the camphoric; from sugar, the saccharine; from gum, the mucous: but these are, perhaps, more strictly oxides. Fire separates the pyrotartarous acids, the ligneous and the pyroligneous acids. The carbonic acid we have al- ready noticed. Of these, the chief acid, perhaps that from which every other with some modifications proceeds, is the acetous. The tartarous and boracic acids will indeed merit our particular attention, on account of their me- dicinal formulae ; but the malic, the citric, the oxalic, acids, do not essentially differ. The benzoic acid, Mr. Hatchett, in the Philosophical Transactions for 1805, (Part II.), considers, with some reason, as a produc- tion of fire; in his own strictly philosophical lan- guage, a product rather than an educt. The saccha- rine, the camphoric, the mucous, the suberic, are cer- tainly modifications of the acetous acid; and the lig- neous, the pyroligneous, and the pyrotartarous, acids, are only vegetable acids disguised by an empyreumatic oil. We have thus confined our views to the acids of vi- negar and tartar. The former is the product of fer- mentation, or of that new combination, Avhich, by the " play of affinities" from the slow intestine motion of the particles of a saccharine, and afterwards of a spi- rituous, fluid takes place. See Fermentation. The acetous acid, as offered to us by the spontaneous changes, in consequence of fermentation, contains a large proportion of mucilage. This is separated by dis- tillation, or more certainly by freezing; but the mode which chemists have preferred is uniting it with cop- per or lead, and distilling it from these bases. In this Avay it undoubtedly acquires new properties, and, in the modern nomenclature, merits the title of acetic acid. It is then highly fragrant and volatile, confined only by the purest gold or crystal; and, in this state, combined with aromatics, it becomes a very useful and safe pro- phylactic, a preservative from the infection of putrid fevers. See Infection. Acetous acid is formed of the vegetable principle car- bon, united with hydrogen and oxygen; and this com- pound is not only the result of the gradual decomposi- tion of saccharine matter in fermentation, but is pro- duced more rapidly by the action of nitric acid on many vegetable bodies; this acid supplying the oxygen, which is othenvise absorbed from the atmosphere. Though very commonly a vegetable matter, its immediate prin- ciples are sometimes unexpectedly combined, and Ave discover it in animal and mineral productions. Itwill be obvious that its acid is destroyed by earths and alkalis, but the tartarous neutrals are also decompounded by it. Vinegar dissolves sugar, mucilages, and gums, and mixes in every proportion Avith alcohol. It softens gum resins; and, triturating Avith vinegar, renders gum ammoniac and asafoetida more readily soluble in wa- ter. It dissolves the peculiar acrimony of the alka- lescent plants, and consequently forms the best men- struum for squills, colchicum, &c. Medicated vinegars are very common, and foreign pharmacopoeias offer a considerable number. See Acetum. Acetated potash was formerly styled terra foliata tartari, and tartarum regeneratum: a more modern appellation, scarcely disused, is the diuretic salt. It is a deliquescent salt, and not adapted either for powder or pills. It may be decomposed by tamarinds and almost every acid, even the citric and phosphoric, and by al- most every variety of neutral, either alkaline, earthy-, or metallic. It is soluble in an equal Aveight of Avater at 60. The preparation is difficult and uncertain. The acetated natron has been styled the sal vegeto minerale; but it has never been employed as a medicine, and even its chemical properties have not been proper- ly investigated. The acetated ammonia was formerly styled Mindere- rus spirit. It is a deliquescent salt, and Ave receive it usually in a liquid form, but seldom of a certain strength; though a medicine given in doses of half an ounce or an ounce does not require any minute accuracy. When procured in a solid state, its crystals are long, slender, flatted, and of a pearly white colour: they melt at 170, and sublime at 250°. It is decompounded by fixed al- kalis, lime water, the acids of lemon, phosphorus, and tartar, as well as the three strong mineral acids ; by alum, Epsom salt, nitrated silver, muriated iron, ace- tated lead, and the vitriols. The acid of tartar, in common language, is the cream of tartar, which is the deposition from a\ ine, purified from the oily and colouring matter, and crystallized in irregular masses, formed by a confused mixture of needle-like crystals. In this state it is gritty between the teeth, and of a harsh unpleasant sourness ; soluble in sixty times its Aveight of cold, and half the quantity of boiling water. It is not, however, a pure acid, but contains from twenty-three to thirty-three hundredths of potash. The purification of tartar is kept a secret; but it is probably effected by the admixture of pipe clay, since, by repeatedly washing the crystals of tartar, an earth of this kind remains. It has been a pharmaceuti- cal problem to render cream of tartar more soluble in water, and borax has been employed for the purpose; but the latter is by this means decomposed. The real acid of tartar is not deliquescent, and for this reason it is entitled the dry powder of lemonade. It is not the reputed salt of lemons, which is in reality the salt of wood sorrel, though it is supposed to add not a little to the bulk of this expensive preparation. The powder of lemonade is prepared by mixing a drachm of the essential salt of tartar with six drachms of sugar, and adrachmoftheeleosaccharum of oil of lemons. It is ob- vious that alkalis and earths will destroy the acid, but the eyes and claws of crabs are not purely calcareous; and though with chalk it forms an indissoluble salt, Avith magnesia, on the contrary, it forms a soluble one. C H E 417 C II E But whatever its affinities are in the moist state, in a dry powder they are not exerted; and the acid of tartar fonns the basis of a salt, from which the carbonic acid is readily separated in solution. We hinted at this mixture Avhen we spoke of the exhibition of this acid; and the preparation consists of one drachm of the acid, with two of kali, or three of natron, adding a little sugar according to the taste. This acid decomposes all the salts, whose basis is the vegetable alkali. It decomposes also muriated lime and barytes, nitrated silver, muriated iron, acetated and nitrated mercury, acetated lead, and all the vitriols, as well as soaps of every kind. The tartarised kali is the tartarised tartar of former authors, the soluble tartar of pharmaceutists, and is usually prepared by saturating the superabundant acid of the cream of tartar by adding kali. It is soluble in alcohol, and in four parts of cold Avater. It is decom- posed by all acids and by acid. fruits; by lime, barytes, strontia, and magnesia; partly by the sulphats of potash, soda, alumine, and magnesia; and by the muriats of barytes, lime, and ammonia; by cubic nitre, and the most common metallic salts. The tartarised soda has been styled sal Rupellensis ; but as the crystals of tartar are saturated Avith the soda, it is obvious that this is properly a triple salt, and has been justly called by the Edinburgh college, tartris po- tassae and sodae. Its crystals are very large and regular, in the form of prisms, of eight nearly equal sides, di- vided longitudinally almost to their axis. It is bitter, soluble in about five parts of water, effloresces, but does not deliquesce, in the air, and consists of about 54 parts of tartrite of potash and 46 of tartrite of soda. All acids decompose it; even the acid fruits, alum, mu- riated lime, Epsom salt, nitrated mercury, acetated lead, and the vitriols, have the same effect. Tartarised ammonia seems not to have been examin- ed : it certainly has not been employed as a medicine. Its crystals are tetraedral pyramids, with obliquely truncated summits. Borax is a natural production, which nature offers, partly saturated Avith soda, as the acid of tartar is with kali. The crystals of borax are hexangular prisms; of which two sides are broader than the others, terminated by Avhite triangular pyramids. The taste is styptic and urinous; it colours vegetable blues green, is soluble in 18 parts of cold water, and in 6 of boiling. It slightly effloresces in the air, swells Avith the loss of nearly half its weight from heat, and becomes a porous friable mass, melting in a greater heat to glass. It is decom- posed by all acids and alkalis, by the sulphats, nitrats, muriats, phosphats, and fluats, of all the earths, and of ammonia. The boracic acid forms 39 parts, soda 17, and Avater 44. Its acid Avas styled by Homberg, who discovered it, the sedative salt, from its supposed soothing power in fevers. It appears in small, shining, laminated crys- tals, and its specific gravity is 148. It vitrifies in the fire; is soluble in Avater and alcohol, imparting to the latter the property of burning with a yelloAV flame. Of borax we have already spoken; but of the borats Ave know little, and they certainly form no part of the ma- teria medica. The citric and oxalic acid are employed in medicine; but their compounds, the citrats and the oxalats, except in one instance, the citras potassae, do not claim the phy- VOL. I. sician's attention. We must not, hoAvever, Avholly omit them or the other acids, as in the rage for novelty they may in turn share our regard. The acid of lemons is with difficulty separated from its mucilage, so as to be reduced to the state of a limpid solution or a crystalline form. Various attempts have been made to concenter it by freezing, or to combine it with spirit of Avine, from which the mucilage is easily separated. The most successful plan was suggested by Scheele, to combine the acid Avith chalk; from Avhich, as the salt is nearly insoluble, the mucilage may be readily washed: the citric acid is then separated by adding the sulphuric. It is one of the strongest of the native acids; and cannot, like the greater number of the others, be converted into the oxalic by means of the nitric acid. Its crystals are octoedral prisms, truncated on their solid angles. The citric acid unites Avith alkalis, earths, and even metals. With the fixed alkali it is supposed to sit more easily in the stomach than any- other neutral; which, if true, may be owing to some remains of the carbonic acid gas separated from the alkali, and entangled in the fluid : but all neutrals pos- sess, in a certain degree, an anti-emetic power. The citric acid decomposes all tartarised neutrals. The malic acid is not peculiar to apples, from whence its name is derived, but is found in all unripe fruits, and maybe converted into oxalic'acid by the nitric. It is separated from the mucilage by combining it with chalk, and then adding the acetite of lead. The ma- late of lead thus formed is decomposed by the sulphuric acids. This acid is frequent in a variety of plants, par- ticularly the succulent ones, and in common parsley : and Vauquelin tells us, that when the juice of a plant furnishes a copious precipitate with oxalate of am- monia, and a flocculent one Avith acetite of lead, it un- doubtedly contains a malate of lime. By fire, this acid is destroyed or converted into carbonic acid. The ma- lates of alkalis are deliquescent, but the malate of alu- mine is with difficulty soluble: it unites Avith iron and zinc : the chalybeate salt does not crystallize; that with zinc forms fine crystals. The oxalic acid Avhich nature offers us combined like tartar, in part with an alkali, has a penetrating sour taste. It effloresces in the air; and is soluble in twice its weight of cold, and half its weight of boiling, water. Like all the weaker acids, it dissolves the metallic ox- ides rather than the metals themselves ; and it combines Avith the more common earths. With lime it forms a salt so insoluble, that it becomes the surest test of cal- careous earths and its compounds ; though Brugnatelli suspects its infallibility. The acid of sugar is one of those products from the vegetable oxides by means of the nitric acid Avhich avc have already mentioned. Not only sugar, but muci- lages, mild oils, and flour, assume by this intermede the form of an acid; and this acid is invariably the oxalic. The gallic acid seems to collect its oxygen from the air, since long exposure to the atmosphere is necessary to its production. The taste is acid and astringent; it effervesces with lime, and reddens the blue vegetable infusions. The salt requires twelve times the quantity of cold water, and one and a half of warm. It dissolves also in alcohol, in equal quantities when hot, but re- quires four times its Aveight when cold. It forms ox- alic with nitrous acid; and the acid, Avhen sublimed, 3H CHE 418 CHE resembles in obvious qualities the benzoic. The gallic acid is totally distinct from the tanning principle; with Avhich, as both are often united, it has been confounded. The acid of cork is sharply acid and bitter. It deli- quesces in the air, and becomes broAvn by the sun's light. It is distinguished from the acid of camphor, by turning the solution of indigo green; from the gallic acid, by its yellow precipitation; and from the malic, by its solid form. It does not burn or smoke on hot eoals, like the tartarous; gives a green hue to a solution of nitrat of copper, without occasioning any precipita- tion ; and does not attract lime so strongly as the oxalic acid. The benzoic acid appears very generally in the vege- table chemistry; and we have mentioned it as the acid which gives the balsams their distinguishing properties. Since that article was printed we have received Mr. Hatchett's valuable observations on this and some other acids; and we have thus a striking proof, if any other was wanted, of the utility of frequently returning to the same subject in a progressive work like the present, if we would, as we profess, render it a picture of the science at the present moment. The properties of the benzoic acid, as generally recognised, occur under the article Benzoinum. We must now add, however, the formula adopted in the last edition of the Edinburgh, from the Prussian, Pharmacopoeia; not as a chemical re- finement only, but as better fitting it for being reduced to a powder, should it be ever employed as a medicine. Twenty-four ounces of gum benjamin are triturated with eight quarts of water for half an hour; the water is strained off, and the gum again triturated with three quarts of water and strained. The strained liquors are mixed and evaporated to a quart, to which diluted sul- phuric acid is gradually added while any precipitation appears. The precipitated acid is dissolved in boiling water, strained Avhile hot, and set aside to crystallize. The crystals, Avhich are less beautiful than the flowers, must be washed in cold water, and preserved in a dry phial. The camphoric acid has not been used in medicine, and the properties of its neutral salts are little known. Its crystals resemble the muriat of ammonia, and are, with difficulty, soluble in water. It is not, perhaps, very different from the benzoic acid. It burns without any residuum; does not precipitate lime from lime water, nor produce any change in the sulphuric solution of indigo. Two animal acids yet remain, the phosphoric and prussic; for the uric acid we shall not again consider, unless additional information lead us to resume the sub- jest. See Calculus. Phosphoric acid is produced from phosphorus (see Inflammables) by burning, but is not in that pro- cess saturated with oxygen. It is in a more perfect state when prepared, as usual, by nitric acid. The phosphoric acid when pure is not corrosive, and has no smell; its specific gravity is three times that of water, and it may be concentrated to dryness, when it is styled the glacial acid of phosphorus. It combines with al- kalis, and the alkaline earths; but its salts are seldom soluble. With magnesia, if the acid is in excess, the salt is soluble; and were not phosphorus a suspicious medicine, we should recommend this salt to a cautious trial. The only neutral employed by the physician is the phosphat of soda; a salt almost tasteless, though suf- ficiently active as a cathartic for children, perfectly safe, and highly useful. Its crystals are rhomboidal, and they effloresce in the air. It is decomposed by alkalis, the mineral acids, tartarous neutrals, alum, muriated lime, Epsom salt, muriated barytes, and almost every metallic salt. The prussic acid is an ingredient in the vital fluid, and may be obtained by distilling blood with the nitric acid. It has an acid taste and suffocating smell; com- bines with alkalis and metals; and has lately been disco- vered in the vegetable kingdom as a component part of bitter almonds, the cherry, peach, and apricot kernels, and perhaps laurel and peach leaves. Berthollet sup- poses its basis to be composed of hydrogen, nitrogen, and carbon; but the proportions are not known. It has in no form been yet employed in medicine, except in the (now neglected) black cherry water. Two anomalous neutrals yet remain, which, to com- plete the subject, we shall here consider, viz. the hydro- sulphurat of ammonia, introduced into the last edition of the Edinburgh Dispensatory, and the salpolycrestum, Glaseri. Tromsdorf seems first to have remarked that sulphurated hydrogen combines with different bases like an acid. The hydrosulphurat of ammonia is prepared by decomposing sulphurat of iron with muriatic acid. When the acid separates the iron from the sulphur, the latter, with the oxygen of the water, forms sulphuric acid; while another portion of the sulphur forms the hydrogen, forming sulphurated hydrogen gas, which is afterwards combined with the ammonia. This is the preparation of the salt recommended by Mr. Cruick- shanks in diabetes, which he styles hepatised ammonia; and though experience has not established its utility in this complaint, there is great reason for supposing that it may be useful in some others, particularly in phthisis. It must be, however, employed with caution, since it produces vertigo and other unpleasant symptoms. The sal poly crest of Glaser is only a combination of an imperfect sulphureous acid Avith potash. It is easily decomposed; and though it was once a celebrated re- medy in Germany, is now rarely used. Alkalis are salts of an opposite nature, and very rarely found native; never, perhaps, pure. They are either the vegetable, the mineral, or the volatile: but the two former are not exclusively derived from that kingdom which gives them their distinguishing appel- lation ; as the vegetable alkali has been found in some granites of a very early formation, if not primordial, and the mineral in numerous vegetables. Alkalis Avere long supposed to be elementary sub- stances; but a few years since M. de Morveau an- nounced that he had discovered the vegetable alkali to consist of hydrogen and lime; the mineral of the same principle and magnesia. His few experiments were, however, inconclusive; and would, perhaps, not have occurred to our notice, but for the facts pointed out when Ave spoke of the decomposition of the muriatic acid. The whole is strongly prepossessing from its simplicity. The alkalis in the earlier chemical works Avere by no means such as the modern chemistry recognises by this title. They are, in the modern systems, considered as imperfect neutrals, neutralised by the carbonic acid or fixed air, which, as we have hinted, does not deprive them of their alkaline properties; nor, indeed, when C HE 419 CHE supersaturated with this acid and become acidulous, do they Avholly lose their alkaline or urinous taste. We have nothing further to add on this subject. See Alkali. Earths. Chemistry has lately been enriched by numerous additions to this class of bodies, and medi- cine has also made a feAv acquisitions. Though earths should not appear to be the bases of alkalis, yet many approach alkalis very nearly in numerous properties. In general, earths are insoluble in water, at least when joined with carbonic acid; and in this state also they are without taste and smell. They are fixed, and unal- terable in fire, assuming the form of a dry powder, and their specific gravity rarely exceeds 4.9. The five earths employed in medicine are, the barytes, strontia, lime, magnesia, alumine; the five others are the yttria, glucina, zircona, agustina, and silica. These are ar- ranged nearly in the order of what may be styled their alkalinity. Barytes is a greyish white porous body, possessing even a greater pungency than lime. It tinges blue co- lours green, and, as we have said, destroys animal sub- stances. Its specific gravity is nearly 4, and it is not af- fected by the strongest heat. It is slaked in the air, and by Avater, like lime; and when dissolved in hot Avater it crystallizes on cooling, in needle-like crystals, com- posed of 53 parts of water, and 47 of barytes. Water dissolves 0.05 of this earth, and resembles in taste and properties lime water. Boiling water dissolves half its Aveight. It Avill not unite with oxygen, azote, hydro- gen, carbon, or charcoal, but joins readily sulphur and phosphorus. (See Barytes). Strontia resembles barytes in every circumstance, ex- cept that the salts it forms with acids have somewhat different properties; and it will probably be found that potash and soda, barytes and strontia, lime and mag- nesia, are very nearly and respectively connected. The specific gravity of strontia is about 3.7. One part of strontia requires 162 parts of cold Avater, but boiling Avater dissolves it more freely. In cooling, the earth is deposited in thin quadrangular plates, which are often parallelograms: occasionally they adhere and form cubes, containing about 0.68 of water. It is not poi- sonous ; and though it has been tried in medicine, it does not seem to possess any peculiar medicinal powers. Li7ne is an earth well known, and has already been particularly noticed (see Calx). We may add here, for the sake of the connection, that its specific gravity is about 2.4, and that it is soluble in 450 times its weight of Avater. Its neutrals are supposed to be astringent. It combines, in the form of lime water, with the oxides of mercury and lead; but Ave know not that these com- pounds have been employed in medicine. Magnesia was first pointed out as a distinct earth by Dr. Black. Its properties are less strikingly alkaline than the preceding earths, and it does not melt in the strongest heats that can be employed; nor does it be- come acrid by calcination, though the air which it loses in the fire is rapidly regained on exposure to the atmo- sphere. If, therefore, the calcined magnesia is not care- fully kept from the air, it soon differs little from the common earth. Its specific gravity is 2.33, and its com- pounds, Avith acids, are soluble; yet even Avith the vege- table acid, the neutral is deliquescent and not pleasing to the taste. The fossils in which it predominates are soft and unctuous to the touch. Alumine is an earth of the highest importance in me» dicine, since its sulphat, the common alum, is a very- valuable remedy; and the boles, in which it is often a principal ingredient, are useful in sheathing membranes deprived of their mucus. The earth is soft to the touch, and adheres to the tongue, in consequence of absorbing its moisture. Its specific gravity is 2.0. It absorbs Avater, and is diffusible through it: but alone it is wholly insoluble; and in fire infusible. It unites with alkalis, and many different earths. Of the remaining earths our account will be neces- sarily short, as they are useless in medicine. Yttria appears in the form of a tasteless, white poAV- der. It is insoluble in water, and does not change vege- table blues. It refuses all union with fixed alkalis, but unites with the carbonate of ammonia. With acids it forms salts of a sAveetish but someAvhat austere taste, and in fire it is unaltered. Glucina is obtained in white, light masses, adhering strongly to the tongue, unaffected by fire, and insoluble in water. This earth unites Avith all the alkalis, Avith acids, and with sulphurated hydrogen. Zircona appears also as a white powder, soft to the touch, without taste or smell; of a specific gravity equal to 4.3. Though infusible by heat alone, Avhen surround- ed by charcoal its particles unite to a flinty hardness. It combines with carbonated alkalis, and is soluble in all the acids, though insoluble in Avater. Of agustina, the existence as a distinct earth has been disproved. If Tromsdorf's experiments may be trusted, though the results have not been supported by other chemists, it resembles alumina, and refuses to unite with all alkalis. It hardens when heated Avithout ac- quiring any taste, and its salts are tasteless. Silica is well knoAvn by its common appellation, flint. It melts with alkalis, forming the well known and use- ful compound, glass; but it is insoluble in acids, and wholly useless in medicine. It occurs in vegetable substances; and must consequently admit of such a minute division that we may expect to find it also in the animal fluids. It occurs, we find from late expe- riments, in the Bath waters; but we have no reason to think that it contributes to their medicinal virtues. Its source is unknown; but if potash is only lime united to hydrogen, as this salt dissolves flint, on the separation of the hydrogen, the latter will necessarily form distinct concretions, in which state we find it. We regret thai this system of De Morveau's is not better established, since it elucidates so clearly various facts in mineralogy, many more indeed than Ave dare hint at. Silica com- bines with barytes, and, Avhen recently formed, unites with about 1000 parts of its weight of Avater. Inflammables. These are sulphur, phosphorus, the various kinds of pitcoal, charcoal, and amber. Of these the two former only are medicinal, and to them Ave must return; but to preserve the connection avc shall give a very short outline of the chemical proper- ties of each. Sulphur is known to be a yelloAV substance, brittle, fusible, electric, insoluble in water, of the specific gra- vity of nearly 2.0. It sublimes at 170°, melts at 1853, burns Avith a pale blue flame at 300°, and Avith a bright white flame at 570*. It combines Avith different pro- portions of oxygen, and occurs in a variety of minerals, particularly metallic ores. 3 U ^ C HE 420 CHE Phosphorus is a concrete oxide, generally prepared irom urine or bones, of the consistence of wax, of a reddish colour, which it loses by being kept in the dark. It is soluble in essential, and with some precautions in expressed, oils. When the oil of cloves is employed, a flash of light follows each time the bottle is opened. Phosphorus in the dark emits a pale light, but at about 100° of Fahrenheit melts and burns Avith a vivid flame and violent heat. It is brittle under 32°, and its fracture is vitreous and somewhat lamellated. It unites Avith oxygen, but attracts it only when nitrogen or some other intermede is added. This union would appear to be a mixture, but that phosphorus attracts oxygen from the oxy-muriatic acid. With oxygen, as Ave have said, the phosphoric acid is produced. The union of phosphorus with oxygen takes place Avith considerable violence if the ingredients are struck only. Nitrate of silver, or oxygenated muriat of potash, forms, with phos- phorus, the most violent fulminating powders, in conse- quence of percussion only ; but even common muriates, with heat, Avill have the same effect. This is a fact of more importance, as phosphorus has been lately given internally; but great inconveniences have arisen from its exhibition, Avhich seems sometimes to have proved fatal. Its specific gravity is 2.0382, taste acrid, smell alliaceous. It is raised into vapour by a heat of 180°, and boils at 534°. Of charcoal and pitcoal (see Carbo) we have spoken at sufficient length, as they are not substances very often employed in medicine. Respecting amber, usually ar- ranged under the inflammables, Ave have nothing to add. See Amber. Metals are opaque, brilliant bodies, considerably hard, very frequently malleable in different degrees, though some are flexile and elastic. They make"no impression on the organs of smell or taste, except in some in- stances Avhen rubbed. They are the best conductors of electricity ; and during the oxidation of some of these bodies, the Galvanic influence becomes powerfully con- spicuous. All may be melted by heat, and the greater number are exhaled in vapour. Metals are divided into those which, by the addition of oxygen, become acid, and those which are oxidised, without showing any acid properties. Of the former kind arsenic, tungstein, molybdenum, chrome, and columbium. Of the latter, gold, platina, silver, copper, iron, plumbago, lead, tin, zinc, mercury, tellurium (sylvanite of Kirwan), antimony, bismuth, manganese, nickel, niccolanum, cobalt, uranium, titanium, palladium, osmium, and iridium. We shall shortly mention their properties in the same order, excepting only those gene- rally employed in medicine; and their medical effects depend so intimately on their chemical treatment, that it would neither be easy nor advantageous to separate ihe different parts of the subject. Tungstein is a semimetal of a gray colour, fusing with great difficulty, oxidisable in the air by heat, and afterwards acidifiable. In the state of an oxide it is yellow ; in that of an acid, white. The fonner gives to glass a blue or brown colour. Molybde7ium has a very slight metallic splendour, and a low specific gravity. It is oxidised by sulphuric, and easily acidified by nitric, acid. The acid is white and styptic. Though the specific gravity of the metal is but 6, that of the acid is 8.4. Chrome is of a whitish gray colour, very brittle, and with difficulty fused or oxidised. Neither the sulphuric nor muriatic acids dissolve it; but the nitric changes it first into a beautifully green oxide, and aftenvards into an orange yelloAV acid. Columbhun is little known. It was discovered in an American fossil by Mr. Hatchett, and its acid is a white poAvder, insoluble in water. Of the oxidisable metals, we shall omit, for the rea- sons mentioned, gold, silver, copper, iron, lead, tin, zinc, mercury, antimony, bismuth, and manganese. Platina has not yet found its way into the materia medica, nor is it likely soon to become a medicinal sub- stance. It is of a gray colour, approaching to black, when polished. Its specific gravity is about 21, and it yields to gold only in ductility, and to iron in hardness. It is fused in 160° of Wedgewood, 21.877° of Fahren- heit, could Fahrenheit's scale be continued to this point. It is a good conductor of electricity and Galvanism ; is oxidised by the former, producing a gray powder. It is oxidised and dissolved by the oxy-muriatic, but more certainly and quickly by the nitro-muriatic, acid. Plumbago is a carburet of iron, seldom pure, and re- quiring a high degree of heat for its union with oxygen. Tellurium, which Mr. Kirwan styles sylvanite, is of a bright lead colour, but brittle and crystallized in lamel- lae. Its specific gravity is about 6.1. It soon melts and sublimes. It burns with a greenish flame and a Avhite smoke, resembling the smell of radishes. Its oxide melts into a straw coloured radiated glass. It is soluble in sulphuric, nitric, and nitro-muriatic acids. The colour of nickel is between that of tin and silver, nearly 9 in specific gravity; when pure, extremely duc- tile and malleable; infusible, and with difficulty oxidisa- ble in the air: yet it yields to the nitrous and nitro- muriatic acid only, tinging them of a brilliant green. It combines with phosphorus, sulphur, and the different metals. Its oxide is of a light clear green, giving to glass a broAvn and orange, in some instances a red, hue; but reducible by fire only. It is strongly attracted by the magnet, and can assume polarity. Richter. Nic- colanum, lately discovered by the same author, very nearly resembles nickel. Cobalt is a metal so brittle as to be capable of being reduced to poAvder. Its grain is fine, its colour of a reddish gray, and its specific gravity nearly 7.8. It is oxidated previous to its fusion, and requires a high degree of heat for its melting. It yields to all the acids, and unites with phosphorus and sulphur. Its oxide is of a deep blue, and gives this colour to glass. In the arts it is styled zaffre, or smalt. Uranium presents a mass of small globules slightly united, of a pale broAvn, sometimes of a gray, colour. Its specific gravity is 6.44. It is very infusible, but yields to several of the acids, and unites Avith phospho- rus. Its oxide is yellow, colouring glass of a greenish yellow an emerald green, or brown of different shades, and is very soluble in carbonated alkalis. Titanium occurs in hard friable masses, of a crystal- line appearance; internally of a bright red. It is very infusible, and yields only to the principal mineral acids by boiling. Its oxide is a deep red, blue, or white. Of iridium, osmium, and palladium, three metals, if truly distinct ones, found in platina, Ave yet knoAV little, C H E 421 C II E and of course shall not enlarge this (already too exten- sive) article, by enumerating properties imperfectly known. What has been discovered occurs in the Phi- losophical Transactions for 1804 and 1805. The Vegetable substances Avhich have claimed the chemists' attention are, sap, mucilage, gum, oils, resins, gum resins, caoutchouc, balsams, foecula(starch), gluten, sugar, albumen, various acids, tanin, alkalis, wax, honey, and aroma. These substances, as we have stated in the beginning of this article, consist of carbon, hydrogen, and oxygen. The tanin, lately in- troduced to our notice, has been lately examined Avith peculiar attention in the Philosophical Transactions for 1805, by Mr. Hatchett. He has produced it with a variety of substances artificially, viz. by the action of nitric acid on any carbonaceous substance, vegetable, animal, or mineral; secondly, by distilling this acid from common resin, indigo, dragon's blood, &c; thirdly, by digesting common resin with gum elemi, asafoetida, camphor, Sec. which then yield a principle very nearly resembling tanin to alcohol. The Animal substances which have been the objects of the chemist are, the blood, the gastric and pancreatic juices, the milk, the sebaeic acid, the bile, the urine; the prussic, zoonic, formic, and bombic acids; the hard parts of animals; the humours of the eye; cartilages ; brain; synovia; tears ; mucus of the nose, Sec.; cerumen of the ears ; saliva; pus; semen; sweat; liquor amnii; eggs; hairs; feathers, and silk. These are more particularly the object of this work, and have been or will be considered in separate arti- cles. We need scarcely repeat, that nitrogen, or azote, is the distinguishing principle of animal substances; and have already observed that their component parts are nitrogen, hydrogen, carbon, and oxygen. The ultimate analysis of animal substances is pecu- liarly embarrassing, on account of the extensive combi- nation of their elements, for the simplest agent produces numerous transformations; many of which, from the rapidity of their progress, escape us, and the last results are only obvious. The agent employed, most success- fully, by Scheele, Bergman, and Berthollet, is the nitric acid; and the result, as we have often mentioned, is the evolution of azote in large quantities. The consequences arc also a change in the acid; the copious production of ammonia; carbonic, oxalic, and malic acids; the transformation of one portion of these matters into fat; and of another into a yellow, bitter substance, the bit- ter of We It her. The effects, however, vary- according to the strength of the acid, the duration of its action, and the kind of substances examined by its means. These varieties have been lately the subject of MM. Fourcroy and Vauquelin's inquiries, and we shall take this opportu- nity of stating their results. The particular experi- ments have not yet been published. The nitrous acid, from its first action, changed the muscular flesh into a yelloAV substance, with little taste, though still sensibly acid, and very imperfectly soluble. When the action was longer continued, the result was a matter equally yellow and acid, but very bitter, and very soluble. By a still longer continued action, the matter was soluble, inflammable, and fulminating, not only by heat but by percussion. Indigo furnished a similar substance, and still more copiously than muscular flesh. Haussman andWelther long ago discovered it; and MM. Fourcroy and Vau- quelin attribute it to the separation of the azote, and to the combination of the hydrogen and carbon of the flesh, with the excess of oxygen furnished by the acid. They suspect that the yellow substance which tinges the bile, is equally produced by the separation of the azote and the union of the other ingredients, furnished probably by the blood. Yet this appears less probable ; since the blood Avhich is to furnish the bile is carried by a very circuitous course, after it has received the oxygen from the air, and the contents of the vena portae abound seemingly more in azote than in oxygen. While Ave are speaking of animal substances, it may not be uninteresting to add the experiments of those chemists on the smut of wheat. They found, in this de- generated corn, a green oil of the consistence of butter; phosphoric acid, in part combined with magnesia; some lime and ammonia; carbon, and a vegeto-animal sub- stance, exactly like that which is produced in the de- composition of the gluten of wheat by putrefaction. They consequently conclude, that the smut is the residuum of the farina, decomposed by a putrid fer- mentation ; and suspect that it arises from an over proportion of animal manure, assisted by a hot and moist season at the period of its flowering, or the forma- tion of the grain. What may be further requisite for the different facts relating to medical chemistry, may be found under Af- finity, q. v. CHE'MICI, (from chemia). Called also flatdarii. Men who pursue the art of chemistry. CHEN ALO'PEX, (from #jjv, a goose, and xXwxvfe, a fox). Shell drake. So called from its being of the goose kind, and crafty like a fox. See Vulpanser. CHENOCO'PRUS, (from #jjv, a goose, and xoirpos, dung). Goose dung. It was formerly used as a pow- erful resolvent, diuretic, and anti-icteric. The green was thought the best; it Avas collected in spring, dried, and given from 3ss. to 3 i. for a dose. CHENOPODIUM, CHE'NOPUS, (from w», a goose, and srovs, a foot). Goose foot, or Sow bane ; from its likeness to a goose's foot. Called also atriplex sylvestris, pes anserinus, botrys, botrys Mexicana, and atriplex silvestris latifolia. It is reckoned among the uterines, but seldom used in the present practice. There are four species enumerated by the writers on the materia medica, viz. the c. bonus henricus and ru- brum Lin. Sp. PI. 318. c. botrys and ambrosoides 320. These are all oleraceous plants, possessing little medical power. The c. anthehninticum Lin. Sp. PI. 320, has a fragrant though somewhat faint smell, and an aromatic taste. As the name imports, it is recommended for destroying worms. This forms the link between the oleraceous and the fetid species, which follows. See Mercurialis and Botrys. Chenopo'dium fcetida, Chenopo'dium vulva'ria. See Atriplex fcetida. CHEOPI'NA, (from #««, to pour, and vnva, to drink). See Chopino. CHE'RAS, (from xtu"> to pour out). It is so called during its discharge. See Scrofula. CHEREFO'LIUM. See Chjerophyllum. CHE'RMES, (from the Arabic term charmah, or karam). Also called coecum scarlatinum, chermesinum CHE 422 CHI ttnctorium and bapticum,alker77ies, coccibadicum, grana kermes, coecum insectorium, quisquilia, scarlet grain, and KERMES BERRIES. Kermes, among the Arabians, and xoxxos, among the Greeks, signifies a small worm; grana arboris Ilicis, quibus punicea inficiuntur. An insect which much resembles the green house bug, lays its eggs on the quercus ilexlAn. Sp. PI. 1420, the scarlet oak. The females of this kind have no wings. The colour of these berries, or rather insects, is like that of a blue plum; the red colour which they have Avhen brought to us, is from their having been washed with vinegar. They are about the size and shape of juniper berries that are cut into two parts; the hole, in the flat surface, leads to the skin of the belly. When these insects are fresh, they appear full of minute reddish ova, and which, in long keeping, change to a brownish red colour. They are preserved by sprinkling with vinegar, which prevents the exclusion of the ova, and kills such of the animalcules as are already hatched, and would otherwise soon fly away. They are brought from France, Spain, Candia, &c. Avhere they are ga- thered in May, and early in the mornings, while the prickly thorns, on which they adhere, are soft with the dew. Geoffroy obtained an alkaline spirit from them by dis- tillation. The fresh kermes, on expression, yield a red juice of a light, agreeable smell, and a bitterish sub-as- tringent, and someAvhat pungent taste ; but before it is brought to us, it is boiled with sugar into the con- sistence of a syrup. The dried grain, if not too long kept, gives out, both to water and to spirit, the same deep red colour, the same smell and taste, as is in the expressed juice. By evaporation, the watery tincture loses nearly all its smell and taste, but the spirituous retains both; and spirit extracts the active parts most completely. They are grateful to the palate, esteemed cordial and astringent, and aphrodisiac, without any real virtue, or m any considerable degree. A confection, called con- fectio alkermes, was made of the juice of chermes ber- ries, and once not unfrequently prescribed; it Avas in- vented by Mesue, and was a faA-ourite medicine of Geoffroy; but, at this time, practitioners have no de- pendence on it. Within our own remembrance, the syrup, with fragments of leaf gold, Avas given as a cor- dial in small pox. Che'rmes minera'lis. See Antimonium. CHE'RNI'BION, (from x"P, the ha7id, and »iw7«, to wash). In Hippocrates it is an urinal, or rather a avash-hand basin. Motherby. CHE'RSA, (from xiP'ro^i earth). See Fjex. CHE'RVA. An Arabian name for cataputia. CHEVA'LIER. See Calidris Belionii. CHEVA'STRE. A double headed roller, applied by its middle below the chin; then running on each side, it is crossed on the top of the head; and passing to the nape of the neck, is there crossed : it next passes under the chin, where crossing, it is carried to the top of the head, until it is all employed. See Fascia. CHEZANA'NCE, (from x^u-> to go to stool, and xvxyxv, necessity). It signifies anything that creates a necessity of going to stool; and in P. jEgineta it is the name of an ointment with which the anus is to be rubbed for this purpose. jEtius gives this name to a plaster, which Avas to have the same effect when applied to the navel. CHI'A. A SAveet fig; so named from C/iio or Scio, where they are propagated. CHI'A TERRA. Earth of Chios, now called Scio, an island in the Archipelago. It is a grayish earth, brought from that island, formerly used as a su- dorific in fevers, but now neglected. Fuller's earth, or pipe clay coloured, and impressed with proper signa- tures, are the general substitutes. CHI'ACUM COLLY'RIUM. In P. ^gineta it is a remedy for disorders of the eyes, of which the dry in- gredients were bruised and infused in Armenian wine. CHI'ADUS. See Furunculus. CHIA'SMOS. It is the meeting of any two things under the form of a cross, or of the letter x» whence it is named. The adverbs chiasti and chiasticos mean the same. CHIA'STOS. The name of a bandage in Oribasius, so called from its resembling the letter x- See Fas- cia. CHIA'STRE, (from the same). A bandage for the temporal artery. It is a double headed roller, about an inch and a half broad, and four ells long. The mid- dle is applied to the side of the head, opposite to that in which the artery is opened; and, when brought round to the part affected, it is crossed upon the compress that is laid on the wound, and then the continuation is over the coronal suture, and under the chin; then cross- ing on the compress, the course is, as at first, round the head, 8cc. till the whole roller is taken up. See Fascia. CHI'BOU. A spurious species of gum elemi, little known in this country, though common in France. CHI'BUR. See Sulphur. CHICHIA'XOCOTL. See Macaxocotlifera. CHI'COS, or CHI'CRES. See Bovina affectio CHI'EN-DENT. See Gramen caninum. CHI'GRES. See Hyboucouhu. CHILCHO'TES. See Piper Indicum. CHI'LI, Bals. de. This seems to have been an imposition. Salmon speaks, but Avithout any proof, of its being brought from Chili. The Barbadoes tar, in Avhich are mixed a few drops of the oil of aniseseed, is usually sold for it. CHILIOPHY'LLON, (from #<>>"*s, a thousand, and the hand, and xypx, a seizure). Gout in the hand. See Arthritis. CHIRO'NES, (from xe'Pi the hand). See Bovina affectio. CHIRO'NIA, (from x"P> the hand). See Bryo- nia nigra. It is also a name for the centaury. See Cextaurium. CHIRO'NIUM. A malignant ulcer, difficult to heal, Avith a hard, callous, and tumid margin ; so called from Chiron the centaur, Avho is said to be the first who cured it. It is also called telephium. CHIRONO'MIA. See Cheironomia. CHIROTHE'CA,and PODOTHE'CA, (from x*'h manus, and iws, pes, or n6tjf*.i, pono, to put). In the preparation of anatomical subjects, they are a glove and a shoe of the scarf skin, with the nails adhering. They are separated with very little trouble after the cuticula loosens from the parts below by putrefaction; and this method is better than that of separating it by means of boiling water. CHIRU'RGIA, (from %etp, a hand, and epyov, work, manual operation). Surgery, or that part of medicine which consists of manual operations. It was our intention to have comprised under the ar- ticle of medicine a general history of that science, as well as of anatomy and surgery; and Ave consequently omitted in its proper place the particular history of the former. On contemplating the subject more nearly, Ave find that it will be too much broken by subjects which, though generally connected, yet branch into distant ramifications. As anatomy is perhaps more intimately connected with surgery than with medicine, we have therefore preferred giving a short sketch of the origin and progress of each in the present article. Anatomy and surgery are the sciences of a rude Avar- like race; for however simplicity of diet and constant labour may preserve health, yet in this ruder state of society, wounds and bruises must have been frequent. If the nation were ferocious and often engaged in combat, the knowledge of the former would be more generally disseminated, and the practice of the latter more necessary. Thus each science was very early cul- tivated ; and in Homer no slight knoAvledge of anato- my is displayed. The Egyptians, whom Ave generally compliment with the earliest advances in every science, often Avith little reason, were probably acquainted with the structure of the human body from their practice of embalming, and it is said that their kings left treatises on anatomy. If what Prosper Alpinus has described as their later practice was traditionally conveyed from the early ages, they had also made a considerable progress in surgery; but we have reason to believe that the greater part was taught them by the Greeks, as we knoAv the practice of bleeding to have been. The Egyp- tians had Mefr-Esculapius; whom the Greeks, in their usual method of appropriating every distinguished per- sonage to their own nation, have transferred to Greece. After -Esculapius, we find the names of Chiron the centaur; Machaon and Podalirius, two sons of jEscu- lapius, mentioned by Homer; Thales, Empedoclus, Pythagoras, Heraclitus, and Democritus. The small circle of the philosophy of those days Avould not be greatly croAvded by the admission of anatomy and sur- gery ; and Ave knoAv that some of these philosophers assiduously cultivated the former study. We have the authority of Stephen of Byzantium for Podalirius hav- ing practised phlebotomy. We can only judge of the ancient state of anatomy and surgery from the works of Hippocrates. He seems to have collected with great diligence all the observations of his predecessors, but his anatomy was general, and someAvhat superficial. He is accused of dissecting brutes, and describing the organs of apes as those of the human race. Indeed this seems to have been true, if all, even the undisputed, Avritings attribut- ed to him be really genuine. Yet many of these are evidently interpolated; and very feAv indeed have reach- ed us without some ground of suspicion. His surgery deserves a better character. His remarks on ulcers and wounds, even at this time, merit attention; but hi» CHI 424 CHI operations were few. He opened abscesses, pene- trated the thorax to discharge any effused fluid, and the abdomen for the same purpose: the head he perforated Avith the trepan. His chief surgical operation was the actual cautery, which he recommends in a variety of diseases, and which modern delicacy or timidity has banished with too little discrimination. Various were the folloAvers of Hippocrates, of whom we have received little more than the names, till the time of Diodes, at the distance of one hundred and thirty years from his era, and about three hundred and eighty years before the birth of Christ. He invented an in- strument for extracting the point of an arrow sticking in a wound, and some bandages which, like the in- strument, bore his name. The last of the Asclepiadean race was Praxagoras. He is recorded in desperate cases of ileus to have opened the abdomen and intes- tines in order to evacuate the faeces, and then to have sewed up the wounds in each. The improvements in anatomy during this long pe- riod were probably few, at least scarcely any additional knoAvledge in this branch has been preserved. The era of the Alexandrian school h?s not been accurately ascer- tained; but its distinguished professors, Herophilus and Erasistratus, were minute anatomists, and many parts of the human body still preserve their names as discover- ers. We have received their improvements only in the works of Galen, at the distance of three hundred and fifty years. They both practised surgery; and Erasistra- tus, Avho was a century earlier than Herophilus, opened the cavity of the abdomen in cases of diseased liver, to apply his remedies to the part itself. Asclepiades of Bithynia was the cotemporary of Erasistratus, and, as appears from Plutarch, an experienced surgeon; but his chief reputation arises from the revolution he occasioned in the practice of medicine, Avhich is not our present ob- ject. Cassius, perhaps a scholarof Asclepiades, at least a cotemporary of his scholars, was apparently an able anatomist and a skilful surgeon; and Aretaeus, who lived near the time of our Saviour, was more distin- guished for his medical abilities, than for anatomical or chirurgical knowledge. Whatever was the era of Celsus, he is certainly the first author after the birth of Christ, who merits our re- gard. His style has been the admiration of ages, and in his collections he appears to have been diligent and attentive. It has been doubted Avhether he himself practised. From some parts of his works it is evident that he did, but not frequently, or probably in import- ant cases. His seventh and eighth books are wholly chirurgical,but in these he treats chiefly of operations; for to these he seems to confine the office of the surgeon. Celsus mentions the operation of lithotomy, but this is not the first time of the subject occurring. We de- layed, however, noticing it till we could bring the Avhole together. It appears from Hippocrates, that the ex- traction of the stone was practised in his time, but con- fined to particular operators, and he forbids its being attempted except by them. Of their methods or suc- cess we have no particular information; and we have only an obscure ray from the Alexandrian school, of a surgeon who attempted to break the stone in the blad- der when it was too large to be extracted entire. In Celsus the operation described is that Avith the lesser apparatus. One hundred and fifty years elapsed before any other author worthy of particular attention offers himself to our notice, and we then meet Avith the famous Claudius Galenas of Pergamus, Avhose undisputed SAvay over all the realms of medicine continued for more than twelve hundred years. Galen was a laborious collector, and a diligent dissector: his anatomical knowledge Avas ex- tensive, and in his work are preserved all that former observers knew. In surgery he possesses little origin- ality, and chiefly comments on the writings of Hippo- crates. From this period, the history of anatomy pre- sents for ages a dreary, unproductive desert. Little was added by the Galenists, who feared to step beyond their master; and the Arabians, who preserved the spark of science when it Avas nearly extinguished in the West, thought themselves polluted by touching a dead body. Surgery, however, was cultivated Avith care. It has been in all ages, in every revolution of society and science, a necessary acquisition. Nearly two hundred years after Galen, Oribasius flourished, who explained and illustrated very satisfac- torily many parts of the Pergamenian's doctrine. His chirurgical chapters are full and instructive, but he pos- sesses little originality. He has been stigmatised as a compiler, and in reality is little more. ^Etius of Amida, followed him, probably about the distance of one hun- dred years, and seems to be a superior author in many- respects, though it is not easy to appreciate his chirur- gical merit from the unconnected form of his observa- tions. His method of puncturing the legs in anasarca, and of relieving inveterate asthma by numerous caute- ries, merits particular attention. He was acquainted with the use of setons; and the Avounds inflicted by the bites of mad animals should, in his opinion, be kept open sixty days. In iEtius are some fragments of Leonidas, a surgeon of the school of Alexandria. The only novelty Ave perceive in these, is the treatment of the Guinea worm, the dracunculis. Paulus of iEgina, whom Dr. Friend places in the seventh century, has been styled the ape of Galen, as his works are supposed to be servilely copied from that author. We do not indeed perceive so many originali- ties in Paulus as some of his admirers seem to have dis- covered ; but he is by no means a compiler only. He was apparently a judicious practitioner; and in his works the whole of the ancient surgery is detailed more co- piously and accurately than in those of any other au- thor. His account of aneurisms is neAV. He describes (almost) the lateral incision in lithotomy, and apparently first mentions the fracture of the patella. If not the first author who recommends bronchotomy, he is cer- tainly the first who distinguishes Avith precision the circumstances in which it is successful. The chief Arabian surgeons were Rhazes, Avicenna, Avenzoar, and Albucasis. It Avould fill but a few lines were we to add all the improvements of the three former. The description of an abscess in the mediastinum by Avenzoar deserves indeed to be mentioned, with his proposal of trepanning the sternum, Avhich somemodern authors have practised Avith success; but the complaint is by no means so accurately distinguished as to enable us often to folloAV the example. Albucasis has given us a complete system of surgery copied professedly from Hippocrates and Galen, sometimes apparently from Paulus of jEgina; but many observations and improve- CHI 425 CHi incnts of his own are added. We may mention one, as it has been lately the subject of some dispute, that is, tying the artery to stop haemorrhages; an improvement usually attributed to Ambrose Parey. At the restoration of learning, authors of credit Avere soon numerous, and surgery- improved rapidly. Ana- tomy for a time lingered in its former imperfect state. When a surgeon appears only in a century, he becomes a distinguished figure on the canvas : the crowd that now hastily folloAV each other must be considered more cur- sorily. Indeed, the greater number who first distin- guished this era were merely copyists of Albucasis; nor have Saliceto or Lanfranc sufficient originality to induce us to rest on them for a moment. Guido de Cauliaco was the first who had any pretensions to originality; though these rather consist in judicious remarks on his predecessors, than any improvement peculiarly his OAvn. In cataracts he depressed the lens. At this time surgery in England Avas at a low ebb. Gilbert Avas very imperfectly instructed in his art; John of Gaddesden was a quack; and of John Arderne's Avorks we cannot judge, as they have not been printed, if Ave except the Treatise on the Fistula in Ano, translated by Read. He is spoken of, hoAvever, with respect by Friend. The appearance of the venereal disease in the six- teenth century turned the attention of surgeons to one object, though they were not wholly inattentive to the science in general. Vigo's Surgery is a work of consi- derable merit; and he explains, particularly, the mode of tying the arteries Avhen cut. Some authors think him the first surgeon Avho used mercury in the venereal disease, the credit of Avhich is usually given to Carpi, Avho undoubtedly first employed mercurial frictions. Carpi's only other chirurgical Avork was on the fracture of the skull. Marianus Sanctus, who Avrote on a parti- cular mode of cutting for the stone, which he attributes to John de Romanis, was an author of this period. Antonius Ferrus, and B. Maggius of Bononia, published on gun shot wounds; Vidus Vidius and J. Andreas on surgery in general; and Taliacotius on supplemental noses, about this period. Ambrose Parey claims a greater share of attention. His works may be even at this time read Avith consider- able profit, as he treats of every branch of the science Avith considerable judgment and precision. He Avas the first Avho condemned the practice of dressing gun shot wounds Avith hot irritating oils; and to him the check- ing haemorrhages by ligatures on the arteries has been attributed. He possesses such a variety of merit, that he may resign his claim to this discovery Avithout any njury to his fair fame. Franco is a French surgeon, avIio treats with singular precision on hernia, and men- tions the use of the seton in hydrocele. He Avas the inventor of the high operation for the stone, urged by necessity, as it was too large to be extracted by De Ro- manis' plan. Paracelsus Avas also a surgeon of this era, but of no credit; Forestus deserves a higher character, and his Avorks even at this time are valuable. It may appear that Ave have forgotten the history of anatomy ; but in the Avhole of this period no anatomist of character has appeared to claim our attention. We uoav, however, approach a period when the science Avas assiduously cultivated; and avc have passed over Fallo- VOL. I. pius and Vesalius, Avho, though distinguished as sur- geons, yet merit more particular notice as anatomists Anatomy, in the sixteenth century, daAvned Avith Sylvius ; but, servilely attached to Galen, he did little more than explain that author's Avorks. Vesalius Avas his pupil; and, ardent in the study of anatomy, he soon discovered many errors in the descriptions of Galen. and clearly shoAved that they were taken from the dis- sections of brutes, particularly apes. The clamour Avhich this accusation excited Avas inconceivable: even deny- ing the infallibility of the pope would have been, among the anatomists of that era, a comparatively venial crime His master, Sylvius, continued for ever, on this account. his irreconcilable enemy. Science, hoAvever, gained by the contest; for, if Vesalius and Galen Avere at issue, the contest must be decided by actual observation. The result was, on the whole, favourable to Vesalius ; but unfortunately he AAras, in some instances, detected in the same disingenuity of which he accused Galen. The anatomy of Vesalius, hoAvever, continued to be for ages a Avork of peculiar interest and value. The early editions are illustrated with AArooden cuts, it is said, from the draAvings of Titian. They are, indeed, executed in a style truly masterly ; but the great painters of that era, Raphael, Titian, and Leonardo de Vinci, Avere ex- cellent anatomists, so far as the structure of the parts influenced the external form. Fallopius Avas also an author of this century, though later than Vesalius. His Observationes Anatomica; Avere published in 1561, and his discoveries Avere nu- merous. The tubes Avhich convey the ovum to the uterus still bear his name. Eustachius lived somewhat later. His tables, Avhich he himself engraved, were found Avithout any explanations, and published by Lan- cisi, in 1714, with some short and imperfect elucidations. TheyAvere republished by Albinus, Avith a copious com- mentary; and even at this time are, with a few excep- tions, very correct and satisfactory. Eustachius was, hoAvever, no man's friend, and a violent enemy of Ve- salius. His anatomical discoveries were numerous and important. Though able and scientific, yet, from a spirit of opposition, he often defended Galen; and thought that he had gained a victory, when he proved that some of the parts were not described from apes, as Vesalius supposed, though he admitted that they Avere copied from brutes. He intended that his plates should be explained by a geometrical gnomon, to avoid the ob- scurity Avhich letters of reference Avould occasion; but his plan is lost. The other anatomists of this century are not of suf- ficient importance to detain us long. Yet we ought not to omit, in the Italian school, the only one to Avhich Ave are indebted for anatomical knowledge, Mercurialis, Avho merits more particular attention as a practical physician, but who Avas also an expert anatomist; Casal- pinus, Avho clearly described the lesser circulation through the lungs ; Varolius, Avhose name is preserved in a distinguished part of the brain; Schenckius, whose collections furnish us Avith so many singular, often ii^ credible narratives; Casper Bauhine, the botanist; Laurenti ; Castellus, our predecessor in lexicography ; Fabricius, ab Aquapendente; Hildanus; Kepler, the as- tronomer; Riolan: the elder Bartholinc, C. Hoffman, Sennertus, Spigelius, and Severinus. CHI 426 ,C HI We have, contrary to our intention, stepped beyond the limits of the sixteenth century, to extend our his- torical sketch to the period of Harvey. The early part of the seventeenth century Avas the era of discoveries, Asellus ascertained the existence of the lacteals, Har- vey of the circulation of the blood; Avhile he, at the same time, established many important facts respecting the generation of animals, establishing, on the firmest foundation, that universal axiom, 07nne ex ovo. The discovery of the circulation has immortalized the name of Harvey ; yet we must add, that the facts already established left little more to be done than to collect and compare them; nor have we any hesitation in re- marking, that the greatest discoveries, that of Newton, respecting the universal influence of gravitation, and of a new Avorld by Columbus, were in the same Avay prepared, so as to require only " patient thinking," at- tentive examination, and a comparison of facts already known. Servetus alluded to the lesser circulation through the lungs; Caesalpinus described it more distinctly, and proved it by the structure and situation of the valves. May not then all the blood in the body circulate? The question Avas ready and obvious; and the chief merit of Harvey and of NeAvton was that of bringing a simple sugges- tion to such a rigorous examination, as incontestably to demonstrate its truth. It has been triumphantly asked, What have we gained by either ? Were it no more, Ave have divested superstition of its terrors, and quackery of its vain pretensions ; but the discovery of Harvey im- perceptibly mixes in every step, either of speculation or practice : the result is noAv so interwoven with every thought, that its influence is not perceived. In the seventeenth century the names crowd on us in such a multitude, that even the enumeration is almost impracticable. Among anatomists and surgeons, for Ave can now scarcely distinguish them, we find Sylvius de la Boe, Veslingius, Horstius; the younger Bartholine, an author of peculiar industry, of great abilities as an anatomist, and a strenuous defender of the newly disco- vered absorbent system; Schneider, the discoverer of the extent of the Schneiderian membrane and author of an ex- tensive work on catarrhs; Ballonius; Van Helmont; Van- derlinden, the very accurate editor of Hippocrates; our own Charleton and Highmore; Pecquet, the discoverer of the receptacle of the chyle; Wallis, who gave us the first rudiments of the method of teaching the deaf and dumb to speak; Glisson, the author of the Anatomia Hepatis; Bohnius, to Avhom we are indebted for a work on the eye, and an excellent treatise, De Renunciatione Vulnerum ; Schultetus, who gave us a most instructive work on sur- gical instruments, and has preserved the form of many, which Avould have been othenvise forgotten; Wharton, author of the Adenographia; Wepfer, Wedelius, Willis, of Oxford, Avhose talents, as an anatomist and physi- cian, are not adequately appreciated at this time ; Mal- phigi, a naturalist and anatomist of the highest rank; Steno Belli7ii,a mechanical physiologist of considerable ability; Borelli, the disciple of Bellini; Dr e line our t, the anatomical preceptor of Boerhaave; Redi, De Graff, Ruysch, Swammerdam, Lower, Etmuller, Mauriceau, Muralto, Lister, Ray, Pechlin, Diemerbroeck, Lewen- hoeck, Duverney, Tyson, Grew, Nuck; Bidloo, the au- thor of some excellent anatomical plates, which Cowper has been accused of republishing, without any acknow- ledgment, and with little alteration ; Vauasens, author of the Neurographia Universalis; Vandcrwiel; and our OAvn Wiseman, though last, not least. The extent of this catalogue, though numerous au- thors of credit are omitted, prevents us from following at length the anatomists and surgeons of the last cen- tury. To attempt it would be a labour of immense extent, disproportioned to the work ; and it Avould be in a great measure useless, since they are generally known. In the early part of the last century Dr. Douglass taught anatomy Avith credit; and to him Ave are indebted for Dr. William Hunter, and, more remotely, for his brother, J. Hunter. In Scotland, the first Monro Avas an ana- tomist and surgeon of unrivalled excellence. In Ger- many, Haller merits peculiar and distinguished com- mendations ; while, in both countries, the second Mon- ro, Hewson, and Meckel, perfected the discoveiy of the third distinct system of vessels, the lymphatic, Avhich Mascagni of Italy has delineated with singular ele- gance. Italy can also boast of the very able anatomists, Morgagni and Valsalva. In surgery, Cheselden, Sharp, Pott, and many others, have been equally an ornament to their country and to the science they professed ; nor have their successors been less distinguished: but of living surgeons it is not perhaps proper to speak, since it is so difficult to speak without offence. In France, Petit, Mery, Le Dran, Lc Cat, Daviel, and Peyronie, have greatly extended their art; and in Germany Heister has given the best general system of surgery ,which appeared before thatofMr.Bell. Here, then, we must close the history of surgery, and proceed to the other branches of this article. The object of surgery is apparently every external com- plaint not owing to an internal cause, and every dis- ease in which an operation is required. Of the first class are, wounds, tumours, inflammations, and organic complaints. The latter comprehends a great variety of internal complaints, which are partly the object of the physician, and, in part, of the surgeon. These are, diseases of the brain from compression; fractures of the cranium; polypi of the nose; accumulations of cerumen in the ears; scirrhous tonsels ; obstruction of the larynx from inflammation; accumulations in the chest, either of air, water, or purulent matter; herniae of every kind; abscesses of the liver, or other viscera, pointing outwards ; calculus in the kidneys or bladder; suppression of urine, or faeces ; fractures; dislocations; diseased joints, Sec. Yet the surgeon should reflect, that he will ahvays merit greater praise from curing without an operation, than by an operation performed with the greatest dexterity. Unfortunately, many sur- geons suppose that the operation is their chief busi- ness ; that, by it, their character obtains a degree of splendour, which the best and most successful plan of cure Avould not othenvise claim. Let the young sur- geon disregard this delusive splendour, which will en- tice him often to his patient's injury. On the other hand, let him not too long delay an operation that may be necessary, or protract to the moment of ex- hausted strength Avhat requires some efforts of the constitution to bear or contend with. Each fault is too common; and it has been a great object, in our separate articles, to give such rules as may correcj either tendencv. C il\ 427 C HI When an operation of importance is necessary, it becomes the surgeon's duty to state to the friends the real probability of success, without exaggeration on one side, or too doubtful hesitation on the other. The whole truth, as it appears to him, should be faithfully and explicitly detailed. If, from a fair view of the ar- guments, the operation be decided on, the patient's con- sent should also be gained; yet, at this time, every en- couraging circumstance should be displayed, and every doubt suppressed, or, at least, suggested with caution. The pain, the hazard of an operation, will strongly bias the mind, and give every doubt a disproportioned force; nor is the moment of pain and distress such as Avill enable the patient to examine contending arguments with the requisite discrimination and impartiality. When an operation is performed, it was formerly fashionable to display the dexterity of the operator by a rapid execution. Neatness, accuracy, and minute precision, are noAv studied. We do not think the change advantageous to the patient. If the operation is not so much hurried as to occasion error, it cannot be performed too soon; and nothing is gained by detaining the patient on the table three times the necessary time, because the knife shall be carried as near as possible to an artery without wounding it, or because the smallest particle of muscular flesh shall not be included in a ligature. We have seen an operation performed so sIoavIv, as if the operator thought his success was only obtained by a dilatory caution. After the operation, the application of the bandage is of the greatest conse- quence ; and, as the ease of the patient is much con- nected with the neatness with Avhich it is applied, the utmost attention should be paid to this part of the pro- cess. The profession of a surgeon is of the highest import- ance to society, and it requires a greater combination of talents than any other within the circle of scientific at- tainments. The object is certainly more nearly within the reach of the senses. The surgeon has not, like the physician, to contend often with a form or phantasm. Yet he cannot pursue a disease in all its bearings, in all its consequences, without the most careful discrimina- tion of causes and effects, Avithout an attentive examina- tion of the influence of an injury on the most distant parts. With these poAvers, he must have a command of hand to enable him to direct his knife with the ut- most nicety and precision; a mind unruffled by any ac- cidental unexpected occurrence ; and a readiness of re- source to supply the assistance necessary in any emer- gency. His senses must possess peculiar acuteness, particularly the feeling, Avhich is often more important than even the sight. His hand must not tremble; his mind be unassailed by fear, by apprehension, or doubt, when the necessary operation has been once decided on. It is observed by Celsus, that a surgeon should be able o use either hand; but, by attaining this power, the right might lose a portion of its dexterity; and, though the left may occasionally in the less nicer parts assist the right, yet it should not be wholly trusted. It is said that the surgeon should be young, at least so young as not to have the necessary powers impaired, and of suf- ficient age to have attained the requisite experience. Undoubtedly, by age the faculties are blunted: doubt and hesitation take the place of a proper confidence and a manly firmness; the hand is less steady; the feelings less acute. The age cannot be fixed, since the poAversoi each individual differ at a given time of life. We have knoAvn many surgeons of character and abilities Avho have limited their professional career at the age of sixty. But this decision, formed with the candour and ingenu- ousness of youth, has been forgotten Avhen they reached the limit. It shows, however, their opinion; which Avere Ave to controvert, it would be by fixing a less extended period. But this AveAvould only confine to capital ope- rations; long after sixty a surgeon of abilities may be eminently useful in consultations. A quality very necessary for a surgeon is, a knoAvledge of mechanics, and a readiness in adapting little mecha- nical contrivances to the exigencies of the moment. It is inconceivable how much pain and distress are allevi- ated by such ingenuity; how the cure is often acceler- ated, or the spirits supported. Humanity is, above all, required to complete this first of characters, a good surgeon. In general, sur- geons are proverbially cruel, and they often must be so to fulfil their duty. Yet there is a tenderness of man- ner that makes even cruelty tolerable; in comparison, amiable : and, though the surgeon ought not to feel, he should as much as possible lessen, the patient's pain, and appear to be sensible of his sufferings. A softness of manner, a gentleness of voice, and even a delicacy of form, are not Avithout their effect; and whatever can alleviate distress, though trifling in the general scale, should not be neglected. To the one the patient looks with horror as the butcher; to the other as the minis- tering angel, bringing balm on his Avings to heal and to save. We have employed these few lines for the sake of our younger brethren. May they not be • without their effect! We thought that we had completed our task, Avhen we Avere reminded that the recommendation of the study of anatomy was omitted; but this first, this most important, qualification, can never be neglected by him Avho aims at the character of an accomplished surgeon. It should be his study day and night: the human body should be the work, nocturna versari manu, versari di- urna. The knife should be constantly in his hand to attain a readiness in using it in every direction; to vary the direction in a moment at every angle of obliquity ; to stop; to proceed; to alter the velocity with the readiness which governs the movements of the best managed horse, or, to employ a more delicate meta- phor, the finger of the most experienced musician. But this must be a part of his education; nor should he claim the confidence of the public till all these qualities are attained. The study of the practice of physic may not be con- sidered as essential to a surgeon: yet, as the complaints which are occasionally arranged under each head vary in their minute shades and press on each other, it is highly necessary that medicine should make a part of his education. It has, however, often happened, that a knowledge of the one has led to a presumption that it has equally inspired an acquaintance Avith the other; and each has intruded in a department not his oavh, Avithout a sufficient qualification for the due exercise of it. A surgeon should, we think, possess a sufficient knoAvledge of medicine, to regulate the general treat- ment of the diseases within his own limits. Beyond them he should not pass, without having paid that 3 I 2 CHI 428 CHN attention to the other science, which, had he cultivated Avith care his own, he Avould have little opportunity of attaining. The physician should be equally careful of interfering; yet, in a comprehensive view, surgery be- comes a part of his profession. A man of science grasps particulars in an outline; and as the operative part is beyond his limits, there is nothing to prevent his acqui- sition of so much of surgery as will enable him to assist, sometimes to direct, the less experienced practitioner. One other subject only remains; a subject which we could not have supposed would ever have occurred in a questionable form, viz. Avhether surgery is improved by the labour of the moderns, and raised above its former state. Let humanity decide, and the cause will be soon determined; but we will not harrow up the soul by the repetition of former cruelties. The question will recur in another shape : Is the modern surgeon more success- ful than his predecessors ? The reply is easy. Do we still pour hot irritating oils on gun shot Avounds ? Are not wounds quickly cured by the adhesive inflammation, which required months by the former methods of sup- puration ? Is not the stump healed, by means of the flap, in a few Aveeks? Does the wound, from which the can- cerous mamma has been extirpated, require any thing more than superficial dressings ? To pursue the subject minutely, Avould be to waste the reader's time and ex- haust his patience. Let us select an instance or two. In herniae the operation Avas precarious and ill under- stood : it was consequently but seldom attempted. The modes of reduction were little known, and the trusses so imperfectly calculated for the purpose, that, when reduced, the intestine was seldom retained. We have selected this instance; because we can appeal to facts, viz. the numerous advertisements, even in the begin- ning of the last century, of rupture curers. The greater number we noAV knoAv can be reduced and retained Avith little difficulty; and of those cases Avhich require the operation, nearly one half escape. If the operation were not too long delayed, the proportion of successful cases Avould be greater. In lithotomy, confined for ages to one set of prac- litioners, the means Avere limited and inadequate. The method described by Celsus was, from its nature, con- fined to the age of from nine to fourteen. How many years previous, hoAV very many subsequent, to that age, must have been spent in unsufferable agonies ! What then was the attempt ? First, with the greater ■apparatus; and, secondly, in the higher Avay. Even when it succeeded, an incontinence of urine frequently folloAved each ; and in the greater number it failed. When Frere Jacques pointed out the lateral operation, Iioav crude and imperfect were his first ideas! The grooved staff and the cutting gorget were the improve- ments of very late years. But, previous even to the latter, Cheselden had so far simplified the operation, that many surgeons have professed being able to per- form it in the dark. Indeed, it is one of many operations which depends on the nicety of the feelings rather than the sight. The systems of surgery in our hands are few. The practice of the ancients may be found most eloquently described in Celsus; but at greater length, and often more satisfactorily, in Albucasis, with numerous im- provements, which he claims as his own. It Avas pub- lished with Guido's Surgery, in folio, at Venice, 1500 ; again in 1506 and 1520 ; but the best edition is that of Strasburgh, in 1532, or that at Basil, 1541. Heister connects, very properly, the ancients Avith the moderns ; and, among the latter, Mr. Benjamin Bell almost stands alone; for Mr. Latta's system is less com- plete, and Mr. J. Bell's a very inferior Avork. Mr. B. Bell is, however, too minute and tedious; and so dis- proportionate is his share of attention, that bleeding oc- cupies nearly as many pages as lithotomy. The chief inconvenience, besides unreasonably enlarging the vvork, is, that the young surgeon may attempt the more im- portant operation with the same confidence that he has often successfully performed the less. From the cha- racter of Mr. Blair, we have reason to expect, with some impatience, his promised system. To enumerate the other independent works is un- necessary, as they will occur under each head, and thcy are so numerous as to form an extensive catalogue. CHIRURGO'RUM SAPIE'NTIA. See Sophia CHIRU'RGUS. See Cheiriater. CHIST. See Sextarius. CHI'TON. (Greek.) See Membrana. CHI'UM VI'NUM. Chian wine. A wine of the island now called Scio. Dioscorides says it is less dis- posed to intoxicate than any other sort. CHIVES. See Stamen. CHI'VETS. The small parts at the roots of plants by which they are propagated. Miller's Diet. CHIVIQUILE'NGA. See Cataputia minor. CHILIA'SMA, (from x^x^ai to make warm.) Sec Fotus. CHl'LMIA. See Cadmia. CHLO'RA. Green. See Chloros. CHLORA'SMA, and CHLOROS, (from %X»pos). A palish green colour, shining with a sort of splendour, and inclining to watery: it is applied to leguminous plants before they are dry or come to perfection. CHLORO'SIS, (from chloros, x*-*>pos> green). The green sickness, called also febris alba, the virgin's disease, amatoria febris, and icterus albus. Though Hippocrates does not seem to have known these names of this disorder, yet in the 34th and 35th paragraphs of his book De Internis Affectionibus, he describes it fully; and when it happens to girls, he speaks of it in his book De Virginum Morbis. Most authors treat it as a species of cachexy, and in- deed it is only distinguished from other species by its cause. (See Cachexia.) Dr. Cullen considers it as a symptom of amenorrhcea.—A vitiated appetite, a strong desire of eating unalimentary, often absorbent, substances, are constant attendants on this disorder; and, if married Avomen become chlorotic, their children are weakly, should they have any. The common symptoms, when from difficult menstruation, are a paleness in the lips, a livid colour about the eye lids, indolence, coldness, particularly in the feet, loss of appetite, nausea, vomiting, disturbed sleep, a languid pulse, limpid urine, Avhich in time becomes turbid, a tremor, if exercise is brisk, or if the patient ascends a hill, frequent palpitation of the heart, swelled feet, heart burn, intemiitting headachs, and fainting. See Menses deficientes. CHNU'S, xv*S) fine soft avool; but sometimes chaff or bran; (from ypxvu, to grind, or rasp.) Sound, or wind. CHO 429 CHO CHO'A. See Chu. CHO'ACON. The name of a black plaster, men- tioned by Celsus, made of a spuma argenti boiled in oil, added to a proper quantity of resin. CHO'ANOS, Xoxw, a funnel, (from x*ea> to pour). See Infundibulum. A funnel, or furnace for melting metals. CHOA'VA. SeeCoFFEA. CHOCOLA'TA. This is said by Dr. Alston to be compounded of two Indian words, (from choco, sound, and atte, water ; because of the noise made in its pre- paration). See Cacao. CHCE'NICIS. The Trepan ; so called by Galen and P. .Egineta, from #*m|, the nave of a wheel; (from Xvxvu, to tear, or vellicate). See Trepanum. CHCE/RADES, (from xotS^"i a swine). Strumous swellings, of a malignant quality, painful to the touch, and exasperated by medicines. See Scrofula. CHCERADOLE'THRON,(from x"?<*, a swine,and oXeBpos, destructwi; so called from being dangerous if eaten by hogs). See Bardana minor. CHO IRAS, (from xaiP0C>i a h°g)- See Scrofula. CHO'LADES, (from x°*v> bile). See ^testina. CHO LAGO, (from the same). The small intes- tines which contain bile. See Ilium. CHOLAGO'GA, cholagogues, also colegon, (from X0**}) bile, and xya, to drive out or evacuate). By cho- lagogues the ancients meant only such purging medi- cines as expelled the bilious faeces. We retain the word for such purgatives as are found most useful Avhen bile offends, or are of service when the liver is diseased. Of this kind are rhubarb and calomel, which are sup- posed to increase the bilious discharge more powerfully than any other medicine. Aloes and taraxacum have been considered as useful in occasioning the bile to pass freely into the intestines, though with little reason. See Cathartica. CHO'LAS. See Ilium. CHO'LE, (from xeX»> bile). See Bilis. CHOLE'DOCHUS, (from x°*»> bile, and hx^xt, to receive). It is a common name for the gall bladder, the biliary ducts, and the common gall duct, which commu- nicates Avith the duodenum, called Chole'dochus du'ctus. It seems to be a continua- tion of the ductus cysticus; for it is often observed, that the ductus hepaticus runs, for some space, within the side of the ductus cysticus, before it opens into its ca- vity : at the opening of the hepatic duct into the cystic, there is a small loose membrane to hinder the bile from regurgitating. CHOLE'GON. See Cholagoga. CHO'LERA MO'RBUS. Coelius Aurelianus says, the name is derived from #«*«, bile, and pea, luo. It is called also diarrhea cholerica, fellifl.ua passio, and by some of the ancients, holera. Hippocrates divides this disorder into the moist and dry ; and there is a kind of cholera morbus which fre- quently happens to children from dentition. Dr. Cul- len names it cholera, and defines it a frequent vomiting and purging of a bilious humour, attended with anxiety, gripings, and spasms of the legs. He ranks it in the class neuroses, and orderspasmi. He observes two spe- cies : 1. Cholera spontanea, which happens in hot sea- sons, and Avithout any manifest cause : 2. Cholera acci- dentalis, which occurs from too acrid materials taken into the stomach. The intermittent,inflammatory, arthritic, and vermi- nose cholera, are considered truly symptomatic. The true species is most frequent in autumn, and happens chiefly to young persons, and its seat seems to be the Avhole volume of the intestines, but more particularly the duodenum and biliary ducts, as appears by the vo- miting and stools, which are bilious. The cholera and bilious diarrhoea are incident to the bilious and dry constitutions; for those of a phlegmatic and sanguine habit are more frequently liable to a dif- ferent discharge. Those Avho are subject to a scorbutic acrimony, or those of a passionate temper, are the com- monly reputed victims of the disease. In sultry Aveather it is most frequent: hence it is said by Bontius and Thevenot to be endemic in India, Muritania, Arabia, and America. The true cholera attacks often suddenly : sickness, pain, flatulency, and distention of the belly, are first perceived, and are soon folloAved by frequent vomit- ing and purging of bilious matter; the vomiting and purging come on together, and continue very frequent, Avith violent pain. The matters voided are at first the remains of the food ; afterwards bilious fluids, more or less mixed with frothy mucus, of a yellow, green, and, at last often a black colour; sometimes bloody, like the Avashingsof flesh, extremely acrid, and almost corrosive. The pulse is frequent, and sometimes small or unequal; heat, thirst, and anxiety, noAv attend; cold sAveats pre- sently appear, and spasmodic contractions affect the extremities. In greater degrees of this disorder, the muscles of the belly, and, indeed, the whole body, are seized Avith spasms: ineffectual strainings to vomit, Avith almost continual urging to stool, usher in an hic- cough, lividness of the nails, convulsive contractions of the legs and arms, and death sometimes Avithin twenty- four hours. In the dry species, there is a considerable distention of the stomach and intestines by Avind, which is plenti- fully discharged both upAvard and doAvmvard with ex- treme anxiety, but without either vomiting or purging. The remote causes are various; as acrid poison taken into the stomach, active emetics or purgatives, acrid, fermenting, or putrescent, drinks or diet, and violent passions. The immediate cause is the irritation of the nervous coat of the stomach and intestines, Avhich is communi- cated to the biliary system, occasioning the violent pain and the discharge. Hoffman says, that the dangerous vomiting and purg- ing Avhich infants are thrown into from the vehement anger of the nurse, and those Avhich follow the exhibi- tion of arsenic, some other poisons, and the virulent ca- thartics and emetics, seem to be no other than the true cholera. The dry cholera proceeds from a collection of acrid and flatulent humours in the stomach, by which the ad- jacent nervous parts are irritated and distended. The cholera morbus must be distinguished from a bilious looseness, a dysentery, and the dry cholera. It is distinguished from the first by its rapid attack, its violence, and short duration ; from dysentery, by the absence of the violent forcing pains, and the ineffectual CHO 430 CHO mucous evacuations; and from the dry cholera, by the nature of the discharge. It is often fatal in hot climates, though seldom in tem- perate ones. The more corrosive the matter discharg- ed, the more intense the heat and thirst, the greater is the danger. Hippocrates observes, that if black blood and black bile arc voided together, death is certainly at hand; and an exorbitant discharge of a green fluid, both upward and downward, fainting, hiccough, convulsions, coldness of the extremities, cold sweats, a small inter- mitting pulse, and the continuance of the other symp- toms, after the looseness and vomiting cease, are mortal signs : yet, in this country, all these may concur from a common bilious vomiting, without danger, if they do not continue long after the discharges cease. Danger is extreme, if Avhat is vomited smells like the internal excrements. If the vomiting ceases, sleep succeeds, and the patient seems relieved, there are hopes ; if the disease continues more than seven days, it is seldom dangerous; but the best sign is a free discharge of fla- tus doAvnward. The general indications of cure are : 1st, To correct the acrid matter, and, if necessary, to expel it by art. 2d, To check the violent commotions. 3d, To strengthen the weakened organs. Cholera, strictly speaking, arises from a discharge of superabundant acrid bile. It is the disease of hot climates, and of internperately warm Aveather ; but si- milar symptoms are sometimes produced by poisons, by anger, or fermenting food and drinks. In all these cases mild diluting liquors may be given, and the ma- nagement as in real cholera adopted. The only dif- ference in practice arises from the adAantages of giving opiates sometimes earlier and more freely. In the true cholera, Aretaeus long since commended frequent small draughts of tepid water, to evacuate the present contents of the stomach ; and when bilious dis- charges, loathing, and restlessness, afterwards come on, a quarter of a pint of cold water, to check the purging, to cool the ardent heat of the stomach, and to abate the thirst, may be given: this he advises to be repeated as often as the patient throws up Avhat he drinks : and if fainting,with other symptoms of weakness, appear, a little Avine may, he thinks, be added to each draught of water. Many since Aretaeus have extolled cold water, and the more so, as the climate, season, and constitution of the patient are warm ; for it cools, blunts acrimony, and restores the tone of the parts. In this country it may be given safely, if large draughts at a time are avoided; but toast and water is perhaps safer. Sydenham commends a similar practice. He orders, if called in at an early period of the disease, a chicken to be boiled for a short time in three gallons of Avater ; of this the patient is to drink freely, and a part is to be injected as a clyster, until the whole is consumed : thus the offending matter will be diluted and evacu- ated both by vomit and stool. The clysters may be re- peated as often as they return, at least until the pain abates. Instead of chicken water, as advised by Sydenham, barley Avater may be used, or water impregnated with any insipid mucilage; butter milk, which some prefer above every liquid; gentle acid drinks; or a decoction of oat (or other) bread, that is first toasted, until it is broAvn as coffee, but not burnt, may be employed: as much of this toasted bread should be boiled in the wa- ter as Avill render the decoction of the colour of Aveak coffee. Edinburgh Med. Essays. These liquors should be plentifully drank, until the contents of the bowels are sufficiently evacuated to ren- der the exhibition of opium safe. If the pain and sickness be violent, and the vomiting slight and ineffectual, from a quarter to half a grain of tart. emet. may be given in part of the drink, every three or four hours; or, if the discharge by stool be in- efficient, such mild laxatives as the stomach will bear may be added. Manna is well adapted to this purpose, and may be given with tamarinds. When the strength is reduced by the evacuations, and the primae viae cleared, the vomiting and purging maA be checked Avith opiates. Sydenham directs the tinct. opii, from twelve to tAventy drops, or more, in a little mint water, to be repeated two or three times a day, or oftener, as the urgency of the pain or frequency of the evacuations require, and to be continued, at least night and morning, until the patient recoverssome degree of strength. Opiates are often, hoAvever, in a moment re- jected; and, in this case, a small pill of solid opium will elude the action of the stomach, and check the vomit- ing. This, too, sometimes is rejected; and Ave have then given Avith advantage, a teaspoonful of elixir pa- regoric frequently, which is lost about the fauces, but its effects are communicated by degrees to the stomach. If the disorder hath continued some hours, and the patient is already Aveakened, the opiates may be imme- diately given and continued, as already directed. If the symptoms of weakness are extreme, the pulse weak and intermitting, and convulsions approaching, tAventy- five or thirty drops of the tincture of opium should be given in a large spoonful or two of strong cinnamon Avater, and after it a draught of whatever liquor the patient hath to drink, mixed with an equal quantity of wine. The saline draughts given in the act of fermentation often allay the vomiting very soon: they may be re- peated after each evacuation upwards, and to these some tincture of opium may be added. A free use of the columbo root will be sometimes an adequate remedy against this dangerous disease. It is said rarely to require any means to be employed for pro- moting the discharge of bile, or to cleanse the primae viae, previous to its administration. As soon as assist- ance is demanded, from 3 ss. to 3 ij. of this medicine, finely powdered, may be given in a glass of peppennint Avater, and repeated every three or four hours, accord- ing to the urgency of the symptoms. In hot climates this remedy is almost a specific: it soon abates the vio- lent evacuations ; and by continuing it a few days, every other symptom vanishes. Hoffman observes, that in choleras and bilious diarr- hoeas, especially such as are excited by passion, it is necessary to abstain from sudorifics and a sudorific regi- men, particularly at the beginning ; these being apt to bring on a violent rheumatic or arthritic affection. The cholera morbus sometimes destroys the patient in twenty-four hours. If it is cured, the patient is much relieved in two or three days: it rarely continues a CHO 431 CHO week, except it is the forerunner of some other disease. See Aretaeus, Coelius Aurelianus, Hoffman, Fordyce's Elem. p. 2. Edinb. Med. Ess. vol. v. Wallis's Syden- ham. Cullen's First Lines, vol. iv. 39. Cho'lera si'cca. SeeCoucA. CHOLE'RICA, (from xtXiP*i cholera). Medicines Avhich relieve the cholera. See also Diarrhcea he- PATARRCEA. CHOLICELE. A swelling on the right side, or ra- ther near the pit of the stomach, from an accumulation of bile in the gall bladder. CHOLOBA'PHINON, (from ^A*, bile, and px*lo, to immerge). A metal resembling gold, and which ap- pears as if it had been dipt in gall. See .Es. CHOLO'MA, (from xa*a*-> lame, maimed). Galen observes that in Hippocrates it signifies a distortion of a limb. In a particular sense, it is taken for a halting, or lameness in the leg. CHOLO'SIS, (from x«AeS, lame). In Vogel's No- sology, this is a genus of disease which he defines to be lameness, from one leg being shorter than the other. It is sometimes the case with children, that one leg seems longer than the'other, and the motion of the longer leg is rotatory in consequence of it. Mr. Pott thinks, that this is OAving to a paralysis of the part. In these in- stances, the glutaei muscles and the ligaments are in a very relaxed state, and the disease most probably, in a very great measure, originates from weakness. Amongst the most useful means of relief are, the cold bath, the bark, iron, setons, and vitriolic acid. CHONDRILLA, vel CONDRI'LLA, (from xt"*P*i a grain of any corn; so called, because it emits small particles of gum resembling grain). It is a species of succory, the root of which is perennial, and the leaves minutely indented. The only species of chondrilla in the Species Planta- rum, is the C. juncea Sp. PI. 1120; and the different species of former authors are dispersed under the pre- ceding and following genera, lactuca, and prenanthes; but no species has the slightest pretence to any medi- cinal power, though the gum of the lactuca perennis, the chondrilla carulea of Casper Bauhine, has been used as an emmenagogue. CHONDROGLO'SSUS, (from X"fy"> a cartilage, and yyua-Tti, a tongue). A muscle inserted into the basis, or cartilaginous part of the tongue. See Hyo- glossus. CHO'NDROS, (from xeMi to pour out, and uhtp, water; from the manner, according to Schrevelius, in Avhich the food of the ancients called Alica was made). See Alica cartilago, and Xiphoides cartila- go. It also signifies any grumous concretion, as of msstif Sec CHONDROSYNDE'SMUS. A cartilaginous liga- ment. (From xevfyc*i cartilago, and cvvhe-ptos, con- nectio). CHONDROPHARYNGjE'US, (from jp»Jfc«, a car- tilage, and a place). Galen, in his work De Usu Part, expresses by it particularly the cavities of the eyes; but in other places he means by it any void space. CHO'RDA, xeph> (from x°$tva) to roll up like a cord). Properly a musical chord, metaphorically a ten- don. Poets often express by it the intestines. Para- celsus, in his work De Origine et Curatione Morbi Gallici, calls the penis by this name. A painful ten- sion of the penis in the lues venerea is still called chords. Cho'rda magna. See Tendo achillis. Cho'rda tympani. The fifth pair of nerves from the brain divides into three principal branches, one of which is called the inferior maxillary. (See Trigemini nervi). A branch of the inferior maxillary nerve forms the lingual, which, soon after it leaves its origin, is accom- panied by a small distinct nerve, which runs upward and backward towards the articulation of the lower jaw, in company with the lateral muscle of the malleus, and passes through the tympanum between the handle of the malleus and the long neck of the incus, by the name of the chorda tympani. It aftenvards perforates the back side of the tympanum, and unites Avith the portio dura of the auditory nerve. CHORDAE TENDI'NEiE. See Cor. CHo'RDiE willisii. See Dura mater. CHORDA'PSUS, (from x°P^ a cord, and xtIu, to knit; so called, from the intestines appearing to be twisted into knots, like pieces of string, in a species of painful colic). See Colica, and Iliaca passio. CHORDA'TA GONORRHOEA. A gonorrhoea attended with chordee, or painful tension of the penis. See Gonorrhcea. CHORDE'. See Chorda. It is a painful invo- luntary erection of the penis, happening at all times, but more commonly when the patient is warm in bed: under which circumstance, the penis is not only hard and painful to the touch, but generally bent downAvards in a considerable degree. It sometimes remains after the heat of urine and other symptoms of gonorrhcea have disappeared; but is usually more severe during the continuance of the inflammation, and becomes more or less violent according to the greater or less degree of that symptom. Astruc distinguishes two species; when the "whole body of the penis is regularly drawn doAvnwards in the form of a semicircle, from inflammation, an ulcer in the membrane of the urethra, or in its corpus cavernosum; or when the glans only is draAvn down by inflamma- tion of the fraenum. He also observes, that, besides the chordee, there are other distortions of the penis. If the suspensory ligament that connects the penis to the os pubis is inflamed, or if only one of its cavernous bodies is injured, the penis will either be bent upwards or to one side; and these are relieved in the same man- ner as the chordee. Dr. Rutherford, in his Clinical Lectures, sup- poses that inflammation and swelling in the corpus ca- vernosum urethrae is the cause of the chordee; and Mr. Bell, that the irritation is communicated to the contiguous muscles, producing unequal degrees of con- CHO 432 CHO traction over the Avhole substance of the penis Avhich universally takes place in this disease. Neither expla- nation is, hoAvever, satisfactory; nor can Ave attribute it to any cause but a spasm in the cells of the corpora cavernosa, and an irregular distribution of the blood. It has not, hoAvever, yet been shoAvn that these cellular parts are muscular. If the patient is costive, gentle laxatives should be administered; and in full habits, bleeding is essentially necessary. A cold solution of acetated litharge, or the camphorated oil, applied to the part, and sleeping in tight draAvers, have been recommended. Rubbing the parts Avith tincture of opium, or a strong solution of it in Avater, or pledgets immersed in either, kept upon the parts, have been found useful. Emollient injections, impregnated Avith opium, are exceedingly efficacious in lessening the violence of this complaint: but taking thirty or forty drops of tincture of opium at bed time is the remedy mostly to be depended upon, as it seldom fails to prevent or remove the affection: and this is considered as one of the most effectual remedies in every stage of this symptom, particularly where it has been of long continuance. If opium fails, the hyoscya- mus niger may be tried, beginning with one grain of the extract, and gradually increasing the dose, accord- ing to its effects. Though, in slight degrees of chor- dee, blood letting is never necessary ; still, whenever, it is severe, particularly if the habit is plethoric, and the pulse strong and full, it should never be omitted; and, perhaps, the best mode is by the application of leeches to the part affected ; particularly as it prevents the chor- dee remaining after every other symptom of gonorrhoea has disappeared, which is sometimes the case. Fric- tions, Avith mercurial ointment, have been strongly re- commended ; but they are generally unnecessary, and often useless. See Astruc, Foot, Hunter, Bell, and SAvediaur, on the Venereal Disease. CHO'REA SANCTI VITI, (a x»P^ c*tus saltan- tium). St Vitus' dance. Also called viti saltus; by Paracelsus, lascivus. Horstius observes, that some women, Avho were disordered in mind, once every year paid a visit to the chapel of St. Vitus, near Ulm, and there exercised themselves day and night in danc- ing, till they Avere completely exhausted. Thus they were restored till the return of the folloAving May, Avhen they Avere again seized with a restlessness and disorderly motion of their limbs, in so great a de- gree as to be obliged, at the anniversary feast of St. Vitus, to repair again to the same chapel for the sake of dancing. From this tradition, a convulsion, to Avhich girls are principally subject before the eruption of the menses, took its name. The disorder, however, above described by Horstius is different from what Ave call St. Vitus' dance. Mead and Pitcairn think this disorder paratytic; Sy- denham considers it as convulsive; Dr. Cullen calls it chorea, raid has, on account of the age at which it at- tacks, as Avell as the motions Avhich it exhibits, esta- blished it as a genus, under the class neuroses, and or- der spasmi. He remarks, that it affects those of either sex before the time of puberty, for the most part be- Twecn the tenth and fourteenth years. It manifests i-tlfby i nvoluntary convulsive motions of some parts, commonly of one side, resembling the gestures of buf- foons, in the movement of the arms and hands; the patients, in walking, oftener drag one foot than raise it. Sydenham thus describes it: " A kind of convulsion, Avhich principally attacks children of both sexes from ten to fourteen years of age. It first shows itself by a lameness, or rather unsteadiness, of one of the legs, Avhich the patient draAvs after him like an idiot, and af- terwards affects the hand on the same side, which, being brought to the breast, or any other, part, can by no means be held in the same posture for a moment, but is distorted or snatched by a kind of convulsion into a different posture or place, notwithstanding all possible efforts to the contrary. If a glass of liquor be put into the hand to drink, before the patient can get it into his mouth, he uses a thousand odd gestures; for, not being able to carry it in a straight line thereto, because his hand is drawn different ways by the convulsion, as soon as it hath reached his lips, he throAvs it suddenly into his mouth, and drinks it very hastily, as if he only meant to divert the spectators." This is, hoAvever, a very imperfect and inadequate vieAV of the disease. We shall, therefore, transcribe that given by Dr. Hamilton, in his Treatise on the Utility of Purgatives. " Chorea Sancti Viti attacks boys and girls indiscri- minately ; and those chiefly who are of a weak consti- tution, or whose natural good health and vigour have been impaired by confinement, or by the use of scanty or improper nourishment. It appears most commonly from the eighth to the fourteenth year. I saAv it in two young Avomen, who Avere from sixteen to eighteen years of age. " The approaches of chorea are sIoav. A variable, and often a ravenous, appetite, loss of usual vivacity and playfulness, a SAvelling and hardness of the loAver belly in most cases, in some a lank and soft belly, and, in ge- neral, a constipated state of the bowels, aggravated as the disease advances, and slight irregular involuntary motions of different muscles, particularly of those of the face, which are thought to be the effect of irrita- tion, precede the more violent convulsive motions, Avhich noAv attract the attention of the friends of the patient. " These convulsive motions vary. The muscles of the extremities and of the face, those moving the loAver jaAV, the head, and the trunk of the body, are at different times, and in different instances, affected by it. In this state the patient does not Avalk steadily; his gait re- sembles a jumping or starting; he sometimes cannot Avalk, and seems palsied; he cannot perform the com- mon and necessary motions Avith the affected arms. " This convulsive motion is more or less violent, and is constant, except during sleep, when, in most instances, it ceases altogether. Although different muscles are sometimes successively convulsed, yet, in general, the muscles affected in the early part of the disease remain so during the course of it. "Articulation is noAV impeded, and is frequently completely suspended. Deglutition is also occasionally performed Avith difficulty. The eye loses its lustre and intelligence; the countenance is pale, and expres- sive of vacancy and languor. These circumstances CHO 433 CHO give the patient a fatuous appearance. Indeed, there is every reason to believe, that, when the complaint has subsisted for some time, fatuity, to a certain extent, in- terrupts the exercise of the mental faculties. " Fever, such as arises in marasmus, is not a neces- sary attendant on chorea; nevertheless, in the advanced periods of the disease, flaccidity and Avasting of the muscular flesh take place, the consequences of constant irritation, of abating appetite, and impaired digestion, the common attendants of protracted chorea; and Avhich, I doubt not, may, in some instances, although contrary to the opinion that chorea is not fatal, have been the forerunners of death." This is a very faithful picture of the disease, and we can only add to it, that the belly seems often obstinately bound. We have seen it at every age, from seven to tAventy-two; and, in one case, it occurred in a young woman of twenty, who had been married about three weeks. What can have occasioned the apathy of practitioners respecting this frightful complaint, it is not easy to say. The description of Sydenham has been repeated in every author, and the usual tonics and antispasmo- dice indiscriminately and fruitlessly advised. The dis- ease evidently depends on debility; but we can no more conquer this debility by tonics, than Ave can success- fully combat that which arises from infarcted viscera by bark. It seems to have escaped authors that, in every case of chorea, there is a load in the head, an obstruct- ed discharge from the bowels, at a time when it is the object of nature to determine the fluids to the lower belly, viz. about the age of puberty. Many of the symptoms are those of apoplexy or palsy; but, as usual in cases of debility, the voluntary muscles lose their balance, and convulsions follow. Those Avho have once suffered under this disease are very subject to a relapse. However violent the symp- toms, they never are suddenly destructive. When recent in a young person, of an otherwise good consti- tution, there is hope of a speedy cure. If the menses are obstructed, their return will mitigate, if not cure, the disease. If the temperament is very sensible, the disease hereditary or habitual, the cure is difficult. Nothing, in the records of medicine, is more trifling and indiscriminate, than the mode recommended of re- lieving chorea. The author of this article, more than twenty years since, catching the hint from Sydenham, gave purgatives; and found that this usually^obstinate disease yielded not only soon, but Avith little danger of relapse; and, in this interval, he has had occasion to see more than sixty cases, three times Dr. Hamilton's boasted number, in one of Avhich only he may have been styled unsuccessful. The violence of the disease, indeed, in that instance, Avas subdued; but slight irre- gular motions, especially on any sudden agitation, would not yield. The author's OAvn illness obliged him to re- fer the patient to another physician, but every measure seems to have failed. The choice of the purgative appears of little import- ance ; but it must be active, for no other will produce the necessary discharge; and the saline purgatives are apparently less adapted to the complaint. The author knows no distinction but in their poAver. The most active arc the most useful. In the Edinburgh Medical Journal, there are two cases of chorea in which purga- vol. 1. tives succeeded; and, in Dr. Hamilton's volume theie are many instances of well conducted successful treat- ment by this plan. We have had no reason to follow the purgatives by tonics. The constitution has restored the general health with rapidity and effect. We may just add, that, in the woman neAvly married, the complaint yielded, Avithin a fortnight, to the purgative course. See Wallis's Sydenham, vol. ii. p. 327; Cullen's First Lines, vol. iii. edit. 4. Hamilton on Purgative Medicines; Edinburgh Medical Journal, vol. i. CHO'RION. Membrana externa, qua foetus invol- vitur, (from xaPKi receptaculum). Vide H. Steph. Thcs. Sometimes called camisia fetus, shirt of the fcetus A name of the external membrane of the foetus. In women, as in some animals, the chorion, at the first, is Avithout any sensible placenta. It is also said to have its name from the chorus or crowd of blood vessels Avhich are spread on it. It adheres to the amnios by a gelatinous substance, and is divisible into two lamellae; the internal, or true chorion, is even more thin and pel- lucid than the amnios"; whilst the external, or false cho - rion, is thick and opaque. This spongy chorion adheres to the uterus at every part, and groAvs thicker as it ap- proaches the placenta; Avhilst the internal lamina ad- heres inseparably to the inner surface of the placenta: hence it is plain, that the substance of the placenta is betwixt these two lamellae of the chorion. This mem- brane hath numerous lymphatic vessels; but in the human placenta, these vessels cannot be traced by ffi- jection on the amnios and chorion. The uterus, m- - deed, sends veins to the outer chorion; and perhaps the arteries do the same. See Decidua. The use of the chorion is to sustain the umbilical vessels. CHOROI'DES, (from x6P'°'tt chorion, and eth>s, like- ness). It is an epithet of several membranes, Avhich, on account of the multitude of their blood vessels, resem- ble the chorion. It is the tunica retiformis oculi, a name of one of the coats of the eye. (See Retiformis.) It lines the sclerotis ; is a thin vascular coat of a broAvn- ish colour, and generally said to derive its origin from the pia mater covering of the optic nerve. From the colour of part of this membrane it hath been called uvea; the external surface of Avhich is called the i7-is; but at pre- sent the entire fore part only of this coat is called iris; and the rest choroides. It consists of two laminae; the ex- terior is slightly connected with the sclerotica, and is also covered Avith a black matter, called nigrum pig77ie7i- tum. Both laminae are extremely vascular: the ex- tremities of the vessels of the inner surface project from it, and are termed villi and papilla. As this internal lamina was first noted by Ruysch, it is called Ruyschi- ana tunica. The black substance Avhich lies between the sclerotica and choroides, is also found betAvixt it and the retina. Near Avhere the sclerotica becomes trans- parent, the choroides is firmly united to it; and, at this circle of adhesion, the choroides seems to. change its colour and texture, appearing as a Avhitish ring, of a compact substance, and is termed ciliare ligamentum. Here the internal lamina of the choroides dips imvards, to make what are termed the processes. The ciliary processes are on the inside, betAveen the iris and cho- roides, as the ligamentum ciliare is on the outside. Tin choroides is continued on the inside of the^ transparent part of the sclerotis, and there fonns the iris: the per 3 K CHR 434 C II 11 foration in the middle is called pupilla. The artery is a branch of the carotid. The veins empty themselves into the optic sinuses, which are again discharged into the internal jugulars; but some of these veins commu- nicate with the external veins of the eye, so that part of the blood is emptied into the external jugulars. The nerves are from the ophthalmic branch of the fifth pair, and a branch of the third pair. Opposite to the insertion of the optic nerve, the cho- roides is Avanting: and thus is formed that white speck, on which, if the picture of an object falls, we are inca- pable of perceiving it. Choroi'des plexus. A plexus of blood vessels; a congeries of blood vessels on the lateral ventricles of the brain. See Cerebrum. CHOU DE PALMI'STE. (French.) The cabbage of the palm tree. See Palma nobilis. CHOWDER, is an antiscorbutic, used on the New- foundland station, and consists only of fresh fish boiled with the salted ship provisions. Chowder beer, is an infusion of spruce in wa- ter, from which beer is prepared in the common way. CHRI'STI MA'NUS. See Saccharum. CHRISTOS, (from xPlui to anoint). Whatever is applied by way of unction. CHROME. A newly discovered metal. See Che- i^STRY. ^HRO'NICUS, or CHRO'NIUS, (from xp»&> time). Chronical. Diseases which continue long, and are without any, or at least a considerable degree of, fever. On the con- trary, those which proceed rapidly, and terminate soon, are termed acute. In the cure of chronical disorders, Dr. Fothergill in- timates, that those means or medicines which enable the stomach duly to perform its office, are the most ef- fectual, if not the only remedies. (See Lond. Med. Obs. vol. i. p. 314.) Dr. Cadogan seems to corroborate this, by his observations on the causes of chronical dis- orders ; which, he says, are indolence, intemperance, or vexation : though now and then he alloAvs, that an acute disorder, imperfectly cured,may be the cause of chronical ones. (See his Essay on the Gout and Chronical Dis- eases.) In general, however, chronical diseases depend on an obstructed discharge, or an infarcted gland, usually the liver. Atonic gout may bd another cause; but, in general, an attention to the state of the bowels is essen- tially necessary, and a preservation of the balance of the circulation, particularly an attention to the warmth of the surface and extremities. Wallis's Sydenham, vol. i. p. 4. CHROS, (from xPuxt the skin). Galen says, that the lonians mean, by this word, the flesh in our bodies; /. e. all except bones and cartilages. CHRU'PSIA, (from xpovx, colour, and o-fyix, sight). A disease in the eyes, in which the person perceives objects of colours different from their real ones. CHRYPSO'RCHES. See Parorchidium. CHRYSA'NTHEMUM, (from xPv and pxXxvos, a nut, on account of its colour). See Nux moschata. CHRYSOCA'LLIA. See Chamemelum. CHRYSO-CERAU'NIUS, (from xP»™s, gold, and xepxwos, thunder). See Aurum fulminans. CHRYSOCHA'LCUM, (from w»«s, and £*A*o5, brass). See .Esecavum. • CHRYSOCO'LLA, (from xPVTe^ gold, and xoXXy, glue, or solder). See Tincal and Borax. CHRYSOCO'MA, (from xp"™*, gold, and xow, hair, from its resembling golden hair). See Elichry- sum. CHRYSO'GONUM, (from xp»™s, and yow, a knot). Red turnip. CHRYSOLA'CHANON, (from xpvT*t-> and Xxxxvov, the olus; so called from its leaf and root being yelloAV like the olus). See Atriplex. CHRYSOME'LIA, (from xiVT°ii and mXov, an ap- ple). See Aurantia Hyspanica. CHRYSO'PUS, (from xPVT^i and u^, face or ap- pearance). See Gambogia. CHRY'STALS, and CHRY'STALLOGRAPHY. This subject can scarcely be considered as a medical one, since, perhaps, the deposition of bony matter, more certainly calculous concretions, are the only instances of crystallization in the human body. Yet, as che- mistry has made such gradual and effectual encroach- ments on medicine, and as the variety of crystals are often mentioned in these pages, a short account of this subject is, in every view, necessary and proper. Linnaeus, who made, very early, some imperfect and ineffectual attempts to arrange minerals from their exter- nal appearances, spoke of the more obvious and common forms, which salts and other bodies assume, when pass- ing from a state of fluidity to that of a solid. The che- mical mineralogists, who, under the guidance of Cron- stedt, succeeded, turned tfie attention of philosophers from the obvious properties to the component parts; when, in 1772, the first edition of Rome de ITsle's Chrystallography appeared; and the second edition, in five volumes, was published in 1783. About this pe- riod Bergman, in a separate dissertation, greatly illus- trated the subject. Since that time, the attention of C 11 \ 435 C H Y mineralogists was again directed to external forms, by the abbe Haiiy; who, in numerous papers, published in the Journal des Mines, and afterwards, in 1801, in a separate work, in four volumes octavo, explained, Avith mathematical accuracy, all the different forms of crys- tals ; taught us the mode of their construction, by a suc- cessive application of molecules; and pointed out the way in which the primitive chrystal may be detected. The form of the crystals, in a great variety of solids, has thus been traced; and so constant is the crystalliza- tion of the same ingredients, that, in more than one in- stance, the crystallographer has instructed the chemist; in general, his fiat has confirmed the chemical analysis. CHRY'SUN, (from x?vo'&', gold). An epithet of two collyria for the eyes, and also of two pessaries for the uterus, in .Etius. CHU, or CHUS. The name of a measure. The same as choa, congius. This was a liquid measure among the Athenians, containing six sextarii, twelve Attic cotylae, or nine pints or pounds of oil, ten of Avine, thirteen and a half of honey, according to Galen. Lin- den says, at least eight of wine and four ounces. Rho- dius asserts, that the chus, or con^-ms, Aveighs ten pounds. Castelli. CHUNDRI'LLA VERCU'RIA. See Zacintha. CHU'NNO. See Battatas. CHYLA'RIA, (from £fA««, chyle). See Dysuria. CHYLIFE'RA VA'SA, (from #»*•«, chyle, and A«s, juice,) called, in Paracelsus, chymosum. In general it is a juice inspissat- ed to a middle consistence betAveen fluid and dry. In Hippocrates the word xv*<* is used to express the juice and sorbile liquor of barley, called strained ptisan, being the expressed substance of the barley ; not what the Latins called cremor, which is only the barley water. To xv*6s is opposed ptisan unstrained. By chyle, however, is commonly meant the oily part of our aliment, mixed with the saliva and other juices poured into the stomach and duodenum. It assumes the form of chyle only in the duodenum, since it never appears in the lymphatics, of the stomach. It is ap- parently an uniform fluid, Avhatever be the food em- ployed, or the animal in whose stomach it is digested. It has been supposed, though Avithout sufficient founda- tion, to resemble milk; but milk in the stomach is not absorbed till it has undergone the digestive process, and milk injected into the blood vessels produces the most formidable symptoms. The real nature of chyle is not knoAvn. It,, seems to consist of a serous and a coagu- lable part, with distinct globules, Avhich give it opacity, and have been supposed, rather than proved, to be oily. The small quantity of chyle that can be obtained, is the reason why its nature has not been more carefully exa- mined. The chyle, when it enters the blood, does not imme- diately mix with it, but in many instances seems to pass in a separate state through the whole circulation : for the chyle has been seen to float on the surface of blood, Avhen taken from the arm: in the last stage of a dia- betes, the urine manifestly points out the presence of chyle in it. See Haller's Physiology on the chyliferous vessels. CHYMA'TION. The name of a penetrating medi- cine in Marcellus Empiricus. CHY'MIA. See Chemia. CHYMIA'TRIA, (from xvlJLiXi chemistry, and ixlpeix, healing). The art of curing diseases by chemical me- dicines. CHYMO'SIS, (from %«<»», to gape). It is when, from inflammation, the white of the eyes swells above the black circle, so that there appears a gaping aperture. Galen, de Euphoristis, calls it a red and carnous in- flammation of the cornea tunica. Paulus calls it che- mosis, Avhen, from a vehement inflammation, both the eye lids are turned outwards, so as scarcely to cover the eye, and the white of the eye appears higher than the black, and partly hides it. Le Dran calls it a tumour on the white of the eye. It is really a species of ophthalmia, called by Sau- vages ophtha'lmia chemo'sis, and by De Mese- rey, traumatica. The chemosic, or conjunc- tiva CORNEA PALPEBRAIC OPHTHALMY. SattVageS ascribes it to an external cause, as a violent contu- sion of the eye, whence an hyposphagna, or to a chirurgical operation perfonned on the eye, as an ex- traction of a cataract; to the operation for the unguis, or empyesis, or to an internal cause, as metastasis, or severe catarrh in cacochymic habits. It is known by the black red swelling of the conjunctiva, Avith a depression and obscurity of the cornea, which seems to lie, as it Avere, in a cavity. The inflammation is severe, with excruciating pains of the eyes and head, and a sense of weight above the orbit; pervigilium, fever, pulsation, a swelling, and shutting of the eye lids. It terminates sometimes in the suppuration of the eye, and an irre- mediable blindness or leucomata succeed. In Dr. Cullen's Nosology, it is a variety of that spe- cies of ophthalmy which he names the ophthalmia mem- branaru7n. When the ophthalmy is in this state, it is for the most part accompanied Avith violent pain; the white part of the eye resembles raw flesh, or some- times the pile of red velvet. All the transparent part of the cornea often comes away by suppuration, which destroys the anterior chamber of the eye. The cica- trix, subsequent to the suppuration, hinders the crystal- line and vitreous humours from falling out, and by that means the entire destruction of the globe is prevented: sometimes, however, both happen. This disease is often fatal; loss of sight generally follows, and the pain sometimes destroys the patient. The violence of the disease requires the speediest and 3 K 2 • CIC 4 most powerful aids. Repeated bleeding, according to the strength of the patient, with the most active purges, chiefly of the saline kind, will be necessary. A blister may be applied on the forehead, or leeches to the temples $ and after them a blister over the part Avhere they were applied. Goulard's saturnine poultice may be applied cold over the eye lids, and reneAved as often as it grows warm. Antimonial diaphoretics may be given inwardly, and opium in the largest doses is indis- pensable. Indeed every method ought to be pursued which can most immediately subdue the inflammatory symptoms. See Nosologia Methodica Oculorum, with Notes by Dr. Wallis, and Ophthalmia. CHYMO'SUM, (from xvi*<>^succus). See Chylus. CHY'MUS, xv/*°s, humour or juice, (from xvc*i fundo, to pour out). In the common signification of the word it is every kind of fluid Avhich is incrassated by concoction. Sometimes it means the finest part of the chyle when separated from the faeces; but in general it implies the food in the state in Avhich it passesout of the stomach previous to its mixing with the bile. In Galen, it is the faculty or quality in plants and animals which is the object of our taste. CHY'TLON, (from xva-> to pour out). In Hippo- crates it means a plentiful inunction with oil and Avater. CIBA'RIUS, sal. See Marinum sal. CIBA'TIO, (from cibus,food). By this is meant the assumption of aliment; synonymous also with the ap- plication of the nutritious juices. CIBO'RIUM, CIBO'TIUM, (from x*ff*7«, a bag, which its pods resemble.) See Faba jEgyptia. CIBOU'L. A sort of onion nearly allied to the scallion. They have no bulb at the root, and are culti- vated in the kitchen garden. CI'BUS, from the HebreAvterm kibash,food, ornou- rishment. Ci'bus a'lbus. White food. It is a species of jelly, which in Fuller's Pharmacopoeia is thus made: take four pints of milk, the breast of a boiled capon, and two ounces of blanched sweet almonds; let them be well beat, then boil them over a gentle fire, adding three ounces of rice meal. When they begin to co- agulate, add eight ounces of white sugar, and ten spoonfuls of rose water: mix all Avell together. The Spaniards give the name of cibus albus to a certain American plant. But by avhite meats we noAV mean milk, butter, cheese, custards, and other foods consist- ing of milk or eggs ; as white pot, made of milk or cream, baked with the yolks of eggs, fine bread or rice, sugar, and spice, in an earthen vessel. There are a va- riety of dishes under this denomination; but, strictly speaking, white meats are fish, veal, and chicken. CICA'DA, (quod cito cadit, because it soon disap- pears). The baum cricket. It hath wings, is very noisy, and is said to live on deAv, which it sucks from the dwarf ash or manna tree. Its species we cannot ascertain, though we have examined all those of Gmelin, amounting to 237. These insects, when dried and burnt, are used in the colic or stone as a solvent. CICATRISA'NTIA, (from cicatrico, to skin over). See Epulotica. CICA'TRIX, (from the same). A seam or eleva- tion of callous flesh, on the skin, after the healing of a wound or ulcer, commonly called a scar. 16 CIC It is the destruction of the cellular membrane by in- flammation that causes cicatrices to be draAvn imvards. Some commend the steams of hot water to be often ap- plied to the growing skin to prevent a cicatrix, and to dress the wound with a cerate of wax and the oil of eggs. CI 'CER, (from kikkar, a round mass,) album, nigrum, vel rubrum; cicer sativum, cicer arietinum, erebinthus; CHl'CHES, CICHES, CICERS, CICH PEAS, and VETCH. The sort used as aliment is the cicer arietinum Lin. Sp. PI. 1040. Chiches, a leguminous plant, cultivated in warmer climates, where our finer peas do not thrive so well. They are a strong flatulent food, hard of digestion. They are sown in France, Italy, 8cc. flower in June, and the peas are ripe in July. CI'CERA, (from cicer, because of their size). Ci'cera ta'rtari. Small pills composed of tur- pentine and cream of tartar, of the size of a vetch. CICHO'REUM, CICHO'RIUM, (yirxpx to hx rm X*>£i*>v xietv, because it creeps about and scatters itself in the fields). Sylvestre, and sativu7n. Wild and garden succory. The Avild is the cichorium intybus Lin. Sp. PI. 1142. It is a plant with oblong, dark green, hairy leaves, deeply jagged, like those of dandelion, but larger ; in the bosoms of which, toAvards the tops of the branches, the flowers come forth in spikes, consisting each of a number of blue flat flosculi, set in a scaly cup, which afterwards become a covering to several short angular seeds: the root is long and slender, of a brown colour on the outside, and Avhite within. It is biennial, grows in hedges and by road sides, and flowers in June and July. It abounds with a milky juice, of a penetrating bit- terish taste, and of no remarkable smell :' the roots are bitterer than the leaves or stalks, and these much more so than the floAvers. But by culture in gardens it loses its green colour, and in a great measure its bitterness, and in this state is a common sallad herb: the deeper coloured and the deeper jagged the leaves are, the bit- terer is the taste of the whole plant, which is mildly aperient, and, if freely used, it loosens the belly. The virtue resides in the milky juice, which may be ex- tracted by boiling in water, or by pressure. The wild and the garden sorts are used indifferently, and chiefly as food. If the root is cut into small pieces, dried and roasted, it resembles coffee, and is sometimes a good substitute for it. Cicho'reum latifo'lium. See Endivia. Cicho'reum verruca'rium. See Zaclntha. CICILIA'NA. See Androsjemum. CICINDE'LA, (a dim. of candela, i. e. a little candle; so called from its light). The glow-worm, also called Xxpcvrovpis, noctiluca terrestris, scarabaus, ci- cendela mas etfemina. The flying glow worms are males, and the creep- ing ones the females. Some think them anodyne, others lithontriptic; though probably neither. CICI'NI Ol. (from xtxi, the ricinus). See Ricini ol. under Cataputia. CI'CIS, xtxis. In some places of Hippocrates and Theophrastus it is put forxmts. A gall. See Gallje. CI'CLA. See Beta alba. CICO'NGIUS. Blancard says it is a measure con- taining twelve sextaries or pints* CIC 437 CIC CICO'NIA, (from Cic6nes, the people of Thrace, who held this bird in veneration). The Stork. CI'CUS, (from xixxos, the core). The skin Avhich envelopes the seed. CICU'TA, (quasi cacuta, blind, because it is said to destroy the sight of those who use it.) Hemlock; called by some camarum ; by others abiotos ; and, ac- cording to Erotian, cambeion is an old Sicilian word for cicuta. Cicu'ta ma'jor fce'tida. The conium maculatum Lin. Sp. PI. 349. Spotted hemlock. It groAvs Avild in almost every climate, and with us is found about the sides of the fields, under hedges, and in moist shady places. It is a tall umbelliferous plant, with large leaves, of a blackish green colour on the upper side, and a Avhitish green underneath, divided into a number of small oblong someAvhat oval segments, which stand in pairs on middle ribs; these segments are again deeply cut, but not quite divided on both sides; and many of these ultimate sections have one or two slighter indent- ations. They much resemble parsley or chervil, espe- cially the leaves of the smallest sorts, whose poisonous quality is the most violent. The stalk is round, smooth, hollow, irregularly variegated with spots and streaks of a red or blackish purple colour; the flowers are white, and blow in June or July; the seeds greenish, flat on one side, very convex, and marked with five furrows on the other. The root is oblong, about the size of a middling parsnip, yellowish without, white and fun- gous Avithin, and part of it hollow; it changes its form according to the season. The leaves have a rank smell, but do not much affect the taste. Internally and externally it is narcotic and anodyne: it abates inflammations of the eyes; promotes rest, and eases pain, without producing thirst or headach the next morning, and as rarely creates costiveness; is sup- posed to possess a property of altering thin, corrosive cancerous ichor, and of rendering it mild. It hath been used with some advantage in sanious ulcers, cancers, gleets, painful discharges from the vagina, fixed pains supposed to arise from acrid serum, fluor albus, and scirrhous tubercles; but its efficacy is seldom perma- nent, and it injures the stomach, sometimes the con- stitution. Though it does not cure cancers, yet it is an anodyne more effectual than opium; and in phthisis is often useful for relieving pain and cough. It is useful in syphilis, according to Mr. John Hunter. Dr. Cullen observes, that if hemlock, either in form of powder or extract, has no sensible effect when taken to twenty grains for a dose, the medicine may be supposed to be imperfect, and that if it is to be con- tinued, another parcel of it should be employed. He adds, that he has known it useful in resolving and discussing scirrhosities of different kinds, particularly those of a scrofulous nature; in healing the ulcers of scirrhous tumours, which continued to be surrounded with such scirrhosky; and in some ulcers certainly that approached to the nature of cancer. In those that might be considered truly cancerous, he has knoAvn it relieve the pains, meliorate the quality of the matter proceeding from the sore, and even to make a consi- derable approach to its healing, though it never com- pleted the cure. Mat. Med. It has been considered also as very useful in the chin cough and rheumatic complaints. See Butler on the Chin Cough. When hemlock is imprudently eaten, it causes a vertigo, a dimness of sight, hiccough, madness, cold- ness of the extremities, convulsions, and death: some- times by the spasms, which it produces in the stomach and other parts, haemorrhages, or an epilepsy come on, which, Avithout very speedy relief, are fatal. The pro- per method of relief is to discharge the contents of the stomach by means of the most active emetics, and then to administer frequent doses of sharp vinegar, as in the articles Amanita and Venenum. The proper method of administering hemlock inter- nally is to begin Avith a few grains of the poAvder or inspissated juice, and gradually to increase the dose until a giddiness affects the head, a motion is felt in the eyes, as if pressed outwards, with a slight sickness and trembling agitation of the body. One or more of these symptoms are the evidences of a full dose, which should be continued until they have ceased, and then after a feAv days the dose may be increased; for little advantage can be expected but by a continuance of the greatest quan- tity the patient can bear. In some constitutions even small doses greatly offend, occasioning spasms, heat and thirst; in such instances it will be of no service. The college of physicians of London order the in- spissated juice of hemlock, succus cicutje spissatus, instead of the former extract, to be made in the folloAV- ing manner: let the expressed juice of hemlock, clear- ed from its faeces, be evaporated in a water bath satu- rated with sea salt to a proper consistence. As the powder of the dried leaves has been thought to act, and may be depended upon, with more certainty than the extract, the following direction should be ob- served in the preparation: gather the plant about the end of June, when it is in flower; pick off the little leaves, and throw away the leaf stalks; dry the small selected leaves in a hot sun, or in a tin or pewter dish before the fire. Preserve them in bags made of strong brown paper, or powder them, and keep the powder in glass phials, where the light is excluded; for light dis- sipates the beautiful green colour very soon, and thus the medicine loses its appearance, if not its efficacy; this mode is recommended by Dr. Withering. The extract should also be made of the plant gathered at this period. That which grows in exposed places is gene- rally stronger than what grows in the shade; and that in dry places is also to be preferred. This plant has been taken a long time without any bad effect. When considerable inconveniences have arisen from its use, the cicuta aquatica has probably- been mistaken for it. Externally it is applied with ad- vantage, and particularly in the form of fomentation and poultice. Fotus cicutje. Hemlock fome7itation.—R. Fol. ci- cutae recent, g vi. vel siccae 5 iij. coq. in aquae fontanae lb iij. et lb ij. et fiat fotus. This is commonly made use of to foment cancerous or scrofulous ulcers, pre- vious to the application of the succeeding cataplasm. Catapla'sma cicu't^e, Hemlock cataplas7n.—R. Fo- tus cicutae, q. v. inspissetur avenae farina ad crassitu- dinem cataplasmatis. This is not only applied in can- cerous and scrofulous cases, but to inveterate ulcers, and very often both meliorates their discharge and less- ens (their sensibility, though Mr. Justamond preferred the application of the fresh herb bruised. An ointment is also made of hemlock, by bruising the plant very Avell CIC 438 CI M in a marble mortar, then mixing with it an equal quan- tity of hog's lard, and gently melting them over the fire; afterwards the composition is to be strained and stirred till cold. This has been recommended to be ap- plied to cancerous or scrofulous sores. In this mode it has been useful in resolving some in- durations, especially that of the scrofulous kind; but in the indolent scirrhosities in the breasts of women it is seldom of any service; and the frequent applications of hemlock poultices have been known to do much harm, by bringing these tumours sooner to an open cancer. The hemlock bath requires no direction. The proportions are those of the fomentation. See Wilmer's Observations on Poisonous Vegetables. Withering's Bot. Arrangement, vol. i. p. 161. Cullen's Mat. Med. Cicu'ta aqua'tica, vel viro'sa. Water hemlock, also called slum majus alterum augustifolium, slum eruca folio. Long-leaved water hemlock and cow- bane. It is the cicuta virosa Lin. Sp. PI. 365. Dr. Withering gives the following description of it :— Rundle roundish, Avith many equal spokes. Rundles roundish, with many bristle shaped spokes. Empale- ment; general fence none. Partial fence of many leaves; little leaves, bristly, short. Cup scarcely evi- dent. Blossom general, uniform. Florets all fertile. Individuals : petals five, egg shaped, nearly equal, bent imvards. Chives; threads five, hair like, longer than the petals. Tips simple. Pointal; seed bud beneath. Shafts two, thread shaped, longer than the petals, per- manent. Summits roundish. Seed vessels none. Fruit nearly egg shaped; slightly furrowed; divisible into two. Seeds two, someAvhat egg shaped ; convex, and scored on one side; flat on the other. To this he adds, with rundles opposite the leaves. Leaf stalks with blunt borders; leaves with about seven pair of little leaves, Avhich are variously divided and indented. Petals yel- loAvish pale green. It is met with in shallow waters, and floAvers in July. It is one of the most active of the vegetable poisons. Early in the spring, when it grows|jj in the water, cows often eat it, and are killed by it; but as the summer ad- vances, and its smell becomes stronger, they carefully avoid it. Mr. Wilmer observes, that the poison is of that class which produces epileptic symptoms. Wepfer notices some children, who, on eating the roots of this plant, were seized Avith pains of the precordia, loss of speech, abolition of the senses, and terrible convulsions; the jaAvs were locked, blood started from the ears, the eyes were distorted, and some of them died in half an hour. Others have observed that the old roots are a more ac- tive and sudden poison than arsenic or corrosive subli- mate. If any of this plant is taken, a quick vomit should be instantly given, after which vinegar in water should be drunk freely. See Venenum. See Lewis's Mat. Med. Lond. Med. Obs. and Inq. vol. iii. p. 229, &c. 400, &c. vol. iv. p. 104, &c. Neu- mann's Chemical Works. Medical Museum, vol. iii. p. 566. Withering's Botanic Arrangement, vol. i. p. 177. CICUTA'RIA AQUA'TICA, (from cicuta, hem- lock). PALU'STRIS. See Phellandrium aquati- CUM. Cicuta'ria viro'sa. See Cicuta aquatica. Cicuta'ria. See Chxrophyllum sylvestre, and Myrrhis. CI'DRA. See Pomacea. CI'GNUS. A measure so called, containing about two drachms. CI'LIA, (from cileo, to move about). The extreme parts, or edges of the eye lids; they are semicircular, and cartilaginous, with hairs fixed in them, which are sometimes called cilia. See Tarsus. CILIA'RES, (from cilia, the eye lids,) vel MEIBO'- MII GLA'NDULiE; from Meibomius, the discoverer. On the inner edge of each eye lid, in the tarsus, is a row of small holes, which are the excretory ducts of what are called the ciliary, or Meibomius's glands. The glands themselves appear of a whitish colour, and are situated on the internal surface of the tarsus; their ducts are short, resembling white lines running down towards the edge of the eye lids : like the miliary ones, they secern an unctuous matter, which prevents the attrition of the eye lids, from their frequent motion; keeps the edges soft and free from excoriation, and prevents the tears from falling doAvn the cheeks. See Tarsus. Cilia're ligame'ntum, also called processus ci- liaris. It is a range of black fibres, in the eye, circu- larly disposed, having their rise in the inner part of the choroides, and terminating in the prominent part of the crystalline, Avhere the sclerotis, choroides, retina, cornea, processus ciliaris, and iris, end: they surround the crystalline humour, or rather the part Avhere the sclerotica joins the choroides, and round the edge of the cornea they adhere firmly; at this circle, the cho- roides seems to change its colour and texture, appearing as a Avhitish kind of ring, termed ligamentum ciliare: here the internal lamina of the choroides dips inwards, to make what are termed the processes, which are little folds of the inner lamella of the choroides. These folds become broader until they terminate in a broad point in the crystalline humour; the whole radiated ring, made by the ciliary processes, is sometimes called corona ci- liaris. See Choroides. CILIA'RIS MUSCU'LUS. That part of the muse. orbicularis palpebrarum which lies nearest the cilia, considered by Riolan as a distinct muscle. CILIA'TUS, (from ciliu7n, the eye lash). In botany it means having the margin guarded Avith a sort of bristles like the eye lashes. CI'LLO. One who is affected with a perpetual trembling of the upper eye lid; from cillendo, being in continual motion. CILLO'SIS, (from ciliu7/i, the eye lid). A trembling of the upper eye lid. CI'LO, or CI'LLO, (from cilium, the eye lid). One whose forehead is prominent, and temples compressed, called beetle browed ; the eye lid in these is also very protuberant. CI'MEX. Cimex domesticus,cimexlectularius,(from xeipxt, to inhabit: so called because they infect houses). The wall-louse, or bug: called also cotula. It is of a rhomboidal figure, a dark brown colour, and hath six legs. The skin is extremely tender, so that it bursts with the least compression, and emits an offensive smell. Six or seven are given inwardly to cure the ague, just before the fit comes on, and have the same effect with every thing nauseous and disgusting. C IN 439 C IN CIMO'LIA ALBA, Terra: called also creta ful- lonica, terra and argilla Candida, creta cimolia. To- bacco pipe CLAY. It takes the name cimolia from the island Cimolus, in the Cretan sea, now called Argentiere, where it is procured. It hath nearly the same absorbent quality with the boles, and is often substituted for them. Its soft viscous quality is its only medicinal one, and in this particular it excels most of the earths of its kind. It is the cimolite of modern authors, of a greyish white, inclining to red, by exposure to air. It sticks to the tongue, and though difficult to break, is scratched by the nail. It becomes white in the flame of a blow pipe, and does not melt but with the assistance of a flux. Haiiy, vol. iv. 446. The cimolia alba of the ancients seems to have been a sort of loose marie ; probably it was our fuller's earth. In Cornwall the steatites, a magnesian earth, is used as soap, as well as the cimolia alba of the ancients. It is usually marked with a seal, and called terra sigillata alba : the terra samia is only a fatter pipe clay. Ci'molia purpure'scens te'rra. The smectis of Wallerius; terra saponaria Anglica, terra fullonica, and fuller's earth. It hath its name smectis from c~f*.r)x*>, to absterge. It is a kind of marie rather than a compact earth, and of the same qualities as bole. Indeed Walle- rius has given this name to a true marie and to a stea- tite. CI'NA CI'NJE. See Cort. Peruv. CI'NiE, sem. See Santonicum. CI'NARA,(from xivea, to move, quia movet urinam). Some write it cy'nara, and derive it from xvuv, canis, a dog ; because the plant is sharp, like dog's teeth. The artichoke. Also called alcocalum, articocalus, arti- schhcus lavis, costus nigra, carduus sativus non spino- nus, cinara hortensis, scolymus sucivus, carduus domes- ticus capite majore, carduus altilis. The species used in medicine is the cynara scolymus Lin. Sp. PI. 1159. Artichokes are so well known as not to require a description : they are natives of the southern parts of Europe, perennial, and cultivated in our kitchen gar- dens. The bottoms of the heads, and the fleshy parts of the scales, are easily digested, though flatulent, and afford but little nourishment. They are preserved by drying them to a horny consistence, and are then so light, that forty scarcely weigh a pound. The leaves are bitter, and give out their bitterness Avith the juice, on being bruised and pressed. This juice is powerfully diuretic and useful in dropsies; it should be mixed with an equal quantity of white wine, and three or four table spoonfuls taken every night and morning. An infusion of the leaves is likewise diuretic, and may be employed with the same intention. The leaves themselves are astringent, and contain tanin. In France they have been employed instead of galls. In England we only eat the heads, but the Germans and French eat the young stalks after boiling them^ Ci'nara spino'sa, called also carduus esculentusStcl spinosissimus elatior, chardone, cactos. Cynara caramw- culus Lin. Sp. PI. 1159. According to some authors it is a species of carduus. The chardon. As a medicine it is similar to the artichoke. It is a culinary plant, which is blanched like celery, and, like that, eaten raAV with pepper and salt in Italy. Ci'nara sylve'stris, also called scolymus sylvestris, agriocinara, wild artichoke, or cardonet. Carline acaulis Lin. Sp. PI. 1160. They grow in Italy and France, but the flowers are only used. See Dale, Ray. Ci'nara acau'lis gummi'fera. See Carduus pinea. CINCHO'NA. See Cortex Peruvianus. CINCLE'SIS, or CINCLI'SMOS, (from X'Y**>&, to shake). They all mean a morbid nictitation, or an involuntary winking. Vogel uses the term cinclesis. Hippocrates means by the term a small and repeated motion. CINERA'RIUM, (from cinis, ashes). The ash hole of a furnace. CI'NERES RU'SSICI. See Clavellati cineres. CINERI'TIUM, (from cinis, ashes ; because it is ge- nerally made of the ashes of vegetables or bones). See CUPELLA. CINE'RULAM. See Spodium. CINE'TUS. See Diaphragma. CINGULA'RIA, (from cingulum, a girdle ; because it grows in that shape). See Lycopodium. CI'NGULUM, (from cingo, to bind). A girdle or belt. Dr. Cheyne, in his Essay on Regimen of Diet, says, " Cincture, with a broad quilted belt about the loins, to keep the bowels in their natural situations, and the chylous vessels in the best locality in flabby consti- tutions, weak bowels, and atrophies, is of great bene- fit." This belt is chiefly useful for fat persons. Ci'ngulum mercuria'le. A mercurial girdle, called also cingulum sapientia, and cingulum stultitia. It was an invention of Rulandus's ; different directions are given for making it, but the following is one of the neatest: Take three drachms of quicksilver; shake it Avithtwo ounces of lemon juice until the globules disappear; then separate the juice, and mix Avith the extinguished quick- silver half the white of an egg; gum dragon, finely pow- dered, a scruple; and spread the whole on a belt of flannel. Ci'ngulum sa'ncti Joha'nnis. See Artemisia. CINIFICATUM, (from cinis and facio, to turn f* ashes). See Calcinatum. CINNABARI'NUM BA'LSAMUM, (from cinna- baris). Cinnabar balsam. The simple balsam of sul- phur is a proper substitute, and nearly a similar medi- cine. CINNA'BARIS, cinnabar. Also called cinnabar nativum, minium purum, minium Gracorum, (magnes epilepsia, from its supposed usefulness in epilepsies,) alzemafor, ammion, azamar. Vitruvius calls it anthrax. Mineralogie de Haiiy iii. 437. Native cinnabar, a ponderous, red, sulphureous ore of quicksilver. It is found in Spain, Hungary, the East Indies, &c. The finest is brought from the East Indies. It is found sometimes in veins, occasionally in grains, or crystallized. Its crystals are tetraedrous. Sometimes it is brought to us in a large irregular mass ; at others in smaller roundish ones, smooth with- out, and striated Avithin; and of a bright red colour throughout; its streak red and metallic; and its speci- fic gravity from 5.419 to 10.1285. It is insoluble in the nitric, and soluble in the muriatic acid. CIN 440 CIN This ore consists of sulphur and quicksilver; the finer the colour, the more quicksilver it contains : with these constituents there is generally much earthy mat- ter, from which it is easily sublimed. M. Proust, in the Journal de Physique, vol. liii. has shown that the mercury is in the proportion of 85 to 15 of sulphur, in 100 parts. The mercury seems, however, to be in a metallic state, since, on distillipg a mixture of muriat of mercury and sulphur, the product is oxy-muriat of mercury and cinnabar. .Ethiops mineral, according to Berthollet, differs only from cinnabar by its containing sulphurated hydrogen. See Argentum vivum. See Diet, of Chemistry, Lewis's Mat. Med. Neumann's Chem. Works. Cinnabar is a name now confined to the native and factitious sort; but formerly it was applied to dragon's blood, madder root, ceruss calcined to redness, and to some other articles. Artificial cinnabar, hydrargyrus sulphuratus ruber, is prepared by mixing purified quicksilver forty ounces, and pure sulphur eight ounces. The quicksilver mus^ be stirred into the sulphur melted; and if the mixture takes fire, it is to be extinguished by covering the ves- sel. Then let the matter be reduced to poAvder and sublimed. Ph. Lond. 1788. The quicksilver in the cinnabars is rendered inert by the sulphur, and of no efficacy as an internal medicine. The factitious or native cinnabar is supposed never to be active without having lost a portion of its sulphur, though it has been esteemed an useful medicine in dis- eases of the skin, in arthritic, rheumatic, and epileptic cases. Its chief use is for fumigating venereal ulcers; when the quicksilver is resolved into vapour, and blends in part with a volatile vitriolic acid, derived from the sulphur, forming a mercurial salt. This method is use- ful when a rapid effect is to be produced ; but in gene- ral the salivation excited is violent and profuse, so that this remedy has been lately neglected. If adulterated Avith red lead, it may be discovered by putting a little on a hot iron, for the cinnabar is all eva- porated, and the lead remains. This preparation is used by painters under the name of vermilion ; and the colour is improved by lessening the proportion of sulphur; and if a little arsenic be add- ed in the sublimation, though the preparation is injured as a medicine, it is improved as a pigment. An oval earthen jar is the best subliming vessel. The great art of making this cinnabar is first to manage the fire so as continually to keep the matter subliming, yet not so as to force its way through the mouth of the ves- sel, which is covered with an iron plate. Secondly, to put in but little at a time. Ci'nxabaris grjeco'rum. Sec Sanguis draco- nis. Cinnaba'ris anti'monii. See Antimonium. CINNAMO'MUM, (from the Arabic term kina- men). Also called cinnamum, canella, canella Zeylani- ca, cassia cinnamomea, cassiafistula, canella cuurdo, ku- rudu ; cinnamon. The best sort of Avhich the Arabians distinguish by the term karfe, and the ordinary, by dar- sini; the choicest sort by many is called mosyllon ; the wood of the tree xylocinnamomum. It is the bark of a tree of the laurel kind, groAving in the island of Ceylon, freed from the outer green or greyish part, and cut into long slices, which curl up in drying into quills or canes, the form in which it is brought to us. Cinnamon is very thin, light, and of a reddish yellow, or pale rusty iron colour, someAvhat tough in breaking, and of a fibrous texture. It is the bark of the laurus cinnamomum Lin. Sp. PI. 520. The CINNAMON TREE. It is often mixed with the cassia bark; but the cassia hath a close smooth fracture; when chewed, is slimy; and is of a dark broAvn colour: the cinnamon is rougher to the sight and taste, having an astringency and brittleness in chewing, is of a paler brown colour, and breaks in splinters. It is one of the most grateful aromatics, both to the palate and stomach, of a fragrant smell, moderately pungent but not fiery, sweetish to the taste, and some- Avhat astringent, but not in so considerable a degree as to be trusted alone. It proves of service in several kinds of alvine fluxes, and immoderate uterine dis- charges. The fine flavour is said to reside in the thin pellicle which lines the interior surface of the bark; and which abounds with vesicles of essential oil; the rest of the bark, while fresh, being merely astringent, receiving its flavour from the inner pellicle; according- ly the thinnest pieces are most cordial, and the thicker most astringent. Its stimulus and astringency are said to be occasionally inconvenient; but neither quality is in so great a degree as to be dangerous. Infused in boiling water in a close vessel it yields the greatest part of its virtue. The watery decoction, after distillation, retains only the astringency, without the flavour of the cinnamon. The watery extract is similar. Rectified and proof spirits extract its virtues better than water, even without heat; but, in distillation, they carry over very little of the flavour. An extract made with rectified spirit of wine has all the virtue of the spice : cinnamon affords about l-16th of its weight of extract. The cinnamon water of the London college is pre- pared by adding to a pound of cinnamon as much water as is sufficient to prevent burning; after maceration for twenty-four hours, a gallon is distilled off. As the oil of cinnamon is very heavy, in time it falls to the bot- tom ; and the water loses, with its milky appearance, its aromatic and cordial quality: sugar keeps the oil di- vided and suspended. The spirituous cinnamon Avater, noAv called spiritus cinnamomi, spirit of cinnamon, is directed to be pre- pared by adding of cinnamon a pound, of proof spirit a gallon, and as much water as is sufficient to prevent burning. A gallon is distilled. In distilling with proof spirit, that Avhich arises first is almost flavourless; for the water, which arises after, brings the oil with it; and as the oil is dissolved by the spirit, it is limpid. As the oil of cinnamon is very heavy when cinnamon wa- ter is distilled, a Ioav flattish still and a quick equal fire are proper. As very little of the oil rises with the spi- rit, the best method is first to distil the cinnamon with water only, and then to add a proper quantity of recti- fijKspirit of wine. Pine aromatic principle in cinnamon resides in the es- sential oil, which rises, Avhen distilled Avith water, sIoav and with difficulty, rendering the liquor milky. When a large quantity is distilled at once, a small portion ot the oil is found at the bottom of the receiver. To cin 441 cm obtain this oil more easily and plentifully, let the Avater, after it is distilled, stand in a cold place. A pound of good cinnamon affords a drachm, or a drachm and a half of oil; which, if exposed to the air, loses its virtue, Avithout any sensible loss of its weight; so that it is not the oil which is efficacious, but the spirit in the oil. The oil of cassia bark is substituted for the oil of cinna- mon ; but as they are the same in their medicinal vir- tues, no objections can be reasonably made. The oleum canellae albae and the oleum caryophillorum are mixed Avith the oleum cinnamomi. Oil of cinnamon is one of the most immediate and most powerful cordials in languor, hiccoughs, and de- bility of every kind; it is so extremely pungent, that, on being applied to the skin, it produces an eschar; though a drop or two may be given in a draught, mixed up Avith a little sugar or mucilage of gum arabic. Cinnamon, Avhen fresh, affords a larger proportion of oil; but the Dutch extract great part of it. in India, so that the oil may be most advantageously bought of them. In proportion as the oil is separated, the cinna- mon loses its pungency. It is said that the Dutch ob- tain above an ounce of essential oil from every pound. If this oil be genuine, the point of a penknife dipped into it will smoke only Avhen it approaches a candle. Should it soon flame, it contains rectified spirit of wine. The use of the cinnamon tree is not confined to the bark ; for the leaves, root, and fruit, all yield oils of different qualities, and of considerable value. That produced from the leaves is called oil of cloves, and oleum maldbathri; from the bark of the root, an aro- matic essential oil, or what has been called oil of cam- phor, and of great estimation as a medicine, is extracted, Avith a species of camphor which is much purer and Avhiter than the common kind: from the fruit is obtain- ed a white sebaceous matter extremely fragrant, resem- bling the oleum nucis moschatae per express, of a thick consistence, Avhich in Ceylon is made into candles for the sole use of the king. It is white, and is called cera cinnamomi. The tincture of cinnamon is thus prepared: Take of cinnamon an ounce and a half; of proof spirit a pint. Digest without heat for ten days, and strain. It contains all the cordial and restringent qualities of the cinnamon itself: if it is continued for some time daily, it Avarms and strengthens the stomach; but this daily use is often the parent of the most pernicious custom, dram drink- ing. Ha nuge seria ducunt, in mela. Neumann, in his Praelectiones Chemicae, says, that a pound of cinnamon contains near three-fourths of its quantity of an indissoluble earth, tAvo ounces of resin, an ounce and a half of gum, and about two scruples and a half of essential oil. See Neumann's Chem. Works, LeAvis's Mat. Med. and Cullen's Mat. Med. The compound tincture of cinnamon, formerly the tinctura itromatica, is prepared by adding, cinnamon bruised six drachms; lesser cardamom seeds, freed from their husks, three drachms; long pepper and ginger, reduced to poAvder, of each two drachms; to two pints of proof spirit: after digesting-for eight days it is strain- ed. Ph. Lond. 1788. Cinna'momum a'lbum, Cinna'momum Malabaricum. See Canella alba. Cinna'momum crassio're cortice vulg. i. c. M.v- r.ABATHRUM. See Folium. vol. i. Cinna'momum Macella'nicum, vel cortex Mvgel- laxicus. See Cort. avixteranus. Cinna'momum Malab. See Cassia lignea. Cinna'momum spu'rium, i. e. cort. Caryopiiilloi'- des. CI'NNUM, or CI'NNUS. See Cyceox. CINZI'LLA. See Zona. CI'ON, xim, a column. The uvula is so named from its pyramidal shape. (See Uvula, Him as.) Hippo- crates gives this name to a carunculous excrescence in the pudendum muliebre. CIO'NIA. In Dioscorides it is the middle part ol a Avhelk, or purple fish, near the centre of the striae; Avhich, being calcined, is supposed to be more caustic than the other parts. CIO'NIS, (jfrom xim, the uvula). A painful thick- ness of the uvula. CIROE'A, (from Circe, the famous enchantress; on the supposition that it Avas used in her enchanted pre- parations). Enchanter's nightshade. Circea lute- tiana Lin. Sp. PI. 12. Called also dipcea. Its leaves resemble those of the gai-den nightshade: the' floAvers are small and black; the seeds like those of the millet; they are inclosed in a sort of corniculated capsule: the roots are three or four spans long, white, scented, and heating. It groAvs on rocky ground, Avhere it is exposed to the sun. Its virtues, if any, resemble those of the garden nightshade. CIRCOCE'LE, (from xigo-os, varix, and xsx-,;, a tu- mour). A corruption of Cirsocele, q. v. CIRCULA'TIO, (from circulo, to co7npass about, moving as it were in a circle). Circulation. For what is understood by it in chemistry, see Cihculato- rium and Digestio. In anatomy it is the circulation of any fluid through the vessels destined for its conveyance. Strictly speak- ing, circulation is only applied to the blood, because it moves from the heart to return to it again; but the other fluids do not return to the organ from Avhich they were first discharged. The honour of the discovery of the circulation is un- doubtedly due to Dr. Harvey ; but it has been claimed for Servetus, Columbus, and Caesalpinus. Servetus Avas an opponent of Calvin, and persecuted by him. He was a Spanish physician ; but Avas not the author of any known medical Avork. In a theological tract, by way of allusion, he mentions the circulation of the blood through the lungs, rather indeed as an hypo- thesis thaft as an established fact. It is of more import- ance, in another vieAV, to remark, that he considers the object of the circulation through the lungs to be the in- haling a spirit from the air, and the escape of a fuliginous vapour. He Avas unacquainted, however, with the struc- ture of the heart, or the uses of the valves ; and, with Galen, confines the blood to the liver and veins, while he supposes the heart and arteries filled Avith a spirit. Columbus, in 1 569, folloAved him in describing this lesser circulation, and first explained the structure and use of the sigmoid and tricuspid valves; butAvith little consist- ency adopted, also, the fancies of Galen first mentioned. Caesalpinus published about tAvelve years after Co- lumbus, viz. in about 1681; and had not the authority of Aristotle and Galen possessed his imagination so strong- ly as to shut out the most obvious consequences of the best established facts, the honour of the discovery must 3L C 1 li 442 C I l\ haA-e been his own. But his claims to genit^ of the highest rank are undisputed Avithout this additional laurel. Aristotle first misled him by distinguishing two kinds of blood ; one for the increase and the other for the nourishment of the body : the first he supposed to be derived from the liver, and poured into the vena cava, attracted by the heat of the heart. From the right ventricle he traces the blood, Avith Columbus or Serve- tus, to the lungs, Avhere he supposes it to be cooleel only. The blood, now become spirituous and alimentary, in successive periods, according to this system, causes, by the fermentation excited, the succession of pulsations, while the aliment destined for increase is elicited from the veins; yet in sleep this effervescing blood, he ad- mits, is returned by the veins, the valves of which had been described by J. B. Cannanus, and, more accurate- ly, by Fabricius ab Aquapendente. Such Avere the opinions which Harvey found in the schools; and he need only have recollected that simpli- city was the criterion of truth, to suppose that blood, which circulated in the night, might also circulate in the day. This Avas the foundation of our remark in the history of surgery (see Chirurgia), that the facts were already established, and that it required only "pa- tient thinking" to connect them. The claim to this quality distinguished both Harvey, Newton, and Co- lumbus ; nor, if we know any thing of the human mind, does this representation diminish their credit. Peaches had for ages fallen from the tree; the structure of the valves of the heart been for years known; and the In- dies long discovered by an eastern course; Avhen the calm dispassionate examination of these three first of philosophers drew consequences Avhich had escaped all their predecessors. They have received their reAvard; for they have demonstrated how high human intellect can soar: it is for their opponents to show how Ioav it can descend. With regard to the circulation, however, it is thus dearly described. The blood is conveyed from the left ventricle of the heart, by the aorta and its branches, to the minutest and most remote parts of the body; and then passing from the extremities of the smallest arteries into the incipient veins, whether continuous Or not ana- tomists have not decided, circulates through them into their larger branches into the right auricle of the heart, ana in succession to the right ventricle. It is forced with the fresh supplies that it receives from the chyle, passing 'into the subclavian vein, from thence into the pulmon- ary artery; and after circulating through the" lungs, in its passage, is returned by the pulmonary vein into the left auricle, and thence into the left ventricle. The same round recurs until death concludes the progress. When Harvey promulgated this doctrine is uncertain. It has been supposed, that he delivered his new system in the Lumley lectures, 1615. It is, however, singu- lar, that a discovery so important should have passed unnoticed; though little doubt can be entertained that this important fact Avas established in his own mind early in the following year. This appears clearly from his IMS. De Anatomia Universa. In the year 1619 this great discovery Avas promulgated; for, if we are not mistaken, in that year his Exercitatio Anatomica de Cordis, and Sanguinis Motu, appeared at Frankfort; a choice probably dictated by the convenience of circula- tion on the continent. This treatise is a masterpiece of simple, but cogent and decisive argument. After shortly confuting the errors of his predecessors, he de- scribes the motion of the heart as it appears in a living animal; points out the alternate dilatations and contrac- tions of its different auricles and ventricles, and their effect as regulated by the various valves. He then shoAvs, by calculation, that the blood Aoavs faster into the arteries than it can be supplied by aliment imbibed by the veins; and, as the arteries can receive no sup- plies but from the veins, the former must be gradually- more distended, or the latter more emptied, unless the veins and arteries anastomose, which Avas supposed less improbable, as this communication takes place in the lungs. A few simple experiments illustrate this idea, and establish it beyond contradiction. '* The clamour that this publication excited Avas incon- ceivable. It was either not true, or the ancients had already taught the same. Riolan, a more respectable antagonist than the common herd, was alone honoured with an answer: and the venerable antagonist retired Avith some disgrace from the field, accused of cavilling, unmeaning quibbles, rash unfounded assertions, and even unfaithful experiments. The number and names of his other antagonists which lie before us would fill our page, with little advantage or satisfaction to our readers. During the dilatation of the heart, when the blood enters the ventricles the coronary arteries receive that fluid, contrary to all the other arteries of the body, and thus supply the muscular fibres of the heart Avith the blood; for the passage of the blood is freer through the arteries during the heart's inflation than at the con- traction, because those vessels are then less convoluted. That the heart is not the one and sole cause of circula- tion appears, because the arteries all perform their dia- stole at the same instant in healthy people. If the heart's propelling the blood was the sole cause of the circulation, the pulsation of the artery would be an un- dulation, and in different parts it would be perceived at different times, as the impulse at different distances of the artery from the heart would be in succession. That some other power than the velocity of the blood dilates the capillary arteries to give passage to the globules, seems evident also from the experiments of Dr. Hales. He poured water into the aorta and other arteries of dogs; and though its force and velocity Avere equal to that given to the blood by the heart, yet it ne- ver passed by the anastomoses of the arteries and veins, but through the sides of the arteries; and this seems to prove that the arteries are totally stopped by the con- traction of their fibres after the vital power no longer continues to act, and that the force of the heart hath not a poAver equal to what is required to dilate them. To this experiment indeed objections may be made; but strong arguments may be adduced to render the princi- pal position highly probable. It is supported with great force by Dr. Whytt. The whole arterial tube, therefore, contributes to the emotion of the blood; and the heart, instead of moving a Aveight equal to the whole mass in this Avay, impels no more than about two ounces, the quantity supposed to be contained by the ventricle in each diastole. See Antmalis motus, also Haller's Physiology: The laws of the circulation,or the general circumstances that influence its various modifications, must detain uso C f R 443 C I H little longer. Physiologists have anxiously endeavoured to ascertain the quantity of blood throAvn out by each contraction of the heart, as avcII as its velocity. But these circumstances are of little real importance, and we need not examine nor attempt to refute the calcula- tions and errors. It is enough that the left ventricle contains ahout two ounces; and that probably somewhat less is thrown out at each contraction. Whatever the velocity may be, it is gradually diminishing; for the areas of all the branches exceed that of the aorta, and the angles must sometimes impede rectilineal motion. A proportion of the impetus is in this way lost; nor is the resistance of the coats of the arteries, or the friction, to be wholly overlooked ; though the elasticity and the muscular power, as well as the mucous secretion on the internal surfaces, greatly lessen its effects. The velocity of the blood in the arteries Avill be in proportion to the frequency of contraction ; and this in :f. proportion to the return of blood in the veins, which is influenced by a variety of cau'ses, chiefly exercise and agitation of mind. The frequency of the contraction, which arises from irritability, does not increase the ve- locity of the blood, since, in such instances, the left ventricle contracts before it is filled, and this state is not attended Avith a determination to the surface. In a healthy state the arteries are always full, and conse- quently each impulse gives successive momenta to the whole mass: but this succession is so rapid, and the ac- tion of the arterial coats so immediate, that the pulsation, which is the consequence, is apparently synchronous over the Avhole body. As, however, the velocity dimi- nishes from the causes mentioned, this pulsation must be at last imperceptible; and at some distance from the heart, and more particularly in the veins, it is of course lost. The velocity of the blood -will therefore vary in proportion to the poAver of the heart, to the distance from it, to the causes influencing the action of the arte- ries, and to the direction as affected by gravity. The quantity of blood distributed to any part of the system will differ in proportion to the action of the ar- teries of that part; an action increased by resistance of every kind: but the effects of that resistance, at first owing to the action of the arteries of that part, and af- terwards to the general consent of every part of the cir- •*• culating system, is little affected by the state of the circulation in a distant part. The contrary idea has induced the most singular and preposterous practice. It is the parent of the doctrines of derivation and revul- sion, Avhich we shall afterwards notice. Thus, if the head Avas affected, blood Avas drawn from the feet; but it will be at once obvious, that sixteen ounces of blood from a vein, if affecting one thousand six hundred ar- teries, will lessen the quantity of blood in each only 0.01 ; consequently, on the contraction of the left ven- tricle, only one hundredth part less of blood will be sent to the head. But if the sixteen ounces be taken from the temporal arteries, or jugular veins, the head will be depleted in the same proportion, without any diminution. It is to be regretted that this idea con- tinues to prevail among practitioners; and Ave still find blisters and cataplasms applied to the legs to relieve congestions in the head or lungs. The quantity of blood distributed to different parts varies at different periods. In the groAving state, the heart «videntry increases in its bulk in a less proportion than the capacity of the arterial system. As age approaches, the number of the arteries lessens, and the proportion of the heart gains the ascendancy. In this state the venous system is proportionably fuller than the arterial. In young animals the head is largo, and its vessels full. Diseases of the head, from fulness and haemorrhages from the nose, are then common. At a subsequent period the determination is to the lungs, and soon aftenvardsto the genital system in both sexes; at a more advanced period to the haernorrhoidal vessels. When the num- ber of arteries diminishes from age, avc find venous plethora in the head, Avith serous apoplexies and pal- sies; in the lungs, Avith humoral asthmas and catarrhus suffocativus ; in the abdomen, Avith discharges of black bile ; in the extremities, Avith varices. Any general increase of the action of the arteries de- termines the blood rather to the surface than the internal parts ; but, if checked in its determination to the sur- face, or irregularly accelerated or retarded, the viscera chiefly suffer. If, from the continued action of am cause, a fixed determination to any part is established, it becomes a necessary part of the constitution, and can- not Avithout danger be altered. The Avhole of the blood sent from the heart is not returned to that organ by the veins. The exhalations from the arteries into the cellular substance employ a part of it; the various secretions also greatly lessen it. The arterial system, hoAvever, ahvays continues full, in consequence of the contractility of its muscular coat. The venous system has not this advantage, but the motion of the blood is slower in these ; and, as it is kepi up by the pulsation of the arteries, muscular action, Sec. while advantage is taken of every action by the frequent interposition of valves, these vessels must continue full, since, from the Avant of any active force, a portion must be discharged into the heart, before that below can be propelled fonvard. Some other circumstances respecting the circulation can only be understood Avhen the structure of the heart is knoAvn. See Cor. We have remarked, that there is some doubt Avhether arteries terminate by continuous vessels in veins': in the corpora cavernosa penis they do not, and the veins there certainly absorb the effused blood. The course of the circulation also, Avhen minutely examined, is not regu- larly progressive. It sometimes is retrogade for a little way, favoured by an anastomosis, chiefly Avhen the ves- sel Avill not admit the red globules. The veins too do not all pass immediately to the heart; for, as we have remarked, those of the abdomen unite in forming the vena portae dispersed in the liver, apparently for the secretion of bile. The circulation of the blood in the foetus hath some peculiarities different from what is observed in adults. 1st, The blood does not all pass through the lungs; a very small part only takes that course each time that it returns to the heart. 2dly, The blood brought by the two venae cavae into the right auricle of the heart passes chiefly into the right ventricle, but not entirely ; for some portion goes immediately through the foramen ovale into the left auricle, and especially that brought up by the cava inferior. Suppose, then, two-thirds of the blood passes into the right ventricle,- in order to circu- late through the pulmonary artery; yet all the blood that Aoavs into it in the foetus will not circulate through the 31-2 C 1R 444 C Itt lungs, for a considerable part must necessarily pass by the ductus arteriosus, directly to the aorta, before it hath arrived at the lungs; so that probably not above one-third of the blood circulates through the lungs every time it is brought back to the heart. That blood Avhich Avas throAvn out directly from the right to the left auri- cle, goes thence to the left ventricle, and so on to the aorta, without touching at either the right ventricle or pulmonary artery, and consequently not arriving at the lungs. After the child is born, and a little groAvn up, the foramen ovale is closed up in most subjects ; though, in some instances, it is found to continue more or less open during the Avhole life of the person. CIRCULA'TORES, (from circulo, to compass nbout). See Agyrt.e:. CIRCULATO'RIUM, (from the same). A cir- culatory glass. It is a vessel in Avhich the contain- ed liquor, when put over the fire, circulates by ascend- ing and descending in such a manner, that the more volatile parts of the liquor, raised by the fire, not find- ing a passage, may always fall back again. Thus che- mical circulation is only a species of digestion. Re- peated distillation sometimes ansAvers the end of circu- lation. See Digestio. CIRCULA'TUM. According to Boerhaave, the circilatum of Paracelsus Avas a liquor prepared from sea salt. Paracelsus obtained from this salt a perpetual oil, which he called circulatum minus, circulatus sal minor, ens grimum salium, oleum salis, aqua salis. He had also a circulatum majus, Avhich he called 7nateria mer- curii salis, and ignis vivens. See Barchusen in his Pyrosophia-Maets, Collectanea Chimica Leydens, and Blancard's Lexicon Renovatum. CI'RCULI I'GNEI. See Eclampsis. CI'RCULUS, (dim. of circus, a circle). A circle. Besides its proper signification, it is applied to different parts of the body; as, by Hippocrates, to the balls of the cheeks, the orbs of the eyes, or the cavities which sur- round the eye. Circulus is also the name of an iron instrument used by the chemists for cutting off a neck of glass vessels. The circulus is heated, then pressed close to the glass where to be divided; and Avhen the glass is hot, the application of a blast of cold air, or a feAv drops of Avater, separates it. The circulus is some- times called abbreviatorium. It is also reckoned among surgical instruments, figures of which may be seen in Scultetus's Annamen- tarium Chirurgicum, tab. xxii. fig. 6, 7 ; tab. xliii. fig. 5. Ci'rculus quADRu'PLEx. See Circus quadru- plex. Ci'rculus arterio'sus i'ridis. It is composed of two arteries going round the basis of the iris. From the arteries of the external lamina are sent several rami- fications to the circumference of the iris, where they produce a vascular circle, called circulus arteriosus. From this vascular circle pass off many smaller vessels, which form themselves into arches ; and from these arches still finer vessels are sent, which probably se- crete the aqueous humour. CIRCUMCALUA'LIS. See Adnata. CIRCUMCI'SIO, (from circumcido, to cut about). Circumcision. Albucasis describes several methods of performing this operation ; but the best is to stretch the prepuce over the glands, and make a ligature about it, then with a razor cut of all that extends beyond In warm countries this operation seems to be sometimes necessary, and always convenient, in point of cleanli ness ; for the discharge of the glandulae odoriferae lying under the prepuce, corrupts and becomes acrid; cor- rodes and inflames the glands and the prepuce. CIRCU'MFERUS, (from circumfero, to twist about). In botany it means twisting round like the tendrils of a hop round the pole. CIRCUMFLE'XUS PALA'TI, (from circumfiecto, to fold about; so named from its winding position). Called also musculus tuba novus Valsalve,palato-pha- ryngeus,spheno-salpingo-staphylinus,peri-slaphylinus extern us, tensor palati. Of this muscle Valsalva was the discoverer. It rises from the spinous process of the sphenoid bone, behind the foramen ovale, which trans- mits the third branch of the fifth pair of nerves from the Eustachian tube, not far from its osseous part; it then runs down along the pterygoides internus, passes over the hook of the internal plate of the pterygoid process by a round tendon, which soon spreads into a broad membrane. It is inserted into the velum pendulum pa- lati, and the semilunar edge of the os palatij and ex- tends as far as the suture which joins the two bones. Its use is to stretch the velum, to draw it doAvnwards, and to a side towards the hook. It has little effect upon the tube, being chiefly connected to its osseous part. Innes. CIRCUMFORA'NEI, (quia circum flora versari so- leant, because they attended markets). See Agyrtje. CIRCUMGYRA'TIO, (from circumgyro, to turn round). Circumgyration. A turning of the limb round about in its socket. CIRCUMLI'TIO, (from circumlino, to anoint all over,) in general, is any medicine applied by way of unction, or as a liniment; but, in a particular manner, it is appropriated to ophthalmic medicines, Avith which the eye lids are anointed. CIRCUMOSSA'LIS, (from circum, around, and os, a bone). See Adnata and Periosteum. CIRCUMSTA'NTLE, (from cirewnsto, to stand round). Circumstances. In medicine, they arc whatever are not essentially necessarily connected with the principal indicant. Of this kind, in what are com- monly called res naturales, are the condition of the pa- tient and the part affected; the strength, age, sex, cus- tom, and way of life; in the preternaturales, or the times of diseases, paroxysms, number, and symptoms. In the non-naturales are the air and soil. These circum- stances often regulate the conduct of a physician. CIRCUS, QUADRU'PLEX, from the Chaldee term carka, to surround,) also circulus. The four fold circle. It is a kind of bandage ; called also plin- thius laqueus. See Galen de Fasciis. CI'RRHUS, rather CI'RRUS, (from xe?xs, cornu, a horn; because cirri resemble the figure of horns in their spiral girations). It is one of the fulcra of plants, called also clavicula, tendril, capreolus ; the spiral string, by Avhich some plants fix themselves to other bodies. They are of various textures : some of them emit a glue at their termination, by which they stick as well as cling; others have points, by which they stick into trees and walls, serving also for roots. CI'RRI. In Pliny they signify the four lesser claws of the polypus. See also Cer^e. C'IRSIUM ARVE'NSE, (from xip^s, a vein, to CIS 445 CI T swelling of a vein; which this herb Avas supposed to heal). See Carduus hemorrhoidals. CIRSOCE'LE, (from xipo-os, a varix, and kjjAsj, a tu- mour). It is also called varicocele, circocele, ramex va- ricosus, and hernia varicosa. This is an irregular, elastic tumour of the spermatic arteries and veins. Any large tumour in the abdomen, or external force pressing the veins, or a large tumour of the scrotum stretching the vessels or impeding the return of the blood, may occasion the veins of the scro- tum, or the spermatic veins, to be dilated with blood ; in Avhich case, they are also here and there diversified with large and unequal knots, and the testicles hang lower than in their natural state. This disorder, how- ever, generally depends on a relaxed state of the veins themselves. Sometimes young men of a salacious turn, abound- ing with seminal fluids, are subject to this disorder; but when neither pain nor other troublesome symptoms at- tend, no regard need to be paid to the case, except it be to apply to matrimony for the cure. As this disorder is symptomatic, to remove the circumstances on Avhich it depends will be its relief. It sometimes depends on the pressure of an hernial truss upon the spermatic pro- cess ; and then an alteration in the bandage will probably succeed. If tumours of a scirrhous kind are the cause, and they are so situated as to admit of extirpation, they should be removed. However, when the veins have been long distended, so that their coats are become very weak, incisions may be made longitudinally into them, after which, dressing as in a common wound, a cicatrix will prevent the return of the complaint. Before inci- sions are made in the veins, it will be proper to try a suspensory bandage, the cold bath, the application of a , solution of alum, or other astringents. Before opening the knot in these veins, it will be proper to employ evacu- ants, lying in an horizontal posture, by which the course of the returning blood is facilitated; the scrotum and its contents should be supported by a proper bandage, and strengthening embrocations may be applied to the part affected. See Heister's Surgery. Bell's System of Sur- gery, vol. i. p. 493. Pott's Works, 4to. White's Sur- gery, 334. For the distinction between this complaint and bubo- nocele, vide in Verbo. CIRSOI'DES, (from xtptros, varix, and etdos, forma, likeness; so called from its resembling a varix). It is an epithet in Rufus Ephesius for the upper part of the brain. He also applies this name to two of the four se- minal vessels. ;. CI'RSOS. Kipe-®*, (from xepo-oo, to dilate). See CI'SSA. (Greek.) See Pica. CISSA'MPELOS PAREI'RA, (from xic-c-os, ivy, and xpTeXos, the vine). The wild vine; so called be- cause it has leaves like ivy. See Pareira brava. CISSA'RUS. See Cistus. CISSI'NUM, (from xto-o-os, ivy). The name of a plaster mentioned by P. .Egineta. CIST, or XIST. A measure of wine containing about four pints. CISTE'RNA, (from cista, a cist). A cistern. A name of the fourth ventricie of the brain, and of the concourse of the lacteal vessels in the breasts of women who suckle. CI'STHORUS,and CISTUS, *). See Venter. CCE'LI-FLOS, CCELIFO'LIUM,(from celum, hea- venly, fios, or folium, a leaf; so ealled because it was supposed to be a fallen star). In some places it is known by the name of star fall. Purgamentmn stel- larum; commonly nostoch. Tre7nella nostoch Lin. Sp. PI. 1625. It is a species of jelly, sometimes clear, at others greenish, and agitated with a kind of tremulous motion so long as it is fresh. It is found after rain in meadows, and in dry parched grounds, generally betwixt the spring and summer sea- sons. If not gathered before the rising of the sun, it Avill be shrivelled up to a thin membrane of a broAvnish colour. C OF 457 C O F The nostoc is in reality a moss, adhering to the earth by one or more slender roots. The embryo at first ap- pears like a small tubercle ; which is fleshy, soft, and diversified with inconsiderable inequalities, like those on strawberries, of a greenish blue colour, but after- Avards clear. This membrane is gradually unfolded on the earth, and remains while the Aveather is moist. It affords a clear insipid liquor, that turns hydrargyrus muriatus Avhite, and syrupus violarum green. It af- fords a volatile salt well crystallized, ammonia, and a fetid oil. The Germans use it to make the hair groAv. CCELO'MA, (from xoiXufM, hollow). See Bo- thrion. CGZLOSTO'MIA, (from xoiX<&, hollow, and o-ro^x, the mouth). A defect in speaking, when a person's speech is obscured by sounding, as if his voice proceed- ed from a cavern. CCEMENTA'TIO, CCEME'NTUM, (from cado, to beat together). Cement, also camentum. It is a tena- cious matter, by which two bodies are made to adhere. What is used by the chemists is commonly called lute. See Lutum. Cements are also those powders and pastes Avith which any body is surrounded in pots or crucibles, producing, by the help of fire, changes in the substance round which they are spread. The common cement, direct- ed by Schroeder, is the following: take half a pound of finely powdered brick dust, four ounces of common salt, and of nitre and verdigrise, each an ounce. There are many compositions for cementing, which may be seen in chemical authors; one of the chief is what is called the royal cement, because used in puri- fying gold and silver. It is made with four parts of fine brick dust, one part of green vitriol, calcined to redness, and one part of common salt: when mixed, they must be worked into a firm paste with water. See Diet, of Chem. 4to. Neumann's Works. CQZ'NA, (from xotves, co7nmon ; as a meal necessary to all). Supper. Suppers that are heavy should be avoided, because digestion produces a slight fever, which increases the natural evening paroxysm; and, though the robust feel no inconvenience from neglecting this rule, the invalid will suffer greatly by the error. Sup- pers should, therefore, be eaten long before bed time, that they may be nearly digested before the hour of sleep; and then a draught of pure water will usefully dilute Avhat remains in the stomach. Indeed suppers, in many constitutions, are very pernicious; inducing disagreeable dreams, disturbed rest, the incubus or night-mare, particularly in those who have Aveak di- gestions. CGLNO'TES, (from xotvos, common). The physi- cians of the Methodic sect asserted, that all diseases arose from relaxation, stricture, or a mixture of both. The last Avere called cenotes, because diseases have these in common. CCLRU'LEUM MONTA'NUM, (quasi celuleus, from celu7n, the sky, of a sky blue colour.) Mountain blue. It is a blue ore of copper. Cieru'leum fo'ssile. See Armenus lapis. CCERU'LEUS LAPIS. See Vitriolum cgkru- LEUM. CO'FFEA, (from kofuah, mixing together). Called also jasnmium Arabicum, choava, coffee tree or bush. It is the coffea Arabica Lin. Sp. PI. 245 ; natural order VOL. I. rubiacea, called also bon. When fit to drink it is then named caova. The tree is of the jessamine kind, Avith leaves like those of the bay tree : from Arabia Felix it Avas intro- cuced into the West Indies ; but is said to be a native of the higher .Ethiopia, from Avhence it Avas carried to Persia before it was known in Arabia. The fruit is a juicy berry, including two of the seeds, joined by the flat sides, and covered each with a thin shell. The seeds are of a pale colour and an oval shape, convex on one side, flat on the other, with a remarkable furroAv. Coffee was but little knoAvn in Europe before the se- venteenth century. The first coffee house in London was erected in the Tilt Yard, in the year 1652. In Paris it was scarcely known until 1669 : though at Mar- seilles it was used in 1644. Rauwolfius, a German, and Prosper Alpinus, an Italian, were the first Euro- peans Avho wrote on the use of it. The Arabian is called the Leva7it coffee, and is the smallest; the Java, the East Indian coffee ; it is larger and of a whitish livid colour: the American, English ox- Surinam coffee ; the berries are large, and of a greenish colour ; but the best are small, close and somewhat transparent. This last seems to be an indigenous va- riety of this part of America, and it is doubtful whether the plant is not also a native of Arabia. The Arabic word cahoua signifies any kind of liquor, consequently the liquor made Avith coffee. Hence the Turks derive their cahveh ; whence again the European word cafe. In Arabia, persons of rank only use the seminal cap- sules, and the pellicles immediately covering the ber- ries ; these produce a grateful liquor, but for this pur- pose the capsules must be fresh. The French call this cafe a la sultane. The coffee berries have a farinaceous, somewhat unc- tuous, bitterish taste, and little or no smell. They are roasted to destroy the watery part of the mucilage, and, of course, that flatulence that they have in common with all farinaceous substances. Many seeds by roast- ing acquire the flavour for which coffee is admired. Dillenius hath enumerated in the Ephemerides Na- turae Curiosorum the substances Avhich in smell and taste resemble coffee ; and finds that roasted rye, with a few roasted almonds to furnish the necessary propor- tion of oil, comes the nearest to it. Coffee contains a large portion of acid, a gummy, resinous, and astringent extract, a large proportion of oil, and some salts. The oil in roasting becomes empy- reumatic, and gives the desired flavour. From sixteen ounces of roasted coffee, Neumann ob- tained seven ounces, tAvo drachms, and two scruples of Avatery extract; and afterwards five drachms and one scruple of spirituous extract. On reversing the opera- tion, he obtained four ounces and four scruples of spirituous extract, and four ounces of watery : the resi- duum, in both cases, Avas nearly the same; viz. about one half of the Avhole. The roasted seeds ground intopoAvder soon lose their flavour in the air, impart it to water and to spirit by- light coction or digestion, and give over a great part of it with water in distillation. The roasted berries keep very well; and, to recover their brisk flavour, lay them before the fire a feAv minutes, and, Avhen Avarm, they may be ground for use; they are then as agreeable as Avhen first roasted. 3 X COL 458 COL Coffee should he boiled eight or twelve hours before it is drunk; and if the liquor is mixed with an equal quantity of milk it is excellent. It is the most approved method to prepare the coffee by infusion only. An ounce and quarter of coffee is alloAved to a pint of water, which must be added in a boiling state, and continue simmering, closely covered, for tAvo hours. In this time it must be frequently shaken, or agitated Avith a chocolate mill: in the common ves- sel, styled the coffee biggin, it is prepared very com- pletely. The inferiority of the West Indian to the Le- vant coffee, is said to arise from plucking the berries too soon. They are then larger, but have not attained their true flavour. If coffee is drunk Avarm within an hour after dinner, it is of singular use to those who have head achs from a Aveakness in the stomach, contracted by too great atten- tion, or from irregularity. The phlegmatic and corpu- lent are much benefited by its use. In some delicate habits it produces nervous symptoms; but, in general, gives cheerfulness and serenity of mind. It soon carries off the disagreeahle effects of opium; and has been said, by sir John Pringle, to relieve obstinate spasmodic asth- mas. It certainly prevents sleep in many constitutions; and Ave have known it prove a quick, easy, laxative. Prosper Alpinus is immoderate in his praises of coffee; and the Persians say it was revealed by the angel Ga- briel, to relieve Mahomet after his fatigues. It is slight- ly astringent and antiseptic, moderates alimentary fer- mentation, and is powerfully sedative. Drunk too soon after port Avine, it often produces a disagreeable acidity in the stomach ; and indeed an acidity is obvious, at once, to the taste, on mixing coffee and port wine. See LeAvis's Mat. Med.; Neumann's Chem. Works ; Per- ceval's Ess. Med. and Exp. vol. ii.; Lettsom's edit, of Fothergill's Works, vol. ii. COHOBATIO, COHO'BIUM, COHOPH. Co- hobation. It is the returning a liquor, distilled from any substance, back again upon the same substance, and redistilling it Avith or without an addition of fresh ingredients. The alembic, called a pelican,'was invent- ed for the more easily effecting this operation; modern chemists neglect it. Paracelsus uses the Avord cohob Avhen a disease does not easily yield to the remedies applied. Medicines, therefore, are to be given secun- dum cohob; that is, repeated at intervals. CO'HOL, (from cohol, antimony). See Alcohol. Castellus says, that it is used in Avicenna to express t ollyria for the eyes, in fine powder. COI'LIMA, (from xotXtx, the bowels). A sudden swelling of the belly from Avind. CO'IRA. See Terra Japonica. COI'TIO, (from co'io, to cohabit). The act of ve- nerv. See Venus. COLATO'RIA LACTE'A. See Fluor albus. COLATO'RIUM, (from colo, to strain). A strain- er of any kind. COLATU'RA, (from the same). Any strained or filtered liquor. See Depuratio. COLCAQUAHUI'TL. An American plant, com- mended in palsies and uterine disorders. Raii Hist. COLCESTRE'NSIS A'QUA. Colchester wa- ter. This mineral water is of the bitter purging kind, similar to that at Epsom, but not so strong. See Aqu^E MINERALES. CO'LCHICUM, (from Colchis, a city in Asia, where this plant abounds). Called also coum, colchicum com- mune ; Anglicum, purpureum, et album. Colchicum autu7nnale Lin. Sp. PI. 485. Nat. Ord. liliacea of Murray. Meadoav saffron. It grows in meadows that are moist and rich, and sometimes in marshy grounds. It hath two fleshy bulb- ous roots ; the one producing, from its lower part, a smaller bulb. From the last arises, in autumn, along a furrow, in the side of the old root, a slender, hollow, transparent pedicle ; widening at the top into a floAver, like that of a crocus; divided into six segments, of a pur- plish or whitish colour; withering in two or three days. From the same root spring, early in the following sea- son, three or four upright leaves, like those of the lily ; in the middle of which appear, on short pedicles, com- monly three triangular pods, about the size of small walnuts, divided into three cells, full of roundish dark coloured seeds. The outer root is barren and shrivelled, the inner one produces the plant. When the root is young and fresh, its taste is very acrid; but, when old, it is mealy and faint. For medi- cal purposes it is best when full of sap. Two drachms of this root killed a large dog; after occasioning violent pain for about thirteen hours, it operated by vomit, stool, and urine. One grain of it SAvallowed by a healthy man produced heat in the stomach, and, soon after, flushing heats in different parts of the body, with fre- quent shiverings, followed by colic pains: itching in the loins and urinary passages was soon aftenvards per- ceived, and then came on a continual inclination to make Avater, a tenesmus, pain in the head, a rapid pulse, thirst, and other disagreeable symptoms. Notwithstanding these effects, when dissolved in vinegar, or made into an oxymel, it becomes a safe, but powerful medicine. The roots should be fresh and full of sap when they are used. In slicing them, they emit acrid particles, which affect the head, irritate the nostrils, throat, and breast; the fingers which hold them, when cutting, are benumbed for a time. Their acrimony is wholly taken up by vinegar. When this root is imprudently SAvallowed, a pint of water, with an ounce of vinegar, or lemon juice, and half an ounce of the syrup of poppy heads, form a sa- lutary mixture, which should be drunk frequently. Ace'tum co'lchici. Take of the fresh roots of meadow saffron, sliced, an ounce; white wine vinegar, a pint. Mix and digest in a glass vessel, over a gentle fire, during forty-eight hours ; then strain the liquor. • This vinegar is made into an oxymel, by adding to each pint two pounds of clarified honey, mixing them by boiling. This is the oxymel colchici of the London Dispensatory. As it is of consequence that the bulbs be in perfec- tion, they should be taken up in autumn. This oxymel is agreeably acid, gently pungent, and moderately astringent, clearing the tongue effectually from mucus. In an increased dose it is an emetic, and sometimes purgative ; but its most general effect is diuretic, and as such it is very constant, and remark- ably powerful. The dose should be small at the first; half a tea- spoonful may be given tAvo or three times a day, in- creasing the dose as the stomach will admit. In drop- sies and tertian agues its success has been great; as an COL 4*9 COL • 1 470 COM Bacher's tonic pill is useful, it is from a combination of this kind. The necessity of the union is sufficiently perceived, by joining aromatics Avith the foxglove. Why not rather the oils of juniper or turpentine? Errhines are also of two kinds, the stimulant and evacuant: these are usually combined. We have but one internal sialogogue : but the Hindoo unites the stimulant with the sedative in the preparation of his betel. In the exhibition of emmenagogues we occasionally combine with advantage, the more general stimulants and tonics with the topical stimulants of aloetic purga- tives ; sometimes the latter with relaxants : and, under lithontriptics, we have mentioned the union of the bit- ters, designed to counteract the calculous diathesis, with medicines that act on the calculus itself. We have even expressed our doubts, whether refinement has not too far simplified the medicine of Mrs. Joanna Stephens. Medicines of a more general action do not so fre- quently require combination. We allude to stimulants and sedatives. Astringents and tonics, however, de- mand a more exact attention, properly to appropriate the medicine to the disease, as each is seldom without an admixture of the other, and a stimulant principle is sometimes combined. But this part of the subject requires a minuteness of detail, which can only be ad- vantageously pursued when connected with the consi- deration of separate diseases. In many of these classes, Dr. Fordyce seems to think, that the union of two or more substances of the same class can be more easily borne, and be more effectual, than the same bulk of a single medicine; as water, when saturated with one salt, will dissolve a portion of a dif- ferent kind. It is not improbable; and while, as in the classes just alluded to, we are measuring the degree in Avhich Ave shall add the Avarmer to the purer astringent, we may perhaps increase the activity of the medicine. On this subject we cannot properly decide; for we, too, are of " St. Thomas, and hard of belief." Another method in Avhich combination will be use- ful is, where two indications can be at once answered by the union of different medicines. The instance given by Dr. lordyce is the union of tormentil with ipeca- cuanha in old diarrhoeas. The one strengthens the boAvels, Avhile the other determines to the skin: an ef- fect highly advantageous in the cure. This consequence of combination is peculiarly important, and we would strongly recommend it to the practitioner's attention: but it Avill be obvious, that it rather relates to the ma- nagement of particular diseases; and to pursue the sub- ject would require a volume. See Transactions for improving Medical and Chirurgical Knowledge, vol. ii. p. 314. COMBU'STIO, and COMBUSTURA, (from con and uro, to burn). See Calcinatio. COMEDO'NES, (from co7nedo, a glutton). A sort of Avornis, which eat into the skin and devour the flesh. See Bovina affectio, and Crinones. COME'TES, (from xu^, a bush of hair; so named from its appearance). See Amygdaloides. COME'TZ. Half a drop. COMI'SDI. See Gummi arabicum. COMI'STE, (from *•/*<£*, to provide). Food, nou- rishment. COMITIA'LIS MORBIS,(from co77iitia, an assem- bly). See Epilepsia. COMITISSiE PULVIS, (from comitissa, a count- ess). See Cort. Peruv. CoMinsSiE palm^e, or Palmeri pulv. See Magnesia ALBA. COMMAGE'NUM, (from Commagene, a place in Syria, from whence it Avas brought). The name of an ointment mentioned by Galen. It is also called Syria- cum unguentum. COMMANDUCA'TIO,(from commanduco, to eat). See Masticatio. COMMA'NSUM, (from commando, to eat). See Apophlegmatica. COMMEL. PLANT. USU. An abbreviation of Caspari Commelinis Horti Medici Amstaeledamensi, Plantarum Usualium Catalogus. Amstel. 1724. Commel. pr.elud. An abbreviation of Caspari Com- melini Praeludia Botanicae, Ludg. Batav. 1715. Commel. flor. mal. An abbreviation of C. Com- melini Flora Malabarica, sive Horti Malabarici Cata- logus. Commel. Indig. An abbreviation of Casp. Comnie- lini Catalogus Plantarum Indigenarum Hollandiae. COMMENDATO'RIUM (Bals.) (from commen- dator, the commandei). The balsam of the commander of Berne, Balsamum Traumaticum, noAv tinctura be- zoe's composita. See Benzoinum. COMMINU'TIO, (from comminuo, to break in pieces). Comminution. Contritio. It is the reduc- tion of any solid body into finer particles, and is of two kinds, viz. contusion, or pulverisation, and leviga- tion, or trituration; which differ, however, only in degree. Subsequent to pulverisation, where extremely fine powders are required, two secondary processes are ne- cessary, viz. searching and elutriation: the first is the passing of any pounded matter by agitation through the interstices of cloth of different fineness, stretched across a cylinder, covered with a similar one. The latter is by diffusing the powdered substance in a proper quantity of Avater; then decanting the liquor with the lightest part of the poAvder, as directed in the preparation of crude antimony. In powdering any substance, care should be taken to accommodate the substance to the instruments: such medicines as will dissolve metal should be prepared in stone or glass mortars; very hard bodies will abrade soft marbles: to prevent then the mixture of the instruments made use of with the medicine that is prepared by them, such mortars, stones for levigating on, must be chosen, as cannot be affected by the uses they are employed in. Light dry substances, resins, roots of a tenacious tex- ture, are more easily pulverised if the mortar is pre- viously rubbed with oil; camphor and cortex require a little water: tough substances may be grated or rasped: hard minerals, as flint, calamine, or stone, should pre- viously undergo an extinction ; that is, should be made red hot, and then quenched in water; the alkaline and calcareous stones should be converted into lime by this process. Some metals, if heated to a proper degree, are ren- dered brittle, and then by agitation are easily powder- ed: of this kind is tin. This comminution of metals is called granulation. CON 471 CON Simple as this pharmaceutic operation is, its import- ance is considerable in medicine; resinous purgatives, when Avell triturated, are more easily soluble in the ani- mal fluids, and operate more briskly Avith less irritation: antimony, finely powdered, discovers but little efficacy; but exquisitely levigated, is said to be a powerful altera- tive. Mercurials, and many other medicines, OAve their virtue in part to comminution. Roots, and such other articles as consist of different parts, viz. a resinous, ligneous, Sec. should be complete- ly powdered, and then the whole powdered substance should be Avell mixed together; for, without this pre- caution, one part which yields more easily to the pestle than another, as more friable, will be too active, and another too inert. In levigating, some fluid must generally be added. Earthy and other hard bodies, that are not soluble in water, must first be finely powdered in a mortar, then levigated with water on a hard marble stone, and after- ward dried on a chalk stone. Bezoar should be levi- gated with spirit of Avine. COMMISSU'RA, (from committo, to join together). See Sutura, and Articulatio. This term is also ap- plied to the apparently fibrous structure Avhich unites different portions of the base of the brain. COMMISSU'RES, (from the same). See Labia PUDENDI. COMMO'SIS, (from xow, gluten). The first stra- tum of gummy matter with which bees line their hives. It also signifies that art which is employed in conceal- ing natural imperfections with respect to beauty; from Koppou, ornatum adhibeo. This is distinguished from the cosmetic art, which consists in preserving the beau- ty that is natural. COMMUNICA'NTES FE'BRES, (from com7nuni- co, to participate). According to Bellini, they are two fe- vers which infest a person at one and the same time, the paroxysm of one beginning as soon as the other ceases. COMMU'NIS SAL. See Marinum sal. COMO'SE. See Coma. COMPA'CTUS, (from compingo, to put together). In botany it means being of a firm and close texture. COMPA'SSIO, (from compatior, to suffer with). Compassion. In nosology it is the suffering of one part on account of an affection of some other part: more commonly called suffering by consent, or sympa- thy. See Sympathia. COMPE'BA, and COMI'PER. See Cubeb^e. COyiPLE'XUS,(fromcomplecto,to comprise). Call- ed also trigeminus. This muscle runs obliquely, rising from the transverse processes of the six inferior cer- vical vertebrae: and sixth, seventh, or eighth superior dorsal verterbrae : it then directs its course upwards, and is inserted into the cavity, below the transverse line of the occiput, and bends the head back. It sometimes re- ceives a few slips from the spinal processes of some of the vertebrae of the dorsum. The complexus being re- moved, we see the two recti and the two obliqui. Comple'xus mi'nor, called also 7nastoidaus lateralis, trachelo-mastoideus, et capitis, par tertium Fallopii. When the splenius muscle is removed, we see the com- plexus and the^complexus minor; the complexus is near- er the spine, and the complexus minor is under the up- per edge of the splenius; it is various in different bodies. Albinus describes its origin twelve different ways: it rises from the transverse processes of the three upper- most vertebrae of the back, and from the five lowermost of the neck, where it is connected to the transversalis cervicis, by as many thin tendons, Avhich unite into a belly, and run up under the splenius. It is inserted into the middle of the posterior side of the mastoid pro- cess by a thin tendon. Its use is to assist the complexus, but it pulls the head more to one side. Innes. COMPOSI'TUS, (from compono, to compose). In botany it means compound, aggregate, in opposition to single. In pharmacy a more complicated preparation of a common medicine. COMPREHE'NSIO, (from comprehendo, to under- stand). See Catalepsis. COMPRESSIO, (from compremo, to press upon). See CAebri compressio. COMPRESSOR NA'RIS. See Nasalis. COMPU'NCTIO, (from compungo, to prick). See Paracentesis. CONA'RIUM, (from xuvos, a cone). The pineal gland ; so called from its shape. See Cerebrum. CONCAUSA, (from con, with, and causa, a cause). A cause which co-operates with another in the produc- tion of a disease. CONCENTRA'TIO, (from con, and centrum, the centre). Concentration. To concentrate a body is .to approximate its principal parts by removing those which keep them asunder, and which are not proper to the body concentrated. This word is generally applied to the dephlegmation of acids, and particularly of" the vitriolic by distillation, of vinegar by congelation, and of salts by evaporation. CONCE'PTIO, (from concipio, to conceive). Con- ception may be perhaps defined the first animation of the ovum, at the moment when it escapes from the ovarium, passing through the Fallopian tube to the uterus. The definition, which is undoubtedly connected Avith a the- ory, will be further illustrated under the article Gene- ration, q. v.; but it is sufficiently supported by the weight of evidence. It is only necessary to observe in this place, that the ovum is very probably a part of the mother's system ; that it has not life while in the ova- rium, and that in every part of the progress pointed out, a living full grown foetus has been found. But, however secretly conception is effected, its symptoms are soon conspicuous. These consist in a preternatural irritability of the whole system, particular- ly of the stomach. Vomiting frequently occurs, after a few Aveeks, in the morning, and often incessant through the day. For some months nothing is seemingly retain- ed in the stomach, and yet the child groAvs, though the mother is often greatly reduced. The whole nervous sys- tem is equally disturbed, and fancies the most strange and incoherent often agitate the mind. See Pregnancy. See Malpighius, De Graaf, Harvey, and Hamilton*s Outlines. CONCETTUS, (from the same). The very first rudiments of the foetus in the uterus after conception. CO'NCHA, (from ■srxpx to xoi0£,fy from its gaping). A shell. Some confine this word to the shell, Avhile others intend by it the animal with its shell. Sea shell fish, Avhen boiled, are wholesome food, though supposed to be alkalescent; their shells are C O N 472 CON absorbent; if calcined, they become a quick lime, pos- sessing all the properties of pure calcareous earth. Co'ncha anati'fera, (from anas, a duck). Shell-fish, ridiculously supposed to produce a species of duck. Co'ncha auri'cul/e. See Auricula. Co'ncha cytheria'ca, Co'ncha erythr-s'a. See Concha veneris. Co'ncha Margariti'fera. This word belongs to every shell fish in Avhich pearls are found ; but because the best pearls are found in the East Indies, it is con- fined for the most part to the concha Indica magna, whose shells are moderately hollow, thick, and external- ly of a yellowish colour, rough, uneven, and not striat- ed; internally they are smooth, and shine like pearls. It is a species of oyster, principally found in the Persian sea, and is eaten raAV or roasted. The shell of tfcis fish is the 7nater perlarum. It is also called cochlea 7nOtga- ritifera. See Mater perlarum. Co'ncha stri'ata. The cockle. This is a shell fish employed as a nutriment, but being of a firmer sub- stance than the oyster, is not so easily digested: in other respects it possesses nearly the same properties. See Ostrea and Aliment. Co'ncha vene'ris, or erythr^'a. Venus's shell, is an univalve wreathed shell, having a small longitudi- nal and denticulated chink or aperture in it. It is also called concha porcellana, from its aperture resembling the mouth of a hog; and concha cythe7-iaca, from Venus, or its being found in the island Cythera. As a medicine, for this shell the cockle or any other shell may be substituted; but it is noAv never de- manded. Co'ncha. A liquid measure among the Athenians, which contained half an ounce; from three to five spoon- fuls; in fact, nearly six drachms. Galen says, that the concha mag7ia was the same as the acetabulu7n, which of liquid contained an ounce and a half, and in weight fif- teen drachms; and that the concha minor was half an ounce of liquid, and five drachms of Aveight. It is a term applied also to some of the smaller and shalloAV cavities of the body. CON'CHvE NA'RIUM INFERIO'RES; convoluta inferiora, la7nine spongiosa inferiores. The inferior spongy lamina of the nose. They are situated in the nasal fossae, one on each side ; suspended like the eth- moidal concha, without resting on any thing. The in- ferior edges are the most considerable of the three ; they are rough, thick, a little rounded, and turned to- Avard the os maxillare. By their anterior superior edge, they are joined to the anterior transverse eminences of the os maxillare; their posterior superior edge is the longest, and is joined backwards to the small transverse eminence of the middle portion of the os palati. See Winslow's Anatomy, and Monro on the Bones. Co'ncHjE nauium superio'res ; convoluta superiora ossa, and lamina spongiosa interiores. So WinsloAv calls the inferior part of each lateral portion of the os ethmoides. CONCHARUM ANTIFEBRI'LE. Muscle shells are macerated in vinegar for twenty-four hours, after Aviping off the external mucus. They must then be dried and reduced to a powder; during Avhich operation a spoonful of carduus Avater, to prevent the light parts from flying off, is added. A drachm is the proper dose as a febrifuge and diaphoretic. Bate's Pharmacopoeia. CONCHIFO'LIA, (from concha, a shell, and folium, a leaf; from its bearing leaves bent in the form of a shell). See Manga. CON'CHIS, (from xoyxv, a shell). Among the Romans it is an entire bean Avrapped up in its perfect capsule. CONCHY'LIA FOSSI'LIA, (from the same). Fos- sile shells. They are ridiculously supposed to be lithontriptic, because other shells when calcined are of that nature. CONCHYROI'DES. See Coracoides processus. CONCIDE'NTIA, (from concido, to decay). A de- crease of bulk in the Avhole or any part of the body, or the subsiding of a tumour. CONCOAGULA'TA, (from con and coagulo, to co- agulate together). The confused concretion, or crys- tallization of different salts, first dissolved in the same fluid. CONCO'CTIO, (from conroyMo, to digest). Concoc- tion. It is generally understood to be such a change upon the morbid matter, by the power of nature, gene- rally with assistance of art, as renders it fit for separa- tion from the healthy parts of our fluids, and to be throAvn out of our bodies. But this doctrine, at least in fevers, is certainly false. That morbid matter, when it .exists, passes off from the blood in its pristine state, appears from the matter of the small pox and measles, both which communicate the same disease at every period after the eruption. It is most probable also, that, in every infectious fever, the morbid matter, after assimilating some of the fluids of the patient affected, passes of in the same state that it was received. Acri- mony in the blood is in no case rendered mild by any process in our constitutions : on the contrary, it is al- ways expelled unaltered by some of the emunctories. Pus is never formed of a kindly nature whilst the heat of the body much exceeds the degree that is proper to health. The theory of concoction, however, which has pre- vailed since the days of Hippocrates, has been of the most fatal consequence to the science of medicine, and to patients affected with fevers. It precluded all observa- tion of the effects of medicines in the early stages of such fevers, and left the patient to the ravages of their cause. When the idea was added, that heat Avas the instrument by which the change was effected, the miseries of the sufferers Avere greatly augmented. The curtains were drawn; the windows shut; the fires large and in- cessant; and the medicines of the most stimulating kind. It was truly said, that those who recovered es- caped hx irvgos, through the fire. Sydenham supposed that the concoction of the febrile matter meant no mo rethan a preparation and separa- tion of the morbific from the sound particles. See Kirkland on Fevers, p. 14, 27. CONCREMA'TIO,(from con and cremo, to burn to- gether). See CALCINATIOi CONCRE'TIO, (from concresco, to grow together). In chemistry it is the condensation of any fluid sub- stance into a more solid mass, importing the same as coagulation. In surgery it is the growing together of any parts Avhich are separate in a natural state. CON 473 > CON CONCU'RSUS, (from concurro, to 77ieet together). See Syndrome. CONCU'SSIO, (from concutio, to shake together). A concussion. A jolt or shock in consequence of blows or falls. Concussion of the brain. An affection of the brain, produced by a violent shock, without a wound or frac- ture, though it must have been often the subject of observation, has been but lately distinguished Avith accuracy. It has been confounded with the effects of depression and extravasation; with inflammation and abscess of that organ. The two latter are often its consequences; but should be clearly distinguished in the origin. To take the simplest idea of the disease, we will suppose a cannon ball to pass near the head. The person falls insensible: if it passes near the spine, death, or a paralysis of the loAver limbs, is often the consequence. From this there can be no organic in- jury; none can be traced by dissection: and though the momentum of the air may account for the fall, it will not explain the subsequent disease. This, hoAvever, will be a future consideration. In concussion, the greater number of symptoms Avhich distinguish compression are present. The great dis- tinction is, that the pulse is soft, often Aveak, and sinks on bleeding. A discharge of blood from the nose or ears, and the apoplectic stertor, are Avanting. After a short period has elapsed, the insensibility in concussion is not so great: the patient will complain on the head being moved. The muscles retain their natural tone, and the pupils are often contracted; they are, indeed, sometimes dilated; the insensibility is then extreme, and concussion and compression often so much resem- ble each other, that they cannot, perhaps, ahvays be distinguished. What adds to the difficulty is, that after the insensibility from the simple concussion begins to wear off, inflammation often comes on; not active in- flammation, with violent pain and delirium, but the milder kind, from a dilatation of the vessels, exciting, in consequence, a slight increased action. This, in many cases, unsuspectedly runs its course, till symp- toms of compression come on; and, after death, an abscess is found generally at the base of the brain, though, occasionally, in other parts of that organ. The best foundation of the distinction in these very difficult emergencies is the effects of remedies. In every accident of this kind, blood should be taken. If there is no wound, if there is no evidence of an actual bloAv, it should be taken sparingly. Should the pulse sink, the insensibility continue, we must content our- selves with injecting a clyster, and consider it to be a concussion. Should, however, any blow be discerni- ble; should the patient, on pressing the cranium on every part, show more sensibility when pressed on one rather than any other part; should the pulse not sink on a moderate bleeding; Ave have reason to think the accident has produced a fracture or an extravasation. Concussion is a disease similar to the effect of inso- lation, an affection of the nervous aura, equally pro- duced by noxious vapours, by the simoon of the desert, particularly by lightning or electricity, which probably produce their effects only by the momentum communi- cated to the air. Why this concussion of the air should affect the nervous aura it is impossible to say, until its nature is better known. Shocks, however, of every VOL. i. kind produce, in different parts of the body, similar ef- fects. Hoav often will a fall in old persons occasion infarctions or abscesses in the liver, independent of any topical bruise, or obvious inflammation! By such con- cussions the vessels are weakened, and admit of con- gestion : the load is greater than the debilitated poAvers a can overcome, and suppuration is the consequence. In cases of concussion, our conduct is by no means cleared from difficulties. When the pulse sinks from bleeding, and Avhen we are satisfied, from the other symptoms, that no depression or extravasation has taken place, the warmest cordials have been ordered. Yet, as we have a second stage to dread, they should be em- ployed with caution. Evacuations by clyster, topical discharges from the head, not, with the hasty rashness of some modern practitioners, at once, but in a gradual manner to keep up a constant effect, and prevent, too great a stimulus in the early period, are necessary. Wc may, for instance, apply immediately leeches; but ; ct more than four. At this time, a blister at the n..pe of the neck may be operating. After its discharge has begun, two may be applied behind the ears; and, after a similar interval, another to the vertex. During this period, the bowels should be kept moderately open; wine and nourishment supplied in sufficient quantities to support the strength, and preserve a vital warmth, • Avithout heating. The extremities should be kept warm by friction, and hot bricks, if cold. Mr. Bromfield was led, seemingly by a happy acci- dent, to give the Dover's poAvder; for which he after- wards substituted an antimonial with opium. When Ave consider the extent of the vessels over the whole surface of the body, and recal to our recollection the advantages we derive from an evacuation from the skin in every topical congestion, Ave shall at once see the foundation of this practice, which, in his and other hands, has been found very successful. In reality, Ave consider it as one of the greatest improvements in mo- dern practice; and, from the vieAvs we have given, the foundation of its use is particularly explained. Time, hoAvever, can only perfect the cure. The functions of the brain, if not hurried out of their regular train, ex- erted with too much energy, or too early, gradually re- cover, and the patient, at last, regains his former health: the time, however, is usually long. If the patient has been neglected, or the plan not fully answered its intended purpose, though he appears to recover, yet, at an uncertain interval, shiverings, a low delirium, Avith marks of compression, come on. An abscess has then taken place, and death is inevitable. Mr. Pott, in his description of concussion, has not distinguished sufficiently between the effects of the shock and extravasation; and Mr. Dease, though he approaches nearer to an accurate view of the subject, still confounds the two diseases. From Mr. Schmucker's view of the cause of the dis- order, is suggested the idea of astringent applications; and he informs us, that he employed them with the greatest advantage. The following he seems to pre- fer: R. Aq. pur. fts x. acet. acerrim. tfe i- saI mtri ?•lv- sal. ammon. crud. 5 ij. m. With this embrocation he orders the part affected to be frequently well bathed; at the same time that blood letting is prescribed, together with the internal use of nitre, stimulating injections, and laxatives. In all the slighter affections of the head, the ' 3 P CON 474 CON greatest success, he says, has been observed from such a course; and, even in those Avhich have required the trepan, Mr. Schmucker thinks he has often seen it em- ployed with advantage. In concussions of the brain, even without any external wound, cold epithems and fomentations, he says, are very serviceable, especially if conjoined with stimulating clysters, and the applica- tion of leeches to the temples. Mr. Schmucker further observes, in the same work, that violent concussions of the brain are often produced merely from the passage of cannon balls near to the head, without any external affection being observable. In such cases, and in all similar concussions, emetics, he says, are commonly at- tended with the best effects; venesection, however, must always be premised. See Berengarius de Commotione Cerebri; Mons. Bertrandi's Dissertation on the Concussion of the Brain, in the 3d vol. of the Memoirs of the Royal Academy of Surgery; Wiseman's Surgery, book v. ch. ix. obs. x. Gooch's Cases and Remarks, ed. 2. and Bromfield's Chirurgical Obs. and Cases, vol. i. ch. i. Dease's Obs. on Wounds of the Head; Pott's Works; Bell's Surgery, vol. iii. page 132. Abernethy's Surgical Essays. CONDENSA'TIO, (from condenso, to make thick). Condensation. It implies a contraction of the cu- taneous pores by means of cooling, drying, or astrin- gent medicines. It is also an inspissation of any fluid; condensantia medicamenta are such as authors have fancied possess a power of inspissating the fluids. CO'NDER. See Olibanum. CONDIME'NTUM, (from condio, to preserve). Artyma, conditura. A condiment or preserve. It signifies whatever procures sweetness and a grateful taste to any substance. But, in a more restrained sense, that is called condimentum which is used in preparing aliments, whether with an intention of rendering them palatable, or assisting their digestion. Condiments make so considerable a part of modern luxuries, that a more particular consideration of the poignant substances employed to give a relish, Avhich health and hunger have denied, becomes necessary. We mean not to say that every condiment is designed to give an artificial appetite. Spices in the warm climates are essential to health; and salt in every climate seems to be the same. But we must be more particular. The condiments employed are those used to preserve meat from putrefaction, and those added occasionally in the process of cooking, or at table. Of the former kind, some merely preserve animal food without add- ing to the poignancy of the taste, as ice, vinegar, or a feAv pepper corns. Others give a poignancy, and alter the quality of the food, as salt, sugar, nitre, and smoke; vinegar and spices more intimately mixed, or in a larger proportion. Of the first we need not speak particularly, but only to suggest the necessity of gra- dually thaAving meat preserved by ice, as its texture is otherwise destroyed. Salt condenses the muscular fibres, and renders them harder of digestion; but a large proportion of sugar lessens the inconvenience, and nitre is said to have a similar effect. Nitre, hoAvever, in the quantity employed, is by no means a powerful antisep- tic; and, as a condiment, it seems of little importance. It chiefly imparts a more uniform and pleasing red co- lour thap salt. The poignancy of the salt, however, ren- ders many substances much more digestible, particularly the fatter part of the hog, the bacon. This, if cut thin, is easily, when broiled, borne by the tenderest stomach, and the addition of vinegar assists its digestion. Sugar, we have said, does not harden the animal fibres, and it preserves meat very successfully. It is usually mixed with salt, though in too small a proportion. The weight of each should be equal, or of the sugar superior; and the kind used should be the coarsest brown. Smoke is employed sometimes alone to preserve fish and animal food ; sometimes, as in the herring, bacon, and some forms of Indian cookery, to give a peculiar flavour. If not carried so far as to dry and harden the meat, it seems to render it by no means unwholesome, or difficult of digestion. If the red herring is peculiarly indigestible, it is owing to the rancidity Avhich its oil acquires in the preparation. Vinegar is seldom employed to preserve animal food. Brawn owes little to it; for, composed of gelatinous matter not easily putrescible, it is preserved by prevent- ing the access of air, in consequence of its being tightly rolled. To vinegar and salt we owe the preservation of many different kinds of fish; but for a long continu- ance of their perfect state, spices must be added. In the sauer kraut, the acetous acid, which contributes to the preservation of the cabbage, is formed by its spon- taneous fermentation. Potted meats owe their pre- servation to spice, and to the air being excluded. In all these instances, hard salted meat excepted, we do not find that the food is rendered less digestible. The Avarmth of the condiment may prevent this effect; but we must at the same time reflect, that these highly seasoned dishes are eaten only in small quantities. The condiments added in the cookery, or at table, are, salt, vinegar, pickles, spices, Avine, ardent spirit, soy, ketchup, mushrooms, oil, sugar, and various indi- genous roots and vegetables, with a slight preparation, or in their natural state, as Avell as some animal sub- stances, particularly fish. Of the ancient condiments we cannot speak with precision. The asafoetida supplied the flavour of garlic; the garum Avas not very distant from the anchovy; and many of their native vegetables are supplied at our tables, by the more pleasant aroma- tics of the east. What seems disgusting in ancient cookery, was perhaps not really so; as partly from custom, more certainly from the proportion employed, the effect might be pleasing. We know that even asa- foetida, rubbed only on a warm plate, gives a more pleasing flavour than garlic; and that a judicious mix- ture of different spices is not only more agreeable, but often more wholesome than a large proportion of one only. Who would think of adding a red herring to soup? yet it is often done with success; and, in a small proportion, gives the flavour of ham. We should have apologised for entering so largely on the subject of cookery, but that a most respectable " brother of our order" has indulged his taste in publishing a collection of receipts, in a work entitled Culina Famulatrix. We shall, however, chiefly enlarge on condiments, as salu- tary or othenvise, and shall notice each in its order. Salt, we have already remarked, is almost the uni- versal condiment of animated nature; and it is by no means improbable that the extinction of the vast ani- mal, the mammoth of America, Avas, in a great degree, occasioned by their collection in search of their prey CON 475 CON near the salt lakes of the Alleghany mountains, at the time of some general convulsion; such at least is pro- bable from the vast collection of their bones in that spot. Salt, in this instance, acts as a stimulant; for its excess is as destructive as its moderate use is salutary. Even an oyster may be killed by an additional quantity of sea salt to sea water. As it is void of flavour, we seldom use it in excess; and Ave only see the effects of its increased quantity, in the constant use of salt provi- sions at sea. But to the effects of salt at sea must be added the unalimentary quality of animal food long kept in this state, as well as the almost constant moisture to which sailors are exposed. In some instances, when used too largely, it is said to have brought on symptoms of sea scurvy even on shore. Vinegar we now speak of as a condiment, occasion- ally used. When in a perfect state, it is scarcely ever, in a moderate quantity, injurious. Even the most acid stomachs, and pregnant women most injured by aces- cents, may use it with safety. The fact is, that its ul- terior change corrects acidity; and with animal food little injury will result. With vegetables alone it is not so innocent; yet in this way it is rarely taken but by the robust, to whom no diet is particularly inconvenient. Vinegar, as has been observed, renders some gross ani- mal substances more digestible; but others it seems to harden, and to lessen their solubility. Yet we have seldom found it injurious but with shell fish; and oysters, cockles, muscles, crabs, and lobsters, are we think less easily digested Avhen vinegar is added. The three first when pickled are certainly less soluble. The various flavours given to vinegar, which is by this means so infinitely diversified, must not be an object of our attention, for it is still vinegar unaltered in its es- sential qualities. We know a gentleman who never makes a salad without five kinds of this vegetable acid. Pickles arelittle more than vinegar in a solid, and, we may add, in its most inconvenient and indigestible form. These are vegetable substances preserved by means of salt and vinegar; but the salt, in the early part of the process, chiefly hardens and contributes to their pre- servation. Should the curious reader wish to pursue the subject more closely than our limits will admit, we Avould refer him to the fourth volume of the Amaeni- tates Academicae, in which he will find (p. 536) an entertaining and a not uninteresting essay " De Ace- tariis," by M. Van der Burg, in reality by Linnaeus himself. The simplest form of the acetaria is that of the sa- lad, which takes its name from the ingredient, Avhich should be in the least perceptible proportion, salt. The advantages and disadvantages of salads arise from the choice. The lettuce is soporific, the endive and celery acrimonious; but the power of the first is inconsider- able, of the latter lessened or destroyed by blanching (etiolation). The young mustard, the cresses, and the Avater cresses, are Avarmer; but these will be spoken of under another head. In general, salads to the young and strong are extremely Avholesome, and excellent cor- rectors of alkalescency. In the Aveaker stomachs, the addition of mustard renders them less inconvenient, though the coldness is often troublesome. Sliced cu- cumber can seldom be rendered digestible, even by the warmest spices, except in young and robust stomachs. Vegetables which are preserved by vinegar are chiefly those which are smooth, tasteless, and tolerably finn. Modern luxury flavours them highly with shalot, gar- lic, or the seeds of the nasturtium, and Avith advan- tage. The mango, the Indian plum, is highly flavoured with garlic ; and we emulate it in a similar preparation of the unripe melon. The yellow and the Avarmer pickles of the East and West Indies Ave also imitate by the admixture of a variety of substances, preserved and flavoured in the same way, styled pickalilla. The warmth of the West India pickle Ave obtain by the ad- dition of the capsicum, raised in our green houses. The pickles of our own climate are chiefly the cab- bage, red or white, rendered yelloAV by art; the young cucumbers (gerkins,) the larger cucumbers, or unripe melons (mangos,) the unripe walnuts, the naturally acid gooseberries, berberries, lemons, the samphire (crithmum maritimum Lin.), the buds of the capparis, the tops of broccoli, sliced beet root, Sec. In general, the firmer vegetables are the least wholesome; and those, without the additional warmth of other vegetable sub- stances or spices, often produce inconvenience in Aveak stomachs. Perhaps, in general, they are injurious by exciting a false appetite, Avithout carrying with them sufficient correction. Spices are more harmless condiments; since, if they contribute to convey a larger proportion of nutriment, they warm the stomach, and enable it to perform its office more perfectly. It must be indeed admitted, that the organ will be ultimately weakened by over disten- tion ; but if not greatly abused, the use of spices does no real nor permanent injury. The safest of the spices is, apparently, the common pepper. It is at the same time the most durable and inflammatory; but the quan- tity employed renders the last quality of little effect. The Cayenne pepper is more pungent, but more tran- sitory in its stimulus; and we have had great reason to think that much of its warmth is lost on the throat and fauces. Ginger is peculiarly warm, and its Avarmth is permanently exerted in the stomach, which renders it an excellent addition to cold and flatulent drinks. The warmth of cloves is more inflammatory, and in a small proportion not unpleasant. Mace is milder; but, from its strong flavour, is used in too small a quantity to be either useful or injurious. The capsicum and chili, though scarcely meriting the name of spice, as void of aroma, are, in qualities and botanical analogy, nearly related to Cayenne. The pimento, uniting the flavour of different spices, seems also to unite their qualities; and the cinnamon, chiefly employed for its flavour, un- less used medicinally, has little pretensions to either praise or blame. Wine must be reckoned among the condiments; for though its addition to sauces is in too small a proportion to produce any considerable effect; yet it is often drunk at table, and adds to the inclination for an additional quan- tity of food, and the poAver of the stomach to digest it. This advantage, if it may be styled one, is chiefly ob- tained by the drier and stronger wines, as Madeira, sherry, and Avhite port; more effectually by the strong and sharp wines, as rhenish, vin de grave, and old hock. The sweeter wines pall the appetite, and are reserved for the dessert, whose sweetness would destroy the flavour of the others. We then find the Malmsey, Madeira, the Frontiniac, Tokay, and Cape Avines, in- troduced. This finishes the studied luxury of a modern 3 P 2 CON 476 CON dinner, where every thing is nicely calculated to add to the quantity, since the second is more poignant than the first course, and the dessert more attractive than the se- cond : the Avine joins in the conspiracy against the powers of the stomach, Avhich is thus daily under- mined, and its tone gradually destroyed. Wine is per- hapssometimes really useful in this vieAV ; we mean, in some instances where the stomach requires the assistance of a stimulus to take even the necessary quantity; and in such cases it may be even taken Avith advantage be- fore dinner. In this situation hock is preferable: the next is Madeira; sherry, white and red port, folloAV in succession. When the whole body is exhausted also by fatigue, the stomach will often refuse the necessary food, until it is a little revived by a glass of wine. Spirits, either alone or with water, are occasionally taken Avith similar design; but these are in every form, except occasionally as medicines, injurious. Brandy is chiefly preferred; but it is scarcely less hurtful than either of the others. Soy is imported from the east. It is the production of the bean, the dolictos soia Linnaei Sp. PI. 1023, which is chiefly prepared by a spontaneous fermenta- tion, with the addition of salt, and a small proportion of flour. It merely gives a flavour to sauce. Ketchup is prepared from mushrooms or walnuts, with the addition of salt, and generally some spice. These two fluids are infinitely diversified with the fla- vour of shalot, the warmth and pungency of Cayenne vinegar, the taste of anchovies, Sec.; and sold in many forms, Avith a great variety of names, according to the fancy of Mr. Burges and others. They are not inju- rious if they do not tempt the appetite too far, and in- crease the load beyond the poAvers of the stomach to di- gest. Mushroo77is we have added to the list, which, though in a slight degree nourishing, are chiefly taken for their flavour. See Amanita. Oil must be reckoned among the condiments occa- sionally used, though void of flavour. Its chief use is as a sauce Avith vinegar, to pickled fish, or in salads. It is said in the former to correct the alkalescency of the fish, and assist its solubility. But if this advantage be denied, it may be at least pronounced innocent. It is not easy to conjecture the origin of its use in salads. We have suspected that it may have arisen from a suspicion of some poisonous herbs being incau- tiously mixed with the others. Its more obvious ad- vantage is, that it gives a richness to the salad, and by the assistance of the egg employed to mix it with the vinegar, conveys the poignancy of the latter more uni- formly to every part of the vegetable, in consequence of its viscidity. Whatever may have been the cause or effect, it is very generally employed ; and if not advan- tageous, is pleasant and innocent. Sugar is not commonly used as a condiment except in the form of currant jelly, or occasionally with mint sauce in the early season of lamb. In every instance it is at least innocent. Various indigenous vegetables furnish also a variety of condiments. We employ the root of the horse radish, the capsules and seeds of the nasturtium, the seeds of the mustard, the cresses, the water cresses, and the vour.gmustard, in their earliest periods, sometimes when even the seed leaves only are expanded. These plants belong to the order siliquosa, all of which are in the same groupe, the tetradyna7nia of Linnaeus, one of the most natural classes of the sexual system. They arc, without any exception, pleasant and salutary. Indeed they have been commended more highly than they merit, from circumstances that may for a moment be allowed to detain us. When stall feeding was not common, families in general preserved their winter's stock of food by means of salt; and symptoms of scurvy and of biliary calculi were often the consequence, after some months confinement to this diet. The early ve- getables were then sought with alacrity, and their poAvers were consequently more conspicuous. These vegeta- bles still retain their character, though the occasion of their use is removed. The flour of the mustard seed seems not to have been employed very early, but it is now a general favourite; and in France it is prepared with peculiar care, and enriched with a variety of ad- ditional flavours. Were we to write another culina fa- mulatrix, we might enlarge copiously on this subject, and some similar ones, from a pleasant work published annually in France, of which the third year has just ap- peared, viz. Almanach des Gourmands, the Almanack of Epicures. In this the variety of mustards and other sauces are described; " Avhich have the inestimable ad- vantages of enabling you to eat much, and for a long time without inconvenience." It is sufficient, however, in our situation to remark, that all these indigenous con- diments are Avholesome. Another kind, the last of which we shall speak, is that prepared from fish. Caviare prepared from the roe of the sturgeon is sometimes employed in this way, though more usually eaten alone. Anchovies, which dissolve by heat, are employed as a sauce for fish; but what is styled their " essence," is little more than the sordes that remain. When the fish itself is employed, and the solution clarified, it is almost equally clear with water; and the flavour of the anchovy is delicate and pure. Crabs, lobsters, oysters, cockles, and prawns, are all in turn employed as sauce for fish, and occasionally the oysters for some kinds of fowl; but when dressed, they are far from being easy of digestion. It may be supposed that we have been too lenient to these condiments, which have excited the indignation of the moralist, and of the diaetetic physician. Could we return to a state of nature, or indeed Avere such a return desirable, we might have employed a different language; but Avhile they assail us in numerous shapes, it was of more importance to appreciate with some ac- curacy their various merits than to reject them with indignation. The experimental physician, who endeavoured to imi- tate the process of digestion in his phials, Avas surprised to find that all the condiments, which he employed, retard- ed the spontaneous Changes; and all Avere at once con- demned. Independent, however, of the common argu- ment, that digestion is a process connected with a being possessed of life, we might ask what reason induced him to confound a rapid with an easy digestion. Various in- conveniences we know attend a quick digestion; among which wemay reckon flatulence, headach, and a symptom not generally attributed to this cause, a faintness within about an hour or two after eating We recollect that Psalmanazar, who in support of his fiction was obliged to eat his meat raw, found great inconveniences from too quick digestion, which he removed by mixing large CON 477 CON quantities of pepper with it. In fact, then, condiments may be serviceable by retarding this process; and we have employed • them medicinally for this purpose. Their use has been thought disgraceful, as implying a deficiency of appetite and impaired health, but with- out reason. The person who employs them may in- deed often eat without their assistance, but he can dine more agreeably with it ; and while "to enjoy is to obey," we find little objection to condiments but in their abuse. CO'NDIO, to embalm ; also conditura, andpollincio. Embalming is as ancient as the first record of the cha- racter of physician. See Genesis, ch. 1. v. 2. It is still practised, but not generally. On this subject see Pare Dionis's Surgical Operations; Gooch's Treatise on Wounds, p. 456; Greenhill's Art of Embalming; Bell's Surgery, p. 465. CO'NDITUM, (from condio, to preserve). Pre- serves. They are made by steeping, or by boiling re- cent fruits in syrup or a solution of sugar. It is after- wards either kept moist in the syrup, or taken out and dried, that the sugar may candy upon it: this last is the most usual method. The art was formerly a branch of the apothecary's business, but now is wholly in the hands of confectioners. The Latins and the latter Greeks meant by conditum a sort of acratomeli; that is, a wine impregnated with honey and aromatics. See Mulsum. CONDITU'RA. See Condimentum and Condio. CONDU'CTIO, (from conduco, to draw along,) in Coelius Aurelianus it means a spasm or convulsion. CONDU'CTOR, (from conduco, to guide). A con- ductor is an instrument used in surgery for the direc- tion of a knife when a sinus is laid open. It is also a name of the instrument called a gorget, which is used as a conductor in the operation of lithotomy. CONDUPLICA'TUM FOLIUM, (from con and duplicor, to be doubled). A term in foliation, signify- ing that the sides of the leaf, while in the bud, are dou- bled over each other at the midrib. It is used also in the sleep of plants in the same sense, when the leaves during the night fold together in the same manner. CONDYLOI'D^E, (from xovfvXos, a joint, and uhs, forma, likeness). Apophyses. See Maxilla inferior. CONDYLO'MA, (from xovhxos, a joint or tubercle). A tumour; so called from its resemblance to a con- dyle, a joint bent, or a tubercle. It is a hard eminence, Avhich arises in the folds of the anus, or a hardening or a swelling of the rugae. These tumours also sometimes happen in the orifice of the uterus, and other parts. It is variously described by authors ; by some as a tu- mour of the cuticle; by others as an instance of sar- coma. An anonymous French Avriter says, it is in ge- neral a fleshy excrescence which appears on the fingers, hands, feet, and principally about the anus, the peri- naeum, and the private parts of both sexes. He adds, that Avarts, the tumours called flcus, marisca, sycosis, and thymus, are different instances of condyloma. See Atrices. Authors abound with unnecessary distinctions re- specting these tumours; but all tubercles and fungi, Avhether Avithin the verge of the anus or more outAvard, are of the same nature, and are cured by the same me- thod, whether called condyloma,flcus, fungus, or crista, and are tumours of the glandules of the part; which, increasing by degrees, prove painful and troublesome. Those who are troubled with the piles frequently suf- fer from them ; and they often appear in the pudenda from the lues venerea. If the roots are small, a ligature may extirpate them; if broad, they are best removed by a caustic, but care must be taken that it doth not injure any other part. See P. Egineta, Celsus,Heister,Turner, Wiseman; Bell's Surgery, vol. ii. p. 264.- Condylo'ma. A corn. See Clavus. CO'NDYLUS, (from xovhj, an ancient cup shaped like a joint). A condyle. It is a protuberance in any of the joints, formed by the epiphysis of a bone. In the fingers it is called the knuckles. See Processus. In botany it signifies the joints of plants. CONEI'ON. In Hippocrates it is an appellation of the cicuta; from »ove?, turbo, a turning or whirling round; because it produces a vertigo in those who take it internally. CONE'SSI. (Indian). Called also the codaga pala, conessi seca, cadaguspali. It is the bark of a small tree, called arbor Malabarica lactescens; jasminiflore odoro, siliquis oblongis, growing in Ceylon and Malabar, and on the Coromandel coast, where it is called conessi. It is blackish outwardly, and covered more or less with a whitish moss or scurf, which should be scraped off. To the taste it is gratefully austere and bitter. It is commended in diarrhoeas, and half a drachm may be ta- ken three times a day ; or in sour milk it restrains not only alvine fluxes but haemorrhages. The root, boiled in water, makes a useful fomentation against inflam- matory tumours; and, taken inwardly, destroys worms. When used, it should be fresh powdered, for it soon loses its medical qualities under any form or prepara- tion. When taken to restrain a diarrhoea, an emetic of ipecacuanha should precede its use. Those with whom a diarrhoea is frequent, in moist weather, are much be- nefited by its use, if a dose is taken morning and even- ing. Its genus is unknoAvn. Raii Hist. CONFE'CTA, (from conflcio,to make up). Comfits or sugar plums. Seeds or other substances incrusted with sugar. These, when impregnated with purging ingredients, are given to children who will not take the usual forms of medicines. CONFE'CTIO, (from the same). A confection; called also aligulus. In general it is any thing prepar- ed Avith sugar, and the same with conditum. The latter is usually dry ; the confectio a soft electuary. The dry confects are now a branch of the confectioner's busi- ness, and are the roots of eringo, .the peels of oranges, &c. which are incrusted with sugar, and are called can- died root, or peel. The London college prescribes the following soft electuary : the cordial confection, now called the aromatic confection. Take of zedoary in coarse powder, saffron, of each half a pound ; distilled Avater, three pints; let them ma- cerate for twenty-four hours, then press and strain them. Evaporate the strained liquor to a pint and a half, to which add the subsequent ingredients reduced to very fine powder; compound poAvder of crab's claAvs, sixteenounces; cinnamon, nutmegs, of each two ounces; CON 478 CON cloves, one ounce; lesser cardamom seeds husked, half '.n ounce; double refined sugar, two pounds; and thus form the confection. Pharm. Lond. 1788. This is al- tered from the last Dispensatory, and may be consider- ed as an improvement. It is certainly an agreeable cordial and carminative, but should not be long kept, as it loses its efficacy. It is substituted for the confect or cordial of Sir Walter Raleigh. Confe'ctio alke'rmes. See Chermes. Confe'ctio anaca'rdii. See Anacardium. Confe'ctio aroma'tica. See Confectio cardiaca. Confectio Damocratis. Damocrates's confection.— This Avas formerly called mithridatium, from Mithri- dates, king of Pontus and Bithynia, who, after the ex- ample of Attalus of Pergamus, is said first to have ex- perienced the virtues of simples separately, and then to have combined them. But it should be noted that the original compound, as prepared by Mithridates, consist- ed of but a feAv ingredients. Serenus Sammonicus says, that Avhen Pompey took the baggage of this prince, he Avas surprised to find that this antidote consisted of only tAventy leaves of rue, two walnuts, two figs, and a little salt. Of this he took a dose every morning, to guard himself from the effects of poisons. It is, however, probable this was designed to deceive, as the prepara- tion used by the king of Pontus has been handed down with great care, and is a combination of aromatics and neiwous medicines with opium. If, as Dr. Fordyce al- leges, a variety of aromatics is more useful than a large dose of a single one, we cannot see with what propriety the mithridate is rejected, except on the common prin- ciple, " Est modus in rebus et certi denique fines." At all events, the mithridate—for Ave well remember its use, and its being faithfully, at least with tolerable fide- lity, prepared—was a warm useful opiate. It is now, however, thrown out of the London Dispensatory of 1778. Confectio opia'ta. See Philonium. Confectio sapie'ntum. See Anacardium. CONFE'RTUS, (from confero, to bring together). In botany it means very numerous, and crowded toge- ther. See Athroos. CONFIRMA'NTIA MEDICAME'NTA, (from confirmo, to strengthen). Medicines Avhich restore or confirm the strength of the body, or any part of it: or medicines which fasten the teeth in their sockets. See Tonica. CONFLUE'NTIA,(from confiuo, to flow together). A term used by Paracelsus to express the agreement, conjunction, or confederation of the microcosm with the stars, or of a disease with remedies: in botany it means growing together in partial masses, so as to leave the intermediate parts quite bare; and in small pox, the running together of the pustules when croAvded. CONFOZDERA'TIO is of the same import. From confedero, to agree together. CONFORMA'TIO, (from conformo, to shape, or fashion). Conformation. Some diseases are called morbi mala conformationis, or organical diseases; that is, which depend upon the original ill conformation of the parts, or on the change of their structure from disease. These, if external, may admit of a chirurgi- cal cure; and proper exercise, regimen, and medicines, may sometimes contribute much to the relief even of those which are internal. See also Diaplasis. CONFORTA'NTIA,(from conforto,to strengthen). See Cardiaca. CONf RICA'TIO. (from con and frico, to rub toge- ther). In pharmacy it is the reducing of any easily fri- . able substance to poAvder by rubbing it with the hands; or the rubbing any soft and succulent vegetable with the hands to express the juice. CONir RICATRl'CES,(from the same). Lascivious women, who induce a variety of chronic diseases from unnatural practices. CONFU'S^E FE'BRES, (from confundo, to con- fuse). Bellini thinks that he has met with two fevers attending at the same time, beginning and ending toge- ther, but so confusedly as not to be distinguished. Bel- lini, however, in his distinctions, is too refined, and often himself confused. CONFUSA'NEUS PA'NIS, (from confundo, to mingle together). Bread made of meal, from which the bran has not been separated. CONFU'SIO, (from the same) A disorder of the eyes, which happens when, upon a rupture of the in- ternal membranes which include the humours, they are all confounded together. It is also a mental dis- ease when the ideas are not clear and discriminated. Some authors have laboured under it during their Avhole lives. CONGELA'TI, or CONGELA'TICI. ' Persons af- flicted with a catalepsis. See Catalepsis and conge- latus. CONGELA'TIO, (from congelo, to freeze). Con- gelation, and coagulation. It is such a change pro- duced by cold in a fluid body, that it becomes appa- rently, sometimes really solid. Water is rarified or expanded by congelation ; but this depends on the sud- den separation of the air. Iron, plaster of Paris, and many other substances, expand at the moment of con- gelation. Animal fats, and some oils, usually contract. The calcareous stalactites produced in caverns from the drops of petrifying waters are called congelations. CONGELATI'VA MEDICAME'NTA, (from con- gelo, to congeal). Medicines which inspissate and dry; or are employed to check discharges. CONGELA'TUS, and CO GELA'TIO, (from con- gelo, to freeze). Frozen or frost bitten. Persons thus affected by the cold are compared to cataleptic patients, but still there is much difference between the diseases. When a man is benumbed with cold, and he attempts to warm himself at the fire, the parts exposed to the heat are painful, and a mortification is the general con- sequence. Thus frozen fruit, if put into water nearly freezing, recovers ; but in warm Avater, or in a warm place, soon rots. Those who are severely affected Avith cold, should first put the frozen part into cold Avater, or cover it Avith snow; and next into water somewhat above the freezing point, until a sense of warmth is perceived, or some degree of motion returns. At this time a little warm wine, mixed with camomile tea, may be drunk, and the warmth gradually increased. A mortification will be in this Avay avoided. When travellers begin to be drowsy in the cold, they should redouble their speed to extricate themselves from CON 479 CON danger; for though their sleepiness is urgent, it is always fatal. The heat of our bodies, Avhen in health, very com- monly exceeds that of the ambient air: a consider- able degree of cold is consequently required to freeze our fluids, and the extremities are the first affected, as most distant from the centre. When a mortification from cold approaches, the part affected by it is first pale, then red: this redness is attended with a troublesome pain and a violent itching; after which the colour be- comes almost purple, and at last black. In these cases, the parts, by their sedative powers of the cold, are deprived of life; or at least their irritability is suspended, and consequently accumulated. Should heat be applied, the excessive action, which is the con- sequence, Soon induces mortification, that Avould other- wise be avoided. By introducing the heat gradually, the accumulated irritability is sufficient to restore the life of the part. When gangrene has actually taken place, the increased action of the vessels, as usual in such instances, is excited to separate the morbid from the sound part. There is not the slightest evidence, that the organic structure is destroyed by the expansion of the fluids during congelation. See Tissot's Advice to the People; Van Swieten's Com. on Boerh. Aph. 422, 427, 454; Med. Mus. vol. i. p.71. CONGE'NERES, (from con and genus, of the same kind). When spoken of muscles, it imports those Avhich concur in the same action. CO'NGER, or CO'NGRUS, xoyXpos, (from ypxu,to devour; so called from its voracity). The conger eel. It is a large sea eel, often called the serpent. The flesh, Avhen deprived of its rancid flavour by soaking in salt and water, resembles bad veal. CONGE'STIO. Congestion, or collection. (From congero, to gather into a heap). A SAvelling which gradually arises, and slowly ripens; in opposition to that defluxion Avhich is quickly formed and terminated. CO'NGIUS. A gallon. This is a very ancient measure, and is generally said to have been equal to ten pints of wine, and nine of oil. The Athenian congius, or conchus, weighed nine pounds, and the Roman weighed ten, or contained ten Roman pints of wine. In the London and Edinburgh Dispensatories the gallon is only eight pints. See Chu. CONGLOBA'TA GLANDU'LA. A conglobate gland, (from conglobo, to gather into a ball). All the glands are either conglobate or conglomerate. A con- globate gland is a little smooth body, covered with a fine skin, by Avhich it is separated from every other organ, only admitting an artery and a lymphatic, and affording a passage to a vein, or another to the same lymphatic. See WinsloAv's and Keil's Anatomy. CONGLOMERA'TA GLANDU'LA, (from con- glomero, to heap up together). A conglomerate gland is composed of many little glandular bodies, united in one common membrane. All their excretory ducts sometimes unite, through which the secreted fluid passes. Sometimes the ducts uniting form several ducts, which communicate Avith one another by anastomosing canals, as in the mammae. Others again have several ducts without any communication with each other; as the ghmdulae lacrymales et prostatas; and occasionally each gland hath its own excretory duct, through which it transmits its fluid to a common reservoir, as the kid- neys. See Winslow's and Keil's Anatomy. See Gland and Secretion. CONGLUTINA'NTIA, (from conglutino, to glue together). Healing medicines. CO'NIA. Lime, (from xovixu, to whiten). When joined with c-txxt*), it means lixivium, or ley of vegeta- ble ashes; or Avine impregnated with cones of fir; from xmos, a cone. Dioscorid. lib. v. c. xlviii. CONFFER.E A'RBORES,(from co7ius, a cone, and fero, to bear). Trees which bear cones, as the cedar, fir, and pine. CONI'LE. See Myrrhis. CO'NIS, (from xovts, dust,) fine powder; ashes; a nit in the hair; scurf from the head; and sometimes lime. CONISTE'RIUM, (from the same). See Apody- TERIUM. CONJUGA'TA, (from con and jugo, to yoke toge- ther). In botany it means groAving in pairs. CO'NIUM MACULA'TUxM and MA'JUS. See' Cicuta major fcetida. CONJU'NCTA CAU'SA, (from conjungo, to join together). The immediate cause. See Causa. Conju'ncta si'gna. The pathognomonic signs of a disease. CONJUNCTIVA TU'NICA, (from the same). The conjunctiva is erroneously confounded Avith the ad- nata ; they are two distinct coats, and both but partial coverings of the fore part of the eye, though the con- junctiva is reflected, and also spread over the inside of the eye lids. This is a thin transparent membrane, which lines the inner surface of the eye lids, and at the edge of the orbit has a fold, that is continued forward over the anterior half of the globe of the eye. It is exterior to all the other coats of the eye, and connected Avith the albuginea, by means of a cellular substance, from which it may easily be separated in the dead sub- ject by dissection. The conjunctiva of the eye lids is perforated by many minute foramina, Avhich suffer a thin serum to exhale, to keep a moisture over the globe of the eye. This membrane is transparent, and, cover- ing the albuginea, gives the Avhiteness to the portion of the eye usually distinguished by this appellation. See Ware's Remarks on the Ophthalmy, inc. p. 5. It is sometimes called the mucous coat. CO'NNA. See Cassia fistularis. CONNA'TUS, (from con and nascor, to grow toge- ther). In botany it means two or more distinct things growing together, and having the appearance but of one; as two apples, two nuts, or two leaves. COXNE'CTIO, (from con and necto, to knit toge- ther). See Symphysis. CONNE'XUS, (from the same). In botany it means groAving in pairs. CONOl'DES, (from xmos, a co7ie, and tiS'os, like- ness). Any body in the shape of a cone. See Pinea- lis GLANDULA. CONQUASSA'TIO, (from con and quatio, to shake together). CoNquAssvnoN. In pharmacy it is a spe- cies of comminution, or an operation by Avhich moist concreted substances, as recent vegetables, fruits, or the softer parts of animals, are agitated and bruised till they are reduced to a soft pulp. CONSE'RVA, (from conservo, to keep). A con- C ON 480 CON serve. Conserves consist of recent vegetable matters and sugar, beat together into one uniform mass. On account of the large quantity of sugar contained in conserves, it is obvious that they are chiefly useful as an auxiliary to other more efficacious drugs. Though of the conserves of lavender, wood sorrel, mint, rose- mary, orange and lemon peels, arum, or wormwood, a useful dose may be taken, if the proportion of sugar is diminished. Mucilaginous substances, if mixed with sugar, be- come glutinous, and astringents soft. The more in- tense bitters are improper for this form; and lightly flavoured vegetables soon spoil: the latter must, there- fore, be prepared extemporaneously. The general observations for properly making con- serves are but few: leaves are to be picked from their stalks, and flowers from their cups. When the flowers or leaves are properly prepared, they must be beat into an uniform mass, in a marble mortar, with three times their weight of powdered lump sugar; but Ave are often obliged to diminish the proportion to twice, or some- times to an equal weight. Orange peel may be rasped, or ground in a mill, and then beat up with the sugar. Roses are to be ground before they are beat into a con- serve. If they are infused in a large proportion of wa- ter, and this is separated by expression, their bitterness, perhaps their virtue, is extracted. CONSERVA'TIO, (from co7iservo, to keep). In pharmacy, the same as asservatio; pickling, or pre- serving from putrefaction and evaporation, by some additions ; or exclusion of air, heat, or moisture. CONSERVATI'V A MEDICI'NA, (from the same). That part of medicine which relates to the preservation of health. But for this purpose medicine is of little use. CONSILI'GO, (from con, and siligo, a kind of fine corn; so called from its being usually found among corn). See Helleborus niger hortensis flore VIRIDI. CONSISTE'NTIA, (from consisto, to abide). The state or acme of a disease. When applied to the fluids, excrements, or excretions, it imports their consistence. CONSOI'DES. See Amianthus. CONSO'LIDA, (from its supposed power of con- solidating and agglutinating things broken). Com- frey ; called also alum, and alus Gallica. Conso'lida ma'jor ; Symphytum majus; greater comfrey. Symphytum officinale Lin. Sp. PI. 195. A rough hairy plant, with large, somewhat oval, pointed leaves, producing, on the tops of the branches, spikes of white or purplish pendulous, nearly cylin- drical, floAvers, followed each by four shining black seeds. The root is thick and fleshy, black on the out- side, and Avhite within. It is perennial, grows wild in moist grounds, and flowers in May or June. There is a sort with purple flowers, but it is rarely to be met with. The purple and the white flowers are but varieties of the same species. The whole plant is used, but the root is the only part that deserves notice; it yields in boiling about two thirds of its weight of mucilage, almost void of smell and taste, and similar to that from the althaea, but more tenacious. The comfrey is, therefore, probably prefer- able. This mucilage is its only medicinal principle. Sec T.v wis's Mat. MecL Neumann's Chem. Works. Raii Hist. Conso'lida au'rea, and au'rea co'rdi. See Cha- M.SCISTUS. Conso'lida me'dia, and minima. Daisy. See Bu- gula, Bellis major and minor. Conso'lida mi'nor, and rubra. See Prunella and Tormentilla. Conso'lida sarace'nica. See Virga aurea. CONSO'LIDANS. Consolidating, (from conso- lido, to make firm). This is applied to medicines that produce new flesh. CONSO'MME, CONSUMMA'TUM, (from con- summo, to 7nake perfect). It is a broth so strong as to concrete into a jelly Avhen cold. Frequent mention is made of it in the French medicinal writers. CONSPE'RSIO, (from conspergo, to sprinkle). See Catapasma. CONSPICI'LUM, (from conspicio, to behold). Spec- tacles. Spectacles are either convex, concave, or plain. The first are adapted to old persons; the next to those who see only with distinctness at a small distance; and the third, formed of glass with a light green or blue shade, are designed to defend weak eyes from too strong light. The form of the eye in old and near sighted people has been explained under the terms Ambly opia , and the subject will again recur, vide PhesbytjE and Myopes. + Those who wear spectacles should be very cautious to have the glasses ground with the most perfect accu- racy, and should apply to opticians of credit, rather than to itinerant JeAvs; for the aberrations of the rays produced, by an imperfect figure of the glass, strain the eye to distinguish the image; from this cause indistinct. For a similar reason, the glasses of old people should be not at all, or very slightly, tinged: and the glare which arises from a candle, or a strong sun, may be better avoided by a shade against the former, or over the eyes, to guard against the latter. It has been doubted whether spectacles should be used to preserve the sight. We think that in old persons they will be useful: with the near sighted, who are usually young, they should be discouraged. Old people will save their eyes, and there is little danger of exhausting the degrees of convexity: indeed none. The young will not, indeed, exhaust the degrees of concavity; but the other senses should be kept " on the alert," while they can supply the place of distinct vision. The hearing, the feeling, even the facility of conjecture, are kept alive by disusing spectacles; and we should improve all our powers. As we have al- ready hinted, the near sighted person should use the number next beloAV that of distinct vision, and he will soon attain it. Habit, in this way, will coincide Avith the change which age induces; and not to see with the utmost acuteness, is still an advantage to those who could otherwise see very imperfectly.—All this is, however, refinement; for spectacles used Avith little caution or discrimination have seldom done harm, if the glasses are good. Pebbles, which admit not of scratches, should be in every instance preferred. CO'NSTANS, (from consto, to stand firm). When applied to the strength, or vital powers, it imports firm- ness, or a good condition. CONSTELLA'TUM UNGUE'NTUM. It is an ( O N 481 CON ointment made of earth Avorms, cleansed, dried, pow- dered, and mixed Avith the fat of boars or bears. CONSTIPA'TIO,(from constipo, to crowd together). Obstipatio, adstrictio. Costiveness. Dr. Cullen gives this disorder the name of obstipatio. A person is said to be costive, not only Avhen the contents of the intestines are not daily discharged, but also when what is dis- charged is too hard to receive its form from the impress of the rectum upon it. The daily discharge is, Iioav- ever, relative; for the constitution, accustomed only to this relief every four days, can scarcely be said to labour under disease, if a week should elapse betAveen the pe- riods. See Obstipatio. Hoffman observes, that costivehess is generally ow- ing to spasms in the intestines themselves, or is propa- gated by consent; but various causes conduce to this habit, particularly a Avant of irritability of the intestines and a sedentary life. This habit of body is generally attended Avith headach, vertigo, disagreeable taste in the mouth, and Avant of appetite: it is a frequent cause of chronic complaints, which will be easily understood by Avhat avc have re- marked respecting Cathartics; q. v. The costiveness peculiar to studious people is much relieved by magnesia, with rhubarb, or the ol. ricini. Artificers who sit much, and work Avith their bodies lean- ing forward, are best relieved by the same medicines. In cases of melancholy, neutral salts, if long continued, are most effectual; for they leave no tendency to costiveness. Women, during pregnancy, are sometimes costive; from the pressure of the child's head against the rectum. Care should be taken to prevent an accumulation of faeces by an early administration of mild purges, for harsher ones are dangerous. Old people, from the Aveakness of their muscles, have hard faeces collected in the rectum : and though laxative medicines procure a discharge of the thinner fluids, the indurated matter still lodges, except manual assistance is given. The late Dr. Warren employed, from an obvious connec- tion, a marrow spoon. Aloes, given in small doses, prove sufficiently laxa- tive : and this effect is continued longer after its use, than is observed Avith respect to many other medicines. When flatulencies are very troublesome, if a little asa- foetida is joined with it, more considerable relief may be expected. Calomel also often prevents other purg- ing medicines from leaving costiveness behind. The extraction colocynthidis compos, united with calomel, and corrected by the addition of oleum carui, seu anisi, forms an excellent remedy for relieving and preventing costiveness, if used occasionally. The utility of Dr. James's analeptic pills have led to a suspicion of the utility of the antimonials, joined to the more active fonns of resinous purgatives; and we have already men- tioned the advantages derived from adding a grain of emetic tartar to a drachm of the colocynth pills for this purpose. A form we have often employed with success, consists of half a drachm of the gum pill, as much pill Hufi, with ten grains of antimonial poAvder. Two or three of these pills approach Very nearly in their effects to the analeptic pills of Dr. James. Habitual costiveness hath been much lessened both by the cold and hot baths, by early rising, and Avalking in the open air. In the Lond. Med. Obs. and Inq. vol. iv. are two cases of costiveness which resemble diarrhoeas. VOL. I CONSTRI'CTIVA, (from constringo, to bind toge- ther). See Styptic a. CONSTRICTOR A'LiE NASI, (from the same; for all muscles, called constrictores, have the poAver of straitening). Triangularis; depressor labii superioris. Fallopius first described these, though Placentinus claims the discovery. They rise fleshy beloAV the root of the nares, immediately- above the gums of the dentes incisores, and, ascending transversely, are inserted into the coats of the alae nasi, and the superior part of the upper lip. Constructor am. See Sphincter ant. Constructor i'sthmi fau'cium. From the uvula two arches run doAvn on each side, and there is a cavity between them, Avhere the tonsils are lodged. The an- terior arch goes to the basis of the tongue, and is thus called; the other passes down the palatum molle, and , goes to the pharynx, Avhence it is distinguished by the name of palato-pharyngeus. Constructor lybio'rum. See Sphincter labio- rum. Constructor mu'sculus. See Buccinator. Constri'ctor palpebrarum. See Orbicularis PALPEBRARUM. Constri'ctor phary'ngis infe'rior. See Crico- PHARYNGiEI. Constri'ctor phary'ngis me'dius. See Hvopha- PYNG^EUS. Constructor phary'ngis supe'rior. Sec Cephalo- PHARYNG-ffiUS. Constri'ctor vesi'c£ urixa'ri^. See Detrusob URINiE. CONSTRICTORES PHARYNG/E'I. See Pha- rynx. CONSTRICTO'RII, (from the same). Diseases at- tended Avith constriction. CONSTRINGE'NTIA, (from the same). See As- TRINGEMTA. CONSUETU'DO, (from consuesco, to be accustom- ed to.) Custom. Custom and habit are two terms often used synonymously, and indeed the former is often confounded with the latter. By custom is meant # fre- quent repetition of the same act; by habit, the effect that custom has on the mind or body; so that the for- mer is the cause of the latter. It has been often alleged, and with truth, that Ave are creatures of habit. Custom produces a regularity in ali our returning Avants; and the hour of dinner, of exer- cise, or sleep, brings on the feeling of Avant, independ- ent of any real demand. In general, the frequent and regular repetition of small impressions produces habit, and their influence is soon unperceived: violent impres- sions never become habitual; for, Avhen repeated, the body or mind would sink under their force. The influence of custom on our sensations is singular. Ac- customed sensations, as we have just remarked, are soon unnoticed; and it requires a little increased action to render them the objects of our attention. Yet, when the energy of the mind is excited by the sensation, custom adds to the power of discrimination. The shepherd will distinguish every individual sheep of a large flock; the painter discover beauties and faults in- visible to the common eye; and the musician feel Avith pain the minutest deviation from tune. Custom, there- fore, which blunts bodily sensations, renders the mental 3Q CON 482 CON ones more acute. Volition is not an exertion of mind, but apparently a simple impulse, directed almost ne- cessarily to an end; and it is affected by custom, nearly like the organs of the body. Thus a sensation, which excited a perceptible exertion of volution, Avill, in time, produce it and the correspondent action, without our being sensible of its interference; and so rapid is this progress, that we seem to -will tAvo ends or objects at the same time, though they are evidently, when ex- amined, distinct operations. But though by custom we are no longer sensible of bodily impressions, or the exercise of volition, yet the corporeal organs in their several functions acquire, like those of the mind, pecu- liar accuracy pf discrimination. The musician is not, for instance, sensible of his willing any one motion; yet, Avith the most exquisite nicety he touches a particular part of the string, and executes a variety of the nicest and most complicated motions with the most delicate precision. Indeed, it appears to be a general rule in the animal economy, that if an idea has frequently produc- ed a motion, its poAver is increased; but if the motion connected Avith the idea has been prevented, the power is diminished or lost. It has been supposed that the will, by custom and exercise, may acquire a power over motions in the body not originally subject to it; and we think we have ob- served some instances of this power in a slight degree ©n the motions of the alimentary canal. The most striking instance of this kind, hoAvever, was the power Avhich colonel Townsend obtained over the heart and arteries; and Ave knoAV an eminent professor who, in his youth, could, and is perhaps still able to, produce a considerable effect on his pulse. But this effect of cus- tom is very limited. Its poAver of increasing the force and facility of action of the moving fibres is sufficiently well knoAvn. In the action of medicines on the moving fibres avc find some variety. Moderate power, by cus- tom, loses its peculiar effect. Thus, the dose of emetics and laxatives, when repeated, must be increased; and the dram drinker gradually requires additional quanti- ties, or augmented strength, of his liquor: but if the power be very active, the repetition gives greater facility of motion, as, by the repetition, the mobility of the mov- ing fibres is increased. Another effect of custom on the moving fibres resembles the association of ideas. If two muscles, or the different parts of one muscle, have been used to act together, exciting the action of one will produce that of the other. If, however, this kind of association is prevented by a strong effort of vo- lition, and strengthened by a different habit, they are induced to act separately, Avith the greatest precision. This poAver is constantly attained by musicians. A singular effect has been attributed to custom, Avhich may perhaps be more satisfactorily explained on other principles. As Ave usually feel only in the sentient ex- tremities of the nerves, it has been supposed, that from custom we refer every affection of the nerve, in its course, to the extremities; and thus the sailor, who had lost his leg many years before, feels a pain in the toe. This, however, certainly does not depend on custom; for a disease of the origin, or in the course of a nerve, is at once referred to its extremity, though the sensation was never before experienced. Custom, Ave find, regulates the degree of tension necessary to produce sensation. The sailor used to the sound of cannon can hear a person speak in a commf>; tone during their loudest roar; and a deaf person will hear more easily Avhile a drum is beating, or in a car- riage. It equally regulates the degree of tension neces- sary to the action of muscular fibres, as the musician experiences by the degree of pressure suitable to the production of a given sound, from a piano-forte or an organ; and it associates mo turns with sensations not otherwise connected. There is no necessary connec- tion, for instance, beuween a particular figure of n country dance and a given tune, since many different figures may be suited to it; but when the music be- gins, the accustomed movements, without any apparent exertion of volition, folloAV. Custom also associates dif- ferent motions, though not necessarily connected; and from the habit established they cannot be performed separately. It determines the degree of force and ve- locity with which motions can be performed, and which, after the habit is established, cannot be violated: a blacksmith can never become a Avatchmaker. Custom establishes also the order in Avhich certain sensations and motions return. An infant can soon be brought to feed only at regular hours; and those who retire regu- larly to the garden immediately after breakfast, will feel little or no inconvenience should their breakfast be de- layed for an hour or two. The same call will also regu- larly return with almost every change of the constitution in other respects. These motions, established and associated by custom, are sometimes broken with difficulty, and occasionally with injury to the constitution. If the supply of food, or the discharge of the excretions, be not obeyed, the call will often not again recur till the next period, and the feelings be uncomfortable in the interval. Indeed, the deprivation of the most trifling accustomed gratifi- cation frequently injures the health, while the most dis- cordant noises, the most offensive smells, or the most disgusting objects, lose every unpleasing effect from habit. It Avas this which occasioned the ancient sage to remark, " Optimum vitae genus eligito, nam consuetudo faciet jucundissimum." Choose the best occupation, for custom will 7nake it the pleasantest. On the other hand, these accustomed associated motions constitute the most obstinate diseases. Intermittent fevers, epilepsies, co- mata, See. when the periodical return is established, are most difficult of cure. In sueh circumstances we can- not often succeed without stopping all motion, to begin again a neAV and more salutary series. CONSU'MPTIO, (from consumo, to waste away). See Phthisis. CONTABESCE'NTIA, (from contabesco, to pine or waste away). See Atrophia. CONTA'GIO, (from contingo, to meet or touch each other; vel infe'ctio, from inficio, to infect). Conta- gion, or infection. It has been lately attempted to distinguish these two Avords, though not Avith a happy discrimation. We should approach more nearly to common language, if Ave employed the adject'iye "infectious" to diseases communicated by contact; for we infect a lancet, and Ave catch a fever by contagion. In the present state of our knowledge of the subject we must perhaps employ these terms as synonymous, though we shall, in general, follow the distinction now suggested. Contagion, then, exists in the atmosphere: and Ave CON 483 CO^ know distinctly but of one kind, viz. marsh miasmata, Avhich probably consists of inflammable air. All moist earth seems to be also injurious; and we now know that moistened earth absorbs the oxygen, and leaves, of course, the azote. Putrefying vegetable and animal substances have also been accused, particularly of pro- ducing the yellow fever of America; and there is no doubt of their being highly pernicious, though from what kind of exhalation Ave cannot say : mineral exhala- tions seem never to have produced fever. Another kind of contagion is that which produces the epidemic ca- tarrhs ; others which occasion the plague, the dysentery, the cynanche malignata scarlatina.' Egyptian ophthal- mia, 8cc. but these we need not anxiously enumerate, as th'eir nature is obscure; and the security, if it can be obtained, rests only on the general principles of avoiding cold, damp, night air, and Avhatever checks perspiration or debilitates the nervous system. The fevers which may arise from moistened earth cannot be avoided; but those from marsh miasmata Ave may escape, by choos- ing a situation where the prevailing winds do not bloAv from neighbouring marshes; or, at least, Avhere the Avinds at the period the marshes emerge from under the water, the only time of considerable danger, are not frequent from that quarter. Many of the diseases above mentioned are " infec- tious" also; and though it has been lately the fashion to deny contagion or infection, yet numerous are the victims that have been sacrificed to this pernicious sys- tem. The plague may still be pronounced eminently infectious. The small pox, the measles, the yellow fe- ver, the ulcerated throat, the scarlatina, catarrhus epi- demicus, and the hooping cough, are probably so, in a decreasing ratio, according to the order. Others, less infectious, require somewhat of more immediate con- tact. The dysentery, perhaps, connects both classes : then follow the itch, the sibbens, and the venereal dis- ease ;" perhaps the yaAVS. Other complaints supposed to be infectious, are apparently so from their being the offspring of contagion only. We have omitted in this enumeration the jail and hospital fever, as of doubtful origin, partaking both of infection and contagion. The miasmata are undoubt- edly diffused through hospitals, jails, and transports ; but the diseases usually received from the human body, or the recent effluvia, give activity to the contagion be- fore introduced. Thus we find a person, apparently Avith- out fever, coming from an infected hospital or jail will convey the disease, Avhile he himself, having constantly imbibed the poison, is habituated to it; and the infec- tion requires an exciting cause, or the'effluvia in a more active state. Contagious or infectious matter acquires peculiar virulence from confinement, especially with woollens nr cotton; and in this way infection is diffused from dis- tant countries. The last plague which infested the toAvn in which we now Avrite arose from a traveller re- marking to his companion that, in a former journey, he had the plague in the room Avhere they sat. " In that corner," said he, " was a cupboard, where the bandages Avere kept: it Avas noAv plastered ; but they are probably there still." He took the poker, broke doAvn the plas- tering, and found them. The disease Avas soon disse- minated and extensively fatal. People are very variously susceptible of infection. The slightest breath will sometimes induce the diseuM . while others will daily breathe the poisonous atmo- sphere without injury. We remember a young ladv having a violent fever in a boarding school. Each scho- lar constantly passed the door of her room, and no one caught the disease. When recovered, she Avas removed. with fresh clothes, to a lodging, Avhere there Avas no communication with the persons of the house; but two young Avomen, of the latter, Avere soon affected Avith a similar fever, and narrowly escaped. We mention this fact, not to alarm, but to induce the extremest caution, particularly in those Avho have previously lived in per- fectly wholesome air. The period at which the disease takes place subse- quent to infection, is different in differentcircumstanc.es. Should a case of fever occur within a Icav hours after a person has been exposed to it, the fever will assume the contagious type. Generally speaking, hoAvever, most fe- brile infections appear active from about ten to fourteen days. The period is scarcely e\er less than seven, or more than twenty-one days. Infection is, indeed, more often taken than is supposed. A slight shiver is followed by perspiration, by a diarrhoea, or some other spontaneous discharges, and nothing more is heard of the fever. But its nature is shown by prostration of strength, Avant of appetite, &c.; which continue, at least, during the first septenary period, if not to the fourteenth day. It is ge- nerally received with the air in breathing; but its effect is felt at the back of the fauces only, and from thence in the stomach. During the progress of contagion, and while exposed to infection, cold chills, indigestion, and the depressing passions, should be as much as possible avoided. The. sick room should be kept Avell ventilated, and the dis- charges immediately removed: it should be also fre- quently exchanged for free open air; the mouth and throat gargled with oxymel, a decoction of bark, ren- dered pungent Avith spirit of vitriol or port wine. We had almost said brandy, which avc once saAV recom- mended in a very respectable scientific journal, the Cri- tical Review, and have since used with some success. But that author was violently reprehended by a gentle- man, " scrupulous," perhaps " over much," as encou- raging dram drinking. We may, at least, pace tanti viri, recommend it to those Avho have no propensity to that pernicious custom. A decoction of" bark, taken two or three times a day, with a few glasses of port wine, may be useful, when infection is around ; and an attention to the state of the boAvels is essentially neces- sary. But nothing will effectually preserve without air '—free open air. Fevers, hoAvever, caught by recent infection are mild, compared -with those Avhich arise from contagion long pent up, styled fomites ; and, in our experience, very feAv such fevers have been fatal. There are other means proposed of guarding against infection. To per- sons exposed to it, camphor worn in a bag on the sto- mach has been recommended. We knoAv not its effi- cacy ; but recollect a late recorder of London (serjeant Glyn) mentioning his having Avorn it in the earlier pe- riod of his appointment, but afterwards disusing it. He added, that he thought himself cooler in court since he had rejected it. Another mode of avoiding infection is, fumigations with vinegar and the mineral acids in the form of air. Vinegar has been frequently cmploved ; 3 Q 1 CON 484 CON hut the discovery of the power of the mineral acids is contested. The late Dr. Johnson, of Kidderminster, evidently first proposed this method ; but from hispub- 'ications there appears to be no evidence of his having employed the acid gases. It seems, hoAvever, from his manuscripts, that he had done so; and, indeed, the ease with which it could be tried is a strong evidence that he had really used it. Dr. C. Smyth, who received a par- liamentary reAvard for this supposed discovery, seems to rest his claim, in a great measure, on his having substi- tuted the nitrous gas, since the muriatic is so offensive to the organs of respiration ; but certainly, previous to Dr. Smyth's application to parliament M. de Morveau had iecommended similar trials. We mean not to decide hastily or rashly ; but, though the casual notice of this plan by Dr. Johnson is certainly anterior to the hints of any other author, yet to our recollection, M. de Mor- v eau preceded Dr. Smyth. Our countryman may not have borroAved the hint; but, in the present state of che- mical science, it lay too much on the level for any one to plume himself greatly on the discovery. The me- thod of preparing each gas is extremely simple; and consists only of adding the sulphuric acid to nitre, or sea salt, deprived of their Avater of crystallization. We have omitted mentioning vinegar, as it connects the former with some other modes of destroying infec- tion. The volatility of the acetous acid adapts it for this purpose without any preparation ; and it is proba- bly highly useful, though perhaps less efficacious than the gases of the mineral acids. It is used in another form, viz. in a highly concentrated state, Avith aromatic oils. The first idea was taken from a preservative, said to be employed by four thieves, who plundered the vic- tims of the plague with impunity, secured by the aro- matic vinegar. It is prepared with great elegance and efficacy by Mr. Henry, of Manchester, and sold under his name. A more recent plan of this kind is the disinfecting bottle of M. de Morveau. The materials are preserved in a bottle made of strong glass, secured in a wooden case, and the stopper kept down by a screw. In this glass about eleven trench drachms of finely powdered black oxide of manganese are put; and to these are added about three ounces by weight, of pure nitric acid of the specific gravity of 1.40, Avith an equal bulk of muriatic acid, of the specific gravity of 1.134. About iavo thirds of the bottle must be empty: it is covered Avith a plate of glass, Avhich is raised by a single turn of the screAV. This plate must be ground and polished, so as to close the bottle accurately, and every particle of dust must be carefully wiped off. When used, it must not be held near the nose, as the pure oxygen gives pain Avhen respired; but in a few minutes it will fill a large room Avith the gas. These materials, if the bottle is opened daily, will last six months. The price, when properly filled, is, in Paris, twenty one francs for each. Ann-ties de Chimie, vol. Iii. p. 347. M. Dumotiez prepares bottles of a smaller size, with hf-.s proportions of the same materials. The chief im- provement is, that a small aperture is made by a turn of the screw. They are cheaper, and adapted for apart- ments of a common size. When infection or contagion has taken place, an emetic is the first necessary step; and this should be folloAved by active purging. After these medicines, a warm cordial diaphoretic, and sometimes a blister, is necessary. If, however, any one medicine is peculiarly and essentially requisite, it is the cathartic; but the emetic must be premised. The reasons for this plan will be afterwards explained. Mineral exhalations have been sometimes supposed to be causes of fever ; but Ave have not found any well authenticated instances of such effects, though Dr. Webster, in his History of Epidemics, has endeavoured with great earnestness to connect epidemics with volca- nic explosions, and other physical phenomena. Those who Avork in mines of lead or quicksilver are, hoAvever, subject to nervous colics and palsies. CONTAGIO'SI, (from contagio, contagion). Dis- orders from infection or contagious diseases. CONTEMPERA'NTIA, (from con and tempero, to moderate). See Temperantia. CONTE'NSIO, (from contineo, to restrain). It sometimes is used to express a tension or stricture. CONTE'NTA, $from contineo, to contain). Con- tents. Any fluids contained Avithin a solid part of the body. CONTE'NTUS, from contendo, to stretch). Stretched. CONTINE'NS FE'BRIS. A continual or a con- tinent fever, which proceeds regularly in the same tenor, without either intermission or remission. This rarely, if ever, happens. See l ebris. CONTI'NUA FE'BRIS, (from continuo, to perse- vere). A continued fever, attended Avith exacerba- tions, and slight remissions, but no intermission ; some- times called assidua. See Febris. CONTO'RSIO, (from cont or que o, to twist about). Contorsion. In medicine this word hath various sig- nifications. See Iliaca passio, Luxatio, Luxation of THE VERTEBRAE and CAPUT. CONTO'RTUS, (from contorqueo, to twist aside). In botany it means ravelled, curled, or twisted. CONTRA APERTU'RA, (from contra, against, and aperio, to open). A counter opening. This is sometimes necessary in Avounds made by puncture, or by a bullet, to discharge what is contained in them, or to prevent their groAving fistulous. The circumstances requiring this procedure are so various, as to demand considerable sagacity in the surgeon. The opening is sometimes made by passing a trochar to the bottom of the wound, directing its point to the nearest skin, and continuing it through, so as to make the old and tht new aperture one continued passage; more frequently by cutting through the skin directly upon the intruded body, or upon the button of the probe, which may be introduced to the bottom of the Avound to direct the in- cision. See Petit and Heister's Surgery. CONTRACTU'RA, (from contraho, to draw toge- ther). Contraction ; called by Dr. Aitkin, beribe- ria. An immobility of any of the joints from a preter- natural contraction of some of their muscles, or from a derangement of the osseous or ligamentous parts of the joint affected. Dr. Cullen ranks this as a genus of disease in the class locales, and order dyscinesie; and defines it " a continued, rigid contraction of one or more of the limbs." He distinguishes two spe- cies. 1. Contractu'ra primaria, from a rigid contrac- tion of the muscles, termed also obstipitas -, a Avord, CON 485 CON that with any other annexed distinguishes the variety of the contraction. Of this species he forms four varieties. 1st. When the muscles become rigid from inflammation. 2d. From spasm. 3d. When contracted, from the anta- gonists being paralytic. 4th. From irritating acrimony. 2. Contractu'ra articularis, from rigid joints. Dr. Aitkin observes, that the disease is most frequent- ly symptomatic : and when it depends on muscular con- traction only, he advises the tepid bath, with bandages, and counteracting by proportional Aveights the increased power of the muscle. Mechanical contrivances, either to assist the paralytic muscles or gradually extend the contracted ones, are chiefly useful. In each instance, the vapour bath is a valuable assistant. Dominiceti Buzaglo, and at present Mr. Pugh, have often succeeded in this disease by a bath of this kind. CONTRA-FISSU'RA, (from contra, opposite, and findo, to cleave). Contra-fissure. See Fissura. CONTRAHE'NTIA, (from contraho, to contract). Medicines which shorten and strengthen the fibres. Astringents are the only medicines of this nature, q. v. CONTRA-INDICA'TIO,(from co7itra, against, and indico, to show). See Antendeixis. ' CONTRA-LUNA'RIS, (from contra, and luna, the moon). An epithet given by Dietericus to a woman who conceives during the menstrual discharge ; but we believe there is no instance of this kind. CONTRARIUS. Contrary. In botany it means not parallel in situation. In medicine, any thing oppo- site in its nature or tendency. CONTRA-VE'RMES, (Sem.). See- Santonicum. CONTRAYE'RVA, (from contra and yerva, a herb, Spanish). A herb good against poisons. Drakena, Cyperus, longus odorus Pe7muanus, dorstenia, bezoardi- ca radix. Counter poison. It is the dorstenia co7i- frayerva Lin. Sp. PI. 176. The contrayerva was first brought into Europe about the year 1581 by sir Francis Drake, whence its name Drakena. It is the root of a small plant found in Peru, and other parts of the Spanish West Indies. There are two kinds; the one placenta ovali, the other angulari et undulata. The sort generally brought to us is about an inch or two long, half an inch thick, full of knots, surrounded on all sides Avith numerous long tough fibres, most of which are loaded with scaly knobs, of a reddish brown colour on the outside, and pale within. The tuberous parts of these roots are the strongest, and should be chosen for use. They have an agreeable aromatic smell; a rough, bitter, penetrating taste; and, when chewed, they give out a SAveetish kind of acrimony. It is diaphoretic and antiseptic; formerly used in Ioav nervous fevers, and those of the malignant kind; though taken freely it does not produce much heat. It is,.how- ever, noAV seldom used; though, with the Peruvian bark in decoction, Ave have sometimes employed it in ulcerat- ed sore throats as a gargle. Dr. Cullen observes, that this and serpentaria are powerful stimulants, and both have been employed in fevers in which debility prevailed. However, he thinks, wine may always supercede the stimulant powers of these medicines; and that debility is better remedied by the tonic and antiseptic powers of cold and Peruvian bark, than by any stimulants. By the assistance of heat, both spirit and water ex- tract all its virtues, but they carry little or nothing in distillation ; extracts made by inspissating the decoction retain all the virtues of the root. The London college forms the compound poAvder of contrayerva, by combining five ounces of contrayerva in powder, Avith a pound and a half of the compound powder of crabs' claws. This powder was formerly made up in balls, and called lapis contrayerva ; employed in the decline of ardent fevers, and through the whole course of low and nervous ones. The radix serpentaria Virginiensis in all cases may be substituted for the contrayerva. See Lewis's Materia Medica; Neumann's Chem. Works; Raii Hist, and Cullen's Mat. Med. Contraye'rva no'va, or Mexican contrayerva. It Avas introduced into Europe after the former, and is brought from Guiana, as well as from Mexico. The root is longish,about tAvo fingers thick, externally rough, and of a brownish colour, internally white, with a pith in the middle, of a sweetish aromatic taste, and but little inferior to the contrayerva introduced before it. This is the root of the psoralea pentaphylla Lin. Sp. PI. 1076. Contraye'rva a'lba. Contraye'rva Germavo'■ rum. See Asclepias. Contraye'rva Virginia'na. See Serpentaria Virginiana. CONTRI'TIO, (from contero, to break small). See COMMINUTIO. CONTU'SA, (from contundo, to bruise). Contusio, collisio, phlosma. Contused wounds, contusions, or bruises. When any part is bruised, the small blood- vessels are broken, and the blood they contained, effused in the adjoining cellular membrane; or these vessels lose their tone, and no longer contributing to the circu- lation, their contents stagnate. In either of these cases, if the impediment is not removed, an inflammation comes on, followed by suppuration, sometimes by gan- grene. There are also peculiar symptoms from any injury done to a nerve, a blood vessel, or a bone. In general, the symptoms< consequent on bruises may be reduced to three classes. First, They arise either when the solids are destroy- ed, and the fluids they contain discharged : those func- tions are consequently abolished Avhich depend upon a due and determinate motion of the fluids through the sound vessels. Secondly, The discharged fluids, collected either in the natural or preternatural cavities of the body, by their bulk and quantity press upon the adjacent parts, and either totally destroy or at least disturb their re- spective functions. Thirdly, The humours thus discharged, may, by their continuance and stagnation in their cavities, ac- quire such a degree of acrimony as to corrode and de- stroy the adjacent parts. When the internal parts are bruised, and the external integuments are entire, or confine the extravasated fluid, the consequence is, 1. An echymosis. 2. A spurious aneurism. 3. A sugillation. 4. Ulcers and gangrenes. 5. Caries; or, 6. Scirrhus. Boerhaave observes, that contusions on fleshy parts may produce suppuration, gangrene, palsy, or a con- traction. On a large nerve, a palsy, atrophy, incurable insensibility, and a gangrene on aU their parts below CON 486 CON the injured part: this may peculiarly folloAV contusions of the spino and its marrow. Contusions of the viscera, he justly observes, are often speedily fatal; they are tender; and their vessels easily burst. Contusions from gun shot Avounds are dangerous i roni the destruction of the organized parts which are bruised, as well as from the general concussion that the whole body suffers from the air violently impelled against it. The effects of concussion we have already noticed, though we have been unable to explain them. In no case should Ave be more cautious of pronouncing on the event of any disaster, than where a concussion or a contusion happens; and where both may have occurred, the caution, if possible, should be greater. See Bohnius de Renunciatione Vulner. § 2. cap. 1. When bruises are received inwardly, it is not easy to judge readily of the extent of the injury done by them ; and Avhen the case becomes more manifest, it is often too late to attempt relief. See Concussion. The remedies must be those chiefly Avhich, by their stimulus, restore the tone of the vessels. For external use, Avhere the skin is not much destroyed, a mixture of sharp vinegar, with twice its quantity of Avater, may be applied frequently by means of linen cloths wrung out of it, and, as often as they dry, moistened again. If there is much inflammation present, the folloAving, called embrocatio ammonia acetata cum sapone, ace- tated ammoniated embrocation avith soap, is very useful. R. Aq. Ammoniae, acetatae solutionis saponis ax %. 1. m. But where the inflammation has subsided, two drachms of aqua ammoniae purae added to the above is considered as very efficacious. Spirituous applica- tions should not be used, except where the sole inten- tion is to strengthen the injured fibres immediately on the occurrence of the accident; in slighter cases, a small quantity of spirit may be mixed with vinegar, and used on the first reception of the bruise. Even such friction as the bruise will bear on the part, or around it, Avill be generally useful. See Discutients. If the bruise is considerable, and particularly if any internal part is affected, bleeding, a cooling, liquid diet, Avith repeated gentle purgings, are of the greatest advan- tage. If the bruise is in the lower belly, clysters are necessary; and Avhere the internal parts are greatly af- fected, leeches or blisters, as near the seat of the com- plaint as can be admitted, are useful. Poultices, Avhich were formerly applied to carry on the circulation by relaxing the over distended vessels, are now disused, as they are found to promote suppuration. Cold vinegar poultices act as stimuli; but cold, in the other forms, is seldom admissible, as the vessels are too weak to re- store the action. This remedy is, hoAvever, useful in relieving the Aveakness which is often the consequence. The advantages of the tinct. opii externally as a re- solvent, of Dover's powders, and the anodyne antimo- nial drops, recommended in the article Concussio, de- serve the same attention when contusions happen, and on the same principles. See Bohnius de Renunciatione Vulnerum; Van Swie- tan's Commentaries on Boerhaave's Aphorisms; Tis- sot's Advice to the People; Bilguer's Dissertation on the Inutility of amputating Limbs, p. 69, 73. Bell's Surgery, vol. v. 446. CONTU'SIO, CONTUSU'RA. See Contusa. CO'NUS. (Greek.) A cone. The fruit of the pine, fir, or cedar tree; or any fruit Avith a broad basis, which gradually diminishes to a point. The trees Avhich bear such fruit are called coniferous. Dioscorides says, that ■xovos is a name of liquid pitch. Co'nus fuso'rius, also called pyramis. A cone. It is a vessel resembling an inverted cone, made of brass or iron, and is used for separating a regulus from its scoriae; for while the fused metal is pouring into the crucible, it is struck Avith a mallet, in order to produce a tremulous motion in it, by which the heavier parts fall to the bottom. CONVALESCENCE, (from convalesco, to grow well). This state implies a recovery from disease, Avhen nature, with little assistance, is supposed capable of re- storing health. In all acute diseases, considerable at- tention is, however, requisite, to prevent a relapse. On recovery from fever, the appetite often returns before the powers of digestion, and, of course, cannot be always safely indulged. In recovery from other dis- eases, the principal complaints should be cautiously kept in vieAV. Thus, after peripneumony, the expectoration should be anxiously kept up; after enteritis, the con- stant action of the bowels; after affections of the head, the utmost tranquillity of the body and mind preserved. In short, convalescence requires, in almost every situa- tion, care equally unremitted Avith that Avhich the con- tinuance of disease demanded. CONVALLA'RIA, (from convallis, a valley). See LlLIUM CONVALL1UM. Convalla'ria, polygonatum. See polygonatum. CONVOLU'TUS, (from convolvo, to roll round). In botany it means rolled up, like a scroll of paper. CONVOLUTA SUPERIO'RA, et INFERIORA O'SSA, (from convolvo, to roll round). See Concha N'ARIUM SUPERIORES, aild INFERIORES. . CONVO'LVULUS, or VOLVULUS, (from con- volvo, to roll together). (See Iliaca passio.) It is also the name of a genus which affords the Jalapa^. Mecoachana, Turbith, and Scammony; q. v. The whole genus usually abounds with plants containing a milky juice strongly cathartic and caustic. Convo'lvulus sepium, Lin. Sp. PI. 218. It is the c. major albus of authors, and resembles, in its virtues, the scammony. Convo'lvulus scoparius, a neAv species, vide Lin. Supplem. 135. Aiton's Kew, vol. i. p. 213. Wildenow, vol. i. p. 872. Probably the plant Avhich affords the lignum rhodium. Convo'lvulus colubri'nus. See Pareira brava. Convo'lvulus I'ndicus radi'ce tubero'sa e'duli, co'rtice ru'bro. Potatoes. See Battatas His- panica. Convo'lvulus mari'timus. See Brassica mari- tima. Convo'lvulus mari'timus Zeyla'nicus, &c. See BlNTAMBARU ZEYLANENSIBUS. Convo'lvulus canta'brica, convo'lvulus sPi'CiE fo'liis, convo'lvulus li'narije fo'lio. See Canta- BRICA. Convo'lvulus soldane'lla. See Brassica mari- tima. Convo'lvulus syri'acus. See Scammontum- Convo'lvulus pere'nnts. See Lupulus. V CON 487 CON CONVUL'SIO. A convulsion, or involuntary contraction of the muscles, (from convello, to pull to- gether). Called also hieranosos, distensio nervorum. Dr. Cullen places this genus of disease in the class neuroses, and order spasmi; and defines it," an irregular clonic contraction of the muscles without sleep," of which he enumerates nine idiopathic species; and five symptomatic. See Nosologiae Methodicae Synopsis, p. 216, vol. iii. Under the spasmi Dr. Cullen includes the tonic and the clonic spasms, where the muscles are rigidly and immovably contracted; and where the violent, irre- gular contractions are alternated with equally sudden relaxations. This arrangement is formed with the strictest propriety, as we shall afterwards find. Convulsions attack persons of all ages, but chiefly the young, or the debilitated; all constitutions, but princi- pally the fair, the delicate, and the irritable; each sex, but particularly females. Its causes are various ; but the chief source of convulsions is, in the opinion of every author, irritation. It is certainly irritation, in sy&tems peculiarly mobile, in other words, easily ex- cited to action; but, as the mobility is greater, the ir- ritation necessary to produce convulsions is less; and sometimes so slight as to be imperceptible. If we examine the functions of the nervous system, we shall find life and health depend on the regular distribu- tion of the nervous power. If it is hurried, irregularly exerted, or deficient, various diseases, and particularly convulsive ones, ensue. Joy, grief, surprise, will equally produce them. Violent exertions, and tone, suddenly relaxed, are also causes of these irregular motions. We do not find, however, that with high health, full vessels, and a firm constitution, however the circulation is ac- celerated, or the nervous poAver excited, convulsions ensue, unless the tone is suddenly remitted. Whatever effect therefore may be attributed to predisposition, the causes are chiefly debilitating ones; and the constitu- tions chiefly affected, those Avhich are weak. It is then irregular action, in Aveak habits, which constitutes the disease. In palsies of every kind, tremors attend every exertion; and the various species of tremor in Sauvages', one only excepted, are obviously from debility. In hysteria there is usually considerable debility, though the circu- lating system is often full; and indeed there is no more common cause of weakness than over distended vessels. This is the exception noticed in Sauvages' species of tre- mor. In epilepsy this debility is less obvious, but the most obstinate cases occur in weak constitutions; and, in others, the irregular action is excited by peculiar and violent stimuli, chiefly affecting the organic structure of some part of the nervous system. The palpitations in chlorosis, the gesticulations in chorea, the convulsive agitations in raphania, the causes of true convulsive asthma, all confirm the idea, that debility is the cause of irregular action. Nor need we add, for it is the subject of common observation, that convulsions close the scene, particularly of disorders induced by excessive evacuations and worn out constitutions; that they are effects of narcotics of every kind, of deleterious gases, mineral exhalations, and even of stimulants that exhaust the Arital poAver, and increase, in consequence, the irrita- bility. We may therefore rest safely- on the position, that irregular action, tither spasmodic or clonic, has its foundation in debility or in irritability; but the former is most frequent, as it is a very common cause of in- creased mobility. From the effects of narcotics, of deleterious gases and similar poAvers, we have reason to conclude, that ir- regular action may arise from debility alone, or at least from obscure and unperceived irritation. Yet in practice we must ahvays keep in view the existence of irritation; and we often find it necessary to check this exciting, at the risk of increasing the power of the predisposing, cause. There is little doubt, for instance, that the ir- ritation ofthemeconium sometimes produces the locked jaw and convulsions in neAV born infants ; this must be evacuated. The sedative power of lead produces the Poitou colic: this irritation must be soothed by opium before laxatives will succeed. A wounded nerve will occasion a locked jaw; the irritation on the nerve must be removed by destroying its sensibility, and the in- creased action of the muscles at the same time counter acted by appropriate remedies, general and topical~ Other convulsions are more effectually remedied by warm stimulants and tonics: the warmest stimulants are often required in the convulsions from sedative poisons or the deleterious gases. In this short dis- quisition, our first object was to establish the principle, that convulsions are rather irregular than increased action, and that their primary cause was debility: our second, not to mislead the young practitioner, who, by attempting to counteract debility, may lose sight of the exciting cause, irritation. Hoav debility acts in producing convulsions Ave pre- tend not to say, nor is the inquiry of importance; there seems, however, to be a ruling power in the constitu- tion, Avhich regulates the distribution of the nervous influence; and, when it is weakened, this influence is irregularly distributed. We mean not to say, with Stahlians, that this power is all wise, and directs every thing for the general good; exciting these convulsions to throw off some noxious matter, threatening destruction to the whole system. If such a power exists, it is im- planted by the Almighty ; regulated according to his fiat by secondary causes; and acting necessarily from the organisation of the machine. In another vieAV, the Avhole nervous influence may be regulated by its state in the brain; and, if that arrangement is altered by any violently stimulant or sedative impression, the rest must suffer a similar change: and, when we contemplate the various phenomena Avhich diseases of the nervous system present, Ave are rather inclined to adopt this opinion. We have, however, already observed that our object is to establish principles, not to build systems. Sometimes convulsions attack suddenly, Avithout any Avarning ; at others their approach is indicated by cer- tain symptoms, such as coldness of the feet, or a sense of creeping, rising like a blast of cold air from a parti- cular part of the extremities to the head; the left hypo- chondrium is sometimes affected Avith tensive and flatu- lent pains, and a costiveness attends; the urine is thin and pale; tremors and various unusual sensations are perceiv- ed, and in different patients other symptoms also attend, as the prelude to more violent ones. During the fit the motions are violent and involuntary, continuing in dif- ferent cases for a longer or shorter period, and returning after different intervals, occasionally after regular inter- missions. Languor, delirium, sleepiness, vomiting, or headach sometimes folloAV the cessation of a convulsive CON 488 CON paroxysm; but there are cases in which little or no sensible uneasiness is perceived on recovery from it. Infants when disposed to convulsions are affected with a cough, vomiting, ordiarrhoea; their features are at times distorted; a blueness appears about their eyes and upper lip, and tAvitchings or startings are often observed, particularly a contraction of the fingers into the palm of the hand; and during the intervals of the fits they are drowsy. As death draws nigh, the con- vulsions are more frequent. Convulsions, however, which have appropriate names will occur in the different articles. It is now only ne- cessary to mention the species included by Dr. Cullen under the genus convulsio. The nine idiopathic species differ only from their causes, where there is any real distinction; for the " universal," the " habitual," the " intermittent," convulsions are varieties only, and the symptomatic convulsions are less objects of particular attention. The result is, that convulsion is a symptom only, and does not deserve a particular generic distinc- tion. There are, however, some forms of the disease so important and dangerous, that they require a more minute attention. The first of these is the convulsio puerperarum. Dr. Bland thinks that convulsions in pregnant wo- men, and during labour, have nothing peculiar in their cause from those which happen to Avomen differently situated; and though external agents, particularly vio- lent affections of the mind, may sometimes, as at other periods, excite them, yet this will rarely happen, unless there is some peculiar vice in the constitution disposing to them. From observation he thinks he is justified in saying, that the puerperal state is far from favouring them ; as Avomen at that time will do and suffer, almost with impunity, what at any other would be attended with the most serious consequences. But whatever maybe the cause, he observes, there is evidently in the fit, as in the apoplexy, a too rapid and dangerous determina- tion of the blood to the head, which demands the most immediate and serious attention. To remedy this, blood must be immediately drawn, and, if possible, from the jugulars. The state of the labour should then be in- quired into; and if the child is not too far advanced in the pelvis, it will be right to prescribe a large stimulat- ing clyster to empty the boAvels, and at the same time lessen the determination to the head ; this, if not suffi- cient for the purpose, should be assisted by a few grains of jalap and calomel, or some other brisk purge. If the labour is far advanced, the convulsions will act upon the foetus; and if there is no impediment, either from wrong presentation or disproportion of the child to the pelvis, will, in a little time, safely expel it. If any obstacle to delivery is found, the position of the child, if faulty, must be altered ; or we ought to have recourse to other necessary assistance, in the same manner as if convul- sions Avere not present. In either way the termination of the labour will frequently put an end to the convul- sions. But if this is too hastily performed before the vessels have been properly emptied, and the rapid mo- tion of the blood in them diminished, there will be dan- ger, from the torrent rushing too, impetuously into the intestines or other abdominal viscera, of inflammation in some of those parts, inducing puerperal fever, and often death. But where the labour is not far ad- vanced, after the exhibition of the clyster and purgative, thirty drops of the tinct. opii may be given, and repeated, interposing occasionally the clyster or cathartic, as symp- toms shall indicate. See Dr. Bland's Essay on the Treat- ment of Convulsions during Parturition. Though we, however, allow Dr. Bland's authority to merit every attention which his judgment and long practice demand, Ave think that convulsions of puerperal women are really connected with that state. They oc- cur to those who never otherwise have been affected with the disease; and they cease when labour pains force down the child, as if its pressure on some of the nerves of the pelvis had occasioned the irritation. The neces- sary doses of opium also are 'much larger than he re- commends, and even ten grains of solid opium may be given in a clyster. We have seen half a drachm ordered. Dashing cold water in the face has sometimes succeeded, according to Dr. Denman's recommendation, and the foxglove, according to Dr. Hamilton's; but the chit i object is to hasten delivery. In every other respect, Dr. Bland's directions appear to us highly judicious. Convulsions are sometimes a symptom attending fe- vers, and may be produced by inanition, as when hae- morrhages or diarrhoea have occurred; or by repletion. Relief will most readily be procured by evacuations from the bowels in the last case; and by antispasmo- dics, particularly opiates, in the former. When they are caused by wounds, Avarm oil, or the Avarmer balsams, applied to the injured part, often effect a speedy- cure, when stricture in the part has been previously relieved by manual operation: the causes of irritation are indeed various, and therefore different means Avill be required to effect this end. Convulsions in children, from teething, require the loss of blood, particularly if the gums are swelled and painful. When depletion is the cause, cordials must immediately be administered, and a generous nourishing diet allowed. If, as we have said, plethora is a cause of debility, suppressed evacuations, Avhich also occasion it, become a source of irritation. The repulsion of cutaneous dis- eases, of the haernorrhoidal discharge, sometimes of the menses, are therefore frequent causes. In such cases, some evacuation is necessary; but so much only asAvill take off the immediate effects of the plethora. The other remedies must be adapted to the local fulness; these are chiefly laxatives, diaphoretics, and aloetic me- dicines, interposing in every instance opium, and, in the uterine obstructions, opium with camphor. Convulsions in children are owing to irritation of almost every kind; to flatulence; to the irritatidh of the gum distended by teeth; to acrimony in the stomach and boAvels, or worms. In every such instance we must guard against the peculiar irritation, as it occurs to our notice. The stomach and boAvels must be certainly kept clear, and opiates then administered, either by the mouth or by clyster. When flatulence is apparently the cause, to the opium in a clyster, the asafoetida should be added. Worms are a more important source of irritation ; but all children have worms: and if symptoms of irritation continue after rhubarb and calomel have been repeatedly given, worms maybe fairly accused as a cause, and me- dicines for this purpose employed. Not to anticipate what will be the subject of more particular considera- tion, we may now add, that the bear's foot, the hel- leborus foetidus, is the only certain remedy. coo 489 COO . The more general remedies for convulsions are musk and the Avhole tribe of fetids. These seem to act as sedatives, or rather as inirritants, a class of medicines Avhose nature we shall explain under that term. Warm bathing appears to relieve in a similar way. Nor can we attribute the effects of valerian to any other power. The union of the valerian with bark seems to give it an additional efficacy, from some influence Avhich we can- not explain. The remaining observations on the reme- dies for convulsions have been anticipated in the article Antispasmodics; q. v. See also Spasms. Convu'lsio In'dica. See Tetanus. Convu'lsio a ne'rvi pu'nctura. See Trismus. Convu'lsio rapha'nia, soloniensis, et ab ustila- gine. See Raphania. Convu'lsio u'teri. See Abortus. CONY'ZA, (from xovis, dust; because the poAvder is sprinkled to kill fleas in places Avhere they are trouble- some). Flea-bane. The leaves of this plant are com- monly glutinous and strong scented, the cup of the flower generally scaly, and of a cylindrical form. The flowers consist of many florets, which are succeeded by seeds covered with a downy substance. Cony'za .Ethiopica. See Elichrysum. Cony'za ma'jor vulga'ris. Mas Theophrasti, conyza major Diosc. Greater flea-bane. See Bacchar. Cony'za m^nor flo're globo'so, pulicaria, conyza minima, et media. Small flea-bane. See Inula Dysentebica. The chief use of all the flea-banes is to destroy fleas and gnats by burning. COOKERY. (See Aliment, page 72.) Though in this article we have, perhaps, introduced all the more essential remarks, yet Ave must still add what fancy, fashion, or refinement, has suggested. It is not gene- rally understood how profuse and prodigal civilized na- tions are in the expenditure of aliment. A large pro- portion escapes unchanged, and becomes, with the ex- crementitious fluids, a manure. Many substances, re- jected as useless, are employed in the same way. We shall begin with the latter. Fish, when caught in a proportion beyond that which the inhabitants can consume or preserve, are scarcely objects of the present attention; but the bones, which we reject, after the modern processes of cookery still contain useful aliment. When ground, they yield gela- tine to the common processes. The stomach of dogs extract it, so that they discharge almost pure calcare- ous earth. Later refinements have extracted nutri- tious particles from bones, by an instrument styled a digester, and, from its inventor, Papin's digester; in Avhich Avater, in a strong well secured iron vessel, is heated far beyond the boiling point. The fins of fish, some parts of the skin, have been in a similar way dis- solved. Boiling in close vessels has been recommended by some authors, as preventing the evaporation of the finer parts, or Avhat may be styled the aroma of animal food. This is, however, an useless refinement; for this aroma is soluble in water, if not carried off by too great heat. To preserve it, the water should be kept immediately below the boiling point, and the process longer con- tinued. This makes beef, mutton, and chicken tea, su- perior to the broth of either; and, if we would be still VOL. I. more nice, the meat should be put in a close earthen vessel without any Avater, and placed in a water bath, at about 200°o f Fahrenheit. It is stewed in the steam raised from the food; and the jelly, thus formed, con- tains the more delicate and nutritious particles of the food, with the flavour unimpaired and unaltered. In this state it is well adapted for delicate stomachs, and for food in febrile cases. When, as in baking, the vo- latile parts are not closely confined, they are altered by- heat, and acquire a kind of empyreuma not agreeable to the taste, nor easy in the stomach. In the common ovens, this compound, empyreuma, is often very offen- sive. The great refinement of modern cookery is, however, the minute division of the aliment. In this consists the real secret of the effects of the soup prepared according to count Rumford's plans; which are only the decoc- tions of the farinacea, with a proportion of animal food, deprived, by the continuance of heat, of all their nourish- ment, Avhich is communicated to the Avater. To this various condiments are added; of which the cheapest and most useful is the red herring, more often used in the soups of the luxurious than they are themselves aware. It is an instanee of Avhat we remarked in the condiments of the ancients, of the effects of even un- pleasant substances in a very minute proportion. COOPE'RTIO, (from-cooperio, to cover over). Co- vering, clothing, or a small cloak, by which the body is defended from the air, the same as zrepiTJoXy,. amlctus, from -zregie-leXXeiv, co-operire, tegere, to cover, in which sense it is several times used by Hippocrates. It is applied to the belly, and uterus investing the foetus; and also to a medicament, which is placed upon the tooth, involving it like a plaster, by Scribonius. To this article we have referred a most important subject, viz. clothing in general, on which the health greatly depends, and in diseases meriting also the most scrupulous attention. The ancients furnish little information; for their clothes were uniformly woollens, seldom probably cleansed in the washing tub. The inconvenience from this source they avoided by frequent bathing, Avhile the limbs Avere anointed with oil, on coming from the bath. Linen was unknown till after their connexion with Egypt in the time of Augustus, and then not generally used : the sericae vestes Avere cotton ; for the country of the Seres, the lesser Bulgaria, is unfavourable for the propagation of the silk worm, and the ancients were un- acquainted with China, or any country to the east of the Gulf of Martaban. A proof of their ignorance of silk is, that in the time even of Justinian it was sold for its weight of gold. We mention these circumstances chiefly to explain the cause of the slight attention paid to this subject by the ancient physicians ; for, however changeable the climate, they suffered little in conse- quence of their woollen dresses, which we have no rea- son to think Avere peculiarly fine or thin. In more modern periods it is a subject of peculiar importance ; and, Avhen we consider the most modern fashions, calls for the strictest attention. How can you bear the access of cold air to your naked body ? asked an European of a Canadian Indian. I am all face, he replied ; meaning that custom had render- ed it familiar. Were Ave in a state of nature, this reply might be satisfactory: yet we knoAv that catarrhs 3 R COO 4$0 coo and-rheumatisms are the most constant diseases of the savage. In polished life, a more particular inquiry is necessary. The interior clothing of the present period consists of linen, of cotton, or of flannel. The first, usually- worn next the skin, must be frequently changed. The effect of frequent change is to keep up perspiration, and it was even supposed to produce emaciation. The only real inconvenience of linen is, that it absorbs moisture slowly ; in other words, its hygrometrical af- finity is inconsiderable, and if for a short time removed from the body after copious perspiration, it feels damp and cold. We bear, however, with this inconvenience from the comfort we feel in changing it; nor, Avhen used only as the garment, next the skin, is it ever ma- terially injurious. The hygrometrical affinity of cotton is more consi- derable, and calico, for shirts or bed gowns, is prefer- able. For children, on many accounts, it is the only proper shirting. To the feeling it is warmer than linen, though less pleasant; though it equally at least pro- motes perspiration. In the more improved state of the manufacture of calicos, there is little distinction either in point of comfort or salubrity between them and linens; yet, in the latter view, they are on the Avhole preferable. The hydrometrical affinity of flannel is still more con- siderable; and copious indeed must be the perspiration that makes them inconveniently damp. To this must be added, that the spiculae of the wool stimulate the surface and excite the action of the cutaneous vessels, while the inconvenient roughness is soon, from custom, unobserved. It may now appear that Ave have proved little more than the superiority of flannel to calico, and of this to linen ; yet, we think, we have placed their different merits on such a foundation as will elucidate many modifications of our clothing. Our upper garments, in this climate, are generally of Avoollen ; and, where this material is not used, we compensate by numerous folds for the thinner texture, and the increased conducting power of heat. This last circumstance, of the greatest importance in our present consideration, we have explained in the ar- tle Caloric. Air is a bad conductor of heat, and po- lished surfaces receive it slowly. Hair and wool, there- fore, Avhose surfaces are polished, conduct heat imper- fectly, and more so in proportion to their fineness, which occasions the more frequent interposition of aerial molecules, and their little affinity for heat. This renders the eiderdown so peculiarly warm. We did not men- tion the effect of this circumstance in our comparison of the internal coverings of our bodies, not to confuse it Avith the hygrometrical affinity, and because it is more peculiarly applicable here; but its influence will be suf- ficiently obvious. As conductors of heat, from the body, silk is r.:ore powerful than cotton, and cotton than Avoollen. Each is colder, therefore, in the same propor- tion than that Avhich follows. Black also conducts heat from without better than white, and the more refrangi- ble rays better than the less refrangible. In warm weather, therefore, these colours are warmer in the same order. Count Rumford's later refinements on this subject, are not sufficiently established to induce us to enlarge on them. These considerations will lead us to a choice of cloth- ing, in different circumstances, for the preservation of health. In general, we have erred by clothing our- selves too thin, and changing our dress too early in the summer. It Avas formerly a rule, even Avhen the seu- sons Avere seemingly more forward than at present, to " keep the winter dress till May be done;" but AvenoAv change it more early, or adopt that of the demi-saison, Avhich is scarcely more warm than the dress of summer. It is not, hoAvever, the real Avarmth Avhich is of so much consequence, as the sudden changes of dress in the same day; not according to the change of tempera- ture, but to fashion. The drawing-room may, indeed, be Avarm, but the passages which lead to the door are cold; and the modern fine lady is ill adapted for so sud- den a change, eitherfrom dress or habit. It has been remarked, that consumptions have been much more frequent in Scotland since the plaid has been disused; and in England, Ave fear, from the present fashions, they will be still more abundant than at any former period. It has been constantly remarked, that the breast and the feet should be carefully guarded from cold. We see sufficient reason, from theory and experience, for the latter caution ; and it will not be difficult to explain the former, when we reflect, that a local chill deter- mines the fluids to the internal parts of the same organ. Thus, chills in the breast produce catarrhs and peripneu- mony ; in the extremities, rheumatism ; in the face, coryza and ophthalmia. The application of different kinds of clothing to dif- ferent diseases, presents some variety which merits at- tention. In the thin emaciated habits, flannel has been forbidden. It exhausts, it is said, too much ; yet these are generally susceptible of cold; and by this safeguard we avoid its most unpleasant effects. Such plans, how- ever, should be conducted with a discriminated cau- tion. If flannel be adopted, cold air should not be ex- cluded, and the patient accustomed to a moderate breeze, till habit allows of greater cold with impunity. Calico should in the summer be substituted for flannel, and the period of its wear protracted annually ; Avhile in spring the flannel should be earlier thrown off. The changes, for a time, should be conducted with care; and in the height of summer the cold bath will assis? this progressive improvement. In general,, hoAvever, flannel does little harm if free air be allowed. Its ob- ject is to guard against the bad effects of cold air; nor should it be Avorn if the air is at the same time carefully excluded. When, however, the object is to produce and con- tinue a free discharge of SAveat, flannel is essentially necessary. The " nine times dyed blue flannel" has certainly the virtues of common woollens, and no other. Flannels were formerly worn Avhen the patient was con- fined to bed in fevers, in a profuse SAveat, to promote concoction. At present they are employed only in rheumatisms, and occasionally in salivations. In each their utility is obvious. In fevers at present, fresh linen is usually alloAved daily, and the patient feels the high- est gratification from the change ; and calico in this state is not equally grateful, certainly not more advan- tageous, except the perspiration is very profuse. We must add, that the flannels should be frequently changed and washed. Those who would think them- selves injured if they did not change their linen COP 491 CO V daily, will often not change their flannel for months. flannel shirts should neA cr be worn above tAvo or three days Avithout being rinsed in cold spring water, and hung in open, free air. Extraordinary warmth of clothing should be admitted with caution ; and in no instance, unless it can be steadily employed. In general, it should be the object to bear changes of temperature with impunity; but this invulnerable constitution can only be gained by degrees. Those accustomed to indulgences should proceed Avith the utmost caution, and be aware that the attempt is highly dangerous. The cautions already suggested, Avill form their chief security. Besides the clothing mentioned, modern refinement has introduced some new manufactures. The shaAvl, the eiderdown, and the Shetland avooI, OAve their peculiar advantages to the fineness of the texture, in the Avay al- ready explained. The fleecy hosiery is a manufacture of cotton, where the inner surface is raised into a soft, fiocculent pile. As it does not possess the stimulus of wool, we doubt if it is greatly superior to the fine soft Avoollens. Common consent, perhaps fashion, gives it the preference, and the dictates of fashion we shall not oppose. ' The fine fur of animals often covers the skin, and is peculiarly wann; but it must be employed, in health, with caution, as its disuse is dangerous. It may be an useful lesson to add, that ladies should scarcely ever change their " bosom friend." Velvets are Avarm from their Aveight, rather than their pile; plushes from both. The cause of the coldness of silks will be suffi- ciently obvious from their texture; but the oiled silk, or linen, is warm, from preventing all access of air, and closely confining the heat of the body. COOPERTO'RIA, (from^the same,) i. e. cartilago thyroidea; called also abicu7n. See Aspera arteria. COO'STRUM. See Diaphragma. COPAI'BA. See Balsamum. COPAl'BvE INJE'CTIO. R. Bals. copaibae 3 ij. mucilaginis g. Arab. 3 ss. aquae calcis 5 ss. m. proper in gleets, in the latter stage of the gonorrhcea, and in the lluor albus. Cop.\i'BiE cum oli'bano mistu'ra, consists of two drachms of powdered olibanum, mixed Avith half an ounce of the balsam, Avith Avhich half an ounce of mu- cilage of gum arabic, and twice the quantity of honey, are incorporated. Five ounces of cinnamon Avater are gradually added. In the dose of an ounce, or an ounce and a half, this mixture will be useful in humoral asthmas, in leucorrhcea and gleets. « COPE'IA, COPE'LLA AMERICA NORUM, and COPELGA. The name of a tree in Hispaniola, in America, whose leaf serves for paper, and of Avhich the Spaniards there make cards. This tree affords a bituminous matter resembling pitch. Raii Hist. CO'PHOS, xuQos, deaf, (from xu$ou, to be deaf). A sort of toad mentioned by Nicander. It also signifies deaf, dumb, or both, or a dulness of any of the senses. COPHO'SIS. See Cophos and Dyseco-,. likeness). See Dentaria and Corallodendron, Coralloi'des fungus, (from xopxXXiov, coral, and eihs, likeness,) also called erotylus. C lav aria coral- loides Lin. Sp. PI. 1652. It is of a fleshy, fungous tex- ture, of a yellow colour, and branched in the manner of coral. It is said to be corroborant and astringent, but little notice is now taken of it. CO'RCHORON, (from xo$r,, the pupil of the eye, and xopeu, to purge). See Anagallis. CO'RCULUM, (a dim. of cor, the heart); called also cor. The heart or essence of a seed, and the pri- mordium of the future plant attached to and involved in the cotyledon. It consists of theplumula, the ascend- ing scaly part, and the rostellum, the descending part of the corculum. CORD. EUR. An abbreviation of Euricii Cordii Botanologicon, sive Colloquium de Herbis. Cord. An abbreviation of Valerii Cordi Historia Stirpium. CO'RDA, or CHO'RDA. See Chordee. Co'rda ty'mpani. The portio dura of the seventh pair of nerves having entered the tympanum, sends a small branch to the stapes, and another more consider- able one, Avhich runs across the tympanum from behind forwards, passes between the long leg of the incus and the handle of the malleus, then goes out at the same place where the tendon of the anterior muscle of the malleus enters. It is called chorda tympani, because it crosses the tympanum as a cord crosses the bottom of a drum. Dr. Monro thinks that the chorda tympani is formed by the second branch of the fifth pair, as well as by the portio dura of the seventh. Co'RDiE willi'sii. See Dura mater. CO'RDIA SEBESTI'NA. See Sebesten. CORDIA'LA. See Cardiaca. CORDO'LIUM, (from cor, the heart, and dolor, pain). See Cardialgia. CO'RE. (Greek.") See Pupilla oculi. CORE'MATA, (from xogeu, to cleanse). Brushes ; but in P. JEgineta it is used to signify medicines for cleaning the skin. CORIA'CEUS,(from corium, leather). In botany it means thick and tough, like leather. CORIA'NDRUM. Coriander. (Derived, perhaps, from topis, cimex, a bug, because the green herb COR 495 COR and seed stink intolerably); also called cassibor and corianon. The coriandru7n sativum Lin. Sp. PI. 367. The plant is an umbelliferous one, Avith finely divided leaves; the lower ones like parsley; the seeds of a pale yellowish-brown colour, and striated. It is a native of Italy; cultivated in some parts of England; annual, flowers in June, and ripens in July or August. The leaves have a small degree of an aromatic smell, mixed with somewhat offensive. The seeds Avhen fresh are also disagreeable, but by drying they become grate- ful : to the ta6te they are moderately warm and pungent. Dioscorides has asserted, that these seeds, taken in a considerable quantity, produce deleterious effects; but Dr. Withering has known six drachms of the seeds taken at once without any remarkable consequences. Mathiolus considers them as antiseptic; but they are generally used as stomachic and carminative. Mixed with sena in infusion, they more poAverfully correct its odour and taste than any other aromatic, and are equally powerful in obviating the colic pain it is very apt to pro- duce. Rectified spirit of wine takes up all their virtue, but water only partially extracts it. Distilled Avith water, a small quantity of essential oil is obtained, which partakes agreeably of the quality of the seeds. Pure spirit carries off, in evaporation, a great part of their flavour. Raii Hist, and Lewis's and Cullen's Mat. Med. CORIA'NON. See Coriandrum. CORIA'RIUM, (from corium, leather; because the dried leaves are used in tanning). See Rhus. CO'RIS, (from xeipu, to cleave, or cut; so called be- cause it heals wounds). See Symphytum petraum. Co'ris lute'a, Co'ris legi'tima cre'tica. See Hypericum saxatile. Co'ris monspeliensis Lin. Sp. PI. 252. A bien- nial plant of the south of Europe, intensely bitter and nauseous, but apparently an active medicine; and em- ployed, it is said, with success in syphilis. ^CORIUM, (from the Hebrew term gor). The skin of a beast; also leather, from whence the buff appearance upon the blood is called coriaceous. See Dartos. CORK, the bark of the quercus suber Lin. Sp. Pi. 1413 ; formerly employed as an astringent, but hoav dis- used. It affords an acid; for which see Chemistry. CORN. See Cerealia. Corn salad, an early salad possessing the celebrated antiscorbutic qualities of early vegetables. It is the valeria7ia locusta Lin. Sp. PI. 47, var. x. CORNACHI'NI PU'LVIS. See Scammonium. CO^RNEA, (from cornu, as it resembles horn). A coat of the eye, which is also called sclerotica cera- toides. It is the first proper coat of the eye, strong, thick, and tendinous; its anterior part is distinguished by the name of cornea tra7isparens, or lucida, and the posterior part by that of cornea opaca. The transparent part is sometimes called cornea; and the posterior part cor7iea opaca, and sclerotica, or sclerotis: the former only is elastic. "The opake part is made up of several laminae closely connected, whose fibres run in different directions, and form a dense, compact substance. The cornea consists of an external and internal la- mina, each of which is composed of thinner laminae. Its substance is in some degree elastic, to fit the eye to different magnitudes and distances ; it is also perfo- rated Avith many small holes, through Avhich a fluid is supposed to be constantly discharged, but which soon evaporates. The sclerotica and cornea are furnished with arteries, chiefly from a branch of the internal carotid. The nerves proceed principally from the ophthalmic branch of the fifth pair. The cornea transmits the rays of light into the eye, and produces the first refraction of the rays necessary to vision. Its natural transparency is liable to be ob- scured by inflammation, by abscesses, and ulcers. It seems more proper to consider this coat of the eye as the sclerotica, and the cornea only as its transparent part. See Sclerotica. CORNE'STA. See Cornumusa. CORNI'CULA, (from cornu, horn). A conical per- forated instrument of horn, which was formerly used as a cupping glass. The broad part was applied to the skin, and by sucking from the smaller end, the skin was raised into the instrument. CORNICULA'RIS PROCE'SSUS. See Coracoi- des PROCESSUS. CORNICULA'TjE PLA'NTjE, (from cornu, horn). Plants which produce many distinct horned seed pods, called siliqua. CO'RNU ARIETIS, the appearance of the section of the pes hippocampi, a portion of the brain. Co'rnu ce'rvi, (from the Chaldee term karnah,) in chemistry, is the beak of an alembic; but it generally means the horn of the stag or hart, particularly of the male red deer, though the horns of the fallow deer are commonly employed. See Dama. Hart's horn shaved gives out to Avater, by boiling, a soft insipid and flavourless jelly, in quantity about one-fourth of the Aveight of the horn. This jelly is used as a nourishing diet, and to obtund acrimony; it is usually mixed with the juice of lemons, or with Avine or spice, according to the different circumstances of the patient. The Edinburgh college directs the fol- lowing : Jelly of hart's horn. Boil half a pound of the shav- ings of hart's horn, in six pints of water, to a quart: to the strained liquor add one ounce of the juice of lemon, or of Seville orange, four ounces of mountain wine, and half a pound of sugar; then boil the whole to a proper consistence. The horns of deer are used for obtaining a liquor, salt, and oil, denominated liquor, sal, and oleum cornu cervi; but there is no observable difference betAvixt one animal substance and another for this purpose, except in the different proportion of oil which they afford; hence the bones of oxen and other animals, the hoofs of horses, the horns of oxen, ivory, the shells of tortoises, hair, and silk, all afford nearly the same liquor, salt, and oil. See Alcali. Hart's horn is said by former chemists to be prepared philosophically, when it is suspended in a still, while distilling any spirituous liquor; the horn being cut into thin slices, and exposed to the vapours, by which it is rendered white and friable. This preparation Avas acci- dentally discovered at Dresden, in Saxony, by Casper Pantzerus, an apothecary and native of Prussia. At present it is boiled till the black part separates, and then the inner white part is dried for use. Hoffman orders some alkaline salt to be put in the Avater when boiling, COR 496 COR to soften the black part; This process frees the horns from their glutinous matter, and thus renders them friable. By calcination, the earthy part is obtained most pure and perfect; its quantity about half the Aveight of the horn. The London college directs pieces of hart's horn to be burnt till they become perfectly Avhite, then rubbed to a very fine powder, called cornu cervi calcina- tum, calcined hart's horn, phosphas calcis of the last edition of the Edinburgh Pharmacopoeia, which is to be powdered and levigated for use. As the intention of this operation is to separate the volatile parts, the heat cannot be too great: yet some caution is necessary in this respect, as by suddenly hardening the external parts, the internal are guarded from the action of fire; for the earth of hart's horn is not convertible into quick lime. The horns left after distilling the spirit, salt, and oil, are as proper as fresh ones; but they are a mixture of calcareous earth and phosphoric acid, and the weakest of the absorbents. The earth of all bones is similar. Hart's horn, by late experiments, is found to contain 27 parts of gelatine, 57.5 of phosphat of lime, and one of carbonate of lime, with about 14.5 of water. The bones of animals, sometimes substituted, contain also a small proportion of phosphat of magnesia. Burnt hart's horn, or burnt bones, are therefore slightly con-. taminated with these salts. The phosphat of lime has been recommended in rickets by M. Bonhomme, and used in France, it is said, with success; but it has sel- dom been given in England. Solutions of this earth in vegetable acids are suppos- ed to be restringent, and they probably act only by unit- ing with acid humours in the primae viae. The London college only directs the following decoction of hart's horn. Take of burnt hart's horn prepared, two ounces; gum arabic, six drachms; distilled Avater, three pints; boil the Avater to a quart, and strain it. This is used as a com- mon drink in fevers attended with laxity of the bowels, or after violent diarrhoeas. Decbctum cretdcewn. Take of chalk finely powder- ed, two ounces; of gum arabic, half an ounce; boil it in three pints to two of water; pour off the liquor from the heavier parts that fall to the bottom. This may be substituted for the former, but each would be useless if the gum was not an ingredient. If a little cochineal is added, it is called decoctum ru- bru7n, red decoction. See LeAvis's Materia Medica. Neumann's Chemical Works. Co'rnu unico'rnu. See Unicornu. Co'rnu fo'ssile. See Unicornu. Co'rnu cervi'num. See Coronopus. CORNU 'A, (from cornu, horn). Horny excrescences, which sometimes arise on some part of the body. Cornu'a ute'ri, called also plectena. In compa- rative anatomy, the horns of the womb. The womb in some quadrupeds is triangular, and its angles resemble horns. CORNUMU'SA. A retort, called also batia, cor- 7iesta, cornuta. CO'RNUS. The cornel tree. Cornus sanguinea Lin. Sp. PI. 171. The fruit is moderately cooling and astringent. The schagri cottam is a species of cornel Avhich groAvs in Malabar, the expressed juice of which, drunk with sugar, is cooling and astringent. CORNU'TA, (from cornu; from its resemblance to a horn). A retort. See Cornumusa. CORO'CRUM. See Fermentum. CORO'LLA, (from corona, a crown). One of the seven parts of fructification, according to Linnaeus, who defines it the inner bark of the plant present in the flower: it is the coloured or painted leaves of the plant, consisting of petals, and nectarium. The corolla of Linnaeus, English botanists call blossom. CORO'NA, (from the Hebrew term koren). A crown. In botany it is a series of small beards, or rays, in discoid flowers. Coro'na se'minis is the appendage to the top of many seeds, enabling them to disperse, serving them as wings. This is either the calyculus, formed of the pe- rianthium of the flower, as in the scabiosa, knautica, 8cc.; or the pappus (down), as in the hieracium, son- chus, &c. Coro'na cilia'ris. See Ciliare ligamentum. Coro'na imperia'lis. Crown imperial. It is a bell-shaped flower, and an ornament of our gardens. In the petals is a sweet juice, which the Turks use as an emetic; but the whole plant is esteem- ed poisonous. Coro'na re'gia. See Melilotus. Coro'na so'lis. Sun flower; called also chi7na- lati; helianthus annuus Lin. Sp. PI. 1276. This flower, well knoAvn as an ornament in gardens, is a native of Peru, and other Avarm countries of America. It is not knoAvn to possess any valuable medicinal qualities; though it is noticed as heating, and an agreeable food. It produces a resinous tear, which is its most active part. A gum also flows from it, if the seed vessels Avhen ripe are cut small, and boiled in water. The seeds are made into bread. Coro'na so'lis pa'rvo flo're tubero'sa radice. See Battatas Canadensis. Coro'na te'rr.«. See Hedera terrestris. Coro'na glandis, the margin of glans penis, just above the odoriferous glands. Coro'na veneris, the eruptions Avhich surround the forehead at the roots of the hair, in cases of syphilis. CORONA'LE OS, (from corona, a crown). See Os frontis. CORONA'LIS, (from the same,) vel ARCUA'LIS SUTU'RA, (from arcus, a bow). The suture upon the crown of the head. CORONARIA LIGAME'NTA, (from corona, a crown). The coronary ligament of the radius is a sort of ligamentary hoop, surrounding the circular cir- cumference of the head of that bone, reaching from one side of the small lateral sigmoid, or transverse cavity of the ulna, to the other, in an arch, which is about three- fourths of a circle. It is nearly as solid as a cartilage. It connects the radius very closely to the ulna, yet ad-: mits of the pronation and the supination of the arm. CORONA'RLE ARTE'RI^E et VEN.E, (from the same). The coronary arteries and veins. Those of the heart are also called cardiaca. The first branches which the aorta sends off are the coronary ar- teries of the heart; and they appear between the aorta and the pulmonary artery, running round the basis of the heart and to the apex, giving branches chiefly to their respective ventricles. They frequently anasto- mose both at the basis and apex. One of these runs an- COR 497 COR teriorly, the other posteriorly on the heart, and some- times there are three. They are lost in the substance of the muscle. The coronary veins of the heart folloAV very nearly the arteries; they rise chiefly from the right auricle, and come out in the angle between the vena cava and the passage into the ventricle; one principal branch runs to the apex; the great trunk, to the other parts. Dr. Hunter says, that the coronary vein of the heart opens into the right auricle, between the orifice of the cava inferior and the passage into the ventricle, and is fur- nished with a semilunar valve, to hinder the blood from flowing back. The great coronary vein, and the orifice by Avhich it communicates Avith the right sinus of the heart, were knoAvn, it has been said by M. Wolf, to Galen; but Eustachius seems to have been the first who noticed the valve with Avhich this orifice is furnished. Since his time, M. Wolf says anatomical Avriters have con- stantly spoken of this valve as of a semilunar shape; but he asserts that its figure is oblong and narroAv, and that it is a peculiar valve, different from every other in the human body. The coronary artery of the stomach rises from the coe- liaca, goes first to the left side of that organ, a little be- yond the superior orifice, round Avhich it throws branches, and also to every part of the stomach near it: and these branches communicate with those Avhich run along the bottom of the stomach to the pylorus: afterwards it runs on the right side of the superior orifice, along the small curvature of the stomach, almost to the pylorus, where it communicates with the arteria pylorica, and turning towards the small lobe of the liver, it gives off some branches to it: then it advances under the ductus venosus to the left lobe of the liver, in which it is lost near the beginning of the duct just named, having first given off some small branches to the neighbouring parts of the diaphragm and omentum. The coronary vein of the stomach is sometimes a branch from the vena portae ventralis, or from its princi- pal branches. It sometimes springs from the splenica. The coronaria ventriculiisso called, because it surrounds its upper orifice. It runs along the small arch to the pylorus, and gives out branches to the sides of the stomach. CORONA'RIUM LIGAME'NTUM, (from the same). See Jecur. CORONA'RIUS STOMA'CHICUS. The ramifica- tion of the nerves from the eighth pair near the upper orifice of the stomach. CORONA'TUS, (from corona, a crown). In botany it means croAvned, appearing like a coronet. CORO'NE, (Greek). A croav. The acute process of the loAver jaw bone is so called from its likeness to a crow's beak. See also Processus. CORONI'LLA I'NDICA, (adim. of corona; from the appearance of its flower). See Indicum. Coroni'lla monta'na. See Emerus minor. CORO'NOID, (from xopuvn, a crow, and et^os, like- less; resembling a crow's beak). See Processus. CORONOI'DES APO'PHYSIS U'LN.E. It is at the upper end of the ulna prominent, and a little point- ed, resembling abroad short beak. It is received into the anterior cavity above the pulley, at the lower extre- mity of the os humeri, when the fore arm is bent. vol. i. Coronoi'des apophysis maxi'llje. See Maxilla INFERIOR. CORONO'PUS, (from xopmy, a carrion crow, and , contention). A small ball made of leather, and stuffed Avith bran, or sand, or other mate- rials : it Avas suspended by a string about the height of the navel of the person Avho used it. When people were too fat, they took it in both hands and pushed it from them, and receding as it returned, they received it into their hands, and so continued the exercise. See SPHiERISTICA. CORYDALES, (from xopo%, a helmet or hat). A natural order of plants resembling a hat or helmet. CORYLUS. (Greek). See Avellana. CORY'MBAS, or CORY'MBF, (from xxpx, the head). The ivy tree. So called because it grows into a large head on the top. See Hedera arbokev. CORY'MBUS, (from corymbe, the ivy). A cluster of floAvers or fruit standing on pedicles, which are so disposed as to form a sphere. In its proper accepta- tion it is a cluster of ivy berries. Linnxus distinguishes COS 504 COT by this name a species of inflorescence, in Avhich the flowers groAv in clusters, each upon a separate peduncle as on the siliquose plants in general. CORY'PHE. Kofvpv). The vertex or top of any thing. See Vertex. CORY'ZA, (from xxpx, the head, and &u, to boil; because it is attended with an inflammatory defluxion from the nose). See Gravedo and Catarrhus. COSCU'LIA. The grains of kermes. See Chermes. COSMETICA. Medicines Avhich take off pimples or other irregularities of the skin. They are usually saturnine or other metallic preparations, and often highly injurious. The celebrated wash of GoAvland is a weak solution of corrosive sublimate. Antimonials taken in- ternally are safe and useful. COSMETO'RGES. A Avord, invented by Dolaeus, to express the sensitive soul. COSMIA'NA ANTIDOTUS. The name of an antidote in Marcellus Empiricus. CO'SMOS. Rythmus, a regular series. In Hippo- crates it is the order and series of critical days. CO'SSI, (from xis, a worm). Tubercles in the face, like the head of a worm. See Varus. CO'SSUM. A malignant ulcer of the nose, men- tioned by Paracelsus. CO'STA PULMO'NARIA, and CO'STA HE'RBA PANO'NICA. See Hieracium Alpinum. CO'ST.E, (from custodiendo; because they surround and keep in the lungs). The ribs. The costae, in anatomy, are generally twelve on each side, sometimes eleven, at others thirteen: their extremities next the vertebrae are rounder and stronger than those Avhich join the sternum ; the upper edges are more round than the lower, which are depressed internally for lodging the intercostal vessels and nerves; this channel is not ob- servable at either extremity, Avhich directs us to per- form the operation for the empyema rather at the sides of the thorax than near the sternum or spine. The ribs are articulated at each extremity, of which the posterior is doubly- joined to the vertebrae; for the head is received into the cavities of the two bodies of the vertebrae by ginglymi, and the larger tubercle is articu- lated to the transverse process of the inferior vertebrae by arthrodia; they are thus guarded against luxations. They are divided into true, called vera,^ and false, called spuria, illegitima, 7nendose, notha. The true are the seven superior, whose cartilages are joined to the sternum; these ribs include the heart and lungs. The false are five inferior, whose cartilages are not joined to the sternum; unto all these the diaphragm is con- nected, and within them the stomach, liver, &c. are con- tained. The cartilages of the false ribs are only connected to one another by the membrane which covers them ; the two last are joined to the vertebrae by a round head, and their cartilaginous extremities are lost in the interstices of the muscles, so that they are more moveable than the other ribs. The upper rib, contrary to the rest, is flat upwards and downwards, that it may not incommode the lungs, and leave room for the subclavian vessels and muscle. The anterior extremity of each rib is lower than the posterior; therefore, when elevated, the cavity of the thorax will be increased in its diameter backwards and fonvards, and the middle part of the superior ridge is lower than the posterior part; thus, Avhen elevated, the diameter of the thorax will be laterally increased. The ribs are but little used in sleep, respiration being then chieflv carried on by the diaphragm. Co'sTAj,"in botany. The fibres of the leaves, or the long strings which run either across or lengthways through them, are called their ribs. COSTA'LES NE'RVI, (from costa, a rib). See DORSALES. COSTO-HYOIDiE'US, (from costa, a rib, and hy- oidaus, belonging to the hyoidal bone). A muscle so named from its origin and insertion. See Coraco- HYOIDiEUS. CO'STUS, costus arabicus Lin. Sp. PI. 2, (from the Arabic term kasta). Also called costus Indicus, ama- rus dulcis Orientalis, tsianakua. Sweet and bitter costus. It is a root brought from the East Indies; about the size of a finger, of a pale greyish colour outwardly, and yelloAV within. In Arabia a bitter and a SAveet sort were formerly distinguished; and in commerce three kinds are occasionally found, derived either from the amomum, the costus, or the alpinia of Linnaeus. The root of costus is recommended as stomachic, diaphoretic, and diuretic; it impregnates the urine with a violet smell. On evaporating a decoction of this root, almost all its smell is dissipated ; but a bitter ex- tract is obtained nearly equalling two thirds of the root. The spirituous extract is but small in quantity. Raii Hist. Lewis's Materia Medica. See Zedoaria. Co'stus cortico'sus. See Canella alba. Co'stus horto'rum minor. See Ageratum. Co'stus ni'gra. See Cinara. CO'STYLE. The socket of the hip bone. See Acetabulum. COTARO'NIUM. A word coined by Paracelsus, implying a liquor into which all bodies, and even their elements, mav be dissolved. CO'TINUS. (Greek). The olive of the Greeks; the red sumach of the moderns. CO'TIS, (from xotJt), the head). The back part of the head; sometimes the hollow of the neck. COTONA'STER. See Sorbus. COTO'NEA. See Cydonta. COTO'NIUM. See Bombax. CO'TTI VI'NI. A name of some Italian Avines rendered luscious by boiling the must of the poorer sorts. CO'TULA. (See Cotyle and Cyathus). A twelve ounce measure; and sometimes the appellation of bugs. See Cimex. Co'tula flo're lu'teo radi'ato. See Buphthal- mum. Co'tula fcetida, (from cos, a whetstone). A kind of camomile, with leaves like a whetstone. See Cha- MjEMELUM fcetidlm. CO'TYLA, (from xolvXti, a cavity). See Cotyle. It is any deep cavity in a bone, in which any other bone is articulated; but generally used to express the cavity which receives the head of the thigh bone. It also sig- nifies a deep sinus surrounded with large lips, or any cavity like the glene, but deeper. CO'TYLE, CO'TYLA, or CO'TULA, (from the COL 505 C R JE same). Among the ancients it was a drinking cup, or any thing which had a cavity, as the hollow of the hand. Among the Greeks it was a measure, and is nearly the same as the hemina of the Romans, Avhich held nine or ten ounces. See Cyathus. COTYLEDO'NES, (from the same). Cotyledons; acetabula ; certain glandular bodies adhering to the cho- rion of some animals: but no such substances are ob- served in the human chorion. COTYLE'DON, (from xSjvX*, cavity). The lateral bibulous, perishable lobe, or placenta of the seed, des- tined only to nourish the heart. The greater part of seeds have two lobes; some have more; some only one, and others none : hence a distinction of all plants into acotyledones, monocotyledones, dicotyledones, polycoty- ledones. (See Botany.) Some herbs, also, whose leaves are concave, and shaped like the cavity of the hip joint, bear this name. Cotyle'don, (from xolvXy, a cavity.) Cotyledon um- bilicus veneris Lin. Sp. PI. 615. Acetabulum, cotyle- don major, kidney wort, navel wort, and wall pen- ny WORT. Its whole appearance resembles house leek; the root thick, knotted, with many small fibres springing from it. It grows on old stone Avails, and flowers in May. The leaves are slightly cooling, astringent, and diuretic; but are seldom used. Cotyle'don marinum. See Androsace. COTYLE'DUM, A'LTERUM. See Crassula. CO'UM. See Colchicum. COUP DE SO'LEIL. See Ictus Solaris. COU'RADI. See Paianeli. COU'RAP. (Indian.) The modern name for a dis- temper very common in Java and other parts of the East Indies. It is a herpes on the axillae, groins, breast, and face; the itching is almost perpetual, and the scratching is followed by great pain, with a discharge of matter, which fixes the linen firmly to the skin. Courap is a general name for any sort of itch; but this distemper is thus called by way of eminence. It is so contagious that few escape it. For the cure gentle and repeated purging, and externally the sublimate in a small quantity, are employed. See Bontius de Medi- cina Indorum. COU'RBARIL. The American name of the tree which produces the gum anime. Called also locusta ; animifera arbor Brasiliana ; Brasiliensis arbor siliquo- sa ; cancamum Grecorum ; ceratia diphyllos ; ictaiba ; courbaril. Hymenea coubaril Lin. Sp. PI. 537. It grows in many parts of the West Indies, particularly in the Brasils. See Anime. COURO'NDI. It is a tall evergreen, which groAvs in the East Indies; the juice of its leaves and the ker- nels of its fruit are astringent, and used with whey to cure diarrhoeas and dysenteries. Rheed's Malabar, 4 tab. 50. Raii Hist. COU'ROS. So Hippocrates called the child in the Avomb Avhen perfected there. See Conceptio. COUROY-MOE'LLI. A shrub growing in sandy places in the East Indies: the bark and root boiled in milk are esteemed an antidote against the poison of ser- pents. It has not yet found a place in botanical systems. Raii Hist. COU'SCOUS. The African name of a paste made of the flour of millet, Avith some flesh; and, when eaten, vol. i. a small quantity of lalo is also put. It is much used as food about the river Senegal. COU'TON. A tree Avhich grows in Candia, resem- bling the walnut tree; arbor vinifera couton juglandi similis of Bauhine. When this tree is wounded, an agreeable liquor flows out, which resembles Orleans wine. Its genus is unknown. CO'VALAM; called also cucurbitifera trifoliate. beli, seu serifole Bengalensium, capotes, cydonia exotica. Cratava marmelos Lin. Sp. PI. 637. It is a tall tree, growing in Malabar, and in the island of Ceylon: its fruit is shaped like an apple ; the outer rind is thin and green ; under it is a woody one, inclos- ing a viscid yellowish moist substance, of a sweetish acid taste, in which are long, flat, white seeds ; it is tur- gid, with a gummy pellucid juice. This fruit is astrin- gent whilst unripe; but when ripe, of a delicious taste. The bark of the tree strengthens the stomach, and re- lieves hypochondriac languors. Raii Hist. A species of sterculia, called tongchu, greatly resembles this plant, of which M. Correa has formed a new genus. Linnaean Transactions, vol. v. COU'VRE CHEF, le grand. Cou'vre chef, en tria'ngle. See Ric^e, Deligatio, 5, 7. COWPE'RI GLANDU'LA. Cowper's glands, from the discoverer. They are small, hemispherical, and compound. One of them is situated on each side of the urethra, without the corpus spongiosum and acceleratores muscles, between the bulb and prostate. Each has an excretory duct, through which a mucus is evacuated upon the internal surface of the urethra for its defence. Whether there be other glands belonging to this part, as some authors assert, is uncertain. In women we observe, before the hymen, an orifice on each side, from Cowper's glands, which lie upon each side of the perinaeum, and serve the same purpose as in the male. They are called also 7nuscosa glandula, and glandule vasculares. CO'XA. See Femur. CO'XiE DOLO'RES. See Ischiadicus morbus. Co'XiE o'ssa. See Os innominatum. COXE'NDIX, (from coxa, the hip). See Ischium, and Os innominatum. COYU'TENA LUZO'NIS. See Fagara major. COZTIECZO'COTL. See Mecaxocotlifera. CRAB LICE. A species of pediculus, which infests the axillae and pudenda. They fix to the skin, and are with difficulty removed. They are, however, easily destroyed by slight mercurials, either in an ointment or lotion. CRAB YAWS. A name in Jamaica for a kind of ulcer on the soles of the feet, with callous lips, so hard that it is difficult to cut them. The unguentum hydrar- gyri fortius is the best remedy. CRA'DE. In Hippocrates it is the branch of a fig- tree. CRA'DLE. A moveable bed to lull children to sleep; and a case in Avhich broken limbs are placed, whose arched top prevents inconvenience from the Aveight of the bed clothes. CR^E'CA MA'JOR. See Vicia. CR/E'PALE, and CRA'PULA, (from**,*, the head, and vrxXXu, to agitate). A disorder of the head, pro- duced by excess both in eating and drinking. Indiges- tion. 3 T C R A 506 C R A CRA'MBE, (from'the Arabic word caromb). A cab- bage. Sec Brassica. CRAMBEION. (See Cicuta.) In Hippocrates it signifies a decoction of cabbage, (from xpxy£*i, a cab- bage). CP.A'MPUS, cramp, (from krimpcn, to contract; Germ.) It is a sudden and violently painful rigidity or spasm of a muscle. This complaint is often very trou- blesome, but not usually dangerous; though instances have occurred in Avhich, passing from the limbs to the bowels, the patient hath with difficulty recovered: it principally affects the limbs or neck. In the Medical Museum, vol. iii. is an instance of a cure effected by drinking a glass of tar water every night and morning. For present relief a roll of brimstone is re- commended to be held firmly in the hand, which quickly breaks, and thus the patient is eased: it breaks, how- ever, from the heat only ; yet a violent exertion of some other muscles contributes to relieve it. This disease is cither idiopathic or symptomatic. When of the former class, it affects the legs, thighs, or other parts suddenly, Avhilst swimming in cold water, or whilst the tibiae are exposed to the cold night air; or Avhen the muscles are uneasily situated: the digastric muscles are subject to this complaint; Avhilst the neck is exposed naked to the cold air the pain is intolerable, but in a minute or two abates spontaneously, particularly if Avarmth Avith fric- tion is applied to the parts, if the contraction of the muscle is counteracted by external pressure, or the part affected be placed in a situation Avhere extension may be produced. The sympathetic cramp is that Avhich affects the loAver extremities, particularly in the cholera morbus, Avith strong distention and excruciating pain of the calves of the legs: all the flexor muscles of the legs and thighs occasionally suffer from this cause. After a vomit has been premised, thirty or forty drops of liquid laudanum should be administered. If the breast should be affected Avith this spasm, a fugitive pleurodyne arises, Avhich is temporary, but violent, with danger of suffocation ; if the throat, a spasmodic angina. CRANEI'A. See Cornus. CRA'NGON; also called squilla crangon, and the prawn. It is a sea shell fish of a delicate flavour, afford- ing a light and easily digestible food. CRA'NIOLOGY. We have introduced this subject in the article Cerebrum, and have there laid the foun- dation of the present inquiry, by considering the brain as the material organ of an immaterial principle; as the instrument rather than the agent. The faculties of the soul are found only in animals which have a brain, are generally proportioned in their extent and variety to the size of the brain, are injured or destroyed by the lesion or destruction of this organ. We find also the intellectual faculties independent of each other; and, even Avhen they exist apparently in the same perfection in one individual, they are exercised Avith different degrees of activity at different times. This independence of the faculties is a position of consider- able importance in Dr. Gail's system, our chief object at present; because he at once draws a consequence from it, that faculties, thus independent in their nature, are not connected in the organ, and that the evolution of the organs is in the direct ratio of the corresponding facul- ties. We doubt Avhether the conclusion is correct; nor, indeed, do avc sec, if it be admitted, how the author can refuse to alloAV of the division of Avhat is immate- rial, a solecism in physics, or separate independent poAv- ers acting in different parts ; in fact, of as many souls as there are faculties. Dr. (hill thinks, however, that the evolution of different faculties is the cause or effect of distinct protuberances of the cranium, and that the peculiar mental power of the individual may be ascer- tained by inspecting the skull. With these vieAvs he has compared the skulls of ani- mals and those of men, whose faculties are analogous or contrasted. His inquiries have, it is said, not only as- certained the facts to be hereafter mentioned, but proved that the faculties called instinctive in animals, as attach- ment, cunning, circumspection, &c. are found equally in man; that the bulk of the organ determines the genus, Avhile the reciprocal proportion characterizes the in- dividual ; that the disposition to every faculty, given originally by nature, may be expanded by exercise or favourable circumstances, sometimes even by diseases ; but that it can never be created, where nature has not originally given it. The accumulation of the organs, he remarks, is made in a regular manner from behind fonvard, and from below upward; so that animals, in their approach to man in the variety of their faculties, have the superior and anterior parts of the brain more expanded. In the most perfect animal, man, there are, in the author's opinion, organs in the anterior and su- perior parts of the frontal and parietal bones, destined for the faculties, which belong exclusively to him. In this vieAV Gall's system entirely corresponds to the ob- servations of Camper on the facial line, noticed also in the article Cerebrum ; q. v. But though we have spoken of the bulk of the brain, as distinguishing the possession of intellectual faculties in their greatest variety and extent, yet bulk alone does not more furnish the criterion of intellect, than the size of the body does that of strength. Many large un- wieldy men are much weaker than those of a smaller size, whose limbs are firmly knit, and whose muscles display, by their SAvell, the effects of frequent and spi- rited exertion. A large round head, in the same Avay, sIioavs a feeble intellect; while the varied bold projec- tions of the cranium display, it is supposed, varied and active mental powers. Dr. Gall, Avho first promulgated this system at Vi- enna, has been since travelling through Germany, to in- crease his collection of skulls, and to improve the nice arrangement of faculties from a vieAV of the cranium. We lately heard of him in Saxony; Avhere he is said by professor Boetiger, Avho accompanied him, to have been very successful in ascertaining the qualities of the mind by this neAV kind of physiognomy. He has never pub- lished his lectures ; but we are led to expect a full ac- count of his system from Dr. Bishoff and Dr. Hufeland, translated into English. We shall, however, give at present the outline, and correct or supply Avhat may be erroneous or deficient in another article. The subject wiil again recur under Organology. As a plate will render long descriptions unnecessary, Ave shall refer to an engraving, copied from one in the 55th volume of the Journal de Physique, for the differ- ent parts of the cranium, which designate particular qualities of mind; and shall here add a few of the singu- lar, and sometimes, Ave think, trifling or ridiculous C tt A 507 C R A ubservations by Avhich Dr. Gall endeavours to establish his system. A system-builder will often stoop very Ioav for assistance in support of his fabric. In conformity Avith his opinions, before hinted at, he considers the medulla oblongata as the seat of the organ of the tenacity of life. The bulk of this part is propor- tional to the size of the occipital hole; and he finds it larger in Avomen than in men, proportionally very large in the cat, the beaver, the weasel, &c. The organ of lasciviousness is, in his opinion, at the basis of the skull, behind the medulla oblongata. It is only conspicuous about the age of puberty, and in cas- trated animals is never observed. In the ape, the rab- bit, and the cock, this part of the skull is very large. It is peculiarly large in pigeons and sparrows, so as al- most to form an epiphysis; and, in some human skulls of idiots distinguished for lasciviousness, this part Avas very protuberant. The organ of attachment i3 peculiarly large in spa- niels, and less visible in greyhounds. The organ of courage, contiguous to those of " pa- rental affection and attachment," explains, in our au- thor's opinion, the exertions of courage from animals and human beings, in defence of their young or their particular friends. This organ is very inconsiderable in the hare, the sheep, and the greyhound; but very conspicuous in the hyena, the lion, the Avolf, and parti- cularly in the bulldog. Mr. Gall adduces as a proof of the existence of the organ of courage, the covA'ard, Avhen affrighted, " scratching the back part of his head behind his ears, as if he wished to excite its action !!" The organ of cunning is nearly connected with that of pillage. We mean not to be ludicrous Avhen we add, that our author found it in poets (Journal de Physique, vol. Iv. p. 206, note). It is very conspicuous in the heads of Calmucs, in foxes, cats, pies, Sec. rFhe organ of the sense of locality constitutes, with respect to places formerly seen, local memory; Avith re- spect to future objects, combinations of new localities. This organ is particularly conspicuous in birds of pas- sage, in landscape painters, ana in the skull of the great Frederick. It is fainter from age. The frontal sinus enlarges inwardly, and diminishes this portion of the brain. The organ of the sense for collecting or remembering facts is subject to a similar change from age. Among animals, it is chiefly conspicuous in the elephant. "Among men (we noAV employ Dr. (titii's own words) I have found this organ not only in those who have a retentive memory for facts and things, but in those Avho have what are called systematic heads; Avho arrange their facts, and draAV conclusions from them : in those Avho possess a quick perception, and are distinguished by an anxiety of knowing every thing. It even appears that the operation of combining facts, to draAV conclu- sions from them, is the chief action of this organ : at least the elephant, avIio conceals the Avater in his trunk to pour on the person Avho offended him the day before, arranges many facts, and draAVS from them a truly logi- cal conclusion; nor is there cw:y other organ in the ele- phant's head to which wc can refer this power. The involuntary motion of a man, who perceives that he has reasoned incorrectly, supports these suppositions: he strikes the middle of his forehead." The organ of painting and the distinction of colours Gall has found in many great painters, and has parti- cularly noticed it in a head of Raphael. The organ of the ?nusical sense and articulate sounds is very distinguishable in singing birds, in the jay and parrot; but does not exist in those Avhose notes are harsh and inharmonious. He found it very conspicuous in the heads of Gluck, Mozart, Haydn, and Pleyel. The organ cf verbal /ne7nory is distinguished by remarkable projections of the eyes. The organ of liberality lessens as a man grows old: in fact, he then becomes avaricious. It is very near the organ of painting and music; and this, he thinks, is the reason why men of such talents are generally prodigal. We wish he could have examined the head of Gains- borough ! The orga7i of the metaphysical spirit is found in the heads of the ancient philosophers, particularly Socrates; among the moderns in Kant. The organ of goodness forms that oblong elevation found constantly in the heads of Christ and the Virgin, painted by Raphael and Corregio; and contributes to convey the ideas of gentleness and goodness, Avhich are so attractive. It is found in the skulls of all Avho are naturally good, and is Avanting in those Avho are Avicked. Animals of prey have no vestige of this organ. The organ of music and of theatrical talents Gall has found in all the great singers and actors. In those Avho are born deaf, and are consequently dumb, it is very conspicuous; as they arc obliged to depend on gestures for the conveyance of their ideas. The organ of religious veneration is on the top of the frontal bone; and it is this, observes M. Gall, Avhich has probably induced all races of mankind to look for their divinities in the superior regions, since " there is no phi- losophical reason why Ave should not place them below as well as above ourselves." The organs described by Dr. Gall are thirty-three in number, Avhich the plate, Avith the explanations, -will point out. These are some of the most singular of his remarks; and from them our readers may form a judg- ment of his abilities, and the probability of his system. CRA'XIUM, (quasi xxpxviov, from xxpx, the head). Called also calva, and calvaria, cerebri galea. The skull. It is that part of the head which is covered with hair: besides the os frontis, it consists of the two parietalia, the tAvo temporal, the occiput, the os ethmoides, and os sphenoides. (See Caput.) As t > the medicinal virtues of the human skui!, they differ not from those of other bones. It was formerly givon in epilepsy; but the intention Avas to excite horror, as the bone was to be a part of a man Avho had died a violent death. CRA'NTERES, (from xpxivu, toperfjri7is. See S.i- piexti-e dentes. CRAPULA. (See Cr.epale.) It is also x^xittzx , a surfeit. A disorder from something taken into lh.' stomach, and occasioning sickness, or at least a loath- ing of the offending matter. It sometimes signifies a plethora, from indolence, and full but imi.-.roper lVeding; in Avhich case perspiration is check< ci, and eruptions formed on the skin: this is sometimes called the cholera accidentalis. See Cholerv morbus. A surfeit from r.nimal food is best remedied by a vomit, even though a vomiting and purging attcu!. For the management in cases of poison, s .-e Yr...i.ni\m 3 T 2 CRE 508 CRE When an excess of feeding is the cause, after an evacuation of the stomach and boAvels, rigid abstinence is for a time peculiarly necessary; and after the symp- toms of sickness disappear, the boAvels should be kept free, food very gradually alloAved; and the intervals be- tween the meals should be considerable. CRA'SIS, (from xepxwvftt, to mix). The temper or consistency of the blood peculiar to every constitution. CRASPE'DON, (from xgufixa, to hang down). See Hypostaphyle. CRA'SSA ARTE'RIA, (from crassus, large). See Aorta. Cra'ssa me'ninx. See Dura mater. Cra'ssa inte'stina. See Intestina. CRASSAME'NTUM, the coagulated portion of the blood when suffered to cool at rest; containing the gluten, the fibrin, and the red globules. See Blood. CRA'SSENA. Saline, putrefactive, and corrosive particles, which produce ulcers and tumours of various forms. Paracelsus. CRA'SSULA, (from crassus, thick; so named from the thickness of its leaves). Called also faba crassa, faba inversa, sedum telephium, fabaria, anacampseros maxima, cotyledum alteram, scrofularia mediavel tertia, acetabulum alterum. Common orpine, or live long. The sort used in medicine is the sedum telephium Lin. Sp. PI. 616. It is a plant with unbranched stalks, clothed with thick, fleshy, oval leaves, but producing no leaves im- mediately from the root: the flowers stand in form of umbels on the top of the stalk, and are followed each by three, or four, or six, pods full of small seeds: the root is irregular and knobby. It is indigenous in England, and perennial. Common orpine, with the leaves slightly or not at all serrated, grows in hedges and shady grounds, hath red- dish or Avhitish pentapetalous floAvers. The leaves are cooling, but their power seems too inconsiderable for a place in practice. They are applied to inflamed hae- morrhoids, and sometimes to paronychiae. Cra'ssula minor. See Sedum. CRATAEGUS, (from x^xlos, strength; so called from the strength and hardness of the wood). The wild SERVICE TREE. Cratje'gus Alpi'nus. The white boam tree. See Aria. Crat.&'gus oxyca'ntha. See Spina alba. CRAT.E'GONUM, (from xpxlxios, strong, and ytvo- y.xt, nascvr, to make; so named from its strengthening virtues). See Melampyrum. CRATEW.E SLUM. See Nasturtium aquati- CUM. CRATI'BULA, CRATI'CULA, (from craticula, a gridiron). The iron bars or grate which cover the ash- hole in chemical furnaces. CRATICULA'RIS, (from the same). Bread boiled on the grate of a furnace, or on a gridiron. CRA'TON. See Cataputia minor. CRE'A. See Tibia. CRE'BER. Frequent. From the Hebrew term kebor. It is applied to respiration, and to the pulse, Avhen the intervals betwixt each respiration, or each pulsation of the artery, are short. CRF^MA'STER,(fromxpefAxu, suspendo, to suspend). These muscles are also called suspensorii testium. They arise from the inside of Poupart's ligament on each side, run to the perforation Avhere the seminal cord passes out, and expanding over it, make part of the tunica vaginalis communis. The course of this muscle being very oblique, makes the spermatic cord seem much more so than it really is. Their use is to draw up and suspend the testes. CRE'MER. The name of a distemper endemial in Hungary, which seems to resemble crapula. It is cured by drinking a small quantity of any cordial Avater. CRE'MNOI. The lips of ulcers, also the labia pu- dendi, (from xpefiv®*, a precipice, or shelving place). CRE'MOR, (from xpij^vov, lactis crumen, a xpivu, se- cerno). It is the expressed or strained juice of any grain, particularly of barley boiled till it be so soft as to pass through a strainer (see Ptisana) ; also the cream of milk. See Chylus and Lac Cre'mor calc viv. The cream or flour of quick lime is the calcareous earth, which, having regained the carbonic acid from the air, is insoluble in water. Cre'mor lithargy'ri aceta't. See Plumbum. CRENA'TUM, (from crena, a notch). Crenated. When the edge of a leaf is cut into angular teeth, it is called acutely crenated; when into segments of small circles, instead of angular teeth, it is said to be obtusely crenate; when the larger segments have smaller ones upon them, the leaf is then said to be doubly crenate: the same term is applied to the corolla and nectarium in some cases. CREPA'TIO, and CREPATU'RA, (from crepo, to make a noise). In pharmacy is the cracking or bursting of any seed in boiling or roasting, and this is to be un- derstood when seeds are directed to be boiled ad crepa- turam. See also Hernia scrotalis. CREPI'NUM. See Tartarum. CRE'PITA jE'TAS. See .Etas. CREPITA'TIO. See Decrepitatio. CRE'PITUS, (from crepo, to make a noise). Crack- ling of the joints, which may happen either from a de- fect of synovia, or a deposition of cretaceous matter, as in the gout; but is generally OAving to the former cause. Mr. Sharp recommends a frequent use of fomentations, rubbing the joint with the ungt. hydrargyri, and to ad- minister purges occasionally. It means also a discharge of air from the anus Avhen attended with a noise. Cre'pitus lu'pi. See Lycoperdon vulgare. CRESPI'NUS, (quasi crispinus, from crispus, curl- ed, crisped; so called from the crispness of its leaves and Avood.) See Berberis. CRE'SPULUM, (fromcrispus, crisp; from the crisp- ness and curledness of its leaves). See Bupthalmum. CRE'SSIO, (from cresco, to grow; because of their abundance every where). See Nasturtium aquati- CUM. CRE'TA, (from Crete, the place whence it was first brought). Chalk. The only kind now used in me- dicine is the white chalk, which is found in most parts of the world. It is a pure white mineral calcareous earth of different degrees of hardness; it crumbles be- tween the fingers, and stains them white; readily diffuses in water when finely powdered, and as soon subsides; sticks to the tongue without any astringency. Its form is amorphous, stalactitical, or crystallized; specific gravi- ty from 2.3 to 2.7. Its crystals are rhomboidal para!- CRE 509 CRI lelopiped, and when transparent their refraction is double. The best is that which is perfectly white, soft, close, and solid, equal and uniform when broken, free from sand and flints, and insipid to the taste; though chalk, when first dug, has often a slight pungency, as it has not a full proportion of carbonic acid. Many other earths are of a similar nature, but this being the purest is preferred. It dissolves in all the acids, particularly in the nitrous and muriatic; even totally in vinegar. The vitriolic precipitates it from all other acids, and forms with it a selenite. It is convertible into quick lime : with bo- rax it melts into a transparent glass. The solutions of it in acids are bitterish. Chalk is employed as a remedy against the heartburn, and other disorders that have acidity in the primae viae for their cause. Some use it, when finely powdered, to sprinkle on erysipelatous inflammations. Two drachms for a dose, and repeated at proper intervals, have often effected, it is said, a speedy cure both in a diarrhoea and a dysentery; but this effect, if true, must be owing to its absorbing those acids whose stimuli caused the morbid excretion. When milk turns sour on the stomach, a scruple of chalk may be given with each half pint. This, however, is a very uncommon effect; but chalk is also added when milk forms a hard coagulum, and lies heavy on the stomach. When on any account a free use of chalk is required, if the belly is inclined to costiveness, laxative medicines should occasionally be taken, as the earth may otherwise accumulate. Chalk should be finely poAvdered, and separated from its grosser parts by elutriation. Boerhaave prefers it to the cornu cervi calcinatum for making the white decoc- tion Avith. Bates formerly used to boil half a pound of chalk in three pints of water to a quart, after which he just permitted the grosser parts to fall, and poured off the yet turbid fluid for use; and the London college directs the following chalk mixture, formerly called julepum e creta: take of the whitest chalk prepared, one ounce; of double refined sugar, six drachms; of gum arabic, finely powdered, two ounces ; of distilled water, a quart: mix. Pharm. Lond. 1788. See Dale. LeAvis's Mat. Med. Diet, of Chem. Neu- mann's Chem. Works. Cullen's Mat. Med. Besides these, the following are often used : Compound ointment of chalk: neutral cerate of Kirk- land.—R. Cretae pp. aceti distillati, olei olivae aa | iv. emplastri lithargyri ^8. aq. lithargyri acetati % ss. The chalk and vinegar are to be mixed together, and over a slow fire, incorporated with the litharge plaster, and oil; when sufficiently united, the water of acetated li- tharge is to be added. This is allowed to be an efficacious remedy, when applied to inflamed parts and ulcers, and is much employed in practice. Chalk is often applied to ulcers in its dry state, when the discharge is thin and acrimonious, with success; and it is sprinkled on the poultices in burns, according to Mr. Cleghorn's plan, with singular advantage. We find in some foreign authors an acetat and a citrat of lime recommended in scrofula, pruritus, hernia, hu- moralis, tumours of the mesenteric glands, in a dose of one or tAvo ounces daily. In this kingdom, the muriat of lime formed by saturating common muriatic acid with chalk, is recommended in scrofula and obstructed glands ; of which from half a drachm to half an ounce., in a pint of water, is to be taken daily. Decoctum £ creta. (See Cornu Cervi.) Pulvis £ creta compositus; pulvis e creta comp. cum opio. See Bolus. The two last supply the place of the pulvis e bolo compositus, a pulvis e bolo compositus cum opio, of the old London Pharmacopoeia. Cre'ta nigra. Black chalk, called also humus nigra pictoria; has never been employed in medicine. Cre'ta ru'bra. See Ochra. Cre'ta selexusia, called also terra selenusia. The best is of a shining white friable appearance, and readily- diluted Avith a fluid. It is drying and astringent. Cre'ta cimo'lia. Tobacco pipe clay. And creta fullonica. Fuller's earth. See Cimolia alba. CRETA'CEUM A'CIDUM, (from creta, chalk). The carbonic acid. CRE'THMON. (Greek.) See Crithmum. CRE'VIS. See Astacus fluviatilis. CRIBRA'TIO, (from cribrum, a sieve). Searsing. In pharmacy, it is the passing of powders and pulps through a sieve, or searse. CRIBRIFO'RME, and CRIBRO'SUM OS,(from cribrum, sieve). See Ethmoides os. CRICELA'SIA. The driving a hoop as high as the breast of the person who used it was formerly com- mended for rendering the limbs pliable, and strengthen- ing the nerves. It was an ancient gymnastic exercise. CRI'CO-ARYT^NOID^ET MUSCULI, (from xpixos, a ring, xgvrxtvx, a funnel, and eifos, forma). Muscles of the larynx, whose office is to open the glottis. They arise from the cricoid cartilage, and are inserted into the arytaenoid. Cri'oo aryt^noi'des latera'les. They lie laterally upon the upper edge of the cricoid cartilage, and are inserted into the lower part of the side of the arytaenoid. They serve to dilate the glottis. Cri'co ARYTiENoi'DES po'stici. They lie upon the back part of the cricoid cartilage, and are inserted into that knob which stands on the back part of the basis of the arytaenoid cartilage, near the angle of the basis, one on each side. They open the larynx, and are called, by Casserius, par-cucullare. Cri'co pharyng^i. These muscles arise from the lower part of the side of the cricoid cartilage. They seem to be appendices of the thyro-pharyngei, showing no other marks of distinction but their insertions, and a small difference in direction, because as they run back- Avard they descend a little; for this reason, Winslow says he hath sometimes looked on them as one, arid calls them thyrocrico-pharyngei. The lowest of these muscular fibres, he says, makes a complete circle back- Avards, between the two sides of the basis of the carti- lago cricoides, Avhich is the beginning of the oesophagus, and has been sometimes supposed to form a distinct muscle, called esophagus. There is another fasciculus of fibres occasionally detached from the thyro-pha- ryngaeus, and inserted laterally in the thyroid gland, for Avhich reason I call it musculus thyro-adenoideus. Innes calls it the constrictor pharyngis inferior; and de- scribes it as follows. It arises from the side of the thyroid cartilage, near the attachment of the stemo- hyoidaeus and thyro-hyoidseus muscle, and from the C It I 510 C II 1 cricoid cartilage, near the crico-thyrodaeus. This muscle is the largest of the three, and is inserted into the white line, where it joins with its fellow; the superior fibres running obliquely upwards, covering nearly one half of the mitldle constrictor, and terminating in a point; the inferior fibres run more transversely, and cover the beginning of the oesophagus. Their use is to compress that part of the pharynx which they cover, and to raise it with the larynx a little upAvards. See Pharynx. Cri'co thyroid.?, a reed). The stalk or blade of corn or grass. Culminiferous plants have a smooth jointed stalk, are usually hollow, and at each joint wrapped round with single, narrow," sharp pointed leaves : their seeds are in chaffy husks, as Avheat and barley. In grasses and corn, the culm or stalk corresponds to the caudex or trunk of trees; so that it generally denotes that part between the root and the ear or panicle. The stubble of corn remaining after the ears are cut off, is strictlv the culmen. CULMI'NIFERjE, (from culmen, the top). The tAventy-fifth order in Linnaeus's Fragments of a Natural Method. CU'LTER, (from colo, to cultivate). A knife or spear. The third lobe of the liver, named from tits re- semblance. See Auriga. CU'LUS, (kovXos). See Anus. CUMA'NA. (Indian.) Called also gacirma. An Indian tree like that of the mulberry tree, Avhose Avood is so hard that it strikes fire like a flint. CU'MBULU. (Indian.) Called also nux Malabarica unctuosa flore cucullato. A tall tree growing in Ma- labar, the root of which is used in a decoction with rice for common drink in fevers. Neither this nor the cumana is to be found in the systems of the bota- nists. CUMINOI'DES, (from xvp.>vov, cummin, and eifbs, likeness). Wild cumin. Called also cuminum sylves- tre, pastinaca tenuifolia Cretica, and daucus odoratus Creticus. Lagacia cuminoides Lin. Sp. PI. 294. This plant groAvs in Crete: the seeds only are in use; they are carminative. Raii Hist. CU'MINUM. Cumin. (From xvbiv, to bring forth; because it is said to be efficacious in curing sterility.) It is also called cyminum and fe7iiculum orientale. It is the cuminum cyminum Lin. Sp. PI. 365. This plant resembles fennel, but is much smaller; produces longish, slender, plano-convex seeds, of a brownish colour, with yelloAvish striae; is annual; a native of Egypt and Ethiopia. It is cultivated in Sicily and Malta, from Avhence it is brought to us, chieflv for 3 X C UP 522 CUP its fruit, which has an aromatic, sharp, and slightly bit- ter flavour; a strong and not unpleasant smell. The Dutch mix the seeds with their cheeses, the Ger- mans Avith their bread; and pigeons are fond of them. Water takes up their odoriferous particles by infusion, though but little of their taste. Distilled with water they afford a pungent oil, which resembles in flavour the seeds. Rectified spirit extracts their whole virtue: the spirituous extract is very warm, moderately pun- gent, and not a little nauseous. These seeds are carminative and stomachic, and possess these powers in an equal or superior degree when compared Avith the other plants of the umbellife- rous class; but they are rather unpleasing. Externally they are discutient and antiseptic; affording, when ap- plied to the stomach, a warm and salutary stimulus. The cataplasma cumini, formerly theriaca Londinen- sis, of the London college, consists of cumin seeds, one pound; bay berries, the leaves of water germander dried, Virginia snake root, of each three ounces; of cloves, one ounce: with honey equal to thrice the weight of the powders. (Ph. Lond. 1788.) This was formerly applied to mortified parts as an antiseptic, but is now seldom used, though by no means an ineffectual remedy. Emplastru7n cumini, consists of Burgundy pitch, three pounds; yelloAV wax, cumin seeds, caraway seeds, and bay berries, of each three ounces. The pitch and wax are melted together, the seeds and berries are gradually added and stirred well together. (Ph. Lond. 1788.) This is considered as a suitable.application to encysted and other tumours, which suppurate imper- fectly. See Miller's Dictionary. Lewis's Materia Me- dica. Raii Hist. Cu'minum .Ethio'picum. See Ammi verum. Cu'minum pra'tense. See Carum. Cu'minum siliquosum, is the codded wild cumin. It grows in Spain, floAvers in May, and produces the same effects, medicinally, as the poppy. Hypecoum pendu- lum Lin. Sp. PI. 181. Cu'minum sylvestre. See Cuminoides. CUNEA'LIS SUTU'RA, (from cuneus, a wedge). The suture by which the os sphenoides, or cuneiforme, is joined to the os frontis. CUNEIFORME OS, (from cuneus, a wedge,) clavi- cula, cavilla, Chalcoideum os, Basilare os. A name of the os sphenoides, from its being wedged between the other bones. Also the third bone of the first row in the wrist; called so from its appearing like a wedge stick- ing betAveen the two toavs. See Carpus. Cuneiforme os exte'rxum, or chalcoideum exter- num of the tarsus. At its posterior edge it joins the os naviculare and os cuboides; it supports the metatarsal bone of the toe next the little one, and that next the great one and of the middle toe. The os cuneiforme medium vel minimum, is still more Avedge-like than the former; it sustains the metatarsal bone of the toe next to the great one. The os cuneiforme internum vel maximum sustains the os metatarsi of the great one. All these are cartilaginous at the birth of children. These bones are also called chalcoidea ossicula. CUNI'LA SATI'VA, (from xoviXv). See Satureia SATIVA. CU'PELLA, (from kuppel, Germ.). Called also ■ copella, catellus cinereus, cineritium,patella docimastica, testa probatrix, exploratrix, or docimastica. A cupel or TEST. These are vessels used for separating baser metals from gold or silver; they are made of earth, and are hollowed like flat cups, from which they have been named: they resist every degree of fire that is needful to keep any metal in fusion, and retain these metals Avhen fused; but the calces of some metals, particularly of lead, penetrate the common cupels. The ashes of bones or of plants that have been calcined are therefore em- ployed, though Cramer prefers those made with plas- ter : and later chemists prepare them of gold or platina. The bone ashes must be perfectly calcined, then levi- gated ; after which they must be formed into a paste, moulded into their proper form, and burnt in a potter's furnace. See various directions concerning them in the Dictionary of Chemistry. CUPELLATION. A chemical operation by means of a cupel. It is employed to separate the purer from the baser metals, by scorifying the latter. CUPERO'SA, (from cuprum). Copperas. CU'PHOS. Light. When applied to aliments, it imports their being easily digested; when to distempers, that they are mild. CUPRESSUS, (xtto rov xveiv zrxpio-ovs rovs xxpc/MVXs, because it produces equal branches). Called also cypa- rissus. Cypress tree. Cypressus sempervirens Lin. Sp. PI. 1422. It is a tall evergreen tree, native of the warmer climates, bearing male and female flowers on the same branches : the leaves are slender, and so are the branches, which spread, forming a cone, the apex of Avhich is the top of the tree; the fruit is a kind of nut called galbula and glabula, as large as a Avalnut, and astringent. The flowers have an agreeable odour, and have been used in conjunction with some other in- gredients for making an oil, by infusion with olive oil, named oleum cyprinum. CUPRESSI'NUM. Cypress wine. See Cedri- NUM. CU'PRI AMMONIA'TI A'QUA, (from cuprum, copper,) olim,aquasaphirina,ealledcollyrium caruleum. Take of lime water, one pint; sal ammoniac, one drachm; let them stand together in a copper vessel un- til the ammonia is saturated. Phar. Lond. 1788. Cu'pri preparatio'nes. preparations of copper. See -Eris flos. Cu'pri rubi'go. See jErugo .eris. CU'PRUM, (quasi as Cyprium; so called from the island of Cyprus, from whence it was brought). See Ms. In this article we chiefly enlarged on the chemical properties of copper, reserving our account of its medi- cal virtues and its'different preparations to this article, Avhere it Avould be more naturally sought. In a medical view, copper supports, in a singular degree, the canon of Linnaeus, that medicines differ from poison, not in quality, but in power. Its quality is not essentially different from those of iron and zinc; yet copper, in a moderate quantity, disorders the sto- mach and boAvels, producing inflammation and its most fatal consequences. In moderate doses, like all other metals, it is a sedative, a tonic, or antispasmodic. When taken in larger quantities, it produces nausea, with a constant taste of the copper remaining in the back part of the fauces: violent vomiting; the most dreadful op- pression on the breast; the most acute pains of, and a CUP 523 CUP burning heat in, the stomach; colic; vertigo; bloody stools; watchfulness, increasing to delirium; faintings; convulsions; paralysis; and apoplexy; frequently with eruptions on the skin; sometimes resembling lepra. Such are nearly the symptoms arising from copper imprudently or accidently taken; and the authorities which now lie before us of the dangers arising from it, Avould fill more than our page. Yet such is the nauseous taste of this metal, that, in general, it guards the victim from its influence; for the flavour of copper Avould cer- tainly alann the most incautious person of its danger, if it approached under the disguise of aliment. In medi- cine it cannot be always discovered ; and the great danger of employing vessels which have any propor- tion of copper in their composition, has been properly pointed out by Mr. Blizard and others. When copper has been inadvertently swallowed, emetics are seldom necessary. The A'omiting they ex- cite is sufficiently active ; but should sickness, with violent pain in the stomach, ensue Avithout vomiting, as sometimes happens, a few grains of the vitriol of zinc will be effectual. If an emetic is not required, mucila- ginous substances, as oil, butter, and milk, will be useful; and, with these, an alkali will contribute to mitigate the virulence of the poison. Each of these meet in soap. The most appropriate antidote, however, is the sul- phurated alkali (hepar sulphuris), Avhich may be given with milk or with mucilages. The most common artificial forms of copper, as ver- digris, aes ustum, &c. we have noticed in their proper places. We shall therefore mention a few more rarely described. Thefllings of copper are recommended by Struve in the bite of a mad dog; and this preparation has been formerly recommended as a laxative, a diuretic, and a sialagogue. It is recommended also by Cothe- nius in malignant and venereal ulcers. The flos eris is copper in a capillary form, which it accmires by sudden cooling ; and it has been recom- mended as an attenuant by Dioscorides. The sulphur of copper is a dark green powder, prepared by precipitating copper from an acid by means of a plate of iron. This precipitate is triturated with four parts of quicksilver in a glass mortar, and then suspended for a month in a gentle heat; after which the copper is separated, by triturating the mixture with rain Avater. It has been recommended in epilepsies, but has deceived some of its Avarmest patrons. Various are the liniments, cerates, and plasters, to which the preparations of copper impart their colour, and give a name. These, hoAvever, belong to extempora- neous prescriptions, Avhich Ave shall aftenvards notice; yet as not generally knoAvn, Ave may mention the folloAving. The balsai7ium viride consists of verdigris, boiled with turpentine and linseed oil. It has been considered as powerfully deturgent in old foul ulcers. The cera viridis, employed by Plainer in softening, or rather eroding, corns, consists of verdigris, combin- ed with yelloAV wax, resin, and turpentine. This great- ly resembles a plaster highly recommended in the Jour- nal de Medecine, composed of verdigris, combined Avith yellow Avax, and gum ammoniac. The magisterium cupri of Sala differs little from the green crystals of copper; and the aqua viridis of Hart- man is composed of equal portions of verdigris and burnt alum, a double portion of honey, with thirty- two parts of Avhite wine. It is supposed to be highly useful in cleansing foul ulcers of the gums, and other parts, whether they proceed from a venereal or a scor- butic source. The tinctura cupri alkali7ia differs little from the am- moniated copper, to be aftenvards described. It is a solution of calx of copper, by means of ammonia, Avith the alkali in excess. Boerhaave recommends it to be prepared by the filings of copper; Hecker, Avith the erugo ; but both recommend it for cancers and vene- real ulcers. It is also supposed useful in tooth ach, conveyed by means of cotton to a holloAV tooth; by Lieb, in epilepsy; by Boerhaave, in dropsy. Many blue lunar Pictures of the ancients are probably derived from the alloy of copper in silver; and the tinctura 77iartis carulea of the Wirtemburg Pharmacopoeia seems to derive its virtue and its colour from an accidental mixture of copper. The tinctura eris vinosa, so effectual, if Ave believe Sala, in destroying leucomata on the eyes, is prepared from filings of copper in Avine. The more common extemporaneous formulae we shall add. Cupri Calx. R. Cupr. vitriolat. q. v. solvatur in aquae distillatae, q* s. et adjiciatur kali praeparati portio pro- pria, donee cuprum ad vasis imum descendat, deinde bene lavetur, et siccetur. Cupri ammoniati liquor. R. Calcis cupri 5 i- aq. am- moniae 5 ij- These are to be digested without heat till the copper is dissolved. Cupri acetati injectio. R. .Eruginis gr. x. olei amygdal. § iv. m. trituratione donee solvatur in oleo aerugo. Cupri ammoniati injectio. R. Liquor, cupri ammo- niati, g. xx. aq. rosae 1 iv. m. Cupri vitriolati injectio. R. Cupri vitriolati g. iv. aquae distillatae 5 iv. m. These injections are are of the astringent class, and calculated for the latter stage of gonorrhoea. The am- moniated one is considered by Mr. Foot, and recom- mended, as a remedy preferable to all others of this na- ture. Practitioners should be cautious in the use of astringents: they should be first introduced in very small quantity, and gradually increased ; indeed, till the inflammation is considerably abated, they are scarcely at all admissible, and much mischief has been done by their too early administration. The following has been highly useful in that symptom called phimosis, which has been supported-by ulcerations within the prepuce. Cupri vitriolati composita injecto. R. Cupri vitrio- lati g. vi. aquae distillatae 5 iv. aquae lithargyri acetati g. xx. m. Cupro vitriolato prius soluto, atljiciatur lithar- gyrum acetatum, et interpraeputium, et glandem penis injiciatur, et pro ratione effectus caute repetatur. Cupri vitriolati pilule. R Cupri vitriolati g. xx. Olibani, extract, cinchonae, al 5 ij. syr. sacch. q. s. ut fiant pilulae quadraginta. Dosis, ab una ad quatuor indies. These are calculated to remove gleets, and are sometimes advantageous in the latter stages of go- norrhoea. Cupri vitriolati ca/7iphorata aqua. R. Cupri vitrio- lati, bol. gallici ai|ss. camphorae 5'i. aquae ferventis lb iv. Adjiciatur aqua ingredientibus aliis, et quando frigida fiat, per chartam coletur. This is the campho- rated Avater of Bates in a diluted state; it is chieflv 3 X 2 CUR 524 CUT employed as a collyrium, but may be usefully applied to foul ulcers. Cuprum ammoniacum. Ammoniacal copper. (Phar. Edin.) Take of purest blue vitriol, two parts; vola- tile alkali of sal ammoniac, three parts: rub them briskly in a glass mortar till the effervescence is finish- ed, and they run calmly into a violet coloured mass, Avhich is to be rolled up in a piece of bibulous paper, and exsiccated, first upon a chalk stone, and afterwards with a gentle heat, then put up for use in a close phial: this is a very active medicine, used for the same pur- poses, and in the same manner, as Vitriolum cerule- um, which see. It may appear singular that the mixture of two dry powers should be ordered to be dried; but the moisture on mixing them arises from the Avater of crystallization. The theory of this preparation is not well understood, and in general there is a considerable waste of the vola- tile alkali, for all that is added to redissolve the copper, seems to be afterwards evaporated. This objection ap- plies with more force to the usual method of preparing it in the humid Avay. The most effectual, but the most expensive, mode of preparing it, is to precipitate the copper from a solution of its vitriol by means of ammonia, adding more of the latter till the copper is redissolved. This solution must be concentrated by evaporation, and then an equal quantity of alcohol added, which occasions a separation of silky blue crys- tals. In the cuprum ammoniacum there is evidently some portion of sulphuric acid, and the other ingredients are an oxide of copper and ammonia. It has been chief- ly employed in epilepsies, and its virtue seems to be in- creased by the addition of the oxide of zinc. We know not this can produce any chemical change on either, yet, when combined, each may be given in a larger dose. CUR. POST. An abbreviation of curae posteriores, the frequent title of a second part, or supplement. CU'RA AVENA'CEA. A decoction of oats and succory roots, Avith a little nitre and sugar. It Avas for- merly used as a common drink in fevers. CUR'CAS. (See Ricinoides, under Cataputia minor.) Also an edible root, probably of a species of arU7n. CU'RCUMA, (from the Arabic term carki7n). Turmeric. Crocus Indicus, terra marita, cyperi genus ex India, cannacorus radice croceo,7nanjella, kua, kaha; by the Indians, borri-borri; by the Portuguese, saffran de terra ; the Arabians call every root of a saffron co- lour by this name, curcu7na. There are two species, the long and the round rooted; but the first is the best, and chiefly used. It is the curcuma longa Lin. Sp. PI. 103. Indian long rooted turmeric. The root is the only part in use; brought from the East Indies; small, tuberous, and knotty; externally greyish coloured, but internally of a deep lively yelloAV tending to red. It hath a slight aromatic and bitterish taste, and somewhat disagreeable smell. It gives out its virtues both to water and to spirit; by distillation Avith water, a small quantity of essential oil is obtained ; and from the remaining decoction a bitter extract is pro- cured by evaporation. The spirituous extract retains nearly the Avhole virtue of the root. It has been thought a powerful remedy in obstruc- tions of the viscera, particularly the abdominal; in ic- teric and uterine disorders. The dose may be from a scruple to a drachm, but it is noAV very rarely used. The powder is often mixed with yellow peas, ground fine; the roots should be chosen of the largest size, fresh, com- pact, heavy, not easy to break, of a lightish yellow with- out, and a deep reddish yelloAV within. It is chiefly consumed by the dyers. See Lewis's Mat. Med. Neumann's Chemical Avorks. CURD. See Caseus and Lac CURIME'NTOS. The Portuguese appellation of some pains in the limbs, which are relieved by a warm bath, made with an astringent bark produced in the Brasils. CU'RMI, (from xepxu, to mix.) A drink made of barley, which is used instead of wine ; such a liquor is employed in Iberia and Britain, which is prepared of wheat. (Dioscorides.) It is not difficult to recognise in this description our beer or ale; perhaps our white (wheat) ale. CU'RSUMA, or CURTUMA. See Chelidonium MINUS. CURSU'TA. See Gentiana purpurea. CU'RTA, (from curto, to mangle). See Colobo- MATA. CURU'RU. See Bufo. Curu'ru a'pe. (Indian.) A scandent tree which groAvs in Brasil, and bears pods with seeds like beans : these seeds destroy fish, and produce intoxication in the inhabitants ; the Omaguas of Brasil. It is the paulinia curruru of Lin. Sp. PI. 524; or rather thee, pinnata, 525. CURU'TU PA'LA. (Indian.) A shrub which grows in Malabar. The bark of the root boiled in wa- ter cures a diarrhoea; boiled and taken with it, a dysen- tery. Tabcrnemontana alternifolia Lin. Sp. PI. 308. CUSCU'TA. Cuscuta major, cassuta, epithimum. Dodder, and dodder of thyme. The cuscuta Euro- pea Lin. Sp. PI. 180, x and p. It is of the number of plants called parasitical; it hath no leaves; grows on thyme, and consists of a number of slender juicy fila- ments, producing small heads of white or reddish flow- ers, folloAved by roundish capsules full of minute seeds. A large kind, known by the name of hell weed, is com- mon on heaths, upon furzes and nettles. This hell weed destroys the vegetables which afford it nourish- ment, Avhence its name: it is also called diaboli intesti- na, the devil's guts. Dodders are found on almost all plants; supposed to partake of the virtues of those oh which they groAv. They are hardly knoAvn in practice; but recommended as a remedy for rheumatism and gout; as aperitives, antiscorbutics, and gentle laxatives. CUSPIDA'TUS, (from cuspis, a point or spear). Pointed. In botany the term regards the apex only-, when the leaves have the apex sharp like a spear, or terminating in a bristly point. Some of the teeth are called cuspidati. See Dentes. CU'SPIS, (from caspa, Chaldean, a shell or bone, with which spears were formerly pointed). Properly the point of a spear : but it is applied to the glans pe- nis ; and is also the name of a bandage. CU'STOS O'CULI. An instrument to preserve the eye in an operation. CUTA'MBULI,(from cutis, the skin, and ambulo, to walk). A name of some worms either under the skin or upon it, Avhich, by their creeping,, cause uneasiness and pain. CUT 525 CUT CUTANEI MORBI. If cutaneous diseases have been imperfectly, and with too little discrimination, de- scribed or considered by the practical physician, they have claimed a large share of the attention of nosologists, in whose systems each blemish on the skin has been magnified into a genus of disease. We cannot help smiling when to the last of the Linnaean genera in his nosology, Avhich is only a freckle, the following pathetic exclamation is added: Hei mihi! tot mortes homini quot membra, malisque Totsumus infecti, mors ut medicina putetur. In one view, the attention of nosologists to these diseases was properly employed, and, above all, the luminous terseness of the Linnaean language, viz. for the purpose of distinction; yet, were criticism our object, Ave could shoAv that both Linnaeus and Sauvages have failed in attaining this end; nor was accurate discrimination to be probably obtained without coloured plates, resembling those of Dr. Willan. Former authors gave little assist- ance : Mercurialis was too concise and imperfect; Plenck often obscure and inconsistent; Lorry, in his quarto vo- lume, superficial and indistinct: and the ancients imper- fect, confused, and inaccurate in their descriptions. In fact} previous to the appearance of Dr. Willan's Avork, our best assistant was Sauvages, in his larger work on nosology. As we, in general, approve of Dr. Willan's arrange- ment, we shall first explain it, with his own remarks, so far "as he has proceeded, adding those in the orders which have not appeared, that their arrangement sug- gests ; after which we shall subjoin what appears to us an improved order, and an outline of the pathology of those complaints : the latter attempt, we believe, is new, and therefore, we trust, its imperfections will be excused. Dr. Willan's orders are natural ones, viz. pimples/ scales, rashes, vesicles, pustules, tubercles, and spots. The arrangementof these orders is of little importance; yet it has been suggested that it would have been more correct to have placed those first in which the protu- berance was inconsiderable, and to have proceeded ac- cording to their increasing magnitude, as spots, rashes, pimples, scales, vesicles, pustules, and tubercles. Per- haps it Avould be still better, keeping this idea at the same time in vieAV, to divide them into febrile and not febrile; including in the first class, pimples, pustules, vesicles, and rashes, and the others in the second. As the genera are introduced by Dr. Willan, this arranger ment is not perfectly correct; but we~ shall employ it as more suitable to our pathological enquiries. The pimples are styled papulae : they are small ele- vations of the skin, with an inflamed basis rising to a point, with either no, or a very imperceptible, fluid. When any fluid is present, it is serosity, sometimes pe- culiarly acrid, and never becomes purulent, but occasion- ally desquamating in branny scales. The genera in- cluded by Dr. Willan in this order are, the strophulus (the red gum, a vulgar corruption of the red gown, from the generally diffused colour); the lichen (ihe eruption in the spring, or from heat); and the prurigo, or the pimples which arise Avith general itching. The term pimples, or the equivalent appellation in different lan- guages, has been employed with little accuracy. In our author's definition they areproperly and strictly limited; perhaps too strictly. The prurigo he has not, we think, properly defined. It is an itching of the skin, with small papulae, seldom discoloured, with very slight fever, and without contagion. All these genera are connected with a febrile state of the constitution. In the pustules Avhich follow, the little inaccuracy of Avhich our arrangement is liable appears more conspi- cuous. Few are febrile diseases; but the itch, in its ap- pearance, connects this order with the pimples,"and the introduction of variola reduces it to the febrile com- plaints : nor, indeed, is the tinea Avholly free from the suspicion of being originally a febrile indisposition. The genera are, scabies (itch); i7npetigo (a running scab); ecthyma (an ulcerated tetter); porrigo (scald head); and variola (small pox). The itch, certainly, at times degenerates into the impetigo; and sometimes, in a secondary chronic state, forms distinct pustules. The vesicul-s: contain the folloAving genera, viz. the varicella; the pemphigus; the pompholyx; miliaria ; erysipelas; he7-pes (shingles); ecze7na (heat eruption); and aphtha (thrush). There may be some doubt of the pro- priety of admitting aphtha as an affection of the epithe- lion, though it be a continuation of the skin. In that case, syphilis, cynanche maligna, and mercurial sores, should have a place as cutaneous diseases. In this order the genera are arranged according to the magnitude of the vesicle, except in the case of the varicella, to connect this with the former order. Each, except perhaps the eczema, is preceded by fever, as Ave shall show under the different heads. In the last fasciculus, we perceive that Dr. Willan has made some alteration in his arrange- ment, by including the erysipelas, the pemphigus, and the pompholyx,in a separate order, which he styles bullae; but it is unnecessary to notice it particularly, as it does not materially alter our present vieAvs. The bashes, exanthemata, contain the urticaria (nettle rash); rubeola (measles); scarlatina (scarlet fever); roseola (rose rash); purpura (scorbutic rash); erythema (red rash); and the ii-is (the rainbow rash). This, with the exception of the urticaria, Avhose vesicles sometimes rise above the skin, and might, perhaps, be Avith propriety arranged in our author's new order, bullae, form a truly natural association. The cutaneous diseases not attended with fever, are the maculae (spots); squam.e (scales); and tu- bercula (tubercles). The first contains those little insignificant deviations Avhich do not constitute diseases; the second are disgusting and obstinate complaints; and the tubercles are often the most frightful masses. The genera of the order macula are, e/ihelis (freckles); navus (marks supposed to be the effects of the mother's longing); and spilus (amole). The genera of the squam.e are, the lepra (the true leprosy of the Greeks); psoriasis (the scaly tetter) ; pityriasis (the dandriff) ; and icthyosis (the fish skin). These are, perhaps, only forms of the true lepra. The tubercula are, verruca (a Avart); moluscum (the small soft wen) ; vitiligo (soft smooth tubercles) ; acne (stone pock, the red tuberculated face); lupus (noli me tangere); phyma (boils or carbuncles); frambasia (yaws); elephantiasis (Arabian leprosy). We shall add what we consider an improved arrange- ment of these diseases; but should avc err in thinking it such, it will detain the reader for a short time only. C UT 526 C UT A. Febrile cutaneous diseases. I. PAPUL.E. Gen. Prurigo lichen strophulus. 2. EXANTHEMATA. Rubeola, scarlatina, roseo- la, PURPURA, ERYTHEMA, IRIS. 3. VESICUL.E. Varicella, miliaria, erysipelas, HERPES, ECZEMA, APHTHA. 4. PUSTUL.E. Scabies, impetigo, ecthyma, por- RIGO, VARIOLA, FRAMBjESIA. > 5. BULL.E. Urticaria, pemphigus, pompholyx. B. ATotfebrile. 1. MACULAE. Gen. Ephelis, njevus, spilus. 2. SQUAMiE. Lepra, psoriasis, pityriasis, ic- thyosis. 3. TUBERCULA. Verruca, moluscum, vitiligo, ACNE, LUPUS, PHYMA, ELEPHANTIASIS. Cutaneous diseases of the febrile kind often depend on the discharge of some morbid, often a specific, cause; the slight cutaneous affections occasionally ap- pear to be only irritation communicated from the sto- mach. In some instances the white of an egg, in others, fish poison almost immediately after being swalloAved, certainly long before it can have entered the mass of blood will produce papulae. A proof of its not being owing to any deprivation of the animal fluids is, the eruptions being removed on evacuating the stomach. When owing to poison in the blood, and fever is ex- cited in consequence, the copiousness and violence of the eruption are greatly mitigated by the regulation of the febrile state. If the fluids are forcibly propelled, and carried to the exhalants, so as to pass off in the form of sweat, either from the fluid form or the rapidity of the secretion, a portion is stopped by the cuticle, and in- flammation is the consequence. We can easily con- ceive, as in the case of miliaria, where no poison probably exists, that copious sweating in the irritable state of the arterial.system, which occurs in puerpe- ral cases, may occasion eruptions; and we consequently find that, by a duly regulated temperature, this incon- venience can be avoided. In small pox, where a spe- cific poison really exists, the eruption can be always mitigated or even occasionally prevented, by similar measures, viz. remedies peculiarly adapted to lessen the fever. In these cases, the exhalants, which open under the cuticle, convey the fluids in no greater quantity than the pores of this inorganic membrane allow to pass ; so that, though the acrimony is occasionally perceptible by a little prurigo, or by the smell, no pustules inflame or suppurate. It was not without design that we mentioned the form of the fluid discharged; for in almost every instance, gentle perspiration appears better adapted to preserve health and remove diseases than sweating. The form of gas may be chemically more suitable to the morbid cause, than that of a fluid; and it is certainly better adapted to transude through the cuticle, both from its attenuation, and the gentleness with which it is conveyed. Though we have pointed out, in general, the sur- face as the channel by which the cause is evacuated, yet there is a peculiarity in the order exanthemata, and in one genus of the vesiculae, if indeed it be admitted, we mean the aphtha, viz. that the matter is carried to other membranes : in the two first genera, for instance, to the Schneiderian membrane and the throat; and, in the last, to the membranes of the brain; for erythema differs only from erysipelas in form. The small pox virus is some- times poured on the tunica conjunctiva, sometimes on the throat, and the villous coat of the intestinal canal; but this is not its usual or natural outlet. The pustulae we have allowed not to be ahvays febrile; yet they are often so, though the ecthyma and variola are obviously diseases of this kind : and the former in- cludes the phlegmous. The scabies, though not febrile, has this peculiarity, that it is excited to action by warmth and a more generous diet; but the operation of these existing causes we cannot now examine, until the cause itself is more clearly understood. The exist- ence of an animalcule, producing the diseases, has been lately, denied. When, however, the itch has been re- pelled rather than cured, its form, on its return, is very generally pustular. The kind of fever in these cutaneous diseases greatly differs. It is inflammatory or putrid, continued or re- mittent. In the bullae it is generally remittent. For this variety no adequate reason can be assigned: but the continued form of fever is generally observable in those eruptions where the poison is of a specific kind; the remittent form seems rather suited to the sporadic or accidental eruptions. Several diseases concur in their general nature with the cutaneous. The nearest is dysentery, which greatly resembles them in their pathology and cure. Epidemic diarrhoeas from cold are not very different. Ulcerated throat, pertussis, and croop, are affections of the epithe- lion continued from the skin. But of these we must not now treat. The cutaneous diseases not febrile are of two kinds, viz. affections of the cuticle, or of the parts beneath. The maculae and squamae are of the former kind; but the genera included under the first of these are not, as Ave have said, diseases. Mere pressure on the cuticle will produce squamae, but the causes in general are dif- ferent. They seem to arise from an acrimony of ten con- stitutional, which, however, has not always sufficient power to excite inflammation; or, more probably, they are the diseases of torpid habits-little susceptible of in- flammatory excitement. This acrimony, either natural or acquired, is gradually deposited under the cuticle till it rises in irregular masses, or, from the pressure be- neath, assumes a scaly form .The porrigo might, perhaps, with propriety be referred to this order, except that, as a disease of the roots of the hair, its source is below the cutis. The tubercles, we have said, are seated below the skin. The verrucas are connected with the extremities of the nerves; but their origin is doubtful, and their cure uncertain. The other tuberculae are enlargements of the sebaceous glands as the wens; depositions become morbid by stagnation, as the phymata ; or effects of de- praved fluids or broken constitutions, as the lupus and elephantiasis; to which the Italian disease, the pelagra, may be added. The tubercles of the ele- phantiasis are often most horrible in their appear- ance ; and Sauvages has exhausted the monstra hor- re7ida informia ingentia in the description. They occur, however, only in the decline of life, and are preceded by marks of a decayed constitution, or depraved fluids. The same appearances also precede the true lepra; but these considerations Ave must resume under their proper heads ; q. v. CUT 527 C U T It will appear singular that we have referred fram- baesia to the pustulae. The disease is little known; and the best account of it, that of Dr. Adams, in the 6th volume of the Memoirs of the Medical Society, justifies the chapge. CUTA'NEUS MU'SCULUS,(from cutis, the skin; belonging to the skin). See Platysma myoides. CUTA'NEUM OSSIS COCCYGIS LIGAMEN- TUM. It goes out anteriorly from the extremity of the os coccygis; is slender, and divides into two portions at the orifice of the anus, which run into the membrana adiposa, are inserted in the skin on each side of the anus by a kind of expansion, and continue to divaricate: they are lost on the sides of the perinaeum. CUTA'NEUS. See Sphincter ani. There is also a nerve so called. See Cervicales. Cuta'neus inte'rnus nervus. It rises from the union of the seventh cervical, and first dorsal pairs, runs over the other brachial nerves, and passes down on the inside of the arm, between the muscles and integuments; it divides into two branches, which accompany one an- other as far as the inner condyle on one side of the vena basilica, being covered by the ramus medianus of that vein; then runs down towards the wrist, where it spreads, and on the beginning of the palm of the hand. The other branch passes backward along the integuments, and down to the little finger. CU'TCH. See Terra Japonica. CUTI'CULA, (a dim. of cutis, the skin). The scarf skin. The Greeks call it epider7nis, because it is placed upon the true skin as a covering. It is more compact than the true skin, full of pores for the eva- cuation of what transpires through it from the body, though the best glasses do not enable us to discern them : it hath neither blood vessels nor nerves, there- fore it is void of sense. Dr. Hunter thinks it an orga- nised body, though its organization cannot be demon- strated ; and there is not the slightest reason from its functions or diseases to consider it as such. The pores described by LeuAvenhoeck have not been found by later observers. When abraded it is rapidly reproduced, and is greatly thickened by pressure, either external or from tumours beloAV its internal surface. The integuments, or the universal covering of the body, are the cuticle, the rete mucosum, the cutis, and the membrana cellularis: besides these, the old anato- mists reckon the membrana communis musculorum, which does not exist; and the panniculus carnosus, which is only found in brutes. The rete mucosum is added by the moderns, and is found between the skin and the cuticle. The cuticle is continued only over all the external parts of the body : in the cavities, as in the mouth, oeso- phagus, aspera arteria, intestines, 8cc. it becomes almost imperceptible, and not to be distinguished from the cu- tis vera. The external covering of these internal parts is called the epitheliU7n ; and the surface is rendered ir- regular by innumerable papillae. No nerves nor vessels can be demonstrated to exist in the true cuticle. In examining the pores, the cuticle seems to insinuate itself into them, to complete the excretory tubes of the cutaneous glands. The fossulae of the hairs have like- Avise the same productions of the cuticle, and it seems to give a sort of coat to the hairs themselves. The best method of separating the cuticle for examin- ation is to macerate it in water, or to suffer some putre- faction to take place. The cuticle is a medium betwixt the skin and the sub- jects of feeling, and moderates the impressions, Avhich, without it, would be too painful. It is also said to mo- derate the perspiration, which, without it, would be too copious. This, however, is hypothetical. It seems to be a sheath which, in some degree, compresses the whole body, anch gives a tone to the extreme vessels. To its relaxation the effects of warm bathing, a moist or a humid atmosphere, have been attributed. Yet, as a simple solid, it can be but inconsiderably contracted by cold or expanded Avith heat; and though we cannot deny it some power as a counterpoise to the distention of the subcutaneous vessels, that power is probably trifling. The cuticle is very incorruptible, even when the sub- jacent parts are destroyed by sphacelus; and suffers the effect of caustics to act on the subjacent parts Avithout itself being destroyed. The colour of the cutis differs in different persons, and also in different parts of the same person; but it is owing to the difference in the rete mucosum that com- plexions are so opposite to one another. See Edinburgh Med. Essays, vol. iv. page 79. In the second volume of the Medical Museum is a remarkable instance of a young man losing the use of his hands, by the cuticle being thickened and hardened in an extraordinary degree. He was a dyer, and by fre- quently cleaning brass wire in the mixture, which con- sists of the oil of vitriol, tartar, and alum, this complaint was gradually produced. His hands were quite stiff from the hardness of the cuticle; and on endeavouring to straighten the fingers by force, blood started from every joint. As the acid seemed to contribute much to the disease, an emollient liniment, with equal parts of olive oil and aqua kali, was ordered. After a few days one half of the aqua kali was omitted, and the yolks of two eggs added. By this means the hardened cuticle began to peel off; a new flexible one appeared underneath; he began to have some use of his fingers; and, after little more than two months, he obtained'a perfect cure. CUTICULA'RIS MEMBRA'NA, (from cuticula). See Dura mater. CUTICULO'SUS. See Sphincter ani. CCTILL.E. Certain cold fountains in Italy, men- tioned by Celsus and Pliny, which were used in baths. CU'TIO, (a cutis duritie, from the hardness of its skin). See Aselli. CU'TIS, (from xvlou, to cover with a hide, or from cutan, a covering^ Chaldean). The skin. It is called by Herodotus, anthrope. It is a strong, thick, universal covering of the external parts of the body, immediately above the adipose membrane. It is composed of a close texture of fibres of various kinds, and of veins and arte- ries, variously disposed : where there are large orifices, it is gradually lost. Its inner surface is moulded upon the outer surface of the membrana adiposa, whose mem- branous part produced, seems to form the skin. The skin, on its outside, is unequal: this is occa- sioned by the miliary glands, and the bulbs of the hair. It is naturally contracted; but when it is swelled, it is smooth. Upon its surface we observe the papillae py- ramidales, which are longer in some parts than in others, as in the fingers, Avhere they are called villi. They ap- pear in rows, each having two ranks contiguous, and are C V A 528 C Y D the organs of touch. Opposite to the joints the skin is thin, and formed into plicae, to admit of a free motion. Its Avhole surface, outwardly, is covered with the rete mucosum, and the cuticle. The skin is thickest between the shoulders, and on the back part of the neck. Dr. Hunter says, that when the skin is once destroyed it is never regenerated, but the edges stretch considerably to form a covering : after that, a cicatrix, Avhich is hardened flesh, completes the healing. The loss of substance is discovered by injec- tions. The outer surface is furnished with small eminences, called papilla pyramidales, and the inner with the mi- liary glands. Fewer papillae appear on the skin of the belly than elsewhere : the anterior portion of it is not only thinner and more compact than the posterior, but it may naturally be very much increased in breadth, to an extraordinary degree, Avithout losing in thickness what it gains in breadth; and it is generally more diffi- cult to pierce the skin of the belly Avith pointed instru- ments than of the back. Though the best glasses cannot assist us to see pores in the cuticle, the naked eye can discern them in the skin, Avhich is the seat of many diseases. Dr. Willan's late publication on these, has superseded the Avorks of all his predecessors on cutaneous diseases of the skin. Cu'tis anserina. When from cold, fear, or terror, the skin is contracted, the bulbs of the hair are conspi- cuous, and the surface resembles that of a newly pluck- ed goose. CU'TT. See Terra Japonica. CY'AMOS JLGYPTIA'CUS. See Faba jEgyp- TIACA. CY'AMUS, (from xvu, to bring forth ; from its fe- cundity). See Faba. It also signifies a wood louse in the form of a bean. See Aseli.i. CY'ANUS ORIENTA'LIS MAJOR MOSCHA- TUS, SWEET SULTAN, Ol* SULTAN FLOWER. It is slight- ly cordial. Centaurea moschata Lin. Sp. PI. 1286, as. CY'AR, (from xeu, to pour out). Properly, the eye of a needle ; but i\ is used to signify the orifice of the internal ear. See Auris. CYA'SMA. BroAvn spots in the lips, forehead, and hands of pregnant women. CYATHIFO'RMIS, (from cyathus, a cup, and for- 771a, likeness). In botany it means shaped like a cup, that is partly cylindrical, but expanding toAvards the top. CYATHI'SCUS, (from the same). The hollow part of a probe, formed in the shape of a small spout, as in an ear-picker. CY'ATHUS, xvx6os, a cup, (from xve,v> to pour out). It was a common measure among the Greeks and Ro- mans, both of the liquid and dry kind ; equal to an ounce, or the twelfth part of a pint. The sextans was tAvo ounces; the quadrans, three; the triens, four; and were named from the portion of a pint they con- tained. The quincunx Avas five ounces; the semis, six; the septunx, seven; the bes, eight; the do- drans, nine ; the dextans, ten ; the deunx, eleven ; the as, sextarius, or cotula, tAvelve. The cyathus Avas made Avith a handle like our punch ladle. The Ro- mans Avere used to drink as many cyathi as there were muses; also as many as there were letters in their pa- tron's or their mistress's name. Pliny and Galen say, that a cyathus of the Greeks weighed ten drachms ; though the latter elsewhere observes, that a cyathus contains twelve drachms of oil, thirteen drachms and one scruple of wine, water, or vinegar, and eighteen drachms of honey. Among the Veterinarii, the cyathus contained two ounces. The modern cyathus is g i. ft. CY'BITOS. See Cubitus. CYBOI'DES. See Cuboides. CY'CAS CIRCINA'LIS seu I'NDICA. See Pal- ma Japonica. CYCE'ON, (from xvxxu, to mix ; also cinnum, or cin- nus). It is a mixture, of the consistence of pap, made with wine, honey, flour, and cheese ; perhaps the ma- caroni of antiquity. This name was given to some pti- ■ sans; and to a kind of salad in which cheese was mix- ed. See also GLnus anthinos. CY'CIMA, (from the same; so called from the mixture of the ore Avith lead to form litharge). See LlTHARGYRUM. CYCLA'MEN, EUROPIUM, (from xvxXx&, to surround; from the spiral coiling of its leaves and stalk). See Arthanita. CYCLI'SCUS, (from xvxXos, a circle). See Trochis- ci. Also an instrument formerly used in the operation of the trepan. CYCLO'PION. The white of the eye, (from xvxXou, to surround, and u-^, the eye). See Adnata. CY'CLOS. A circle. See Bucce and Orbita. CY'CLUS METASYNCRI'TICUS. It is a long protracted course of remedies, persisted in for restor- ing health. CYCNA'RION, (from xvxves, a swan). A collyrium mentioned by Galen and P. .Egineta, from its colour resembling,that of a swan. CY'DAR. See Stannum. CYDER, a fermented liquor from the juice of apples. It runs so quickly into fermentation that much care is necessary to check the process, which Avould otherwise soon render it acid. When in a good state, it is a very wholesome drink, though accused of producing rheu- matism. Cyder drinkers are generally thin, but firm and muscular; certainly subject to rheumatism, and occasionally to gout; but, on the whole, healthy and long lived. The SAveet cyders of Herefordshire are less Avholesome than the strong, more pungent, cyder of Devonshire. Cyder, when made early, of unripe fruit, is sharp and acrid; apparently able, Avithout any suspicion of lead, to occasion the colica pictonum. The poison of this metal, however, often impregnates, from accident or design, this otherwise wholesome beverage; and the most fatal colics and palsies are the consequence. CYDERKIN, a small cyder made by infusing the mock in Avater, and aftenvards pressing. It is weak, and must be drunk immediately. From pears it is called perkin, and is prepared in the same Avay. CYDONA'TUM, (from cydoneum, a quince). A preparation of quinces with an addition of aromatics, described by P. yEgineta. CYDO'NIA, (from Cydon, a tOAvn in Crete, where they greAv). The quince tree ; also called cotonea, and 7nalus^ cydonia. It is the pyrus cydonia Lin. Sp. PI. 687. The AVILD QUINCE TREE. The quince tree is low, a native of the rocky banks of the Danube, and common in our gardens. Its fruit re- sembles, in shape, round pears; hath an agreeable and C Y M 529 CYN strong smell, an austere and acid taste; and its express- ed juice, taken in small quantities, is cooling and re- stringent, useful in nauseas, vomitings, nidorous eruc- tations, as well as some kinds of diarrhoeas: by boiling, it loses its astringency. The seeds abound with mu- cilage, which they yield to boiling water. One drachm makes six ounces of mucilage, resembling in consist- ency the white of egg, recommended in aphthous affec- tions, and excoriations of the mouth and fauces; though that of the simple gums appears at least equally effica- cious. It is the most agreeable of all the mucilages, but is apt to mould in a short time. The London college directs the following mucilage of quince seed: Take of quince seed, a drachm; distilled water, eight ounces : boil with a gentle fire, till the water thickens; then strain through a linen cloth. Formerly a syrup was made of the juice of the fruit, and a conserve, called marmalade, jelly, miva cydonio- rum, or diacydonium ; but it is noAv an article of con- fectionary only. See Lewis's Mat. Med. Raii Hist. Cydo'nia exo'tica. See Covalam. CYE'MA. See Cuema. CY'GNUS REGI'NE. A collyrium described by .Etius. CYLI'CHNE, (from xvXi%, a cup). A small vessel or box for holding medicines ; a galli-pot, or pill- box. CYLFNDRUS, (from xXivu, to roll round). The cylinder. A tube, equal in diameter from top to bot- tom. The fruits of plants are termed cylindrical, when they resemble a column. Martyn says, it is applied to stems, and some leaves, which 'are round, or rather without angles ; but many times longer than they are thick. This, however, is more properly expressed by Columnar, because they are not of the same diameter from top to bottom. The term is applied to the calyx, to the style, and to the spike; as well as to masses of plaster. See Magdaleones. CY'LLOS, (from xoXXou, to make lame). In Hippo- crates, it a kind of luxation bending outwards, and hol- lowed within. Such a defect in the tibia is called cyllosis, and the person to whom it belongs is called, by the Latins, varus or blessus, and is opposed to valgus. N CYLLO'SIS. See Cyllos. CY'MA, xvptx, fetus, (from xvu, to bring forth). Cyme. It properly signifies a sprout or tender shoot, particularly of the cabbage. Linnaeus explains it to be an aggregate flower, composed of several florets, sitting on a receptacle, producing all the primary peduncles from the same point, but having the partial peduncles scattered or irregular; all fastigiate, or forming aflat surface at top. The cyme is either naked or with bracteae. Flowers disposed in a cyme are called cy- mose flowers: hence cymosae, the sixty-third of Lin- naeus's natural orders in Philosophia Botanica. CY'MB-E OS, (from cymba, a boat; so called from its supposed likeness to a skiff). See Scaphoides os. CYMBALA'RIA, (from cymbalum, a cymbal; from the resemblance of its leaves to an ancient cymbal; also called linaria). Ivy-leaved toad flax, or ivy wort. It groAvs on old walls in Italy and Switzer- land ; and hath the same virtues as the navel Avort. See Androsaces. VOL. I. CYMBALA'RIS CARTILAGO. See Cartilago CRICOIDES. CYMBIFO'RME, (from cymba, a boat). See Sca- phoides. CY'MIA. Sec Carora. CY'MINUM, (Arab, kumin). See Cuminum. CYMO'SjE. See Cyma. CYNA'NCHE. See Angina. CYNA'NCHICA MEDICAME'NTA. Medicines appropriated to the cynanche. CYNA'NTHEMIS, (from xvov, a dog, and taitfus, a flower ; because dogs are said to eat it). See Chamve- melum F(ETIDUM. CYNANTHRO'PIA, (from xvov, and xv^u-xos, a man). A kind of melancholy delirium, in which the persons affected believe they are changed into dogs. Sometimes the term for hydrophobia. CY'NARA SCOLYMUS. See Cinara. CY'NCHNIS. (Greek.) A small vessel to hold medicines. CY'NICUS, (from xvuv, canis). Canine. Certain convulsions are called cynic spasms. See Sardonicus risus. CY'NIPHES, (from the Hebrew word cnis). Flies or gnats. Van Helmont. CY'NNIA. See Carora. CYNOBO'TANE, (from xvuv, a dog, and /3«7«vjj, a herb). See Cham^emelum foitidum. CYNOCO'CTANUM. See Aconitum. CYNOCO'PRUS, (from xvuv, a dog, and xonpos, dung). See Album Gr^cum. CYNOCRA'MBE, (from xvuv, can is, x^x^*), cabbage; because dogs are said to eat it as a cathartic.) See Mercurialis, Sylvest. and Hippomanes. CYNOCY'TISIS, (from xvuv, canis, and xvltcros, the cytisus; because it cures the distemper of dogs). See Cynosbatos. CYNODE'CTOS, from xvuv, a dog, and frxxvu, to bite). Bitten by a mad dog. CYNO'DES, (from xvuv, a dog). Canine. CYNODE'SMION,(from xvuv, membrumvirile, and ha, ligo). A ligature by Avhich the prepuce is bound upon the glans ; or the lower part of the prepuce. CYNODO'NTES, (from xvuv, a dog, and ohvs, a tooth). See Canini dentes. CYNOGLO'SSUM, (from xvuv, a dog, and yXurrr,, a tongue ; from its resemblance). Hound's tongue. Cynoglo'ssum majus vulgare canina LIN'GUA. Greater hound's tongue. Cynoglossum officinale Lin. Sp. PI. 192. It is a biennial plant; producing, the first year, large, soft, tongue-shaped, long, pointed leaves: the second year, a thick branched stalk, with pointed leaves joined to it, Avithout pedicles : on the tops of the branches are dark purple flowers, which are folloAved by four flat seeds: The root is oblong, and of a dark broAvn or blackish colour on the outside, but white within. It grows in shady places, and flowers in June. The roots that grow in moist grounds haA e a rank, but not very strong, smell, like those of the narcotic plants, which in drying is mostly dissipated ; those on dry ground have very little smell. In medicine is use- less, but ithas been employed adversus pediculos. CYNO'LOPHA, (from xvuv, a dog, and Xotp«s, a protuberance). The asperities ok hie uppf.k 3 Y C YP 530 C YS dorsal vertebrae : in dogs they are particularly emi- nent. CYNOLYSSA, (from xvuv, a dog, and Xva-e-tj, mad- ness). See Lyssa and Hydrophobia. CYNOMORON, (from xv,jv, a dog, and y.upov, a ber- rV) ■ See Hippomanes. CVNOMY'A, (from xvuv, a dog, and y.vx, a fly). See Psyllium. CYXOPTICON. See Dacneron. CYXORE'XIA, (from xvuv, and ef*|'«, an appetite). See Boulimus. CYNORRHO'DON, (from xvuv, and '(•&*, a rose). The dog rose. CYNO'SBATOS, (from xvuv, and px%s, a thorn). The berry of the dog rose. Canirubus, cynocytis, rosa sylvestris vulga7-is, and inodora. It is the rosa canina Lin. Sp. PI. 631. The avild briar, or hip tree. It is one of the largest plants of the rose kind, a native of Britain, grows wild in hedges, and flowers in June. The fruit contains a sour sweetish pulp, Avhich is made into a conserve, by adding to a pound of the pulp of the berries (hips) of double refined sugar twenty ounces. The hips are to be split, and the hairy seeds carefully separated. When the fruit is melloAved by standing a feAv days, it must be pressed through a hair sieve, and to the pulp the sugar must be added. Ph. Lond. 1788. If this caution is not observed in pulping the fruit, the rough prickly matter enclosing the seeds may be retain- ed in the conserve, which will occasion uneasiness at the stomach, an itching about the anus, and sometimes vomiting. Though formerly it was ordered in large closes, to correct acrid bile, sharp urine, heat in the stomach, and esteemed useful in many disorders, as dropsies, calculous complaints, dysenteries, haemorrha- ges, Sec. it is iioav considered only as agreeable to the taste, and principally used as a vehicle to more effica- cious remedies. There is also a reddish green, spongy, hairy excrescence, made by small ichneumon flies, on the stalks of this tree, called bedeguar, celebrated for its astringent poAver; but it has not yet been sufficiently tried to speak Avith great certainty of its power. CYXOSO'RCHIS, (from xvuv, canis, and opxis, a testicle; from the testicular shape of its root). See Orchis. CY'OX. (See Canis.) Also the inferior part of the penis and prepuce. See Penis. CYOPHO'RIA, (from xvy^x, the fetus, and «», tree, and 0X1- Qxvov, fra7ikincense.). See Rosmarinus. DENDROMA'LACHE, (from hvhov, and ^xXxxn, the 7nallow). See Malva rosea. DENODA'TIO, (from denodo, to loosen). See Dis- SOLUTIO. DENS, (quasi edens, from edo, to eat, or from o2~ns efovlos). A tooth. The teeth are usually sixteen in each jaw; they are divided iftto the body above the gum, and the root, or fang, which is within the socket of the jaw; the neck is the line of division between the root and the body. They are composed of a bony substance and an enamel. Little attention was paid to the teeth before the period of Eustachius, Avhose work appeared in 1563. He was followed by a French surgeon, Urban Hemard, about tAventy years afterwards ; but though the teeth and their diseases Avere more frequently mentioned in anatomical and chirurgical works, we find no express treatise on the subject till the year 1740, the date of Fouchard's work. This author was followed in 1771 by Mr. J. Hunter; by Dr. Blake in 1798; and Mr. Fox in 1803. The enamel covers only the body of the tooth, that part which is not covered by the gums, so far as to its neck : it is not vascular, nor capable of being injected : for if animals are fed with madder, the body of the tooth will be coloured, but the enamel will remain un- altered ; or, if the enamel be steeped in a Aveak acid, it Avill become a powder; but if bone is thus steeped, a soft elastic part remains. Chemically examined, the enamel consists, like bone, of phosphat of lime, and gelatine, viz. of 29.67 parts of phosphoric acid ; 43.3 of lime ; and 27.10 of gelatine and water. It is generally agreed that the enamel is never reproduced. It certainly is not when broken to the subjacent bone; but its surface seems to be occasionally supplied, though its hardness prevents injury from at- trition. Each root is hollow, for the admission of vessels and nerves to pass into the substance of the teeth ; but these cavities grow less in advanced age. Ossification begins in the body of a tooth, and is con- tinued to the root; and there are as many points of ossi- fication as there are tubercles in the tooth. Mr. John Hunter suspects that the teeth, when full grown, are' not simply bone. He observes, that bones are tinged with the colouring matter of madder when they are com- plete and perfectly grown, if the animal is fed for a time Avith this root; and teeth, whilst growing, receive this tinge, but not Avhen they are perfected. In all other bones this red colour is, in time, carried off by absorp- tion, and they return to their original colour; but a groAving tooth, if coloured, never loses it. This does not show the want of an absorbent system, for teeth, Avhen their nerves are destroyed, seem to be slowly ab- sorbed ; and they certainly continue, while alive, to be vascular. The Avhole anomaly seems to arise from the minuteness of their vessels. The rickets do not affect the teeth; for Ave never find them groAv soft like the bones, but they remain perfectly hard: lastly, in old age, the other bones become brittle and waste; but the teeth, except when carious, continue in their former state. The teeth are divided into three classes, viz. the inci- sores, canini, and molares. The incisores, called also dentes lactei, and dentes risorii, are the four anterior teeth in each jaw; they appear the first. The canini, or dentes oculares, are one on each side of the incisores, in each jaw. The molares are five on each side of both jaws. Sometimes before twenty years of age, often about five or six and twenty, the last of the grinders ap- pear, and are called dentes sapientia and dentes genuini. Mr. John Hunter divides and names them as follows; viz. from the symphysis of the jaw on each side, are two Incisores, q. v. ; one cuspidatus, (see Canini dentes ;) two bicuspides ; and three molares, the last of which is the sapientia dens. See Morales. The incisores, canini, and the two first of the grinders, are formed at the birth, and are those teeth which are shed. They usually appear about the seventh month, and are shed about the seventh year. The secondary teeth are formed in sockets of their own, Avhich are situated below the other socket. The three dentes molares on each side do not come through the gums until the first set of teeth is shed ; then they come through Avith the second set, and are never shed. Some people never have the last molares. At about three years of age a child hath the whole of its first set of teeth, which are twenty. There are generally as many protuberances on the body of the teeth as there are roots : but the latter some- times grow together; at other times they are divaricat- ed, especially in the upper jaw, where, not having a sufficient depth, because of the maxillary sinus, they spread and are extracted with greater difficulty than those on the lower jaw. The fifth pair of nerves supply the teeth with branches, which, with the blood vessels, are surrounded by a membrane, and, running under the teeth, enter into the cavities through a hole in the roots. From an attention to the fifth pair of nerves, and the parts to which they are distributed, many of the phenomena at- tendant on disorders of the teeth may be explained. It is in general supposed that the teeth, when a child is born, are lodged in sockets in the jaw-bones, and are covered with, and inveloped by, a thin, very irritable, and sensible membrane, the periosteum of the teeth ; so that when the teeth begin to grow, they must neces- sarily distend, and force their way through this mem- brane, which, from its sensibility, gives great pain, and occasions fevers, startings, and all the symptoms of teething. As soon as this membrane is completely divided in that part by the tooth, the child is relieved for the present from the fever and other complaints; which are subject to return upon the successive rising of the other teeth. This general account must be admitted with many restrictions, derived from more minute inquiries. The teeth are formed in the foetus, and even the rudiments of the second set are very early conspicuous. They os- sify in distinct points; and, at the period of birth, these ossified points are nearly contiguous. They are covered with ajnembrane Avhich is divisible into two DEN 541 DEN layers; most dense and thick near the edge of the jaw, and softer as Avell as more gelatinous beloAV. The exter- nal layer is spongy and vascular; the internal more ten- der and delicate, Avithout vessels: though Mr. Hunter, perhaps from accident, has inverted this order. The membrane is fastened to the neck of the tooth, Avhich, pressing against it, deprives itof life, and thus occasions its absorption, as Avell as of the gum above. Laceration seldom takes place, though in some instances it seems to do so, as the ragged edges have been observed. In general, the diseases attributed to dentition do notarise from the distention of this membrane, but to the state of the stomach, and are often relieved by a slight opiate, Avith the volatile alkali. It has been a too common prac- tice to divide the gum; but this is an unnecessary seve- rity, and often useless. It is only when the tooth distends it considerably, with violent inflammation, that such an operation is admissible. Disorders in the teeth, in more advanced age, depend chiefly on a caries, and an inflammation in the mem- brane Avhich covers their root. When a tooth is ca- rious, it often occasions a fetid breath ; and the air pass- ing into, or any warm or cold substance touching it, excites pain. Relief is often obtained by filling the carious part with opium for occasional relief; but with gold or silver laminae for more permanent ease. When the membrane which spreads itself about the roots of the teeth is considerably inflamed, bleeding or purging, ac- cording to the state of the constitution, will be needful; warm barley water may also be held in the mouth, and the methods useful in other inflammatory disorders may be employed. Blisters may be applied behind the ears, or on the back ; and horse radish or pellitory root may be held between the gums and cheeks, to excite a dis- charge of saliva. Besides these general causes, scorbu- tic and venereal complaints will affect the teeth; in which cases, the method of cure will consist in general remedies adapted to them. See Dentifricium. On the teeth, and their disorders, see Mr. John Hun- ter's Natural History of the Human Teeth ; Eustachius de Dentibus; Hoffman de Dentibus, eorum Morb. et Cura ; Hurlock on Breeding of Teeth ; Moss on the Management of Children; Bell's Surgery, vol. iv. p. 191; White's Surgery, p. 280; Blake and Fox on the Teeth. Dens caballi'nus. See Hyosciamus. Dens ca'nis. Dog's tooth. Erythroniu7n, dens canis Lin. Sp. PI. 437. The flower is shaped like that of a lily; the root is long, fleshy, and formed somewhat like the tooth of a dog; the leaves resemble those of the cyclamen. The dried roots are commended as an- thelmintic ; but are not used Avith us. Dog tooth spar in mineralogy is one of the original forms of crys- tals. Dens le'onis, also called taraxacum, urinaria, hie- racium Alpinum, hedypnois. Dandelion. It is the leontodon taraxacum Lin. Sp. PI. 1122. It is a low plant, with long, narrow, deeply indented leaves, lying on the ground, among Avhich arises a single,naked, hol- low pedicle, bearing a large, yellow, flosculous flower, followed by small seeds, covered Avith a tuft of long down: the root is oblong, slender, yellowish, or brown- ish, on the outside, and white within. It is perennial, common in uncultivated places, and flowers from April to the end of summer. The roots, stalks, and leaves, abound Avith a milky, bitterish juice, but of no particular flavour. They Avere supposed to be mildly detergent and aperient; but owe their credit chiefly to their milky juice, Avhich Avas supposed to be saponaceous. Boerhaave highly com- mends them as a resolvent; but the more immediate and sensible operation of this plant is to loosen the belly, and promote urine; which it does with little sti- mulus, though in a slight degree ; and has been consi- dered as highly efficacious in removing biliary obstruc- tions. Dr. Pemberton, in a late Avork, speaks of it with commendation in these complaints. Murray observes, that this plant resolves viscid humours, opens obstruct- ed vessels, and is a remedy for various eruptive com- plaints ; and Bergius considers it as an effective, hepa- tic deobstruent, recommending it in hypochondriasis and jaundice. He recommends it boiled in Avhey, or formed into broths and apozems. It has also been sup- posed useful in dropsies, pulmonic tubercles, and some cutaneous disorders; given in decoctions of the plant and root; or the expressed juice is sometimes adminis- tered, from one ounce to four, three or four times a day. The plant should always be used fresh; for even ex- tracts of it, as well as the roots and leaves, lose their power by keeping. It may also be taken as part of diet, and eaten fresh. The young leaves blanched resemble in taste the endive, and make a good addition to salads in the spring. The roots are roasted, and used at Got- tingen, by the poorer people, for coffee, from Avhich a decoction of them properly prepared can hardly be dis- tinguished. See Raii Hist. Lewis's Mat. Mad. It is also a name of the auricula muris, and some other plants. DE'NSITAS,(from densus, thick). Density. Dense bodies contain a considerable quantity of matter within a proportionally small bulk. But in medical Avritings, denseness sometimes means frequency, and is applied to the pulse, and to respiration. DENTA'GRA, (from dens, a tooth, and xypx, a sei- zure). It is used both to signify the gout in the teeth (see Arthritis), and an instrument for drawing them, called also dentarpaga, dentiducum, odontagogos. DENTA'LE VIRIDE STRIATUM. SeeENTALiuM. DENTA'LIS LA'PIS, (from dens,) the tartareous matter formed on the teeth, resembling in hardness a stone. DENTA'LIUM, (from the same). Also called den- tale, autalis, tubulus dentalis, and tooth shell. It is the shell of a small sea fish, oblong, slender, and of a whitish,,greenish, or reddish colour; about two inches long, striated, and marked with two or three bands. As a medicine, it differs little from the oyster shell. DENTA'RIA, (from the same). Dentaria penta- phyllos Lin. Sp. PI. 912. Coralloides, septifolia, sept- foil toothwort, and coralwort. This plant hath a long pod, full of round seeds; when this is ripe, its valves are twisted into a spiral fonn, and discharge the seeds with violence: the root is squamous, fleshy, and denticulated. It floAVers in April: the root is drying and astringent. Denta'ria. See Plumbago. DENTARPA'GA, (from dens, a tooth, and xcttx^u, to fasten upon). See Dentagra. DENTA'TA,(from dens, a tooth). The second ver- tebra of the neck. It is remarkable for its process. DEN 542 DEN called pr^rrssus dentatus, Avhich plays in the holloAV of the aitterior arch of the vertebra above it, called Atlas. From the sides of the processus dentatus, the ligaments go off to attach it to the Atlas; and from its point a strong one is sent out to the os occipitis. In botany a dentated leaf, called denticulatum, is distinguished by spreading points or teeth, remote from each other, about the edge. DENTA'TUS PROCE'SSUS. See Atlas. DENTELLA'RIA, (from dentella, a little tooth). See Plumbago. DENTES COLUMELLARES, (from dens, and co- lumella.) A little column. Dentes canini of Varro and Pliny. Dentes lacte'i. See Incisores. Denies occula'res. Eye teeth. SeeDExs. They are thus named, because their nerves are supposed to be connected Avith those of the eye, and that any injury they receive may equally injure that organ. Dentes riso'rii. See Incisores. DENTICULA'TA, (from de7iticula, a little tooth). Indented, or cut round in small notches. See Mocha- TELLINA FOLIIS FUMARIiE BULBOS.*. DENTICULA'TUM, (from the same). See Den- TATA. DENTIDUCUM, (from dens, and duco, to draw). See Dentagri. DENTIFRI'CIUM, (from dentes fricare, to rub the teeth). Dentifrice; called also odontotrimma. Medi- cines for cleaning the teeth. Many preparations are em- ployed for this purpose, chiefly consisting of scuttlefish bone, bole, bark, myrrh, salt, and soot. Each operator has his receipt, Avhich he highly commends and con- ceals. Any very fine poAvder is apparently of equal ser- vice, but mastich and^myrrh are the general bases: most commonly the fonner. The powder is flavoured with orris root, with ambergris, Sec. and coloured with dra- gon's blood, bole armoniac, or red sanders, professedly to strengthen the gums, but really to conceal the bleed- ing from the gums. It Avas formerly the custom to add common salt or crude sal ammoniac to dentifrices; for Avhat purpose we know not; but both are now disused: and one of the most boasted tooth powders that we have seen, is only magnesia coloured with rose pink. The carbonated dentifrice is merely powdered charcoal, and it has been employed chiefly from its poAver of destroy- ing the colours of different fluids, discovered by LoAvitz. (Sec Charcoal.) Soot is used from the Avhiteness ob- served on chimney sweepers' teeth; but it possesses no very peculiar merit. A sufficiently pleasant and effica- cious tooth powder is made Avith two parts of finely pow- dered mastich, two parts of myrrh, and one part of cas- sia. It cleans the teeth, preserves them from decaying, and renders the gums peculiarly firm and hard. In fact, hoAvever, almost every poAvder seems equally efficacious, and, if it be impalpable without acidity, equally innocent. The calculous concretion which forms on the teeth is of singular hardness, and with great difficulty remov- ed ; nor has modern chemistry yet discovered a a men- struum Avhich Avill dissolve it without injuring the ena- mel. Acids soften this firm covering, and render it transparent. Dentists universally reprobate their use, and Ave cannot, therefore, encourage it. We suspect, however, that their occasional application will not be injurious : we are, at least, certain, that the injury acids may do is recoverable. The brushes should be hard and strong ; the hairs set at somo distance, that they may clean'the interstices of the teeth, where the tartar lodg- es ; and the brush should be used more in the longitu- dinal direction* Avith respect to the teeth, than across them. If the powders are perfectly fine, no injury can arise from the brush. The preservative tinctures are of little use. Their basis, like the poAvders, is mastich, and their appellations fanciful. DENTILLA'RIA, (from denticula, a little tooth; so called because its root is denticulated). See Plum- bago. DENTISCA'LPIUM, (from dens, a tooth, and scal- po, to scrape). Also called odontoglyphon. An instru- ment for scraping off the crust which is formed on foul teeth. In Oribasius, it is an instrument for separating the gums from the teeth. DENTITIO, (from dentio, to breed teeth). Also called odontiasis, odontophya. Dentition, or breeding of teeth. Sauvages, in his system of Nosology, makes this a species of odontalgia. Cullen makes dentitid synonymous Avith odaxismos; but does not admit it as a disease. Hippocrates uses the word principally with respect to the gums,Avhen the teeth are forcing a pass- age through them; and modern writers folloAV his ex- ample. Children often suffer much uneasiness from the cut- ting of their teeth : though teething is not a disease, yet from accident and temperament it sometimes produces the most fatal disorders. The fever and inflammation excited in a full habit may terminate in peripneumony or suffocation ; and when the child is fat and plethoric, the most cooling diet and the most active laxatives must be employed. A troublesome cough is often attendant on teething; in which case a small blister applied to the nape of the neck is of considerable service. A fresh one may be ap- plied when the first begins no longer to produce any discharge. Dr. YVithers observes, in his Treatise on the Asthma, p. 301, 302, that, "If a child has a disease in his breast, the cutting of a tooth, as it often excites pain, fever, and general irritability, will be found commonly to in- crease it. But this affords no proof why a cough and shortness of breath, Avith a pulmonary obstruction in the lungs, should be thought a necessary attendant on teeth- ing. According to the best of my observations, it is an indisputable fact, that healthful children cut their teeth without a cough ; and Avhen in others a cough attends teething, it is, in general, an accidental circumstance, proceeding from a local complaint in the breast, and is not merely symptomatic of the cutting of a tooth. The violence of the cough, the rising of the phlegm from the lungs, inflammations, pulmonary obstructions, and ulce- rations, which have followed, and been proved by dis- section, have fully convinced me of the truth of the above assertion. I should not have dwelt at all on this fact, if I had not observed that the notion which I am endeavouring to refute is pernicious to society, and productive of fatal consequences. For Avhen we say that a cough, Avith shortness of breath, is a common symptom of teething, we unite the tAvo complaints to- gether under one idea; and as Ave consider teething as natural and necessary, the other, being united Avith it, and regarded only as an effect, falls in under the same DEN 543 d e o general idea, and consequently is too often supposed to require no particular treatment; by which means it is neglected, and in many instances proves fatal." When children are vigorous, they cut their teeth earlier; Aveakly children, particularly those that are dis- posed to the rickets, are later before their teeth appear, A discharge of saliva, or a diarrhoea, are favourable symptoms during the time of cutting the teeth. Child- ren attended with these symptoms are rarely affected Avith convulsions, or any other violent disorder. Hoffman observes, that the teeth appear sometimes in the seventh month, at others in the ninth, or even the twelfth. In some, this process, gives but little uneasi- ness ; in others, it is accompanied with very trouble- some symptoms. In difficult dentition the child is preternaturally hot, cries immoderately, starts in his sleep, often applies his hand to his mouth, sucks Avith eagerness, and even bites the nipple. The gums swell, and look Avhitish or reddish; the saliva is copiously dis- charged, and often hangs viscid from the mouth; the belly either costive or too loose. Sometimes acute fe- vers, convulsive and epileptic paroxysms, distortions of the jaws, and other violent symptoms are joined, differ- ent in different subjects, according to the difficulty of the eruption of the teeth, or the sensibility of the child. Amongst the prognostics, he says, that those Avho are plethoric," sleepy, costive, those affected in dentition Avith a cough, Avho are of great sensibility, or an hereditary passionate disposition, have the most to fear. Hippocrates observes, that those who are attacked by the acute fever escape convulsions, and that the teething is easiest in winter. The principal indications of cure are, to abate the pain and inflammation, and to soften and relax the gums. If the body be not naturally lax, it should be kept so. A spontaneous looseness is salutary, and should not be checked; for convulsions and other threatening symptoms will then probably fol- low. Breeding the teeth commonly begins about the third or fourth month: it may be knoAvn by a copious dis- charge of saliva taking place; its being pleased with having its gums rubbed with a finger, or other harder substance ; its becoming more fretful and uneasy, start- ing in its sleep, or suddenly awaking. If noAv there are also great heat, thirst, fever, a dulness and droAvsiness, particular attention should be paid to keep the boAvels lax, if they are not already so; if a looseness at this time attends, though it is somewhat severe, it should not be checked. The griping, which occasionally accompanies this looseness, is generally abated by the use of a little magnesia, or prepared chalk. When the drowsiness, starting, and feverishness come on, bleeding with leeches will be singularly useful. Two leeches may be applied to the neck every or every other day, until these symp- toms abate. During the thirst, if children crave sweet- ened drinks, liquorice may be boiled in the water Avhich is given, as it does not increase this troublesome symp- tom. After the bleeding, blisters behind the ears, or on the back, are not to be omitted. The antimonial eme- tics should be repeated occasionally until the fever is removed; and, in many cases, the sp. cornu cervi, re- commended by Sydenham, is useful. Should convulsions come on, the above treatment will be also well adapted to relieve. A discreet use of anodynes is an important addition in this instance; and, in general, after free evacuations they may be given by the mouth, or in an enema. The second stage, or period of teething, is that of cutting the teeth. This usually begins about the seventh or ninth month : in this the symptoms or ma- nagement are, in general, the same as those of the first period. A child, hoAvever, who a little before was pleased with having his gums rubbed, Avill now seldom suffer any thing to touch them ; for when a tooth is penetrating the gum, it is exceedingly sensible of pain from the slightest touch. It may be knoAvn that a tooth is near cutting, Avhen the gum in one particular part appears fuller and more distended than usual; the gum in that part looks red, and is inflamed at the bottom or base, but is paler or whiter at its point or edge ; and when the tooth is very near, the edge of the gum seems as if it was covered with a flat Avhite blister, appearing also thicker and broader than the edges of the gums in other places: at this, but at no other period, if any alarming symptoms come on, cutting the gum over the edge of the approaching tooth, will be a speedy and often an effectual means of relief. If cut earlier, though the symptoms abate, the tooth will not appear for some days, or perhaps weeks. Sometimes the gum heals, and the former uneasy symptoms return; and it has been necessary to repeat the operation frequently; a severity Avhich, though the Avounded gum should not unite Avith a hard cicatrix, is to be discouraged. It is, hoAvever, by no means certain, that the subsequent opera- tions are not more painful, and that the appearance of the tooth is not retarded; that repeated cutting the gum renders it harder; for the contrary is said to take place; on which see J. Hunter's Practical Treatise on the Dis- eases of the Teeth, p. 121. Bell's Surgery, vol. iv. p. 191. White's Surgery, p. 280, &c. DE'NTO, (from dens, a tooth). One whose teeth are prominent to a great degree. DENTODU'CUM. Dextiducum. See Dexta- gra. DENUDA'TIO, (from denudo, to make bare). De- nudation. It is spoken of parts that are laid bare bv the flesh being torn from them. ' DENUDA'TUS, (from the same). An order of plants in the vegetable kingdom, whose flowers are naked. DEOBSTRUE'NTIA, {de, priv. and obstruo, to ob- struct). Deobstruents. Deoppilativa. DEOBSTRUENTS. This is a class of medicines formed Avithout any precise or definite object. Obstruc- tion was a.cause of convenient application, from its vague indefinite meaning; and, while lentor and vis- cidity Avere the sources of diseases, deobstruents Avere common remedies. We declined speaking of them in the class of aperients; as for these medicines there was an apparent foundation, we mean not to say that there is not some foundation for the present group, yet it is less clear and satisfactory. Obstruction, during the reign of the humoral pp. thology, Avas, as Ave have hinted, frequently introduced as a cause; but though fevers and inflammations Avere then ultimately resolved into obstruction, deobstruents were confined exclusively to chronic complaints: of these, infarctions of the viscera were chiefly attacked by gentle laxatives, from this effect styled aperients, of Avhich Ave have already spoken. The obstructions to be removed by this eluss of mc- DEO 544 DEP dicines, are those of natural discharges, or infarctions of organs, Avhose utility is less obvious, and from which no excretory ducts proceed. The natural discharges, to restore which Ave employ deobstruents, are those of the menses, of the haernorrhoidal vessels, of the nose, the lungs, and the skin. The first we must treat of under the title of Emmenagogues; the second we have spoken of in the article Cathartics ; the others will occur under the articles of Errhines, Expectorants, and Diaphoretics. Our present object is, then, those tumours out of the circulation, or in parts where the circulation is languid, and from Avhich no excretory ducts proceed. We have already stated, that where obstruction oc- curs, tAvo modes of treatment offer themselves to our notice; the one consists in forcing on the circulation, by increasing the vis a tergo ; the other in moderating too great action, in order to prevent the fluids from being further impacted, the obstruction increased, and suppuration supervening. The first can seldom be ef- fected by violent stimulating remedies; yet we have had occasion to show, that mercury, by sloAvly and steadily increasing the action of the arterial system, and of course the momentum of the blood, sometimes succeeds. It certainly, at times, removes complaints of the liver; sometimes, though rarely, scirrhous tumours of the breast, and other parts where its topical application by friction can be combined with its internal stimulus. The internal use of arsenic, in cancers, must be referred to the same head; and other stimuli sometimes succeed in different complaints. The tartar emetic ointment has been useful in bronchocele, and occasionally in the white swelling of the knee. In the latter also, the arum, and the gum ammoniacum, with squills, have been successful. These, then, are deobstruents from their stimulus. When the application of sea weeds and sea salt, Avith their internal use, relieves cases of scro- fula; and mesenteric tabes, or the burnt sponge, under the tongue, lessens the bronchocele; they appear to be useful in the same Avay. The sedative or refrigerant deobstruents are medicines of the same classes, though they have not been usually arranged under this head. When we give nitre, and employ the antiphlogistic regimen in cases of tubercles in the lungs, we use them as deobstruents. A similar treatment is often, for the same purpose, adopted in in- cipient cancers. The general remedies of this class, however, besides opium, are, the cicuta, the lactuca virosa, the belladonna, the aconite, and the various ge- nera of the same order. These have been used as de- obstruents in other parts of Europe, it is said, with success. We have to regret that we cannot add our testimony to their efficacy. It has not been uncommon to unite the tAvo orders of deobstruents; and not long since fashionable to join the extract of cicuta with mercury in tubercular con- sumptions; arum, with the same preparation, as an ap- plication to white swellings; mercury, antimony, and opium, in internal obstructions; and mercury, with camphor, externally applied. We have enlarged on this class more fully than, per- haps, its importance might have demanded; for, from being highly valued, it has been neglected in the later systems. It Avas proper, therefore, to show, that the establishment of this association Avas not Avholly theore- tical, and to point out its real foundation. DEPART. See Discessus. It is also called quar- tatio, which see. - DEPA'SCENS U'LCUS, (from depasco, to ea> down). See Phagedena. DEPENDENS, (from dependo, to hang from). De- pendent. In botany it means hanging down, pointing towards the ground. DEPERDI'TIO, (from deperdo, to lose). See A.BORTUS. DEPETI'GO, (from de, and petigo, a running scab). ScC PrURIXUS DEPHLEGMA'TIO, (from de, and phlegma, phlegm). Vinous spirits are said to be dephlegmated, or rectified, when freed from the usual proportion of water. DEPILATO'RIUM, (from de, and pilus, hair). De- pilatory. Medicines which take off the hair, such as quick lime and orpiment. There are three kinds of de- pilatory medicines: 1. The psilbthra, or depilat&ria, by way of eminence; 2. Those which thin the hair; and, 3. Those which are corrosive, and extirpate the hair. The first and third are nearly the same, at least the hair cannot be effectually taken off unless its roots are destroyed. DEPI'LIS, (from the same). See Alopecia. DE'POT LAITEUX. See Lymphs ductus. DEPLUMA'TIO, (from de, and pluma, a feather, or hair). An affection of the eye lids, with a callous tumour, Avhich causes their hair to fall off. ./Etius says, it is a disorder in the eye, consisting of a madarosis and sclerophthalmia. DEPREHE'NSIO, (from deprehendo, to catch una- wares). See Catolepsis. DEPRE'SSIO, (from deprimo, to press down). A depression. In surgery this word generally signifies a sinking of some part of the skull, which happens from an external violence, by which the bone is fractured, or pressed inAvards. This injury is sometimes named impressio, introcessio. In this case, the same symptoms may attend as are observed in an extravasation within the skull, and are caused by the same means, viz. mechanical pressure : they differ widely from those of a concussion of the brain. See Concussio, Extravasatio, Cerberi, Compressio. Dr. Hunter seems to think, that it is almost impossi- ble to raise a depression of this kind, because the frac- ture is usually more extensive in the inside than exter- nally, and the spiculae can never be brought exactly to fit each other. But as, according to Hildanus and Van- der Weil, some skulls have been depressed without fracture, success may be expected, at least, in some cases; and Avhere the bones are soft and yielding, they may be raised by means of a string fastened to an adhe- sive plaster, which may be applied to the depression, after shaving the part. But, after all, if their elevation were easily practicable, it would not be advisable, in general, to be contented Avith mere elevation; for all the ills attending and succeeding simple fractures, are more likely to happen from depressed pieces of bone; therefore the depressed pieces should be generally re- moved. DEPRE'SSOR, also deprimens, (from deprivo, to pull, or draw down). In anatomy, a name applied to several muscles, because they depress the parts to which they are fastened. Depre'ssor angu'li o'ris. A name given by D E V 545 DER Albinus to the dcpi-essor labioru7n communis. It rises from the outer part of the lower edge of the lower jaAV, at the side of the chin, and is continued outwardly, to the greater zygomaticus, to the nasalis of the upper lip, and thence into the outer part of the orbicularis, where it surrounds the upper lip at the corner of the mouth. It extends and joins the elevator of the corner of the mouth. Depre'ssor epiglottidis. It rises from the liga- ment on the thyroid cartilage on its fore part, and is inserted in the epiglottis, near its basis, on each side. Depre'ssor labio'rum commu'nis. See Depress- or ANGULI ORIS. Depre'ssor la'bii superi'oris; tria7igularis, co7i- stridor ala nasi. It rises from the sockets of the in- cisores, runs to the superior part of the upper lip, and sends some fibres to the nose. Depre'ssor o'culi : humilis rectus inferior, depri- mens musculus inferior. It rises tendinous from the back part of the. socket, cohering in some measure Avith the covering of the optic nerves, and is inserted into the fore part of the sclerotica, after running under the eye. Depre'ssor superci'lh. See Corrugator coi- TERII. DEPRESS'ORES A'L.E NA'SI. The plural of depressor. The depressors of the wings of the nose. They arise from the upper jaw bone outAA-ardly, where the gums cover the sockets of the dentes incisores and canini, and are inserted into the root of the wing of the nose, advancing a little Avay up the side of the Aving: they pull the alae doAvnwards. Depresso'res costarum. They are so similar to the levatores longiores, as to need no further descrip- tion: their office is the reverse of the other. Depresso'res labii inferioris. Also called qua- drati. They arise fleshy on each side of the chin, proceed obiiqucly, and, crossing each other, terminate together in the whole edge of the lip, where it groAvs red. Depresso'res maxillai inferioris. See Platysma MYOIDES. DEPRESSO'RIUM, (from dtprimo, to depress). An instrument used for depressing the dura mater after the operation of the trepan. DE'PRIMENS, (from deprimo, to depress). See Depressor, and Depressor oculi. DEPURA'TIO, .(from depuro, to purify). Depu- ration, clariflcatio, despU7natio, vel rectficatio. It is the freeing of any fluid from all heterogeneous feculence, and rendering it more transparent. This operation is of three kinds: 1st. Decantation, Avhich can only take place Avhere there is a difference in the specific gravity of what constitutes the mixture ; so that the lighter part can be poured off. When oils arc to be separated from Avater, or indeed from other fluids, a tritorium, or se- paratory glass, is used. 2dly. Despumation. The principle of this mode of depuration is the existence of air in the fluid, which, when rarified by heat, rises to the top, carrying with it the feculae, Avhich may be separated by a spoon. 3dly. Clarification, performed by add- ing the Avhites of eggs, or such fluids as will coagulate by means of heat, and entangle all the heterogene- ous matter, Avhich may be easily separated. 4thlv. Filtration or percolation, performed by pass- ing, without pressure, the fluid to be purified through VOL. I. strainers of linen, flannel, or paper, which, retaining the feculence, permit only the clearer fluid to pass. In filtration, a soft porous paper is folded in the shape of a funnel, then placed into one; and, after suffer- ing some water to filtrate through it, to dissolve the alum, usually employed in the manufacture of the pa- per, the liquor is to be gradually poured on, to pass through it. When flannel is used it is commonly formed into a cone, called Hippocrates' sleeve, and its base is hung on three props, with the apex of the cone doAvnwards ; it is then filled with the liquor, Avhich gradually drops from the apex: it is generally used when the fluid to be de- purated is hot. Distillation and sublimation are practised in the de- puration of spirits and salts, and the operation is then called rectification. DEPURATO'RIA FE'BRIS, (from de,andpurus, pure). Depuratory fever. A name given by Sy- denham to a fever, which prevailed in the years 1661 and 1664. He called it depuratory, because he observed that nature regulated all the symptoms in such a man- ner as to fit the febrile matter for expulsion in a cer- tain time, either by a copious sweat, or a free perspira- tion. See Sydenham's Works. DE'RAS, and DERMA, (from k*u, hexs, a sheep skin). The title of a book in chemistry, treating of the art of transmuting base metals into gold. It is written on sheep skins; hence also Derma. DE'RBIA. See Impetigenes. DERI VA'TIO, (from derivo, to draw from; and from de, and rivus, a river). Derivation. In medicine, when a humour cannot conveniently be evacuated at the part affected, and is attracted from thence, to be discharged at another place, it is called derivation: thus a blister is applied to the neck to draAV away the hu- mour from the head. The doctrine of derivation and revulsion, as under- stood and explained by the ancients, is, in their sense of these terms, Avholly exploded. By revulsion they meant the driving back of the fluids from one part to determine it to another. The only rational meaning that the word revulsion, as here, applied, can have, is the preventing too great an afflux of humours to any part, either by contract- ing the area of the vessels, or diminishing the quantity Avhich floAvs from them ; the first of these intentions is ansAvered by the application of repellents to the part; the last by bleeding and other evacuations. The great object of the older authors Avas, hoAvever, to derive from a part, by establishing a drain in a very distant one. Thus they applied sinapisms to the feet to relieve the head. The fallacy of this reasoning we have noticed under the article of Circulation. Revulsion was a reciprocal term to derivation: for revulsion was, in their sense, made by deriving to a distant part. The language and the ideas remain, though the error has been often de- monstrated. It means also the derivation of a Avord, deducing it from its original source. DERMATOI'DES, (from hfMa, a skin, or leather, and ei&s, likeness). See Dura mater. DERMATOLOGIA, (from hpfL%, the skin, and Xoyes, a discourse). A treatise on the skin. DERMATO-PATIIOLOGIA. The pathology or diseases of the skin. DE'RTROX, (from hpit, the skin, or covering). See Abdomen, Omentum, and Intestina. 4 A D E T 546 D I A DESCE'XSIO, and DESCE'XSUS, (from descendo, to move downwards,) mean the gentle and moderate motion of the body, or of the fluids, downwards. The chemists call it distillatio per descensum when the fire is applied to the top, and all around the vessel, Avhose orifice is at the bottom, and the vapours consequently driven there. Liquifying salts by exposing them to the air, as in making the aqua kali, is also a sort of dis- tillatio per descensum. DESCENSO'RIUM, (from the same.). See Botus. DESE'SSIO, (from de, and sedeo, to sit down). Celsus uses this Avord for sitting on a close stool. De- surrectio is used in the same sense, q. v. DESICCA'TIO, (from desicco, to dry up). Dry- ing. The chemists also refer it (though improperly) to calcination. DESICCATI'VUM, (from desicco, to dry up). De- siccative. See Epulotica. DESI'DIA OBLI'VIO, (from deses, sloth, and obli- viscor, to forget). That inactivity and forgetfulness which attend the approach of lethargy._ See Lethar- gus, under Caros. DESIPIE'NTIA, (from desipio, to rave, or to doat). See Phrenitis. DE'SME, (from ha, to tie, or bind,) a word Avhich occurs in Moschion. A faggot. See Manipulus. DESMI'DION, a diminutive of desme; a handful. DE'SMOS, (from fcu, to bind up). In Hippocrates ■de Fractura, this word signifies an affection of a joint after a luxation, when, as if tied, it is rendered incapa- ble of bending or stretching out, which proceeds from inflammation. DESPUMA'TIO, (from despumo, to scu7n). See Depuratio. DESQUAMA'TIO, (from de, privative, and squama, the scale of a fish). To take off scales. Sometimes it signifies the same as abrasio; and by a metaphor is applied to the separation of a foul bone, the laminae of which rise like scales; more properly termed Exfolia- tio ; which see. When the scarf skin peels off after some eruptive complaint, the process is named desqua- matio. DESQUAMATO'RIUM, (from desquamo, to scale off). An epithet of a trepan, called also exfoliativum, for abrading part of the cranium. DESUDA'TIO, (from desudo, to sweat). See Ephi- drosis. It is also profuse sweat, succeeded by an eruption of pustules, called sudamina, hydroa, and boa: these are of the miliary kind. DESURRE'CTIO, (from desurgo, to arise from). The same as desessio ; but, though the derivation of the tAvo terms appears to be widely different, they have been used in the same sense, to go to stool. Castelli. DETE'NTIO, (from detineo, to detain). See Ca- talepsis. DETE'RGENS, (from detergeo, to wipe off). De- terging. (See Abstergentia.) These were medi- cines formerly supposed to have a specific power in cleansing Avounds ; but it is now found that proper pus is the most healing application, and that foul sloughs are only separated by exciting the action of the vessels beloAV them. DETERIORA'TIO, (from deterior, worse). De- terioration. The impairing or rendering a thing worse. DETERMIXTA'TIO, (from determino, to fix bounds to). In botany it means the prescribed habit of an herb, as to the number of its leaves, their direction, or inser- tion, and from Avhich it never deviates. In medicine, an increased action of the vessels of any part, and an ac- cumulation of fluids in it. DETERSO'RIUM, (from detergeo, to cleanse). The apartments at baths where the sweat was scraped off. DETERSO'RIUS, (from the same). See Abster- sivus. DETONA'TIO. Detonation, (from detono, to make a great noise). In chemistry it is that noise and explosion which some substances make upon the appli- cation of" fire, or rather sparks. Detonation is a less degree of thundering noise, and less explosive than ful- minatio. (See Calcinatio, by detonation). As ni- tre is the cause of most explosions, the word detonation hath been appropriated chiefly to the inflammation of this salt with inflammable bodies; and it is frequently given to those inflammations of nitrous acid Avhich are not accompanied with explosion. Compositions have lately been discovered Avhich detonate by percus- sion, or even the slightest friction. But this rather belongs to Fulmination; q. v. See Dictionary of Che- mistry. DETRA'CTIO, (from detraho, to draw forth). See C A T H JE. R V SIS DETRA'HENS QUADRA'TUS, (from the same). See Platysma myoides. DETRA'CTOR AURIS, (from the same). See Abductor auris. DETRI'TIO, (from detero, to rub off). In a general sense it is taken from trituratio. See Rhacosis. DETRU'SOR URI'N^E, (from detrudere, to thrust or squeeze out of.) Douglas divides the muscular cover- ing of the bladder into tAvo distinct muscles: the muscle composed of longitudinal fibres he calls the detrusor ur'ma, Avhich he describes as arising from the prostate gland going round the fundus,-and being lost in the gland again ; the oblique fibres form a muscle, which he calls constrictor vesica urinaria, and describes as run- ning obliquely under the other. But Dr. Hunter thinks this distinction merely artificial. DE'UNX. See Cyathus. DEU'RENS FE'BRIS, (from deuro, to burn). See Ardens febris. DEU'STIO, (from the same). See Encausis. DEUTE'RIA, and DEUTE'RINAS, (from hvlepos, secundus). A poor kind of wine, which the Latins call lora. Also an adhesion of the placenta. DEUTE'RION, (from the same). See Secundina. DEVALGA'TUS, (from de, and valgus, bow leg- ged). See Bl.esus. DEX'AMENE, (from hx^ft-xt, to receive). Any re- ceptacle, but particularly the Jabrum or folium, that is, a deep basin in which bathers might SAvim. It was also called colymbethra and embasis. DE'XTANS, (from the same). See Cyathus. DIA, h*. The beginning of several terms in medi- cine : and when the name of any thing begins Avith these three letters, they signify composition, and the word with which they are compounded is the chief ingredient in the composition. A variety of instances may be seen in the succeeding articles. DIABA'CANU, (from frtx, and pxxxvov, a principal ingredient in it.) An »hepatic remedy mentioned by Trallian. D I A 547 D I A DIABE'BOS, (from peSxioa, to strengthen). The ankle bones. Hippocrates uses this word. See As- tragalus. DIABESA'SA, (from hx, and p^c-xcrx, wild rue). The name of a preparation, in which rue forms a part. DIABE'TES, (from hxGxivu, to pass off, or through). Diarrhea urinosa; dipsas; diuresis ; hydrops ad matu- lam; profiuvium urina. An excessive discharge of crude urine, exceeding the quantity drunk. Boerhaave, in his Institutes, says, it is a frequent copious discharge of lacteous urine, in conjunction with an extraordinary tenuity of the fluids. Dr. Cullen places this genus of disease in the class neuroses, and order spasmi: which he defines a chronic flow of urine, made in immoderate quantities, and of a preternatural quality. He notices two species, 1st. Diabetes mellitus, when the urine hath the colour, odour, and taste of honey. 2d. Diabetes insipidus, when limpid only. Dr. Home defines it to be an extra- ordinary increase of the urine as to its quantity, and that of a sweetish taste, attended with perpetual thirst, and a dry skin, which for the most part is also scaly. Youth is scarcely ever attacked with this disorder: its most frequent subjects'are those in the decline of life, often those who have drunk liberally of wine in their earlier years, and who are also employed in the more violent kinds of business. The flow of insipid urine is owing sometimes to a nervous irritation, and from this cause it appears to be occasionally a symptom of hysteria. It has been owing to relaxation of the kidneys from drinking mineral Ava- J ters in excess, occasionally to unnatural indulgences, and, as has been said, to too great tenuity of the fluids :( generally speaking, when permanent, it is a symptom of debility ; when temporary, it is nervous. The insipidity of the urine is not always owing to a deficiency of its solid contents, but to their diluted state, from the large proportion of the menstruum. Yet in some fevers, ap- parently of the nervous kind, with affections of the head, we have perceived the salts almost wholly re- tained. The other species is that which has lately attracted the greatest attention, the diabetes mellitus. In this disease the urine is no£ only copious in quantity, but Avholly different in its quality, since it contains no ani- mal matter, and yields, on evaporation, a considerable quantity of sugar. To constitute this disease, it is not necessary that the urine should be in an unusual quan- tity ; since we find an instance where, in an anomalous consumption, the urine contained three ounces of sugar in a pint, without being uncommonly copious. In general, in the diabetes mellitus, the skin is dry, parched, and often scaly. The appetite not greatly im- paired ; but the patient is Aveak and emaciated, with a Ioav quick pulse. It has been said, that, on the stop- page of the discharge, anasarca has come on; but, in twenty cases we have seen, no such termination has occurred. It is, however, by no means a common com- plaint. The thirst is excessiye. In speaking of aliment, we have mentioned sugar as highly alimentary : the chyle and milk have been consi- dered as abounding in sugar; so that, Avith some au- thors, the conclusion was easy, that the discharge Avas milky, with others that it was chylous. Modern che- mistry, in ascertaining carbone to be the principle of vegetable substances, and azote of animal, has led Avith more reason to the conclusion, that the saccharine dis- charge was an imperfectly animalised fluid; and this idea is supported by the disease occurring in exhausted constitutions, Avhile its chief remedies are tonics and stomachics. When we reflect on various symptoms of disease, we shall find that saccharine discharges are not uncommon. The depots laiteux of puerperal women are of this kind: in hectics we find the sputum occa- sionally sweet; Ave have found the saliva of a honied sweetness. Hippocrates has remarked, that the sweet smell and taste of the cerumen are a fatal symptom; and the colliquative sweats of hectic patients are occasionally found to impart the smell of acetous acid, after being confined in napkins. From these facts, our conclusion, that the celiaca passio may be a deposition of the same kind, will not appear very unreasonable. Dr. Gottlieb Richter, professor of medicine at Gottin- gen, thinks, according to his experience, that a diabetes is occasioned by a stimulus which acts upon the kidneys. When the particular irritation cannot be discovered nor removed, to counteract its action upon the kidneys by antispasmodics and sedatives, is the proper remedy. In proof of which he refers to Whytt and M'Cormic, who saw it originate from gouty matter, and Sydenham from healing an old ulcer. Steller, Avho cured a patient with bark and opium; Dobson, by warm baths; M'Cor- mic, by Dover's powder; Brisbane, by almond emulsion; support, in his opinion, the same doctrine. Dr. Richter says also, that tincture of cantharides and bark have been variously used Avith advantage against diabetes; and sup- poses,.that the first acted by carrying off irritation, as in the chin cough; the second by allaying irritation, as in agues. But notwithstanding these, he depends chiefly upon his oavii experience, and gives some cures in sup- port of his opinion: one case, Avhich succeeded a bilious fever, wherein the pulse Avas small, tense, irritated, and quick, attended with an uneasy sensation and fulness in the region of the stomach; all the complaints groAving worse towards evening, Avas cured by a vomit, by which a very great quantity of bilious matter Avas evacuated. A second, Avherein some scorbutic symptoms appeared, was conquered by wort. A third and fourth, for which no precise cause could be discovered, yielded to tartar emetic and valerian in the first case; in the second, to ipecacuanha, Avhich occasioned vomiting; and as often as the patient vomited, the disease disappeared for twenty-four hours : but besides these medicines above mentioned, he strongly recommends camphor in emul- sion. See Medical and Surgical Observations, Edin- burgh, 1794. This author seems, hoAvever, evidently to confound the two species of diabetes; and after having mentioned his arguments and facts, Ave may safely conclude that they do not apply to the diabetes mellitus. We know nothing of the process of animalisation, but that it is connected Avith the production or union of azote. The mode in which it is effected we cannot in this place ascertain; and all that the refinement of mo- dern practice has suggested, with the assistance of the improved state of chemistry, is the exhibition of azotic - substances Avith an animal diet. The following remarks, which Ave transcribe from the~ 4 A 2 D I A 548' D I A last edition, are apparently directed to the increased Roav of limpid urine. " The diet should be the same as in an hectic fever, viz. animal substances, such as broth made of beef, shell fish, milk often, and in small quantities; jellies, barley- water, in which the root of comfrey is boiled, and lime water, may be the common drink. " Moderate exercise on horseback, and dry friction of the Avhole body, assist in promoting perspiration; and which, Avhen excited, peculiarly tends to divert the dis- charge through the kidneys. " When unquenched lime is mixed with the serum of blood, it generates those salts that are necessary to the true urinary discharge; and if lime water is drunk as freely as the thirst requires it, its efficacy exceeds that of Bristol water in the cure of a diabetes, notwithstand- ing the latter is esteemed as a specific: but, in order to this advantage from lime Avater, it must be drunk while the heat continues, Avhich it possesses from the lime being quenched in the Avater. " At proper intervals, during the use of lime water, as above directed, the acidum vitrioli dilutum; cort. Peruv. limatura ferri; and Avhatever can improve the crasis of the blood, may also be administered. " A flannel shirt may be worn, to solicit a discharge through the skin. The tincture of cantharides is said by Dr. Morton to be a specific in this complaint. Others prefer the serum aluntinosum, made as strong as the stomach will bear it, and direct half a pint to be taken night and morning. With others, the vitr. caerul. gr. ss. given twice a day, dissolved in any agreeable liquor, is most depended on. When the means first proposed are unsuccessful, recourse may be had to these, or such other means as experience may suggest. Rhubarb is found to be of singular advantage; and from the success Avhich follows on the use of antispasmodics, joined with other means, a spasm in the ducts, through which some other excretions are conveyed, rather than an irrita- tion in the kidneys, may be a principal cause of this malady." From these confident assertions the disease may be supposed tractable, and easily yielding. Each species is, hoAvever, peculiarly obstinate, and Ave fear both resist the best concerted plans. The hepatised ammonia see Chemistry) has failed in our hands; and the best, most successful, remedies have appeared to be bark, with Dover's powder, and a diet highly alkalescent and animaliscd. Yet, in general, every attempt has alle- viated the disease only; for how can we expect to cure Avhat is, perhaps, a symptom only of a broken constitu- tion ? See Aretaeus, Lommius, Boerhaave, Lister, London YIedical Observations and Inquiries, vol. iii. p. 274, Sec. vol. v. p. 298. Cullen's First Lines, vol. iv. Sy- denham. DIA'BOLUS META'LLORUM. See Stannum. DIA'BOLI INTESTINA. See Cuscuta. DIABO'TANUM, (from ^•», and porxvr,, an herb). The name of a plaster prepared of herbs. DIABRO'SIS, (from hxQgoo-xa, to eat through). See Anastomosis, and Anabrosis. DIACA'DMIAS, (from fox, and xxfo*ix, cadmia). The name of a plaster, whose basis is cadmia. DIACALAMI'NTHES, (from fox, and xxXx^ivGns, calamint). The name of an antidote Avhose basis is cala- mint. DIACA'RCINON, (from hx, and xxpxivos, a crab, or crayfish). The name of an antidote prepared of these kinds offish. DIACA'RYON, (from £tx, and xxpvov, a walnut). See Juglans. DIACA'SSIA, (from fox, and xxmx,'cassia). See Cassia fistularis. DIACASTO'RIUM,(from^«, andxxrlo?tov, castor). A name of an antidote whose basis is castor. DIACATHO'LICON, (from hx, and xx6oX,xos, uni- versal). See Catholicon. DIACELTATE'SSON. A name given by Van Helmont to a purging preparation of antimony. It seems to mean, in Paracelsus, a vomit excited by quicksilver. Sometimes this word signifies quicksilver dissolved in alcahest. DIA'CENOS,(ffom foix, and xevos, empty, void). An epithet of porous bodies, as sponge, or pumice stone. DIACENTAU'RION, (from hx, and xevlxvgtov, cen- taureum). See Chamadrys. DIACENTE'TON, (from hx, and xevlea, pungo, to prick). The name of a stimulating collyrium in Celsus. DI ACH ALA'SIS, (from SixxxXa, to relax). A re- laxation of the sutures of the cranium. DIACHALCI'TIS, (from foix, and £<36Ax/7 to fuse, or 7nelt). See Fusio. DIACHY'TICA, (from the same). See Discuti- entia, and DlSSOLVENTIA. DIACHY'TOS, (from the same). An epithet of wine prepared from grapes that have been dried seven days, and were pressed on the eighth. DIACINE'MA, (from foxxtvea, dimoveo, to put aside). See Luxatio. DIACLY'SMA, (from hxxiveu, and xXvfr, to wash out, or rinse). See Gargarisma. DI ACOCCYME'LON, (from hxxiveu, and xoxxvpeXov, a plum). See Diaprunum. DIACO'CHLACON, (from hxxiveu, and xoxxxxes, DIM 549 DLE flints). An epithet of milk in Avhich red hot flints have been extinguished, supposed to be sudorific. DIACO'DIUM, (from hx, ex, and xofoix, a poppy head). See Papaver album. DIACOLOCY'NTHIDOS PILULE. Alex. Tral- lian's composition Avhich bears this name is called pil. de nitro in the Augustan Dispensatory: they consist of aloes, colocynth, nitre, &c. DIACOLOCY'NTHIS, (from hx, and xoXoxwSis, co- locynthis,) from colocynth, which is the chief ingredient in the preparation. DIACO'MERON. The name of an antidote in Myrepsus. DIA'COPF, (from foxxoxTu, to cut through). A deep cut, a wound, or the cutting off any part. DIACOPR.E'GIA, (from hx, xott^, dung, and « fractures, or wounds. DIAMAPE'NATUM, (from hx, and x^xgevx, acid cherries). It is a confection of acid cherries, cajled umarena, reduced to a pulp, passed through a. sieve, then mixed with sugar, and aromatics. See Schroder. Pharmacopeia Medico Chimica, lib. 4, p. 41. DI ^MARGARTTON, (from hx, and pxpy*s,fa, pearl). An antidote in which pearls are the chief in- gredient. DIAMA'SCIEN. See .Ems flos. DIAMASSL'MA, (from foxp-xTrxopxi, to chew). A masticatovy. DIAMBRtiti PILLULE, from hx, and xp.£px, am- ber). See Aromatic.e pilule. Di.v'mbr/E sve'civ.s, Species aromatics, now Pul- vis aromaticus. The prescription is originally Me- sne's, and had its name from the ambergrise in the com- position. See Akomatic.e species. DIAME'LON, (from hx, and (JuXnv, a quince). The name of a composition containing quinces. DIA'MXES, and 1)1 APNE. An involuntary and insensible discharge of urine ; a Avord used by Joannes Am-Iicus. DIA-Y< O'ii'JN, (from hx, and pewpov, a mulberry). A preparation of mulberries and honey. DIAMO'SCllU, (from hx, and p.o~x«s, movschus). The name of an antidote containing musk. DIAMOTO'SIS, (from hx, and fu'j»s, lint). See Carbasus. DIA'NA. The chemical, or rather alchemical, name cf silver. See Argentum. DIANANCA'SMOS, (from hx, and xvxy*r„ force, or necessity). The forcible restitution of a luxated part into its proper place. Hippocrates gives this appella- tion to a.i instrument intended to restore a distorted spine. DIA XDRIA, (from fos, and xvi-c. a man). The second class of Linn?:us"s artificial system, comprehend- ing all hermaphrodite fiowers which have tAvo stamina. DlA'NTLONti (from fox, ;aid xvSos, a flower). The name of an antidote in Galen, which is thus made. R. 1'ior. ro:ism:.rini £ i. rosarum rubrarum et radicis glycyrryzac £u 5 v*- cary^tivtiav aromat. ipicae nartii nucismoschatae radicisgalangal. corticis cinnamomi ra- dios zedoariae ligni aloes seminum cardam minoris sem. anethi, et anasi, niacis. aa 9 iv. m. DIA'NTHUS CARYOPHI'LLUS. See Carvo- fhillus ruber. ■DIAOPO'RON, (from fox, and onupx, an autU7nnal fruit). A composition of quinces, medlars, and ser- vices. - DIAPA'SMA, (from hxTrxfy, to sprinkle). Sec Catapasma. DIAPEDE'SIS, (from hx, through, and **?«•, to pass). The transudation of blood through the coats of an artery, or occasionally betAveen its fibres. See An- astomosis. DIAPE'NCIA. See Alchimilla. DIAPE'NSIA. See Saxicula mas. DIAPE'NTE, (from hx, and vevle, quinque). A composition Avhich consists of five ingredients ; gentian root; aristclochia fonga; shavings of ivory; bay ber- ries : bac. laur. et myrrh. a.i p. aeq. m. f. pulv. Mesne is said to be its author; but Vegetius described it before him. It is now only used by farriers. DIAPEPE'REON. An antidote mentioned in Ga- len. DIAPHjE'XICON, (from 'fox, and ?«<*<£, a date). The name of an electuary for discharging phlegm ; as well as a medicine made of dates. DIAPHILEDO'NU. The name of an antidote in Myrepsus.. DIAPHLY'XIS, (from foxuch, in general, the principles on which they act. We must noAv attend to their effects on the animal economy. The connection between the state of the extreme »^^els, the system in general, and the stomach, has been already noticed. This has been attributed to a nervous sympathy, and probably is-OAving to such a connection, since the effect is more sudden than can be explained in any other manner. To keep up the action of these vessels must consequently be always of the greatest im- portance, since health is inconsistent with a contrary state; and, in the whole circle of acute and chronic com- plaints,no single circumstance requires greater attention. YVhen we reflect, however, on the extent of the sur- face of the body, we shall find, that to fill the extreme vessels will require no inconsiderable proportion of the fluids. To prevent, therefore, as avcII as to relieve, in- ternal congestions, this class of remedies is of the greatest utility. If, hoAvever, carried to excess, no evacuation so greatly debilitates; and though all secre- tory organs, after their action has been violently excited, sink into a torpid state, the vessels of the skin seem peculiarly disposed to this alternation of inactivity after exertion. If then it is intended to relieve congestion. Ave must be peculiarly cautious to excite no greater action than we can constantly keep up. In all such cases, therefore, the slightest diaphoresis is only admis- sible. In fact, Ave should fill the vessels, instead of promoting any considerable evacuation. As different theories have dictated, we have been sometimes alarmed with apprehensions of producing morbid viscidity and lentorof the fluids by sweating ; at others, taught to promote this evacuation to counteract preternatural tenuity. Each danger is equally imaginary. When sweat is excited, other Avatery discharges are pro- portionally diminished, and thirst leads the patient to require a supply. On the other hand, tenuity of the blood, when it exists merely in consequence of an in- creased proportion of water, is relieved by the kid- neys, Avithout any effort on our side. When it arises from an increase of the ammoniacal salts in the blood, the debility which attends prevents the use of reme- dies which, in any degree, weaken the system. In those cases Avhere acrimony may be suspected, (they are in- deed very rare,) violent, insatiable thirst calls for a sup- ply of Avatery fluids for their solution and evacuation. They are then eliminated through the urinary.organs. We must next consider the diseases to Avhich diapho- retics are applicable. The insensible diapnoe, we have said, is the criterion of health, and can be produced only by supporting the general healthy state. It is most observable in cold weather; and the nearer Ave approach to it in every dis- order, the greater is our success. It is generally ob- tained by free cold air, when this is admissible; and to attain it is our aim in every complaint. The moderate diaphoresis is our chief object in the greater number of acute diseases. To begin, as usual, with the pyrexia, we may remark, that diaphoretics are, in this class, of very extensive utility. Intermit- tents are usually left to their course during the parox- ysm, and the efforts of the physician are reserved for the interval. Yet there are circumstances in which the return of the paroxysm would be fatal; and others, where the delirium, in the hot fit, is most alarming. In each case, diaphoretics are employed: in the first, to support the. circulation in the extreme vessels, that the fit may be obviated; in the second, to hasten the na- tural crisis by perspiration. The kind of diaphoretics chosen for the first purpose, is the warm stimulants ; the reason of which we shall afterwards explain. To assist in promoting perspiration, in the hot fit, the relaxants, and particularly opium, are preferred. This was the practice introduced by Dr. Lind. In continued fevers, it Avas, for ages, the custom to give the most stimulating diaphoretics to promote the con- coction of morbid matter. Not a breath of air Avas suffered to approach the patient; but serpentary, con- trayerva, and volatile alkali, were exhibited in profusion. D I A 555 DI A We have been assured, that three beds have, in succes- sion, rotted by the SAveat, under the same person, in a tingle fever. We still attempt to promote perspiration ; but by cooling, rather than heating, remedies, adapting them to the circumstances and to the temperature of the patient. Modern practice has freely adopted the relaxant diaphoretics, particularly the antimonials, to conquer the supposed spasm on the surface. We trust that Ave shall show that this plan has at least been car- ried to an improper extent, even if it appear Avell found- ed in its principle. In the phlegmasia the skin is hot and dry, and the utility of diaphoretics is obvious. As the temperature of the skin is above the sweating point, cold is chiefly indicated; yet, in many of the diseases, this plan can- not, for reasons already assigned, be carried to a consi- derable extent (see Cold). We must, therefore, adopt the relaxant diaphoretics; and of these we are often obliged, for other reasons, to avoid opium. Antimo- nials are then our chief dependence, with the other remedies peculiarly adapted to the seat of the com- plaint. There is, however, one disease, which is an exception to these general remarks; rheumatism. Af- ter the more active period of the complaint, it admits of the more stimulating diaphoretics; and when the fe- ver has abated, of the most stimulating. In fact, after a time the vessels become torpid and paralytic, to be roused only by the most powerful exciting causes ; but this state can only be explained under the proper head, after many previous distinctions. See Inflammatio and Rhei matismus. In the hem or rhagie we find little room for diapho- retics, except of the most cooling kind. The source of their utility in relieving internal congestions has been already explained; but it Avill be obvious that these re- medies are chiefly of service in active haemorrhages, where the heat is preternaturally increased. In this case, cold drinks and cold applications are, as usual, the most poAverful diaphoretics. In the passive haemorr- hages they relax too powerfully to be of the slightest utility. In reality, they are highly injurious. Exanthemata. The diseases of this order peculiarly require the use of diaphoretics ; but, in the greater number of genera, the heat is already beyond the point which admits of a discharge from the skin, so that the more cooling medicines of this class are preferred, ex- cept in one genus, the 7neasles. In scarlatina, the cold affusions, long continued, have been found of singular utility in promoting perspiration. In the plague, the gentle diaphoresis called by Chenot the diapnoe, is found of the greatest utility ; and it appears probable, from the late experience in this complaint, that this is best obtained by cold. To this general doctrine there are only two exceptions, either when the disease is of a pu- trid nature, or the eruption has.disappeared. In these cases Avarmth of every kind is essentially necessary, and the Avarmer diaphoretics are only employed. In the profiuvia, this class of remedies is of the highest importance. In the only two diseases included under it in the best system of nosology, diaphoretics chiefly relieve. In catarrh, their use is jyell known; and in dysentery, when purgatives have evacuated the accustomed scybala from the intestines, the ipecacuanha and antimonials, so universally- recommended, undoubt- edly act only by determining to the surface. In the first order of the neuroses, the comata, dia- phoretics are not peculiarly indicated. Yet we must keep in our vieAV the advantages Avhich, in every case of internal congestion, arise from keeping the extreme vessels in an active state, since they contain so consi- derable a portion of the fluids. Of the adynamie, dys- pepsia, hypochondriasis, and chlorosis, require the same attention. In each there is always a defect of perspi- ration ; and, in each, to restore it, contributes greatly to the patient's relief. Of the spasmi, tetanus chiefly demands our attention to the state of the skin, as it often proceeds from cold, and is relieved by active sweating. . When mercurials, with opiates are of such singular service, the benefit probably originates from the same source. In asthma, the utility of diaphoretics is sufficiently obvious, from Avhat we have already said ; and in colic and diarrhaa external warmth is singularly useful. In cholera they are of peculiar service ; and Sydenham has remarked, that every remedy to calm the vomiting has failed, till a SAveat broke out. We mention this more particularly, as the advantages of these remedies Avere not duly en- forced under the proper head. Of thevesanie, melancholia alone seems to be parti- ticularly relieved by diaphoretics ; yet, in those cases of mania Avhere there is great internal congestion, could the patient be properly confined, they might be useful. In the cachexia we see little foundation for their pe- culiar employment. In each genus, hoAvever, the cir- culation in the extremities is particularly languid, and the external stimulating diaphoretics are of use. Oi the impetigenes, the diseases merely cutaneous are be- nefited by them; but these require the more gently sti- mulating kind, which act steadily rather than violently: Ave mean the mercurials, the sarsa, the mezereon, and the others enumerated. The chief disadvantages of diaphoretics arise from their debilitating effects. The discharge, therefore, in every instance, should be conducted with caution and moderation ; nor should the practitioner aim at relieving his patient rapidly, when the cure would be 'safer anel more permanent, were the course more gentle and stea- dy; and Avhen the perspiration has been kept up Avith violence, relapses are by no means uncommon. DI A PHRA'GMA. The diaphragm, (from hxtppxre-u, to make a partition, or inclosure, of hx, and «?«, the itch). The name of a medicine for the itch or scurvy. DIAPTE'RNES, (from —-, and -srlepvx, the heel). A medicine made of the heels of animals and cheese. DIAPTERO'SIS, (from—, and vle^o, a feather)] The cleaning of the ears with a feather. DIAPYE'MA, (from —, and wov, pus). See Ab- scessus. DIAPYE'MATA, and DIAPYE'TICA, (from hx- wvjfLx, a suppuration). See Suppurantia. DIA'RIA FE'BRIS, (from dies, a day). See Ephe- mera. DIAROMA'TICUM, (from hx, x^u^xlm). A me- dicine composed of aromatics. DIA'RRHAGE, (from hxp^pvyyvv/ju, to break asun- der). A fracture, particularly of the temporal bones. DIARRHODOME'LI, from hx, pofov, a rose, and peXi, an apple). The name of a composition of scam- mony, juice of roses, &c. See Diagrydium. DIARRHO'DON, (from —, and pofov, a rose). A name of many compositions in Avhich roses are ingre- dients. DIARRHCE'A, (from hx, through, and pea, to flow). Alvi Fluxus, hypexodcs; perlurbatio alvi; a too DIA 557 DIA frequent discharge of the contents of the intestines. Dr. Cullen places this genus of disease in the class neuroses, and order spasmi, which he defines a frequent purging ; the disease not contagious, and unattended with any primary febrile affection. Of this he forms six species: 1st, Diarrhea crapulosa; stercoroso, seu vulgaris; Avhen the excrements are more fluid and more copious than is natural. 2d, Diarrhea biliosa; when yellow faeces are copiously discharged. 3d, Diarrhea mucosa, leucorrhois ; diarrhea lactantium ; serosa ;pituitaria,\el mucosa; in Avhich, either from acrid substances taken into the stomach, or from cold applied particularly to the feet, there is a copious discharge of mucus. 4th, Diarrhea celiaca, called also celiaca chylosa, and lactea ; when a milky liquid, like chyle, passes downwards. 5th, Diarrhea lienteria; when the aliment soon passes through, with little alteration. 6th, Diarrhea hepatirhea ; when the discharge is bloody coloured serum, and not attended with pain. If painful, it is sometimes called a colic. Those who have been rendered weak or irritable by a hot season or sultry climate, or by being exposed to a putrid vapour, are peculiarly liable to this disease. The immediate cause is irritation in the intestines; but the causes of this preternatural irritation are numer- ous: the most frequent are an undue use of purgatives ; acidity, or putrescency of the aliments; acrid bile ; pus absorbed from abscesses, and carried to the intestines ; a laxity of the glands of the intestines; obstructed per- spiration ; putrid vapours; a translation of the morbid matter of other diseases to the intestines; passions of the mind, &c. Whatever other symptoms occasionally attend a diarr- hoea, besides a too copious and too frequent discharge of the intestines, are accidental. The loss of appetite, and of strength, are consequences of the excessive eva- cuations, or of some other attending disorder; sickness and pain are, in many cases, only attending symptoms. While the patient's strength is but little affected by a diarrhoea, it may be generally looked on a salutary ra- ther than morbid evacuation; but sometimes, if neglect- ed or ill treated, the cure is difficult. Diarrhoea, in its most unlimited sense, is a discharge from the bowels; and, in this view, its explanation is peculiarly difficult. The principal distinction which arises is, whether the cause be connected with the bowels, or with other organs; in fact, whether diarrhoea be idiopathic or symptomatic. But this distinction we shall have little occasion to employ, since the greater number of instances are owing to substances actually present in the intestines. The most obvious species is that kind which arises from the ingesta, whether these in their quantity or quality offend. In either case, the first symptoms arise in the stomach ; and, if the patient cannot ascertain the fact from recollecting what he has eaten, he may be re- minded of it, by the taste arising in his mouth, the aver- sion which he feels on recollecting any part of his former diet; from the nidorose eructations, resembling the taste of rotten egg, or even a putrid taste on the back part of the tongue. In such circumstances, no medicine will, in general, succeed, without evacuating the sto- mach ; but to this consideration Ave must return. When the ingesta pass the stomach, they sometimes excite commotions from their action in the intestinal canal. They then usually pass off; but there are in- stances Avhere they are retained, particularly in the co- lon, by a spasmodic constriction; and the increased ac- tion which they excite is sometimes continued from increased irritability alone. In the first instance, con- siderable pain usually attends; in the second, the stools are watery, without pain. Another kind of diarrhoea, confined to the bowels, is from an increased discharge of the fluids poured in from their excretory ducts. The principal fluid is bile; and diarrhoea arises from this fluid in many different cir- cumstances. An increased flow of bile is sometimes owing to continued heat only, and it is then attended with vomiting, as in cholera; sometimes from a previous obstruction of the biliary ducts, when the preceding jaundice will point out it* cause; occasionally from the exciting passions of the mind; from the bites of vipers; from worms; from poisons; from congestions in the liver; from cold; or the cold fit of fevers. Of the other glands whose ducts open in the aliment- ary canal, we have a less perfect knowledge. The pan- creas only is an object of our sense, and its functions are little knoAvn. It is probable, however, that its fluid re- sembles the saliva; and, Avhen we find mercurials em- ployed in friction, instead of affecting the salivary glands, stimulate the intestines, we naturally ascribe it to an increased discharge of the pancreatic fluid. The whole of the canal is covered, hoAvever, Avith mucous glands; and we know that, when the perspira- tion is obstructed, the whole mucous membrane com- pensates for the defect, by an increased discharge. It is said, and, we believe, Avith some truth, that the milk is occasionally absorbed and deposited on the intestines; we can add, after what has been said on the subject of Cceliaca passio and Diabetes, q. v. that the unapplied aliment sometimes takes the same course. In cases of teething, we might consider the increased action of the salivary glands as similar to the increased discharge from the pancreas. We omitted mentioning it, however, under this head, because it is supposed that the irritation communicated through the whole mem- brane contributes to the effect. We dare not either deny or confirm this opinion; but it receives some support from opium being the most effectual remedy. In cases of diarrhoea following suppressed perspira- tion, we considered the discharge as merely vicarious. It is, however, sometimes inflammatory; and it was ne- cessary to separate the consideration in a practical vieAV, from the following circumstance. A diarrhoea sometimes follows measles, which, Sydenham tells us, cannot be suppressed by the usual remedies, but by antiphlogistic plans, and particularly bleeding. Diarrhoea, we have said, arises from acrid poisons; and these, even Avhen they have been discharged, leave the intestines in so irritable a state, that even the common in- gesta excite violent and irregular action. Sometimes even extreme general irritability will occasion a similar effect; and any agitation, even from the depressing pas- sions, will occasion copious discharges from the bowels. This disease occasionally attends fevers, and is said to be sometimes critical, Avhich means, in the language of the ancient physicians, that the concocted morbid matter is throAvn out by the glands of the intestines, probably the liver. Though Ave admit neither of the theory nor of the comment, the fact is certain, and will be found to admit of a different explanation. We now mention it merely to say, that, if in fever the pulse becomes DIA 558 DIA fuller, softer, and slower, the skin more moist, Avithout faintness, though the discharges by stool are copious, they should not be hastily checked. The bowels suffer from another cause. When inter- nal suppuration takes place, the discharge is sometimes lessened, and the purulent matter apparently evacuated from the intestines. It is seemingly absorbed, and again deposited. In cancers we have more than once known this metastasis, as it is called, to take place ; and in phthisis it is not uncommon, especially when there is no morning perspiration, or this discharge disappears, or is checked. It frequently attends peripneumony, and is then a dangerous symptom, as it prevents the na- tural solution of the disease by expectoration; some- times it attends gout, when iti>rings back an almost ex- tinguished paroxysm. Diarrhoea sometimes continues long AA-ithout evacuat- ing the offending substance. YVe must not, therefore, conclude, from its continuance, that the intestines are properly emptied. In fevers it supervenes, or is pro- duced by the most active purgatives, Avithout properly discharging the contents of the canal, which only ap- pear on the solution of the disease When diarrhoea has long continued, it is attended with tenesmus, an ir- regular action of the rectum, suggesting the idea of a discharge impending, without effect. Sometimes the abraded mucus exposes the small vessels, and a little blood is evacuated. It is then said to be dysenteric ; but no two diseases are more essentially distant than" diarrhoea and dysentery, as we shall soon demonstrate. The mucous diarrhoea approaches most nearly to dysen- tery ; but this is either OAving to acrid cathartics or sometimes to cold. Diarrhoea is seldom fatal but in exhausted constitu- tions, where it is generally a symptom of some highly dangerous disease ; or where the tone of the intestines is so completely destroyed, that the aliment cannot be retained a sufficient time to be digested. In general, Avhen it has continued for a long period, it is seldom completely removed; and, in such cases, when it has ceased for a time, the slightest occasional causes have- induced a relapse. The cure of diarrhoea is sometimes easy ; but it fre- quently baffles our utmost skill. When the symptoms, already described in the stomach, lead to a suspicion that irritation is kept up by acrid substances in that vis- cus, an emetic should be premised. This, indeed, is generally necessary in every case Avhere the diarrhoea continues obstinate. It relieves the stomach from acri- mony, checks the increased peristaltic motion down- Avard, gives it an opposite direction, or determines it to the skin: in each way it is useful. After the emetic, it is necessary to procure some respite, and opiates may be employed with safety. By lessening or stopping the peristaltic motion, Ave relax any spasmodic stricture Avhich may prevent the discharge of offending matter; and the gentle laxatives afterwards required, Avill have a more salutary effect. By thus alternating the opiates and laxatives, we at last succeed in reliev- ing the bowels from the irritation of offending matter, and moderately warm astringents Avill complete the cure. The bilious vomiting will be sufficiently understood by what has been observed under the article Cholera. YVe can only add in this place, that Avhile the dis- charges continue dark and fetid, no astringents should" be employed, and we can only alloAV occasional rest by a slight opiate after it, and the laxatives must be soon repeated. When a bilious diarrhoea has followed a suppressed evacuation of bile, or Avhen it arises from passions, from worms, the bites of poisonous animals, 8cc. it requires regulation, rather than immediate suppression, and we may still alternate the opiates with the laxatives; but emetics are unnecessary. The diarrhoea, from conges- tions in the liver, attends those who have lived long in. and been affected-with the bilious diseases of, warm cli- mates. It is a symptom of infarcted liver, and the cure will depend on the removal of the principal complaint. When from the congestion, in consequence of the cold fit of fevers, we must endeavour to relieve the fever by the remedies to be afterwards pointed out. The diarrhoea, which arises from mercurials exter- nally applied, we have attributed to their action on the pancreas; and the medicine must, in that case, be re- mitted, opiates employed, and perspiration excited by Avarm diluting liquors. When the kindred fluid, the saliva, excites the action of the intestines, in the teeth- ing of children, Ave can only lessen it, and diminish the irritation by opium. It must, hoAvever, be recollected, that a diarrhoea in teething is most salutary, and that it should be regulated, not checked. The most frequent cause of diarrhoea is an affection of the mucous membrane, either when its action is in- creased to supply, Avith the other glands, the deficiency of perspiration, or when, from this or a specific virus, as in the measles, these glands are inflamed. In such cases the ipecacuanha, either in active doses, as an emetic, or in milder ones, with opium, as a diaphoretic, is of considerable service. The Avarm bath also, gene- ral or topical, is essentially useful. In the last case, Sy- denham recommends bleeding; but by regulating the discharge only by diaphoretics, and interposing mild laxatives, we have always succeeded in combating it. In general, diarrhoea, from cold, should be treated like a catarrh, which it really is ; and we may be less anxious to keep up any action of the bowels than in the other cases. A similar disease arises from the metastasis of milk, of any unassimilated nourishment, or of purulent matter. These also may be checked ; but the offending fluids will find their Avay by other excretories, and little advantage can be gained, unless the original cause be re- moved. In the instance of the milk only can Ave form any reasonable expectations. This is the diarrhoea that attends puerperal women, and we should be cautious in checking it, though we must equally prevent its excess. In these cases the ipecacuanha, as an emetic, folloAved by the columbo root, and the careful, but occasional, ex- hibition of opium, will best succeed. Every means must, however, be attempted to bring back the milk to its na- tural channel. When the diarrhoea is chronical, moderate astringents and tonics, warm feet, exercise on horseback, and avoid- ing the depressing passions, afford the most reasonable expectations of relief. Opiates, with demulcents, as in the old pulvis e bolo cum opio, the modern pulvis e creta compositus cum opio, are often essentially ne- cessary. The safest astringents in diarrhoea are the opiates, espe- cially if joined with ipecacuanha. The tormentil, the ca DIA 559 DIA techu, the gum kino, the oak bark, and the logwood, may be occasionally employed. We have placed them nearly in the order of their strength; for the tormentil is seemingly the strongest. The logwood appears to OAve its utility, in part, to its mucilage, and is more effectual Avhere the mucous coat of the intestines is abraded. In such cases, which often follow the use of acrid cathartics or poisons, this, with thick gruels, chief- ly of rice, a decoction of althaea, with gum arabic, and every other mild demulcent, is of singular utility. Opiates may be sometimes given in clysters, and they are said to affect the head in a less degree than Avhen swallowed. They relieve more certainly, in this Avay, the troublesome tenesmus; which is often greatly miti- gated also by the pulv. ebolo cum opio, interposing the mildest laxatives, as soap or castor oil. Soap, when joined Avith wax, Avhich thus becomes soluble in our fluids, is often highly useful when the mucus of the bowels is abraded, or tenesmus is trou- blesome. A little opium, and occasionally the Dover's powder, joined Avith these remedies, renders it more effectual. It may be remarked, that Ave have not mentioned rhubarb, on which former authors seem to have a con- siderable dependence in this complaint, from its sup- posed subsequent astringency. We have not found it, however, superior to other purgatives: yet occasionally, in small doses, it seems to strengthen the boAvels; and those Avho depend on its astringent qualities may supply this remedy, where we have mentioned purgatives in general. See Aretaeus; Lommius; YVallis's Sydenham; For- dyce's Elements, part ii.; Dr. Pye's Observations on the Use of Ipecacuanha, in the London Med. Obs. and Inq. vol. i.; Cullen's First Lines, vol. iv. Diarrhce'a carno'sa. See Dysenteria. Diarrhce'a chole'rica. See Cholera morbus. Diarrhce'a urino'sa, or ex oure. See Diabe- 1ES. DIARROX'^E, (from foxppno-o-u, disrumpo). The in- terstices betwixt the circumvolutions of bandages. DIARTHRO'SIS, (from fox, per, and xp9pov, ajoi7it). A moveable articulation ; ab articulatio, and dearti- culatio. Different authors vary in their division; but Dr. Hunter supposes it to consist of three species : 1st, The enarthrosis, or ball and socket; when a large head is received into a deep cavity, as the head of the femur into the acetabulum of the os innominatum: its synonym is genou. 2dly, Arthrodia; Avhen a round head is re- ceived into a superficial cavity: these two kinds admit of a motion on all sides. 3dly, The ginglymus, called also cardo, cardinamentum; because it resembles the motion of a hinge. There are properly but two species of this articulation; the first confined to flexion and ex- tension, the angular ginglymus, Avhere each bone re- ceives partly, and partly is received by the other, as in the articulation of the humerus with the ulna, or where the joint is adapted only to small turns toAvards each side, the lateral ginglymus. This last is either single, as in the articulation of the first vertebra of the neck, with the apophysis dentiformis of the second; or double, that is, in tAvo different parts of the bone, as in the ar- ticulation of the ulna with the radius. DIASAPO'NIUM, (from fox, and cxtuv, soap). An ointment in Avhich soap is a principal ingredient. DIASATY'RION, (from hx, andrxlvetov, satyrionj. An electuary containing satyrion. DIASCI'LLION, (from hx, and e-xixxx, the squill,) vinegar and oxymel of squills. DIASCI'NCI, (from hx, and , nas- cor). It is a distemper of the hairs, Avhen they split at the points. DICHO'TOMUS, (from fox*, double, and re^va, seed). In botany it means forked. DICHOTOPHY'LLON, (from fox*, double, and vXXov, a leaf). See Ceratophyllum. DICO'CTA, (from fos, bis, and coquo, to boil). Wa- ter first heated, then cooled with snow. DICOTYLEDO'NES, (from fos, twice, and xolvXefav, cotyledon). See Cotyledon. DICRjE'US, (from fos, twice, and xptva, to distin- guish). See Bifidus. DICRO'TUS, or BIS-FERIENS, (from fos, twice, and xpova, to strike). A pulsation of an artery which strikes the finger a second time before the usual inter- val, similar to Avhat appears from a hammer striking the anvil, and afterwards rebounding. Solano first observed it, and supposed it a certain sign of an approaching cri- tical haemorrhage from the nose. It is also called a re- bounding pulse. DlCTAMNI'TES,(fromfoxlxt*,vos, dittany). A Avine medicated with dittany. DICTA'MNUS ALBUS, (from Dictamnus, a city in Greece, on whose mountains it grew,) fraxinella, white or bastard dittany. It is a plant with leaves resembling those of the ash tree, but much smaller, and more juicy. On the tops of the stalks are long spikes of purplish and white flowers, which are followed by pods of" black seeds. It is perennial, and grows wild on the mountains in France, Italy, and Germany. Dictam- nus albus Lin. Sp. PI. 548. The roots are whitish; the cortical part, freed from the pith and small fibres, is dried, rolled up, and in this form brought to England. The young roots, about the size of a squill, are the best. When fresh, they have an agreeable smell, dissipated in drying; are considerably bitter; a quality they yield to water and spirit, and which remains in the extract. Formerly this medicine was considered as efficacious in uterine and visceral ob- structions, as well as an anthelmintic. But it had been neglected, till brought again into notice by Stoerck, and recommended in tertians; against worms, particularly the lumbrici; and menstrual suppressions. A scruple of the powder was given twice a day, which may be gradually increased to 3 i- From twenty to fifty drops of the following tincture were successfully prescribed in epilepsies, given two or three times a day: R. Dictamni albi recentis ^ij. sp. vini rect. 5xiv. digere. In cho- loric patients, the root, mixed with steel, has been, said to be efficacious. It is not, however, employed in this country, and probably is of little efficacy. Dicta'mnus Cre'ticus, verus ; origanum Creticum, onitis, dittany of Crete, or Candy wild marjoram. It is the origanum dictamnus Lin. Sp. PI. 823, and is a small shrubby plant, with square stalks, and roundish leaves, that are covered with a thick white down ; the flowers are in spikes of a purplish colour. The flowery tops were formerly brought from Crete, and indeed these are somewhat stronger than ours, which are now al- ways used. It is perennial, a native of stony grounds, and bears the winters of our climate. Those we have from Greece, when we receive them, are not greatly superior to our own. Whilst the leaves are in perfection, they are warm and aromatic, have an agreeable smell, and a hot pun- gent taste, resembling that of the thymus citratus. The garden pennyroyal is of the same quality, but not equally strong. Both water and spirit take up the virtues of this plant. If a large quantity is distilled at once with water, a small portion of essential oil is obtained, of a yellowish colour, a highly pungent, aromatic taste and smell; congealing in the cold, so as to resemble cam- phor : the remaining decoction, Avhen inspissated, is a bitterish, disagreeable mass, but destitute of the flavour and Avarmth of the herb: the spirituous extract possesses all its virtues. See Neumann's Chem. Works; LeAvis's Mat. Med. DIG 561 DIG DICTYOI'DES, (from foxlvv, a net,zndei fos, form). Net like. See Rete mirabile. DI'DYME, (from fohpos, double). See Bifolium. DIDYM.jE'A, (from the same). The name of a ca- taplasm mentioned by Galen, named from the double use to Avhich he applied it. DI'DYMI, (from the same). See Geminus, Testes, and Cerebellum. DI'DYMUS, (from fos, or ha, two). A twin. In botany it means double, or having two of each sort. DIDYNA'MIA, (from fos, twice, and hvxftis, power). Linnaeus's fourteenth class, comprehending those plants Avhich have hermaphrodite floAvers, with four stamens, in two pairs, of different lengths, the outer pair longer, the mddile pair shorter, and converging. These flowers have one pistil, and the corolla is irregular. Linnaeus has divided this class into two orders, gymnosperma, and angiosperma; the seeds naked or covered. DIECBO'LlON, (from fox, and ex£xxxu, to cast out,) a medicine causing abortion: hence diecbolica. DIELE'CTRON, (from fox, and eXexlpov. amber). The name of a troche, in which amber is an ingredient. DIERVILLA. Lonicera diervilla Lin. Sp. PI. 249. This species of honeysuckle is a native of the most northern regions of America, and its young branches are employed in gonorrhcea and suppression of urine. DIET DRINKS. Alterative decoctions, employed daily in considerable quantities, at least from a pint to a quart. The decoction of sarsaparilla and mezereon, the Lisbon diet drink, is the most common and most useful. DIETETICS. The doctrines relating to diet. DIE'XODOS, (from fox, and e%ofos, a way by which any thing passes). Diodos. In Hippocrates, it is the descent or passage of the excrements by the anus. DIFFLA'TIO, (from difflo, to blow away). See Perspiratio. DIFFU'SUS, (from diffundo, to spread out). Dif- fuse. In botany it means spreading wide. DIGA'STRICUS, (from fos, double, and yxo-hp, a belly). See Biventer. DIGE'STIO, (from digero, to dissolve). Digestion. In surgery it is the disposing an ulcer or Avound to sup- puration, by the application of proper remedies. In pharmacy it is the subjecting of bodies, included in proper vessels, to the action of a gentle heat. The term digestion is often used for maceration; and, in this case, the process is Avithout heat: Avhere this circum- stance is not expressed, digestion always implies the operation of heat. In some cases, digestion is used to produce a change in a single body, as in hydrargyrus nitratus ruber; in others, to promote solutions, or differ- ent combinations. Circulation is a mode of digesting: the vessels generally used are matrasses, or Florence Avine flasks, either of which may be converted into cir- culatory vessels ; or the neck of one may be inverted into the neck of the other. The operation is generally performed in a sand bath, byAvhich the degrees of heat may be regulated according to the intention of the che- mist. This heat is never so great as to make it boil. Di- gestion is used for making tinctures, Avines, and elixirs. In the animal economy, it is the conversion of ali- ment into chyle, and then into blood. By digestion, the specific differences of all substances are abolished; the blood, formed from different kinds of aliment, Avhe- ther used singly or together, does not sensibly differ in vol. i. its properties, provided that the organ of digestion be sufficiently powerful to convert them into blood. Di- gestion, in the stomach alone, is capable of convertine;- our food into chyme, and the continuation of the pro- cess can alone assimilate it to our OAvn nature. This function of the animal economy is of most diffi- cult explanation. The ingenuity of physiologists has been exhausted in the solution of the problem; and avc are -still at a distance from any theory that will explain all the different appearances satisfactorily. When, with Hippocrates, v/e attribute digestion to putrefaction; with Pringle and Macbride, to fermenta- tion; or, Avith Haller, to the joint action of solution and fermentation; Ave alter the language only, not the opi- nions. Van Helmont attributed it to the energy of his archaeus, which resided in the stomach; and, though fanciful in language, we shall probably find this process very intimately connected with the vital principle. We must, however, premise some peculiar circumstances in the structure of the parts concerned in the operation, omitted in the general descriptions; because they Avould appear more advantageously, when their application could be at the same time perceived. The alimentary canal extends from the mouth to the anus, enlarged at different parts, to detain the food, and assist the changes it is destined to undergo. When the oesophagus passes doAvn on the left side, the canal crosses the body; and Ave here find the first dilatation, which we style the stomach. In its empty state it appears a bag, into which a substance falls, and from Avhich it must rise to pass out at the other aperture, the pylorus. When, however, the stomach is full, the fundus of this sac is raised against the integuments, and it assumes the form of a crescent. The angle to which the substance passing out must rise, in the empty state, is obliterated ; but the food is retained by the contraction of the strait fibres, Avhich draAV the pylorus toAvards the cardia. Th .■_■ fundus of the stomach enlarges between the folds of thn epiploon, Avhich is its mesentery; and the large vessels of this membrane are thus emptied, discharging their contents into the stomach, Avhich receives also, at the same time, blood, from its pressure on the spleen, which determines a larger proportion of the vital fluid through the vasa brevia. The next dilatation is a little beloAV the stomach, at the part styled the duodenum. The intestine, in this part, is not confined by the peritonaeum so closely as to form a mesentery; but is loosely connected to the back bone, and admits of considerable distention. Here the chyme receives the bile and the pancreatic juice; and, in this part, its animalisation begins, and chyle is formed. The intestines then proceed, of an uniform diameter, till the end of the ilium is inserted, in the manner before described, into the large intestine (see Colon), Avhere it again stagnates; apparently to admit of the absorption of the remaining chyle. The food of animals is very various; yet it consists only of a feAv principles, and these may be reduced to oil, gelatine, and sugar, with the animal matter already prepared. In proportion as the food is of the last kind, its remora in the stomach and duodenum is shorter; but the digestion of matter already animalised, is a problem too simple to detain us. We must remark, hoAvever, that the action of the stomach differs from almost every known power. It has no effect on living bodies: its DIG 562 DIG effects are in proportion to the vital energy; andAvhen this is greatly diminished from any sudden cause, the digestion suffers at the same moment, and in the same ratio. Digestion sweetens also, in a short period, the most putrid substances Avhich the stomach can retain. So different is this process, as well as its instruments, from every other, that we must turn with contempt from the philosophers attempting to imitate it in their phials, did not their exalted character in other pursuits change our contempt to surprise. The changes produced by digestion are very consi- derable. The principles of vegetable substances, as we have already seen, consist of oxygen, carbone, and hy- drogen; animal substances contain the same principles, with a less proportion of carbone, and with the addi- tion of azote. The production of the azote has occa- sioned the chief difficulty; for we know that some proportion of carbone is separated with oxygen, by re- spiration, in the form of carbonic acid gas. We must, however, pursue the subject in its proper order. The changes in the stomach are, by the most mo- dern physiologists, attributed either to fermentation or solution. Each, however, gives a due share of the cre- dit to the division by mastication, combination with the saliva, the effects of heat, and gentle agitation in the stomach by the action of its fibres, producing a regular progressive and retrograde motion. Fermentation, it is contended, does not probably take place, because we do not find its productions, an ardent spirit, and an acid. We have more than once had occasion to remark that we often find an acid, which Ave know to be the product of fermentation, though we cannot detect the previ- ous form. We discover, in digestion, an extrication of air, which, Avhen the process is not interrupted, is again combined Avith the mass, and an acid is perhaps always formed; because, when by accident digestion is dis- turbed, or stopped, in an early period, it is obvious. In better circumstances this acid disappears, in conse- quence of a subsequent union. In short, as our vegeta- ble food is susceptible of fermentation, and in circum- stances which would most probably favour it, we see no reason for denying that this change takes place. Those who contend that digestion is a simple solu- tion, have sought, with some anxiety, for a solvent of a peculiar power; and they have at last, apparently, dis- covered it in what they style the gastric juice, a mucous fluid ahvays found in the stomach, of some peculiar, but no very decisive properties. It is, undoubtedly, a solvent out of the body; but the experiments made by forcing animals to disgorge what they have taken, prove the power of all the fluids of the stomach, not of one only. In every part of the human body, the production of a fluid of peculiar powers is connected with a com- plicated apparatus. In the stomach the mucous glands only seem to produce the gastric juice. When analysed, it is said, by Struve, to contain a phosphorated ammo- nia ; but this conclusion has not been supported by other chemists. Carminiati digested some veal in wa- ter, with a little salt, in a heat of about 100 of Fahren- heit. The decanted liquor he employed in a similar experiment, which he repeated till he produced a fluid resembling the gastric. This would lead us to a suspi- cion that the gastric juice is only the remnant of for- mer digestions, and, in reality, nothing more than a ferment. We are told, however, by Carminiati himself (Journal de Physique, vol. xxi.), that the gastric fluid of herbivorous and of carnivorous animals, when the sto- mach is not organically diseased, assists digestion, and cures intermittents, if given as a medicine. Other au- thors have told us, that it is antiseptic; that it even sweetens putrid meat; and that it greatly assists in healing old ulcers. It is natural to suspect the exist- ence of extraordinary qualities, when detailed by those who, previous to their experiments, had formed a par- ticular system. We may just suggest, however, that if the gastric juice has such miraculous powers, why does it not constantly produce them in the stomach ? If, af- ter a meal made Avith the best appetite, a cause of sud- ded agitation or of deep distress should occur, the food, which would have otherwise produced wholesome chyle, becomes acid or putrid. The stomach is not, therefore, a containing vessel only, gently agitating the mass. Fordyce, after describing the structure of the organs of digestion; the matters applied to the food in those organs; and pointing out that the substances employed for food have the same elements, and each of them all the elements, actually found in chyle, viz. a part which is fluid, and contained in the lacteals, but coagulates on extravasation:—a second, which consists of a fluid co- agulable by heat, and, in all its properties that have been observed, consonant to the serum of blood; and a third, formed of globules, which render the whole white and opaque; observe, that it was, therefore, only neces- sary that these elements should be separated from one another, and recombined inorderforits formation. That the action of the organs of digestion disunited the ele- ments of the food, which were reunited in a new form, so as to form the essential parts of the chyle; and that these three essential parts of the chyle were always the same; and, therefore, when converted into blood, the blood a fortiori, could not, in the smallest degree, be influenced by the food. The elements, according to this author, are separated in the stomach, where they are retained; but the chyle is not formed in this organ. A simple matter, called chyme, is only there produced, which in the subsequent state of the process is, by the reunion of its elements, formed into chyle. Digestion consists of two distinct stages: the first, which takes place in the stomach, styled solution, or fermentation;, and the second in the duodenum, which is more strictly animalisation. In the remaining track of the intestine, the animalisation is rendered more com- plete : the chyle, gradually and progressively formed} is absorbed, carried into the blood, and then applied to supply the different organs, after having been more com- pletely elaborated in the lungs. We must pursue this progress in the order. It has been always, but with little accuracy, supposed that digestion takes place in the stomach. This is not true; for not a particle of chyle can be at any time dis- covered in its lymphatics, coloured matters do not tinge their contents; and what is called the chyme resembles in no respect the white fluid destined, at a future pe- riod, to fill the blood vessels. In the stomach then, perhaps, we shall find solution only in the saliva and other glands of that organ: but it is a solution which we may try in vain to imitate; because it takes place in an animated organ, whose power cannot be for a mo- ment intermitted, without some injury to the result. Fermentation, also, probably soon comes on; and it is DIG 563 DIG apparently assisted by the gastric juice, which acts as a leaven, and in this way only. Such a process is pecu- liarly necessary in herbivorous and granivorous animals, since the change by solution alone is not sufficiently ra- pid for the wants of the system, or equal to the effect of breaking down the denser substances; and since, per- haps, one stage of assimilation may be necessary in this organ to prepare it for the second. If the gastric juice be formed, as Carminiati suspects, and which is highly probable, since it differs in different animals, and always resembles the nature of their food, it is a ferment pe- culiarly adapted, not only to assist the separation of the parts, hut, in some degree, to assimilate them to its own nature. The fluids of the stomach have no effect in dissolving the husks of vegetables, for instance; and consequently fermentation, in some cases, is absolutely necessary. So far, therefore, there is little'mystery. The distention of the stomach, after a full meal, is not, in the greatest degree, at its termination, if the ap- petite has not been stimulated by varieties, or by con- diments. It is farther increased by the separation of air, which is sometimes so considerable as to rise to the cardia, and be discharged through the oesophagus. It is, however, generally again absorbed by the mass, and carried into the blood. The food detained in the sto- mach by the action of its longitudinal fibres is lessened in its bulk by the reunion of its air, and the absorption of its watery parts. The pylorus is then brought in a straighter line with the axis of the organ, and the fluid parts gradually pass over. It has been supposed that the pylorus possesses an elective power, to admit of the passage of some bodies, and to refuse others. In every part of the animal economy we seem to perceive a simi- lar power; nor dare we deny it to an organ of so much importance, whose nerves are peculiarly and acutely sensible. Richerand, who has most pointedly enforced this opinion, seems to think that this elective poAver is at last lost. The stimulus which excited, by its disagree- ble impression, the contraction of this aperture, becomes, in time, habitual, and the passage is effected. Inde- pendent, however, of this cause, heavy bodies not so- luble in the watery fluids are not, for a long time, dis- charged. They lie at the bottom of the stomach; are not presented to the pylorus when it is full; and, when empty, they cannot rise to the angle which that passage forms. In this way, heavy metallic bodies, and even the heavy mucus of weak stomachs, are not discharged. The stimulus of the latter soon becomes habitual; but, after some time, the action of this organ seems to be excited, and the former are propelled into the duo- denum. The food then in the stomach is in part dissolved by the saliva and fluids of the organ; broken down by fermentation, and, by the latter process, in part ani- malised. In this state it is carried into the duodenum, a portion of the intestine, for the reasons assigned, ca- pable of a considerable dilatation. It is here exposed to the influence of bile, a fluid, as we have seen, which has almost undergone a second circulation, without being exposed to the air; or, what is of more conse- quence, without being mixed with fresh animal matter. It is evidently more animalized than any other fluid of the body; and, by its union with the chyme, new com- binations take place, which have not yet been accu- rately observed. Our food, we have said, consists of gelatine, oil, and sugar. These substances are the chief component parts of the chyle. When the vegetable substances are then broken down, Ave want little more than their separation from the other ingredients, Avhich may be probably effected by the bile, and perhaps the combination of a small portion of azote. Fourcroy sup- poses that the alkali, and other saline parts of the bile, are combined with the chyle to attenuate it, and that its resin is discharged with the excrements. YVe should rather suspect that the alkali itself Avas decom- posed, and its azote only combined with the chyle. We certainly find the resin of the bile in the excrementitious part of the contents of the intestines. The pancreatic fluid is here also added; and we have reason to suppose that it dilutes the chyle, while, as an animal fluid, it contributes to the necessary change. The next portion of the intestine is called jejunum. It is distinguished by no peculiar structure, and differs from the rest of the small intestines by being frequently found empty. The only consequence to be drawn from this is, that, in the duodenum, digestion is perfected, and no longer delay is required. As the food, however, proceeds, the process of animalisation appears to go on; and, from the large intestines, the chyle seems to dif- fer in some respects, at least in colour, from that Avhich is carried from the ilium. In the progress of the alimentary fluid through the lacteals, we find it often conveyed into glands, called lymphatic, or conglobate. It is here apparently depo- sited into cells, and mixed still more intimately Avith animal fluids, from whence it is absorbed by other lac- teals, which apparently possess some elective power. Partly for the purpose of a more complete animalisa- tion, and partly to prevent any noxious substance from contaminating the vital fluid, these glands are seem- ingly interposed. We see an equal anxiety for each purpose in the further provisions. The neAV aliment is mixed in the thoracic duct Avith the lymph, absorbed from every cavity, and, even after every precaution, conveyed almost by drops into the blood. It is thus carried gradually to the heart and the lungs, where the last process takes place. We are now well acquainted with the changes Avhich are produced in this part of the animal system. Atmo- spheric air is absorbed, and its oxygen, in part, uniting with the blood, gives it a florid hue; and, in part, com- bining with the carbone, separates it in the form of car- bonic acid gas. It is, indeed, doubtful whether any oxy- gen remains; and whether the separation of the carbone alone may not produce the sensible changes attributed to the oxygen. Our vegetable food, by the gradual ad- mixture of fluids more highly animalised, has now be- come near to our own nature, but it is still not azotic. This last principle seems to be supplied by the air, from whence azote is very probably absorbed. The experi- ments by which this is ascertained are not before the public ; but those communicated to us render it highly probable. It may be said, that, though the bile be obstructed, digestion goes on. It does so; but imperfectly, and the body is emaciated, the strength diminished, and atrophy is the consequence. There is some doubt whether any considerable portion of nourishment is, in such cases, conveyed through the lacteals, and whether the body is not supported by absorption from the adipose membrane, D I G 564 DIG It will be obvious, hoAvever, that some nourishment must still be obtained; for the bile, returned to the blood, is discharged by every excretory duct, and, among the rest, by the mucous glands and the pancreas. A small portion, therefore, finds its way to the digestive organs; and those who have remarked Avith how inconsiderable a degree of nutriment the body is sometimes supported, will not be surprised at the effect of the pittance it must in this way receive. Another objection will be suggested, by the almost total obstruction of the mesenteric glands in some cases of scrofula. Yet, on minute observation, it will ap- pear that every lacteal does not press through a gland. Sometimes it creeps over the surface to immerge in the folloAving; and sometimes it seems cautiously to avoid every body of this kind interposed. The "play of affinities," Avhich takes place on the mixture of the bile, is not yet understood. It is cer- tainly considerable; for Ave sometimes find the benzoic acid in the excrements of herbivorous animals, and sometimes the phosphoric. The former we have rea- son to believe, from some late experiments, to be a pro- duct, whose basis is the vegetable acid; and the latter we have begun to detect in its disguise, and to trace its source in grain. These subjects will soon be more clearly elucidated. Whether produced in the intestines, in the different ca\-ities, or in the circulating system, is yet uncertain; but the phosphoric acid and the ammonia are the creatures of the animal economy, produced by the neiv combinations constantly taking place. The red globules of the blood, though evidently de- rived from the nutriment, resemble so little every part of it, except the oil, that we must profess ourselves ig- norant of their source. They are not oily; and though Ave lose the oil that makes a part of our food, and which is discoverable in the chyle, we can scarcely think that it forms this singular portion of our fluids. It is apparently de'composed, and affords the hydrogen, Avhich is a com- ponent part of the animal economy. When we reflect, however, on the other hand, that we have scarcely any instance of globules swimming, unmixed, in a watery fluid, without being oleaginous; that oil affords a very solid, substantial nutriment; and that the red globules are numerous and vivid, in proportion to the strength of the constitution; we have some reason to suppose that they derive, in part, their origin from this source, though changed in their chemical properties. The application of these newly'formed fluids must be the subject of fu- ture consideration. See Nutrition. The digestibility of different substances Ave consi- dered under the article Aliment, and we there spoke from observation, assuming, as the criterion, the ex- acerbation of hectic paroxysms, which always occurs during digestion, and is greater in proportion to the dif- ficult solubility of the food. Constitutions, however, greatly differ in this respect; and Ave ought f> add, that the opinions of other authors differ from our own. We shall, therefore, adduce the conclusions of a respectable observer, M. Gosse, of Geneva, who, by sAvallowing air, was at any time able to discharge the contents of the stomach. His experiments are recorded in Spalan- zani's Avork; but, that we may not be suspected of dis- torting them to favour our OAvn ideas, Ave shall tran- scribe the account from a late respectable, but unequal, publication. " He informs us, that in about an hour and a hah after the food is taken into the stomacli, it is changed into a pultaceous mass; the gastric juice, likewise, ren- ders it fluid, without altering its nature ; and when di- gestion is properly carried on, there is no appearance of acidity or alkalescence; the food does not ferment; and the process of digestion is not completed until the space of between two and three hours has elapsed. " The chyme which arises from aliments taken either from the animal or vegetable, kingdom is the same; they both are, by the gastric fluid, converted into the same substance, which is in consequence most probably of their both containing gelatine, 8cc. If, however, the di- gesting solvent is not in sufficient quantity, or is in a diseased state, the acetous fermentation will take place in vegetable, and the putrid in animal, matter; hence milk, vegetable matter containing sugar, wine, and even spirits, will degenerate, when left to their spontaneous changes in the stomach, to a very strong acid, and sooner sometimes than out of the body, perhaps from the heat, Sec. All oily substances likewise become ran- cid, and flesh meat putrid, producing acid and putrid eructations, Avhich is never the case in a state of healthy digestion; whilst, in many animals, the digestion is finished before the acetous or putrid fermentation can begin. " Substances insoluble, or that were not digested in the usual time in the stomach. " Animal substances. " 1. Tendinous parts. 2. Bones. 3. Oily or fatty parts. 4. Indurated white of egg. " Vegetable substances. " 1. Oily or emulsive seeds. 2. Expressed oils of dif- ferent nuts and kernels. 3. Dried grapes, and the skins offish. 4. Rind of farinaceous substances. 5. Pods of beans and peas. 6. Skins of stone fruits. 7. Husks of fruits with grains or seeds. 8. Capsules of fruit with grains. 9. Ligneous stones of fruits.' JO. It does not destroy the life of some seeds; hence bitter-SAveet, hemp, misletoe, and other plants Avhich sometimes groAv upon trees, are produced by the means of the excrements of birds, the kernels of the seeds being defended from the menstruum by their exterior covering. " Substances partly soluble, or parts of which were digested. " Animal substances. " 1. Pork dressed various ways. 2. Black puddings. 3. Fritters of eggs, fried eggs and bacon. " Vegetable substances. " 1. Salads of different kinds rendered more so when dressed. 2. White of cabbage, less soluble than red. 3. Beet, cardoons, onions, and leeks. 4. Roots of scurvy grass, red and yellow carrots, succory, are more inso- luble in the form of salad than any other Avay. 5. The pulp of fruit Avith seeds, when not fluid. 6. Warm bread and sweet pastry, from their producing acidity. 7. Fresh and dry figs. By frying all the sub- stances in butter or oil they become less soluble. If they are not dissolved in the stomach, they are, hoAv- ever, in the course of their passage through the intes- tines. " Substances soluble, or easy of digestion, and which are reduced to a pulp in an hour, or an hour and a half. " Animal substances. '• 1. Yreal, lamb, and, in general, the flesh of young DIG 565 DIG animals, are sooner dissolved than that of old. 2. Fresh eggs. 3. Cow's milk. 4. Perch boiled with a little salt and parsley. When fried or seasoned with oil, wine, and white sauce, it is not so soluble. " Vegetable substances. " 1. Herbs, as spinach mixed with sorrel, aretiess so- luble, celery, tops of asparagus, hops, and the ornitho- galus of the Pyrenees. 2. Bottom of artichokes. 3. Boiled pulp of fruits, seasoned with sugar. 4. Pulp or meal of farinaceous seeds. 5. Different sorts ofwheaten bread, Avithout butter, the second day after baking, the crust more so than the crumb. Salted bread of Geneva more so than that of Paris, without salt; brown bread in proportion as it contains more bran is less soluble. 6. Rapes, turnips, potatoes, parsnips, not too old. 7. Gum arabic, but its acid is soon felt. The Arabians use it as food. " Substances which facilitated the menstrual power of the gastric juice are, sea salt, spices, mustard, scurvy grass, horse radish, radish, capers, wine, spirits in small quantities, cheese, particularly when old, sugar, various bitters. " Substances which retarded the gastric poAver are, water, particularly hot, and taken in large quantities. It occasions the food to pass into the intestines without being properly dissolved. All acids, astringents, 24 grains of Peruvian bark, taken half an hour after din- ner, stopped digestion. All unctuous substances, ker- mes, corrosive sublimate. Gosse likeAvise observed, that employment after a meal suspended or retarded diges- tion, as Avell as leaning with the breast against the table; and that repose of mind, A-ertical position, and gentle exercise, facilitated it." See Fordyce on Digestion; Richerand's Elements of Physiology ; Senebier's Observations (Journal de Phy- sique, Mars, 1785); Carminiati's Experiments, ibid. vol. xxvi.; Spalanzani'sTracts; Brugnatelli Sagiod'un Analisi Chimica de succi Gastrici; Steven's Thesis; Gosse's Experiments. DIGESTI'YrUM, SAL SY'LVII, (from the same). See Marinum sal. DIGESTIVA, (from digero, to dissolve). Such ap- plications as promote suppuration, viz. ointments ren- dered stimulating by turpentines and balsams, poultices and fomentations. The object is to excite suppuration by stimulating the vessels, when too languid; to hasten it when the process goes on too sloAvly ; and to relax the vessels when their action is sufficient. By these effects the choice is easily directed. DIGITA'LIS, (from digitus, a finger). Aralda, di- gitalis purpurea Lin. Sp. PI. 758. It is a hairy plant, with serrated leaves ; a thick angular stalk, on which are numerous purple tubulous flowers, resembling the fin- ger of a glove, hanging downwards, in a row along one side, each on a short pedicle; the floAver is followed by an oblong pointed capsule, full of small angular seeds. It is biennial, groAvs Avild tin woods and on heaths, only in gravelly soils, and flowers in June, July, and August. - The leaves are bitterish and nauseous to the taste; they yield their virtue both to Avater and to spirit. Dr. Hulse recommends an ointment made by boiling it in butter, as an application to scrofulous ulcers, with gen- tle purging two or three times a Aveek. Dr. Withering considers this as one of the most cer- tain diuretics in the whole materia medica. The leaves, which are chiefly employed, are given from one to three grains, in powder, twice a day, alone, or united with aromatics, and sometimes formed into pills with soap and gum ammoniac: the dose may be gradually in- creased; but four grains are generally sufficient in drop- sical cases. A drachm of the dried leaves maybe infus- - ed in half a pint of boiling Avater, for four hours, adding to the strained liquor an ounce of any spirituous water : tAvo table spoonfuls, or an ounce given twice a day, is a moderate dose for an adult: if the patient be stronger than usual, or the symptoms very.urgent, this may be given once in eight hours; but, in many instances, hall an ounce will be sufficient. When this medicine purges, it is said to fail of success, and opium may be advanta- geously joined with it: but when the boAvels are too tardy, jalap may be added. It seldom succeeds in men of great natural strength, of a tense fibre, Avarm skin, florid complexion, and a hard pulse. But if the pulse be feeble, or intermitting, the countenance pale,» the lips livid, the skin cold, the belly soft and fluctuating, the anasarcous limbs readily pitting with pressure of the finger, Ave may expect the diuretic effects to folloAV in the most salutary manner. If given in the form of extract, it must be joined with exercise and tonics. The decoction is occasionally preferred to the powder, and given in the following form: R. Digitalis purpureas recentis ^ iv. aquae distillatae fly ij. coq ad fly i. et liquo- ri colato adjiciantur spt. vinosi ^ ij. fiat decoctio.—One large spoonful is to be administered every morning, in every variety of idiopathic dropsy, and repeated every hour, till the patient has taken from three to eight or nine spoonfuls, or till sickness, or some other disagree- able sensation, be induced. The hydropic fluid gene- rally disappears on the next or on the third day, Avithout any repetition of the medicine; and frequently Avithout any apparently increased evacuation; at other times, with vomiting and a large Hoav of urine; and sometimes with purging stools. Such is the flattering account of Dr. Withering; but Ave cannot confirm it from experience in every part. The digitalis is of a suspicious order, and its exhibition is attended often with inconvenience. Yrertigo, sick- ness, and faintness, frequently folloAV. More than one patient has died suddenly during its exhibition; and, though these sudden terminations in dropsy are not un- common, we have apprehended that this poisonous plant may have had a share in the event. We have, there- fore, ahvays prescribed it Avith a trembling caution, and have scarcely ventured giving above two grains three times a day. After some time the pulse becomes slower, the patient Avea"ker, and it seems to be OAving to the ge- neral relaxation which takes place that the urine passes off. It is singular, but undoubtedly true, that it should be useless in dropsies of the young and strong. From its lowering the pulse, it has been given freely in spasmodic asthma, and hectic, so far as our experi- - ence goes, without success. The pulse is, indeed, ren- dered sIoav; but the other symptoms remain Avith little melioration. The unguentum digitalis is made in the same man- ner, and applied to the same uses, as that of cicuta; the ingredients are equal parts of the digitalis purpurea, re- cently gathered, and hog's lard. (For the process, see D I H 566 D I O Cicuta.) It is also a name of the sesamu7n orientale. See Sesamum verum. Digita'lis MINIMA. SeeGRATIOLA. DIGITA'TUS, (from digitus, a finger). In botany it means divided into several parts, and meeting toge- ther at the tail; like a hand, and its fingers. It is ap- plied to the leaves. DIGI'TIUM, (from digitus, afinger). A contraction of the joint of a finger; and a pain, with wasting of the same part. See also Paronychia. DIGITO'RUM TENSOR. See Extensor digi- TORUM COMMUNIS. DI'GITUS, (from digero, to direct, as the natural in- strument of pointing or directing). A finger. In the liands they have particular names. The first, which is opposite to, and thicker than the rest, is called xvltx^p, and pollex ; the second, index, A/#«ves, and salutaris ; the third, f&eo-os, medius, and longissimus ; the fourth, ■srxpxfieros, and annularis ; and the fifth, minimus, auri- cularis. The Greeks called the thumb, xvlix^p, be- cause it Avas alone as powerful as the other four fingers, from xv\i, against,-and xeiP> the hand; and the Latins pollex, from pollendo, for the same reason. The se- cond, or fore finger, Xixxvos, index, because, by point- ing, discoveries are made, or indications given; and sa- lutaris, because, being applied to the mouth, it causes a salutary silence. The third, f*.ee-os, medius, and lon- gissimus, the middle finger, from its situation and length. The fourth, wxpx^a-os, because it was beyond the middle finger; and annularis, from wearing rings upon it, hence called ring finger. The fifth, auricularis, from its clearing the ear, and minimus, from its size. The toes have no names. The thumb and the four fingers are each composed of three bones; those of the fingers are formed alike, but those of the thumb are much thicker and stronger, in proportion to their length. On the outside, the bones of the fingers are cohvex, within flat. Both ends of the first phalanx are in a cartilaginous state at birth. The first joint of the fingers is arthrodia, the two last are ginglymus. The different parts or bones of the fingers are called phalanges ; the first phalanx is the largest, and the last the least. (See Phalanx). Digitus, among the Latins, stands also for a measure, similar to dactylus among the Greeks; the smallest measure, by which the distances of space or time are measured, similar to our jot. However, at the present day, it seems to be a measure taken from the breadth of the finger, properly three fourths of an inch, and equivalent to four grains of barley laid breadthwise, so as to touch one another. Astronomers preserve the name in the division of a great circle, digit. DIGLO'SSON,(from fos, bis, and yXue-a-x, a tongue). A name of the laurus Alexandrina, because that above its leaf a less leaf resembles a tongue. DIGNO'TIO, (from dignosco, to distinguish.) See Diagnosis. DIGY'NIA, (from fos, bis, and yw?,, mulier.) The name of an order in Linnaeus's artificial system, com- prehending those plants which have two pistils. DIHjE'MATON, (from fox, and xi^x, blood). The name of an antidote, in which is the blood of many dif- ferent animals. DIHA'LON, (from hx, and xXs, salt). A plaster prepared of salt and nitre, adapted to foul ulcers. DII'PETES, (from hos, heaven, and viirla, to fall; i. e. falling as rain). See Semen. DILATA'TIO, (from dilato, to expand,) distentio; dilatation. Sometimes it is used for diastole. DILATATO'RES ALA'RUM NA'SI, (from the same). Dilators of the nostrils. They are small, thin muscles, having a double order of fibres decussat- ing each other. They rise from the interior and infe- rior parts of the ossa narium, and are soon inserted into the superior parts of the alae. They raise the alae, and dilate the nostrils. DILATATO'RIUM, (from the same). A surgical intrument for dilating any part. DILL. H. MUSC. An abbreviation of Johannis Jacobi Dillenii Historia Muscorum. DILUEN'TIA, (from diluo, to wctsh away). Di- luents. These are fluids, which render the substance with which they are mixed still more fluid, without adding any acrimony, and are almost universally water. Heat cannot be considered of this kind, because it is not, in the strict sense of the word, a fluid; and, when salt renders the serum more fluid, the term is impro- perly applied. Diluents are, therefore, watery fluids alone; and these undoubtedly dilute the contents of the stomach and bowels; but, should lentor or vicidity exist in the blood, water alone will not remove it. If water is ab- sorbed, it is soon again carried to the kidneys or the skin, and evacuated without any impregnation. Some diluent effect may be produced, if, by joining any of the farinacea, the watery fluid is subjected to the powers of digestion. DILU'TUM,(from the same). Diluted.See Infusum. DILYTjE'A. In Myrepsus, it is the fat of some un- known animal. DIMIDIA'TUS,(from dimidium, half,) divided into half. DI'NICA, (from fovea, to turn round). Medicines against a vertigo. DINNER, (from the barbarous Latin word disnare, to dine). The principal meal, which should be taken about the middle of the day. See Di^eta. DI'NOS, (from fovea, to turn round). See Vertigo. DIO'BOGON. See Scrupulus. DIO'CRES. The name of a pastil in Myrepsus. DIO'DOS, (from ha, and ifos, the way through). See Diexodos. DIOa'CIA, (from fos, bis, and oixos, domus). A vege- table which has no hermaphrodite flower; but in which the male flower is upon one plant, and the female flower upon another. It is the twenty-second of Linnaeus's classes. DKENA'NTHES, (from fox, and oivxvH, the flower of the vine,) an epithem in Trallian against the cholera morbus. DIO'GMUS, (from foaxa, to persecute). See Pal- PITATIO CORDIS. DIO'NIS COLLY'RIUM. A collyrium in Oriba- sius, so called from Dion its author. DIONY'SIA. The name of a plaster for abscesses, invented by Hera the Cappadocian; also called diony- sianum emplastrum. DIONY'SIAS, (from Aiowo-es Bacchus, or wine). See ANDROSiEMUM. DIP 567 DIR DIONISI'SCI. Horned. Certain bony eminences near the temples; or rather the race distinguished by those prominences; from Dionysius, a name of Bacchus, described as horned. DIONY'SIUS. See Lepidium. DIONY'SOS. The name of a collyrium in iEtius; one resembling it is found in P. .Egineta, called colly- rium malabathrinum, and isotheon. DIOPO'RON, (from foix, andoirapx, autumnal fruit). The name of a medicine in Coel. Aurelianus, used against the quinsy. DIO'PTRA, (from hovloyuxi, to see through). An instrument for dilating any natural cavity, the better to see its state, as the speculum uteri. DIOPTRICS; glasses employed to view distant ob- jects, where the rays pass through the lens, in opposi- tion to those where the object is examined after reflec- tion. Spectacles are dioptrical instruments. DIOPTRI'SMOS, (from hotfoot, to see through). The operation which consists in dilating the natural passages with a dioptra. DIO'ROBON, (from ^<«, and opo&s, a vetch). A medicine containing vetches. 4DIORRHO'SIS,or DIORO'SIS, (from hx, and opts, serum,) a conversion of the humours into .serum and water. DIORTHO'SIS, (from hx, and op6<&>, right, or from hopSoa, to direct). The restitution of a fractured limb to its natural situation. DIOSCO'R. An abbreviation of Pedacii Dioscoridis Opera. DIOSCU'RI, (from Atos xovpot, the sons of Jupiter, Castor and Pollux: the parotid glans are so named from their equality in shape and position). See Paro- tides. DIO'TA, (from hs, double, and ovlos, from «t/{, the ear). The name of a wooden cup, with two ears or handles, lined with aromatics, to give a flavour to the liquor contained in it. DIOXELjE'UM, (from ^,«, oft/?, acid, and eXxiov, oleum). A malagma of oil and vinegar. DIO'XUS, (from fo^x, and «ft>?, acid). The name of an acid collyrium in Marcellus Empiricus. DIOSPY'ROS. See Guajacana, DI'PCADI. See Bulbus vomitorius. DIPCE'A. See Circ^ea. DIPE'TALUS, (from fos, double, and zreJxXov, a pe- tal). Consisting of two petals. DI'PHRYGES,or DISPHRYGES. Scoria; (from fos, twice, and pvyu, to torrefy). There are three kinds; 1st, Metallic, produced only in Cyprus; found in the mud of a pool, whence it is taken and dried in the sun, then burnt; as it were twice roasted. 2d, The dross in working copper. 3d, Pyrites calcined to red- ness. DFPLOE, from hnXoos, double, called also meditul- lium). It is the soft part between the two tables of the bones of the skull. DIPLO'MA, The written instrument which gives authority for physicians to practise. It is usually writ- ten on parchment, and folded up; hence its name, from fo*Xao, to fold. Diplomas are noAv disgracefully sold by colleges founded for better purposes; and the blockhead, who cannot write a prescription, ranks with a man of the greatest learning and experience. Also a double vkssel. To boil in diplomate, is to set one vessel, containing the ingredients intended to be act- ed upon, in another larger vessel full of Avater, and to this latter vessel the fire is applied. See Balneum marls. DIPLO'PIA, (from foirXov,-duplus, and o-^is, visus). A depravity of sight, by which the same objects appear double. The symptom is almost always of short dura- tion, and we bear it freely. So long as the object is not within the distance of distinct vision, two images opposite to one faramen, or aperture, having fallen upon the eye, are not united in the retina, but in distinct places; and, therefore, they have not the optic point as a centre : whence the image appears double. The optic portion is a circular point in the bottom of the eye, whose centre the optic axis occupies : but as often as we look at any object with both eyes, so often, unless there should be some defect in the organs, we turn the eyes, that each axis may concur in the same point of the object; and we learn by long habit, that a double image answers to one object, and consequently we judge that object single: but if a double image should fall upon the same eye, and not concur in the optic point, then the same object appears to be seen in two different places, and therefore double. It frequently arises from weakness, when we lose the power over the muscles of the eye, so as not to be able to direct them with accu- racy. The diplopia, then, is the forerunner of death, or in fevers, of delirium. At times, the defect seems to be in the brain beyond the eye; and it has been sometimes an early symptom of hydrocephalus, or of an abscess in the basis of the brain near the thalami nerv- orum opticorum. Dr. Cullen makes it a variety of the second species of pseudoblepsis, which he calls 7nutans, in which objects appear changed from what they really are: and the disease varies according to the variety of the remote cause, of which he enumerates, from Sau- vages, ten species. See Nosologia Methodica Sauva- gesii, et Culleni. Wallis's Nosologia Methodica Ocu- lorum, with notes. DIPNO'OS, (from fos, bis, double, and srveu, to breathe). An epithet of wounds which penetrate through some cavity, or quite through a part, or that have two orifices, admitting the air at both ends. DI'PSACON, theTEASLE, (from h$x, thirst). So called from the concave situation of its leaves, Avhich will hold water, by which the thirst of the traveller may- be relieved. See Aspalathus. DI'PSACOS, (from fo^x, thirst). See Diabetes. DI'PAS. Dry earth, (from the same). Also the name of a serpent, whose bite causes thirst. See Cobra. DIPSE'TICUS, (from fo^xu, to thirst). An epithet for food which causes thirst. DIPYRE'NON, (from hs, bis, double, and zrvpw, a berry, or kernel,) the name of a probe, with tAvo but- tons on one end. It is mentioned by Coelius Aurelianus. DIPYRI'TES, or DIPY'ROS, (from hs, twice, and zrvp,fire). Bread twice baked. Hippocrates recom- mends it in dropsies. DIRADIA'TIO. See Actinobolismus. DIRE'CTOR, (from dirigo, to direct). A grooved instrument for guiding an incision knife. DIRECTO'RES PENIS, (from the same). See Erectores penis. DIRI'NGA. A name, in the isle of Java, for the saveet-scented flag. See Calamus aromaticus. DIS 568 DIS DlSCE'SSUS(from discedo, to depart). A chemical term, in French depart, or linquart, signifies, in gene- ral, any separation of two bodies before united : but it is particularly applied to the separation of gold from silver by the nitrous acid, where the silver is dissolved, but the gold left untouched. DISCOI'DES, (from *<«©-, the quoit used in the Roman games, and eifos, a form). See Crystallina. DISCRE'TA PURGATI'VA, (from disccrno, to separate). A purgative which evacuates a particular humour. DISCRI'MEN, is a small roller about twelve feet long, and two fingers broad, rolled up with one head, and used after bleeding in the forehead, in the following manner: the bandage is held with the left thumb upon a compress, so that about a foot hangs beloAV the fore- * head ; then the roller is carried round the temples and occiput in the circular direction; after this, the part which hangs down is to be carried over the head to the occiput, and there, having rolled it several times about the head, it is to be secured. It is a term also applied to the diaphragm. DISCIFO'RME, (from foe-xos, a quoit, and forma, likeness). See Patella. DI'SCUS, (from^<6-*«, to throw). A disk, or quoit, throAvn to a great distance at a mark. It was one of the gymnastic exercises. In botany, the whole surface of a leaf; disk, of a floAver, is the central part in radiate compound floAvers consisting generally of regular little corollae or florets ; the term is also appled to other ag- gregate flowers, when the florets, towards the middle, differ from those in the circumference. DISCU'SSIO, (from fos, and quatio, to shake through). See Perspiratio. DISCUSSO'RIA, DISCUTIE'NTIA, (from discu- tio, to discuss, or shake to pieces). Discutients, by Dioscorides called also diachytica. They are such me- dicines as dissolve.or dissipate a stagnating fluid without an external solution of continuity. In all bruises the fluids are stagnant. If there is no ecchymosis, the ves- sels are distended and thus weakened, and the principal means of relieving is by exciting their action. Simple friction will often succeed. Ardent spirits, camphor, volatile alkali, the light subtile spirit styled arquebu- sade, which is only a distillation of spirits from some warm plants, are very active discutients. They are, however, more effectual when united with a sedative, particularly with opium; and it may indeed be doubted Avhether ardent spirits do not, in part, owe their virtue to their narcotic poAvers. Relaxants, particularly Avarmth, and oils, are injurious, and induce suppuration. Cold adds greatly to the effect of discutients, and the most volatile are the most poAverful. DISEASE. See Morbus. DISLOCA'TIO, (from fos, ex, out of, and locus, a place). To put out of its place. See Luxatio. DISPENSARY, (from dispendo, to distribute, the shop in which 7nedicines are prepared). It is also the appellation of a modern institution, in which the poor are supplied with medicines and advice. It is more advantageous than hospitals, as a greater number of patients are relieved at a less expense; and less useful, as the diet and other circumstances cannot be properly attended to. It is generally the arena, in which the young physician can display his importance, and ac- quire practical knoAvledge. Every hospital, however, has its out patients, which are nearly on the same foot- ing Avith the patients of a dispensary ; and, if necessary, are often visited at their own houses. DISPENSATO'RIUM,(from dispendo, to distribute, or set in order). Dispensatory. A work treating of the composition of remedies ; called also antidotari- «»!, A dispensatory contains a select number of for- mulae, established by the authority of the government of each country, that the medicines may be prepared in a manner, not only correct, but active and uniform. The publication of authorized regular dispensatories is not, however, of a very early date; but, from the time of the Arabians, different works of authority have been considered as the directors of apothecaries. About the middle of the fifteenth contury, the standard volumes were a treatise of Avicenna, and another of Serapion on Simples, which still remain; the Antidotarium of Me- su,e ; another of JVicholas of Salerno, a tract of Si7non Januensis de Synonymis ; and one of an Arabian author, containing the preparation of simples and chemical re- medies, under the name of Liber Servitoris. About the end of the century, a collection was made from these authors by Nicholaus Praepositus of Tours ; but chiefly from Mesue and Nicholas of Salerno. This general dispensatory Avas folloAved by the Thesaurus Ar- matariorum, theLume7i Apothecariorum, andtheLumin- are Majus, compilations from the same source. Of these two luminaries of modern pharmacy, Mesue seems to have lived early in the eleventh century, cer- tainly before its end; and Nicholas of Salerno folloAved him. Under this name, Ave have, hoAvever, three phar- maceutical Avorks. The principal is styled Nicholaus Magnus; from this there is an abridgment, or rather a contraction, styled Nicholaus Parvus; but, in a sub- sequent era, another Nicholaus called Myrepsus, some- times Alexandrinus, appeared, whose work is the largest of the three. YVe have decided ex cathedra on many disputed points of chronology in this short histo- ry ; but have followed the more probable accounts, though we have not room to assign our reasons. All these works are, in many parts, confused and complicated. The ingredients of the compositions are numerous and contradictory, and of the greater -num- ber it is difficult to ascertain the design. Some remedy was introduced for every complaint, and it was, of course, supposed that the whole would be an universal medicine. The first dispensatory published by authority Avas that of Valerius Cordus, in 1542, by the authority of the senate of Nuremberg. It is chiefly taken from the authors above mentioned, with the addition of some chemical remedies, particularly ether. The Avork it- self, noAv before us, is not scarce; but it is particularly known from the comments and quotation of Hoffman. This work was folloAved by Wecker, whose Antidotari- U7n Speciale appeared in 1561, a distinct Avork from the Secreta of the same author, and by Renodaeus, who pub- lished his Officina Pharmaceutica seu Antidotarium at Paris, in 1608 ; but these Avere the works of individuals. The next dispensatory by authority was the Pharma- copoeia Bergamensis, 1581 ; and it was followed by the Pharmacopoeia Augustana, which appeared at Ausburg, in 1601; and, with the notes of Zwelfer, at Rotterdam, in 1653. The former was the reputed parent of eve.ry other dispensatory; and it Avas succeeded by that of London, in 1618, and of Paris, in 1637. In each too D I S 569 DIS much Avas copied from Nicholas of Salerno; but they are, when avc consider the period at which they appear- ed, respectable collections. It is too common to de- spise the ancients; but those Avho have looked into the Phannacopceias subsequent to the periods of Nicholaus, will find in them the germs of our most boasted formulae, though overloaded and disguised by the number of ingredients. It would not be an uninteresting work to restore to each author his original idea. The Persian Pharmacopoeia, published in the same century, at Pa- ris, containing the Arabian formulae, -will complete this short vieAV of ancient pharmacy. There Avere, indeed, many other Dispensatories pub- lished in the same century, or even more early; but, in general, copies from those which preceded. We shall add the titles of the Avorks Avhich had the best preten- sions to originality. Of these the first and principal is Florentimlm Antidotarium, of which we knoAV not the date; but the Latin translation by Clusius, noAV before us, Avas published at Antwerp, in 1561; Montagna's Antidotarium, at Venice, 1565; Fioraventi's Secreti Rationali intorno alia Medicina, Sec. appeared at Venice in 1600; Poterius's Pharmacopoeia Spagyrica, at Frank- fort, 1698 ; Juncken's Corpus Pharmaceutico-Medicum, at Frankfort, in 1697; Lemery's Pharmacopee Uni- verselle, in the folloAving year; and Mynsicht's Arma- mentarium Medico-Chymicum, in 1631. An early Pharmacopoeia, by Bauderon, Avhose date Ave cannot at present ascertain, Avas republished, with remarks, at Lyons, in 1681, by F. Yerny. The Dispensatories in the eighteenth century were too numerous to be particularly mentioned. The " mere muster-roll of names" AA'ouldfill our page, Avhich may be better employed by a slight discriminated vieAv of the merits of the more modern authorised col- lections. Every country of Europe has iioav its own Pharma- copoeia, established by authority. In the north, the Swedish, the Danish, and the Russian, Dispensatories are respectable and correct collections of Avell arranged formulae. The Danish merits, on the whole, the pre- ference; though the Swedish is more chemically correct. In our OAvn country, the late edition of the London Pharmacopoeia is elegantly, and on the whole accurate- ly, chemical. Perhaps it is too concise; nor does it al- Avays furnish the formulae which extensive practice de- mands. The first edition appeared in 1618; but we cannot find that it was republished till the year 1746, and again in 1788. The Edinburgh college published their first edition in 1722, and it has been followed by editions in 1736, 1747, 1756, 1775, 1792, and 1803. Their last edition is a very elegant and accurate work. The Dublin college has not published any dispensatory till Avithin these feAv years, under the auspices of Mr. Kirwan : it is what may be expected from a learned bo- dy, in an enlightened age. In Germany, the Wirtemburgh Dispensatory AAras for many years the standard of German pharmacy, and the best edition was that of 1771. It Avas aftenvards re- published, but without any change; and is still a neces- sary Avork for those who study the labours of the former German practitioners: it is particularly referred to in Murray's Apparatus Medicaminum. In the north of Germany it has been superseded by the Berlin Dispen" satory, the last edition of Avhich is one of the most VOL. I. ,.- complete Pharmacopoeias Avhich Ave possess; and by the BrunsAvick Dispensatory of 1777, a very inferior AA-ork, abounding in all the useless exuberance of some ancient collections. On the west,- in Holland, the Lcyden and Amsterdam Dispensatories direct the prac- tice ; but neither has lately been revised. In the south of Germany, the Fulda Dispensatory is highly esteemed. It is a Avork of value, and may be perused in every country Avith advantage. That, of Yrienna was first printed in 1729, and reprinted in 1765. It has escaped us if any other edition has appeared. Dispensatories have been published at Presburg and Cracow ; but they Avere early Avorks, and of little value. In France, the first Dispensatory appeared in 1637 % and we knoAV of no edition since that of Boyer, in 175S. The Pharmacopoeia of Lyons, by Vitet, appeared in 1778, and is a very respectable collection. The Spanish and Italian Dispensatories are of too little real value to detain us; and Ave shall close this article Avith a short enumeration of the principal collections of formulae not authorised by any government. The first of these, besides Renodacus and some others formerly mentioned, was Schroeder's Pharmacopoeia, in4to., published at Leyden, in 1656 ; Triller's Dispen- satorium Phannaceuticum Universale, in two volumes, 4to., published at Frankfort, in 1764: the first volume of this work contains the materia medica. A superior collection, hoAvever, is the Dispensatoriuin Universuh' of Reuss, in tAvo volumes, 8vo., published at Strasburg, in 1791; and Spielman's Pharmacopoeia Generalis, pub- lished at the same place in 1783, is a Avork of value. In our oaati country, the Dispensatories of Quincy, ol* James, and Strother, merit our commendation. The first, improved by LeAvis, is still a most valuable pharma- ceutical Avork; but the last improved edition by Dr. Duncan, junior, comprehending the last London, Edin- burgh and Dublin Pharmacopoeias, greatly excels every other collection we have seen. It is full, correct, and satisfactory : Avith all the improvements of modern sci- ence, from the best sources, most skilfully condensed. We oAve numerous obligations to it in the present work. If it wants any addition, it is of the formulae from some of the best Pharmacopoeias of the continent; and the ad- dition of another volume, with these formulae, has been recommended. At present the deficiency is best sup- plied by the improved editions of LeAvis, or by an ex- cellent Avork entitled " Thesaurus Medicaminum," at- tributed, Avith some reason, to Dr. R. Pearson. An ex- cellent work by Plenck, entitled Pharmacopoeia Chirur- gica, and an admirable little manual under the same title in English, must conclude our list. DISPE'RMATUS, (from his, and c-prep^x, semen). Bearing two seeds. DISRU'PTIO, (from disru?7ipo, to breuk asunder,) a violent lacerated Avound Avhich penetrates the skin to the flesh. DISSE'CTIO, (from hs, through, and seco, to cut). Dissection. The cutting up a body, with u vieAVof ex- amining the structure of the parts. See Anato.mia. It is scarcely an objectof a Avork of this kind to teach the minutiae of anatomy, or, of course, to enlarge on the methods by Avhich it may be most satisfactorily learnt. We rather design this article as subservient to forensic medicine, which is an object of considerable importance, and, in general, too much neglected by authors and ■I P I) 1 S 570 13 I S professors. We shall add, hoAvever, afeAv observations on this subject, for the assistance of the younger prac- titioners ; avc trust not without their use. At the conclusion of the article Chirurgia Ave spoke of the necessity of frequently using the knife to attain a dexterity in accommodating the hand to every little change of direction; and Ave would uoav extend the ad- vice by recommending, as frequently as possible, the dissection of those who die of disease. In the theatres of anatomical investigation, some days have generally elapsed before the body can be obtained, and some fur- ther time is necessarily lost before all the cavities can he examined. Exudations, in consequence of this de- lay, often take place ; the blood vessels, if distended, as- sume a livid hue, and give an unfaithful idea of the real appearance of the parts, so that the practitioner does not learn to distinguish disease Avhen it really occurs. If the dissection of diseased bodies be often practised, some of the sound parts will show the young practi- tioner their natural appearance, and, in turn, he will see every part in its proper colours. In such circumstances, his dexterity may be improv- ed by the introduction of probes, bristles, or other in- struments, into the different cavities. The probang and catheter he may thus be able to introduce more readily. He may learn to pass a tent to the upper part of the nose, by conveying a string through it to the back part of the fauces; an operation on Avhich, in haemorrhages of the nose, life may depend. In fact, the young sur- geon should take advantage of every opportunity of in- creasing his readiness in executing every operation which he may be ever required to perform. Another circumstance of no little importance is, that he will learn, in the subject recently dead, and not injur- ed by hasty and rough conveyance, to see the situation of different viscera with respect to the external organs. He will find, for instance, that at the scrobiculus cordis many important parts meet; the stomach, the gall blad- der, and the colon. Each may produce pains there ; and it should be his object to discriminate those which are owing to diseases of the different organs. He will learn also from the diseased state, what deviations some- times take place in these respects. The stomach will be dragged clown by a disease of the epiploon ; the ab- domen filled by one of the ovarium, &c. Each dissec- tion, by careful observation, will thus afford'a lesson ei- ther of instruction or caution. Dissection, when necessary to ascertain real diseases, or to detect crimes, should be conducted Avith the great- est care. In the first instance, the pains are often distant from the seat. We remember a case where pain Avas almost exclusively confined to the region of the navel; the disease was a scirrhus pylorus : another which the best surgeons pronounced to be a scirrhous prostate; it Avas a stone impacted in the pelvis of the kidney : of a child whose complaints were attributed to a diseased liver; it was a mesenteric obstruction. In- stances of this kind, and many Ave might add, will in- spire a cautious distrust, and the propriety of a doubtful opinion, Avhen originally offered. Yet nothing is more common than to find the most positive decisions. At this moment we have cases pronounced to be a wasting of the liver; a dropsy of the womb; and a polypus of the uterus ; the sources of which are either unknown or evidently mistaken. Should such bodies be ever opened, the physician and his science xa ill be disgraced, except by some frauds which, Ave fear, are too common. Deviations from the common structure have been made by art; and it is ahvays easy to find, in any circum- stances, Avhat Ave Avish. YVhen it is the object to detect crimes, dissection be- comes an object of considerable importance. The life of an innocent person maybe the sacrifice of ignorance, inattention, or presumption. The principal inconve- niences Ave shall enumerate, as they occur in the greater cavities. In the head, the surgeon is often called on to decide on the cause of death. This may have oc- curred in a paroxysm of passion, and an accidental rencounter; and death may have arisen from apoplexy, or a blow. In each case, the vessels will be turgid, especially if intoxication, a frequent attendant, has con- curred. In such circumstances, it is necessary to know that the vessels of the brain in a healthy state are usu- ally very conspicuous. If no considerable external in- jury, no inflammation corresponding to the part where a slight or probable Woav may have been afflicted, are observable, it may be concluded that the patient did not die from violence. Even general inflammation, though considerable, will scarcely justify the contrary- opinion ; nor an abscess, if at the basis of the scull, its , most common seat, support a different conclusion. On the contrary, a trifling, and even an inconsiderable bloAV, either on the temple or on the upper orbit of the eye, Avhere the bone is thin, may be fatal; and in such circumstances, the most minute examination of the brain and its bony envelope is essentially necessary. The point of a small sAvord against the upper part of the orbit has been fatal, by penetrating the brain, though the organ of vision has escaped. In the chest, blows and wounds, though violent, will not always be fatal; but, in this part of the body, the effects are generally obvious, and no doubt occurs that merits any elucidation. In the stomach, we are often left in uncertainty. Blows at the pit of the stomach have been sometimes fatal, without leaving any trace. The effect, on this organ, is similar to concussion on the brain. Inflam- mation seldom points out any evident cause; and death, without any alteration of the structure, ensues. Greater are, however, the difficulties when poison is the suspected cause of death; and it is necessary that every practitioner should be acquainted with the inter- nal appearances of this organ. Fortunately, the taste of the most dangerous poisons soon guards a person from any permanent injury; and, of others, the effects are strikingly obvious. The idea of Mr. Hunter, that the gastric juice dissolves after death the substance of the stomach, and occasions erosions in it, is found to have no foundation; and it is a proof, among a thousand others, how far a preconceived opinion influences the most accurate observers. Lead, copper, and arsenic, can be ascertained by their most appropriated tests (see Y^enenum). The vegetable poisons are too nauseous to escape the organs of taste, and the animal influence other organs. On the intestines we see only the effects of stimulant poisons, of inflammation, and its conse- quences. YVounds and bruises offer no subject of remarks, as they are sufficiently obvious. Yet some- times, in severe bruises, the effects, for instance, of military punishment, an abscess forms beloAV, rather- DI S 571 1)18 ijian on the part affected, and is occasionally the cause of death. In cases of death, in real or supposed puerperal cases, it is absolutely necessary to knoAv the appearance of the organs in a.state of health, and in the puerperal state. A woman sometimes dies apparently from poison, and the supposed inducement to this rash act is suspected pregnancy. The cause is, sometimes, with difficulty decided in the early months. If the period of menstrua- lion is at hand, the uterus will assume the appearance of early impregnation, and we once saw it at a different period, though the hymen Avas entire. The appearance of an uterus, lately gravid, ought also to be known, as it may be sometimes necessary to determine Avhether a person, Avho has voluntarily terminated her existence, may have been lately delivered. For two months, at least, and very often much longer, the appearance of a corpus luteum in the ovarium is decisive In cases of puerperal fever, the subject has been greatly confined by those Avho have described the ap- pearances on dissection, being' imperfectly acquainted Avith those of the puerperal state. The natural fulness of the uterine vessels has been styled inflammation, and the coagulable lymph a purulent discharge. In dropsy in tympanites, as well as in the puerperal state just described, the vessels are peculiarly full, and give the suspicion of previous inflammation where none has existed: Adhesions often take place in chronic cases, in the last moments, or soon after death, and ex- cite an unfounded suspicion of an inflammatory disorder having preceded. In real inflammation of the perito- naeum, it is thickened, pulpy, and opaque. A neatness in opening a body and again seAving the wounds, can be judged of by every one. The body should not be too much exposed. In dissecting the head, the integuments should be cut across from ear to car. They may then be replaced, without disfiguring the subject. To examine the thorax, the cartilages of the ribs should be divided on each side, after dissecting off the integuments and the muscles, near the sternum, which may be turned back ; and from the scrobiculus cordis, an incision should be made to each ilium, to ex- amine the state of the abdominal viscera. When these viscera arc taken out, ligatures should be made on every canal, previous to dividing it. The parts should be carefully replaced, and the integuments sown with* what is styled the flat stitch. Sec C. Bell's System of Dissection. DISSE'CTUS, (from disseco,jo cut asunder). In botany it means cut into small notches, fringed. DISSEPIME'NTUM,(from dis, and sepio, to inclose round). It is the thin septum Avhich divides the several cells in the fruit of plants. See Capsula. DISSE'PTUM, (from the same). See Diapijragma. DISSOLVE'NTIA, (from distolvo, to melt). By Dioscorides called diachytica; medicines Avhich dissolve concretions in the body, not only calculous ones, of Avhich we have already spoken, but coagulated lymph, polypi, tubercles, &c. This ridiculous fancy is not yet forgotten. In chemistry, dissolvents are menstrua. DlSSOLU'TIO, (from dissolvo, to loose7i). Disso- lution ; lipothymia, syncope, and death. Solution of continuity is distinguished by the same appellation, and >hus is synonymous vith dialysis. DISSOLL'TUS MO'RBUS. (from dissocvo). See Dysenteria. DI'STA, (from hs, double). See Dyota. DISTE'NSIO, (from distendo, to stretch out). Dis- tention ; dilatatio, pandiculatio, convulsio. Tension has, hoAvever, a different meaning, and Ave shall return to it under the article Febris. DISTI'CHIA, or DISTICHI'ASIS, (from hs, dou- ble, and g-7.'%jj, a row or order). See Districhiasis. DISTICHUM, (from the same,) a species of barley which hath only tAvoroAvs of grains. DISTILLA'TIO, (from distillo, to drop gradually). Distillation ; alsacta, catastag7nos. Sometimes it signifies the same as defluxio, or catarrhus; so Shak- speare speaks of " distilling rheum." In pharmacy it is the separation of the more volatile from the more solid parts of any substance by means of* heat. The operation itself consists of the condensing and collecting the lighter parts of bodies, previously rarefied by heat, and thus separated from the less vola- tile. Re-distilling a fluid several times from fresh parcels of the same kind, is called cohobatio; but little advantage is derived from this practice. When distil- lation is repeated, in order to purify or separate the matter distilled from some parts of less value, it is called rectificatio7i. Distillation with an alembic or a common still is called per ascensum, because thevapours rise and are condensed in the upper part of the vessel; and in this way all distillations may be performed that require no greater heat than boiling water. YVhen a greater heat is required, retorts may be used; and as from their shape the volatile parts can only escape through the side, it is called per latus. When the heat is applied above the bodies to be distilled, and the lighter parts forced dowmvards, it is called per descensum: this me- thod is noAv never used in pharmacy, though occa- sionally in the arts. When the volatile parts, rarefied by distillation, are dry, the operation is called sublimation. When no more heat is applied than is necessary just to raise a vapour, Avhich when condensed only falls in drops, it is called a cold distillation: roses and other substances valued only for their flavour, and Avhich do not admit of drying, are advantageously distilled in this way ; and the dry cake, left after distilling roses, is Avell adapted for making a decoction or syrup: in this kind of distillation, the subject should neither be bruised nor have any Avater added to it: they should be gathered with the morning deAV upon them : and a retort placed in a sand bath, Avith a receiver, is the best apparatus. The worm still is more frecjuently used, and called the hot still, because the materials boil; it communicates Avith a leaden spiral tube (the worm), placed in a tub filled Avith cold Avater (the refrigeratory); in this worm the vapours are condensed, and run out in a small stream into Avhatever vessel is placed to receive it. The end of distilling is the separation of volatile sub- stances from those with which they were mixed; as in obtaining vinous spirits, essential oils, volatile spirits, Sec. or for the more speedy or effectual combination of such bodies as require a boiling heat for their union. As a great object in distillation is to apply no more heat than is necessary to accomplish our intention, re- torts are sometimes used, and are placed on an open fire. Thev are placed also in sand or in water, that the •1 D 2 I) § S 572 D I S heat may be more certainly adjusted to the degree of volatility which the subject to be distilled possesses. In distilling Avater, the menstruum should be attended to, as Avell as the heat to be applied; for, as some essential oils require the full heat of boiling Avater, they cannot he ntised by the use of spirits of Avine: this happens in distilling oil of cinnamon, and some other ponderous oils! Retorts are proper Avhen the subject tote distilled Avould corrode the metal of a still, as in the preparing a mineral acid, or other corrosive matters. Earthen vessels are sometimes used, and, on some feAv occasions, iron ones. But these, and many other observations on this subject, are fully noticed under the articles where an attention to them may be required. Distilla'tio per descen'sum. See Descensio. DISTI'NCTUS, (from distinguo, to set apart). In botany it means distant, and Avithout any contact of parts. DISTO'RTIO, (from distorqueo, to wrest aside). It is applied to the eyes, Avhen a person seems to turn them from the object he would look at, and is then called squinting. (See Strabismus.) It also signifies the bending of a bone preternaturally to one side. See Bell's Surgery, vol. vi. p. 281. Disto'rtio spi'n^, vel vertebra'rum. Distor- tion of the spine. In this disease, the spine becomes more or less curved, and the power of the loAver limbs is usually lessened or destroyed. Mr. Pott calls it a kind of palsy in the lower limbs; in another place he speaks of it as a useless state of them. From his ac- count of the disease, it hath a scrofulous origin; but as its most striking symptoms are from the caries, which takes place in the bodies of some of the vertebrae, may it not be properly termed the strumous spinal ca- ries? Mr. Bell, in his Surgery, vol. vi. p. 294, calls it distortion of the spine. In this disease, the lower limbs are gradually weakened, or their power is Avholly lost. A curvature of the spine nearly about the middle of the lumbar vertebrae is ob- served, Avith a crackling sound on bending them. It is sometimes said to take place on the neck, and to be attended with the same effects on the upper extremities; but we recollect no Avell authenticated case of this kind. To this distemper both sexes, and all ages, are equally liable; though the majority of these patients are infants or young children. When the attack is made on an infant of only one or two years old, the true cause is rarely discovered until some time after the effect has taken place ; the nurse or parents suppose that the child is weakly, or hath been hurt at its birth. When, on the attack, the patient hath been used to Avalk, the loss of the use of his legs is gradual, though not in general very sIoav. At first he sIioavs signs of being soon tired; he is languid, listless, and unwilling to move much, or briskly; soon after he is observed frequently to trip, although there be no impediment in his Avay. When he attempts to move quickly, his legs involuntarily cross each other, and he is frequently thrown doAvn suddenly, and upon endea- vouring to stand still and erect, even for a feAv minutes, his knees give way, and bend forward. When the dis- temper is a little farther advanced, it Avill be found 'b?.t he cannot, without much difficulty, direct either of his feet precisely to any exact point; .nd very soon after, both thighs and legs lose their sensibility, and become gradually paralytic. When an adult is thus affected, the progress of the distemper is much the same, but more rapid. Arrived at this state, whatever be the age or sex of the patient, complaint is made of twitch- ing and frequent pains in the thighs, particularly when in bed, and of uneasy sensation at the pit of the stomach; when he sits on a chair or a stool, his legs are almost ahvays found across each other, and drawn up under the seat; the power of walking is soon afterwards lost. The true curvature is usually from within outwards; sometimes on one side, and sometimes there is a coun- ter curvature resembling an S. This curve of the spine varies in situation, extent, and degree, being either in the lower, or, more rarely, in the upper part of the loins; sometimes comprehending one vertebra only, sometimes two, three, or more; by which the curve becomes ne- cessarily more extensive: but, whatever variety these circumstances may admit, the lower limbs most fre- quently feel the effect. The arms are said to be some- times paralytic; and a feAv instances are said by Dr. Motherby to have occurred, in which both legs and arms Avere affected. The effect is also different in dif- ferent subjects: some are rendered totally and ab- solutely incapable of walking very early, or soon after the appearance of the curvature; others can move with the help of crutches, or by grasping their thighs just above the knees with their hands : some can sit in an erect posture or in a chair without much fatigue; others are incapable of it for any time: some have such a de- gree of motion in their legs or thighs, as to enable them to turn and move for their own convenience in bed; others cannot move Avithout assistance. When a naturally weak infant is the subject, the curvature is in the vertebrae of the back: it is hot un- frequently productive of additional deformity by gra- dually rendering the whole back what is vulgarly called humped; and by subsequent alterations, such persons are shortened in their stature, and debilitated in their constitution; but in all cases where this effect has been gradually produced, Avhatever alteration made in the disposition of the ribs and sternum may contribute to such deformity, it will always be found that the curvature of the spine appeared first, and Avas the chief complaint. Such curvatures, hoAvever, do not produce paralysis in either extremity. The reason is, that, in general, the angle is less acute, so that the nerves are not injured; but should any be compressed, their fibres in these central cavities are so much intermixed in plexuses and ganglia, that the parts are Aveakened only, and their functions impaired, not destroyed. The chief inconveniences arise from the subsequent contraction of the chest and abdomen. The general health of the patient does not seem, at first, to be materially affected; but when the disease has continued some time, and the curvature is thereby increased, many inconveniences and complaints folloAV. When the incurvation is in the neck, and to a consi- derable degree, by affecting several vertebrae, the child finds^ it inconvenient and painful to support its head, and is ahvays desirous of laying it on a table or pilloAV, to take off the Aveight.—When in the dorsal vertebrae, there are a difficulty of breathing, loss of appetite, indt- DIS 573 D I S gestion, dry cough, quick pulse, what is styled tight- ness at the stomach, obstinate constipations or purg- ings, involuntary flow of urine and faeces, Avith the addi- tion of Avhat are called nervous complaints. An adult, in a case where no violence hath been com- mitted or received, usually complains first of weakness in his back bone, accompanied Avith a heavy dull pain, and great lassitude : this is soon followed by an unusual sense of coldness in his thighs, independent of the wea- ther or any obvious cause: his limbs are soon aftenvards affected Avith an unusual sensibility, and frequently con- vulsed by slight spasms, particularly troublesome in the night. Soon after this, he not only becomes incapable of Avalking, but his power of retaining or discharging his urine or faeces is considerably impaired. The adult, as Avell as the child, complains constantly of a tightness and pain at his stomach, and he finds all the offices of his digestive and respiratory organs much impaired. The loss of motion in the limbs, which generally ac- companies a distorted spine, proceeds from this distor- tion. Until the curvature is discovered, the complaint is considered as nervous; but when the state of the ver- tebrae is known, it is attributed to some previous blow, fall, or other accident. In some few instances these may have produced the effect; but, in the majority, some predisposing cause, in Avhich the very essence of the disease consists, may be found; and this is a distem- pered state, generally an inflammation of the ligaments and bones, where the curve soon after makes its ap- pearance. This occasions the ill health of the patient, and in time the curvature. The helpless state of the limbs is the consequence only. It has been supposed that there is a dislocation of the vertebrae ; but the spine bends forward only because the diseased bones, intervening betAveen the sound ones, are unable to bear the parts above. From every circum- stance it is evident, that the complaint arises from a ■scrofulous indisposition affecting the parts that com- pose the spine, or those in its immediate vicinity: this morbid affection shows itself in a variety of forms ; but they, in every Instance, determine the true nature of the distemper. Sometimes the deformity of the spine oc- curs, without any apparent disease of the bones com- posing it; sometimes the deformity is attended with erosion, or caries of the body of one of the vertebrae; and the same bones are occasionally found to be carious, without any crookedness or alteration of figure. Stru- mous tubercles in the lungs, and a distempered state of some of the abdominal viscera, are often attendants of this complaint. When these complaints are not attended with an al- teration of the figure of the back bone, neither the real seat nor true nature of the distemper is pointed out by the general symptoms, and they are frequently un- knoAvn while the patient lives. \Yhen the ligaments and cartilages of the spine become the seat of the dis- order, Avithout any affection of the vertebrae, the whole spine, from the loAvest vertebra of the neck doAvmvards, gives way laterally, forming a great curve on one side, sometimes a more irregular figure, attended Avith many marks of ill health. The attack is occasionally on the bodies of some of the vertebrae; and ulceration, with erosion of the bones, is the consequence. This ero- sion of the bones often produces the curvature peculiar to the disease, by Avasting the body of each vertebra affected; and then the spinal processes of the diseased vertebrae protuberate behind, in consequence of ne de- cay of their fore parts. When the dorsal vertebrae are attacked, the sternum and ribs, for Avant of proper sup- port, necessarily give Avay, and additional deformity is produced. It sometimes happens that internal abscesses and collections of matter are formed near the spine, which, affecting the spine with caries, and proceeding outward, produce what is called a psoas abscess, and destroy th? patient. If Ave carefully examine this disease, it will be found, as Ave have said, to originate from a scrofulous habit, perhaps from a disease of the ligaments, and particular- ly inflammation of the vertebrae themselves. What we style inflammation of the bones, differs from that of the softer parts. It is rather a slight increased action of the vessels, soon destroying their vital principle, probably from pressure, as distention is not admissible. The bones, thus partially destroyed, are pressed on unequal- ly, and deformity necessarily ensues. When the outside of the vertebra is decayed, there is little change; for the flexors of the trunk are strong, and a slight stooping soon relieves the diseased part. When decayed Avithin, to preserve the equilibrium, the neighbouring vertebrae start out. When the disease is on either side, the cur- vature is on the opposite, but the curvature on the side is seldom alone. To prevent uneasiness, the patient re- clines to the opposite side, and this produces the coun- ter curvature, formerly described. It will be obvious that the nerves coming from the diseased bone will be compressed by the curvature; but this compression is not complete, and, like all imperfect compressions, is attended with irritation. Thus the early compression in hydrocephalus appears with all the marks of irritation. This is the reason Avhy the pa- ralysis, from curved spine, is attended Avith spasms, and differs, as Ave shall soon mention, in this essential cir- cumstance, from other paralyses. There is another circumstance of some importance, Avhich Ave must add. If from tonics, or any general plan of restoring strength, the general health is amend- ed, Avhatever remedy is directed to the spine, the dis- ease is relieved, and often when no application is made. This, though not an isolated fact in nervous compres- sions, is yet difficult of explanation. It may arise from anastomosis of nerves; but we know not that nervous influence is retrograde or lateral. We suspect, there- fore, that the nervous energy, like the arterial, is in- creased when any obstacle has been interposed; and by this increase the functions are, at least in some degree, restored. Mr. Pott observes, that, in compliance with custom, he hath called this disease a palsy ; but that, notwith- standing the limbs be rendered almost totally useless, yet there are some essential circumstances in Avhich this af- fection differs from a nervous palsy : the legs and thighs are rendered unfit for all the purposes of loco-motion, and have lost much of their natural sensibility ; but they have not the flabby feel of a truly paralytic limb, that seeming looseness at the joints, nor that total incapacity of resistance which admits of motion in almost all direc- tions : on the contrary, the joints have frequently a con- siderable degree of stiffness, particularly the ankles, so that the feet of children are generally pointed doAvn- wards ; and they are prevented from setting them flat DIS 574 D 1 S on the ground: the legs of the patient are either constantly kept stretched out, and considerable force is required to bend the knees, or they are by the ac- tion of the stronger muscles drawn across each other, and require as much to separate them. When the leg is in a straight position, the extensor muscles act so powerfully as to require a considerable degree of force to bend the joints of the knees; and when they have been bent, the legs arc immediately- and strongly draAvn up, Avith the heels towards the buttocks; by the rigidity of the ankle bones, added to the spasmodic ac- tion of the gastrocnemii muscles, the patient's toes are pointed, as we have said, dowmvards in such a manner as to render it impossible for him to put his feet flat on the ground; which makes one of the decisive charac- ters of this distemper. Thus the marks of distinction betAveen this disease and the palsy are sufficiently strong to shoAv the impropriety of confounding them, and from the slightest attention the two diseases may be easily distinguished. The restoration of the spine to its natural figure de- pends much on the early administration of the help pro- posed : though the distemper may be so far cured, as the patient may recover the use of his limbs, yet it is seldom possible to correct the curvature of the spine; and if the bodies of the vertebrae become completely carious, and the intervening cartilages are destroyed, no assistance is to be expected from any remedies. After the discharge produced by art for the removal of this disorder hath continued for some time, the patient begins to feel better health, he gradually recovers his appetite, is refreshed by his sleep, hath a more quiet and less hectic pulse; but the chief relief is from the loss of the distressing tightness about the stomach : in a little time aAvarmth and sensibility are felt in the thighs, to Avhich the patient hath been long a stranger; and nearly about the same time the poAver of retaining and discharging the urine and faeces begins to be in some degree exerted. The first return of the poAver of motion in the limbs is rather disagreeable, as it is in- Voluntary and spasmodic, principally in the night, and generally attended with .sense of pain in all the mus- cles exerted. At this point it is not uncommon for the patient to remain for some time Avithout making far- ther progress: this in adults occasions impatience, and in parents despair; but in the milder cases, the poAver of voluntary motion generally soon follows the involuntary. The knees and ankles by degrees lose their stiffness, and the patient can set his feet flat upon the ground—a certain mark that the poAver of walking will soon fol- low. The joints, no longer rigid, are weak; and the first voluntary motions are liable to great variation, from a number of accidental circumstances, both external and internal. The first attempts to Avalk are feeble, irregu- lar, and unsteady, and bear every mark of nervous and muscular debility ; but from this point no instance hath occurred in Avhich the full power of walking Avas not soon attained. When the patient can first walk, either Avith crutches or between two supporters, he is gene- rally unable to resist or overcome the more powerful action of the stronger muscles of the thighs over the Aveaker, by Avhich his legs are frequently brought invo- luntarily across each other, and he is suddenly thrown doAvn. Adults find assistance in crutches, by laying hold of the chairs or tables; but for children a go-cart is the best assistant: it should reach up to the arm pit, and enclose the Avhole body. This takes off all inconvenient Aveight from the legs; and, at the same time, enables the child to move them as much as it pleases. Or the instrument of Mr. Jones should be worn, Avhich, in all cases, Avould be serviceable, and in many a perfect cure, as it acts by taking off the superincumbent Aveightfrom the diseaseel vertebrae. See his Essay on Crookedness. While the curvature of the spine remains undisco- vered or unattended to, the case is generally supposed to be nervous ; and nervous medicines are as generally administered, Avithout advantage. When the case is known, recourse is too frequently had to steel stays, swings, screAv chairs, 8cc. to restore the spine to its na- tural figure ; but still the patient grows unhealthy, and, languishing under a variety of complaints, dies in an ex- hausted, emaciated state. The remedy for this dreadful disease consists merely in procuring a large discharge of matter by suppuration, from underneath the membrana adiposa on each side of the curvature, and in maintaining such discharge until the patient shall have perfectly recovered the use of his legs. The effect of drains in all inflammations is well established ; and it matters not by Avhat means the dis- charge is procured, provided it be large, and from a suf- ficient depth. In general, an eschar is made on each side of the curved part of the spine with a caustic: it should be of an oval shape, about an inch and a quarter in length, and three quarters of an inch in breadth, at the broadest part. Apply each caustic near the side of the curvature, so as to leave the portion of the skin covering the spinal processes of the protruded bones unhurt, and so large that the sores upon the separation of the eschars may easily hold, each, three or four peas in the case of the smallest curvature, but in large curves at least as many more. A few days after applying the caustics, the sloughs begin to loosen: it is then proper to cut out all the middle, and put into each a large kidney bean: when the bot- toms of the sores are become clean in suppuration, sprinkle now and then a small quantity of finely pow- dered cantharides on them, by which they are prevented from contracting, and the discharge is increased. The issues should be kept open until the cure is complete; that is, until the patient has not only the perfect use of the limbs, but also his former good health. By means of this discharge, the inflammation is checked, and the car- tilages between the bodies of the vertebrae having been previously destroyed, the bones are united Avith each other. No degree of benefit, nor any tendency towards a cure, is to be expected until the caries be stopped : the larger the quantity of bones diseased, and the greater the degree of Avaste committed by the caries, the greater must be the length of time required for its correction, and for restoring to a sound state so large a quantity of diseased parts. Nothing can be more uncertain than the time required to accomplish a cure: sometimes it is perfected in two months, and at others it requires two years ; in the last circumstances, tAvo thirds of the time have passed without any sensible amendment. The discharge by means of the issues is principally requisite for the cure; yet every assisting means should be applied at the same time, in order to expedite it, such as the bark, cold bathing, frictions, 8cc. Yet, as we haye already observed, general tonics and sea bathi:u- J) i U 575 D I U have at times effected the cure Avithout the issues; and in that case, nature, unassisted, restores the use of the limbs. In the course of lecturing, in the year 1781, Mr. Pott observed, that it seems to be one of the feAv things that Ave may reason upon a priori, viz. that the whole train of the various symptoms of this disease are derived ori- ginally from a constitutional predisposing cause; for, whenever, in a curvature of the spine, the discharge begins to have any effect, the lesser symptoms, if they may be so called, as pain in the stomach, tightness across the breast, incapacity of holding the urine or faeces, all give Avay, before the removal of the lameness from the curve begins to take place. It is to be observed, a curvature of the spine may take place from the mollities ossium, the rickets, and from other causes of caries. An aneurism often pro- duces a caries iii the bones; so an aneurism near a ver- tebra may render it carious : the venereal disease some- times attacks the vertebrae, and produces the same effect. The scrofula is said to be the constant cause of the an- gular protuberance, attended with a useless state of one or more of the extremities: but may not any cause, that produces a caries in the vertebrae, occasion the an- gular instead of the curved appearance of the spine ? and Avhen the carious vertebra happens, so as that it is nearly destroyed, may not all the same symptoms pro- ceed from its destruction, though the causes of the caries were various ? See Pott's Works on this subject; Jones's Essay on Crookedness; Select Cases of the Disorder commonly called the Paralysis of the LoAver Extremities, by John Jebb, M. D- edit. 2; Bell's Surgery; Lond. Med. Jour- nal, vol. vi. p. 358; Earle on the Distorted Spine. DISTO'RTOR O'RIS MU'SCULUS,(from distor- queo, to wrest aside). See Zygomaticus minor mus- culus. DISTRA'CTIO,(from distraho, to draw apart). In chemistry it is a forcible division of substances before united, either by separation or calcination. DISTRIBU'TIO,(from distribuo, to divide). Dis- tribution. It sometimes implies separation. In me- dicine it relates to the nutricious juices, and is the same as anadosis, the distribution of aliment over the body ; or to the excrements, and is then the same as diachoresis, or diachorema. DISTRICHI'ASIS, (from hs, double, and $et%, a hail). Distichia, distichiasis. A disease of the eyelid, Avhich consists in its having a double row of hairs, or at the least supernumerary ones. Galen, and .Etius. See Trichiasis. DI'STRIX, (from the same). The hair growing smaller and smaller. DIURE'SIS, (from fox, by, and ovgov, urine,) the ex- cretion of urine. It also signifies a diabetes. DIURE'TICA. Diuretics, (from hx, by, and ovpov, >ift»«, acrid, and «, «?»?, an ear). A pelican, or circulating vessel, with TWO HANDLES OR EARS. DYSiESTHE'SIA, (from hs, difficulty, and xifSx- ■iofixi, to f el or perceive). A dullness of sensation, or faulty sense. Under this term, Dr. Cullen forms his first order of his fourth class locales ; though in the enumeration of the species he has not adhered closely to the definition. Diseases of this order are synony- mous with hallucinationes, according to this author, and are considered as complaints.whose principal symptom is a depraved or erroneous imagination. He defines them, the senses depraved or destroyed from some de- fect or fault of the external organs. Privativi are re- duced to this head. DYSA'LTHES, (from hs, difficulty, and xX6u, to cure). Difficult of cure. DYSANAGO'GOS, (from hs, and xvxyu, to sub- due). An epithet for tough viscid matter, which is Avith difficulty expectorated. DYSCATAPO'TIA, (from hs, and xxlx-nva, to drink). A difficulty of SAvallowing liquids, Avhich Dr. Mead thinks a more proper term than that used for ca- nine madness, viz. hydrophobia, as it is more particu- larly descriptive of the affection under which the un- happy patients labour; but, in reality, they rfr^arf water from the difficulty of SAvallowing it. DYSCINE'SIA, (from fovs, and xiveu, to 7nove). Dif- ficulty of- motion, from faulty or defective organs : also termed intemperies. This is the third order of Dr. Cul- len's class locales—defined, motions impeded or deprav- ed from the fault of the organs. DYSCRA'SIA, (from hs, and xepxvwfM, to mix). Dyscracy. An ill temperament or habit of the blood and humours, as in the jaundice and scurvy. DYSCRI'TOS, (from hs, and xgins, crisis). Dif- ficult to be brought to a crisis, or brought to an imper- fect crisis. DYSECGL'A, (from hs, difficult, and xxova, to hear). Deafness, called also cophosis. Dr. Cullen places this genus of disease in the class, locales, and order dyses- thesia, which he defines, hearing diminished or abolish- ed. He points out two species : 1. Dvsecce'a organica, from a fault in the organs, by Avhich sound is transmitted into the internal ear. 2. Dysec$,as beset with prickles). Crocodilion, acanthalruca, scabiosa carduifolia, sphero- cephala elatior, globe thistle. Echinops spheroce- phalus Lin. Sp. PI. 1314. It is raised in our gardens. The root and seeds are moderately diuretic, but not used. ECHI'NUS. A hedge hog; qcanthion. In botany, those plants or parts of plants Avhich are beset very close- ly with spines; or the prickly head or cover of the seed. Echi'nus mari'nus. The sea hedge hog or ubv chin. See Amygdaloides. ECHI'TES CORYMBO'SA. See Caoutchouc E'CHOS, (from *!%«s, sound). See Tinnitus au- rium. E'CHYSIS,(from exxvu, to pour out). See Lipothy- MIA. ECLAMPSIA TYPHO'DES. See Raphama. ECLA'MPSIS, (from exXx^a, to shine). It is a ECP 592 EOT flashing light, or those sparklings which strike the eyes of epileptic patients. Coelius Aurelianus calls themcir- culi ignei. Though only a symptom of the epilepsy, Hippocrates uses the term for the disease itself. Dr. Cullen places it as a synonym with epilepsia, and adds, "that Vogel and Sauvages distinguished an eclampsia as an acute disease from epilepsy, Avhich they consider a chronic one; but as it is very difficult every where to place accurate limits between acute and chronic diseases, and as the eclampsia of Sauvages will exactly agree, for the most part, as Avell in the causes as symptoms, with epilepsy, I could by no means arrange it in a different genus from epilepsy." ECLE'CTICA MEDICI'NA,(from exXeyu, to elect). Archigenus, and some others, selected from all other sects what appeared to them to be the best and most rational; hence they were called eclectics, and their me- dicine, eclectic medicine. Boerhaave's system is of this kind. ECLE'CTOS, ECLE'GMA, and ECLEI'CTOS, (from Xeix*>, to lick). See Linctus. ECLY'SIS, (from txXvu, to dissolve). An universal faintness. ECMA'GMA, (from expxG-ra, to form together). See Crocomagma. t ECPEPIE'SMENOS, (from exme&, to depress or p7-ess outward). An epithet for ulcers with protuberat- ing lips. ECPHRA'CTICA,(from ex, and ?, and porxu, to eat, because stags are fond of them). See Pastinaca sylvestris, and Sisarum. ELAPHOPI'LA, (from eXxtyos, a stag, and pilus, hair). See Cervus. E'LAPS. A serpent, whose bite produces a disor- der like the iliac passion. E'LAS MA'RIS. See Plumbum ustum. ELA'SIS, and ELATER, (from eXxwu, to impel). See Elasticitas. ELA'SMA, (from the same). A lamina or plate of any kind; though used to express a clyster pipe. See Enema. ELASTFCITAS, ELA'SIS, ELA'TER. Elasti- city, (from the same). It is the property in bodies by Avhich they restore themselves spontaneously to the figure and dimensions which they had lost by pressure or extension. E'LATE. The vagina, which incloses the flowers and rudiments of the great palm tree. E'late thele'ia. See Abies. ELATE'RII CORT. See Thuris cortex. ELAT'ERIUM ; a Avord often used by Hippocrates to express an internal application of a digestive or a detergent nature. The inspissated juice of the wild cucumber. See Cucumis agrestis. ELATHE'RIA. See Thuris cortex. ELAT1NE, (from eXxvav, as the smaller species). . intirrhinum elatbie Lin. Sp. PI. 851. The leaves of this plant are rough and bitter to the taste; and Avere for- merly recommended internally as an antiscorbutic, and applied externally to heal old ulcers. ELA'TINUM O'LEUM. The name of an oil in Dioscorides. E'LCOS. SeeCATAGMA. ELCO'SIS, (from 'eXxos, an ulcer). Numerous, or large chronic ulcers, carious, fetid, and attended with a sIoav fever. ELECTA'RIUM, vel ELECTUARIUM,(from eli- go, to choose, or rather lackata, from laack, Heb. to lick up, or the Greek word Xeixu, to lick). An electuary. An electuary is of the same consistence and materials as a bolus; and where the accuracy of the dose is not essential, and a frequent change unnecessary, it is preferable to the bolus. In electuaries, when kept in the shops, medicines which will ferment or combine in new forms must be avoided. Nauseous medicines can- not be easily taken in any electuary, and, for these, pills are preferable. The latter is also the more convenient form for many metallic preparations. If electuaries are too hard, they candy; if too soft, they ferment. When soft, they are called opiata. The lighter powders re- quire thrice their weight of honey, and twice the weight of common syrup; but to prevent drying too fast, a little conserve should be added. Deyeux recommends pre- viously crystallizing the sugar in the syrup, or, at least, separating as much of it as will crystallize. The re- mainder will form electuaries not subject to this incon- venience, since the drying depends on the crystalliza- tion of the sugar. Treacle is not subject to this incon- venience. Extemporaneous electuaries should not exceed two or three ounces, half of which is conserve: but this is not a fixed rule, for the consideration of how much of the medicine can conveniently be given for one dose is sometimes to be attended to; when the ingredients are unpleasant, the taste is best covered by mucilage, or a solution of liquorice juice. Mucilage is Avell adapted for the exhibition of powders. See Lemery's Universal Pharmacopoeia. ELECTIVEATTR ACTION,(from eligo, to choose,. or select). This term has been usually applied to che- mical affinities; but as we have employed it in physio- logical discussions, we shall state the foundation on Avhich we rest. This poAver is chiefly observed in the absorbent sys- tem. There is little doubt but that, on the surface, noxious vapours and noxious fluids are not taken up ; and, apparently, when watery fluids are not wanted, even water is not absorbed. In many cases, when the introduction of medicines into the circulating system was thought necessary, numerous experiments were made to discover whether the chyle was impregnated with remedies given to dogs. These, though sought for at different periods, after having been taken, were seldom found. Thus we have an additional proof of the superintending poAver of nature to guard the constitution against injury; since, as Ave have had occasion to remark, the most innocuous fluids in- jected into the blood vessels occasion the most fatal symptoms. How far this choice prevails we are not informed. In Dr. Alexander's experiments, bark and nitre seem to have been conveyed to the blood, as they appeared in. the urine. Even at the first vieAV, these experiments- ELE j95 ELE appear inconclusive, and other more accurate observers have not supported his opinion. This elective power appears equally striking in the stomach and intestines. Food the most strange and singular is sometimes longed for, particularly in fevers, about, or after, their crisis; and the desire may be in- dulged with little injury. The mildest foods are often, by an apparently similar caprice, rejected by this organ and the intestines. In the glandular system we perceive a similar election. The fluids pass through the kidneys often in small and inefficient quantities, apparently from the presence of some medicine which they repel; for, if that is disused, the secretion returns. In this case we find all the other symptoms of a noxious mat- ter; the functions are disturbed, the mind agitated, and fever excited. These symptoms are sometimes owing to an excess of stimulus, which, in weak organs, pro- duces irregular action; but more frequently to the re- pulsion of the fluids, for where there is attraction, re- pulsion is also found. Why medicines affect a parti- cular gland or injure the stomach, though inoccuous in the eye, is a subject not connected with the pre- sent, and will be spoken of under the article Secre- tion ; and occasionally mentioned as a specific sti- mulus. ELE'CTIO, (from eligo, to choose). Election; that part of pharmacy which consists in a knowledge of the materia medica, and directs the choice of drugs, dis- tinguishing the good from the bad. ELECTRICITAS; electricity, (from r,Xexrpov, am- ber). The quality which amber possesses of attracting light bodies when rubbed, has expanded into conse- quences the most extensive, and results the most im- portant: it has become the science of electricity; has draAvn thunder from the clouds; and, in the hands of philosophers, may deprive earthquakes of their destruc- tive poAver. Our province is more humble: it is to trace its poAvers in a little microcosm, in a limited circle, Avhere we once hoped to find it a sakitary guardian; but where it appears only, if not a harmless, at least not a beneficial agent. We must not detail the principles of this science, or enlarge on contending systems. It will simplify our language if avc consider positive electricity as the ex- cess, and negative as a deficiency, of this fluid: the for- mer' as the excess of uncombined electricity, the latter ;*s a deprivation of the due or necessary quantity. A theory of this kind avc could render equally probable ' with any other; but it is unnecessary, since the facts may be readily translated into a more fashionable lan- guage, if such a translation be recjuired. In the vieAV we have just offered, each body has its proportionate share of this fluid, Avhich may be increased or diminished; but, in either case, the equilibrium is only restored with some violence, called a shock; though it may more silently take place by appropriate means, to be aftenvards described. This share is determined by the nature of the body; but is, in general, greater or less as the body is a conductor or a non-conductor; i. e. that it has a power of conducting any excess of electri- city to its common reservoir, the earth, or of confining it to its own substance. Thus metals and fluids are powerful conductors; any dry bodies, particularly vitre- ous ones, non-conductors. The human body is, in ge- neral, a conductor, as consisting of fluids, and commu- nicating Avith the earth by its surface, commonly moist- ened by the perspiration. It has been rendered highly probable, by an anony- mous author, i;i a collection of essays (Exeter Essays), that, on the conversion of any fluid to an aerial form, the electrical escapes; and, on the contrary, that when air is converted to a fluid, that it disappears ; probably, in the first instance^ separated from, and in the last combined with, the fluid. If this be true, in meteorolo- gical phenomena, as it seems to be, from a very care- ful induction from facts, it probably is so in physiology; and it is supported by some striking appearances. Thus the electricity of the human body, in its healthy state, is, like that of the generality of bodies, positive: such also is the electricity of the blood; but, in the animal econo- my, various functions continually go on, in which air is separated and carried off. The electricity, therefore, of the body must be constantly changing; and we, of course, find, as may be expected, that of some of the fluids negative. Such is the electricity of all the ex- crementitious fluids. Again: We knoAV that in confined air, in heated and crowded rooms, these aerial changes are more consider- able; and it is consequently not uncommon, in such circumstances, to find the electricity of the Avhole body- negative. Such observations have, unfortunately, not been duly examined, and Ave must take advantage of incidental facts. The ignis fatuus is, we knoAv, inflam- mable air ignited by electricity. It flies from a person who pursues it, because the electricity of each is posi- tive; but Dr. Priestley has recorded an observation, where it seemed to folloAV the person, who had been long in a crowded room; and Ave learn from Mr. Read, (Phil. Transactions for 1794) that the electricity of the air, in such an apartment, probably from the perspira- tions of a numerous assembly, is negative. We may conclude, then, that the positive electricity of the body disappears in the animal process; but nothing is lost. It, perhaps, performs a most important office, which Ave can only at present guess at; but this is scarcely a place for conjecture. Let us, however, at once hazard it. The electrical fluid, by its union, elicits heat(Pictet sur le Feu, 108); and this fluid is nearly and intimately connected Avith the nervous poAver. The one is probably- occasioned, and the other supported, by the electricity that disappears. If a resinous, as Avell as a vitreous, electricity exist, in other words, two fluids of different and opposite pro- perties, the distinction appears to be immaterial in a medical vieAV. Each produces similar effects Avhen used as a remedy, and this consideration led us to adopt the simple language Avith Avhich avc introduced the subject. Electricity is employed in medicine chiefly Avhen ac- cumulated. If the communication with the earth is cut off, and the fluid accumulated in the body by the action of a proper machine, it is called simple electricity. If then the fluid is draAvn off, silently, by points, or more actively by rounded conductors, the electric aura, or electric sparks, are said to be draAvn. If the accumulated electricity be at once discharged, or, in other language, if the communication between the different sides of the electrical jar be suddenly restored, the shock is said to be produced. Electricity, in eacli instance, acts as a stimulus only. Simple electricity increases the circula- tion, accelerates the jet of blood in bleeding, increases •l G 2 ELE 596 JG L E perspiration, as Avell as the other secretions and the appetite. When the aura is gently drawn off, a slight stimulus augments the action of the vessels, from Avhich it is taken; when by rounded conductors, in the form of sparks, the stimulus is more considerable. When the equilibrium is suddenly restored, every fibre seems agitated. When slight it is felt in the fingers and Avrists only; when gradually more violent, the shock affects the elbows, the arms, and the chest. This hap- pens Avhen the equilibrium is restored, by touching the conductor with each hand; and, in this case, the fluid takes the shortest circuit, through the arms and breast, apparently passing through the nerves; for its effects are chiefly felt where they are more strictly tied down by their sheaths. When the stimulus is wanted in any particular part, the conductors are so placed as to convey the fluid necessary to restore the equilibrium through that part. The effects of the shock are said to be stimulant; but it is rather a violent concussion, Avith- out any discriminated or permanent change. It may be made so strong as to kill smaller animals; and, for a time, to deprive even a human being of his senses. When animals are killed by it, the irritability of the muscles is destroyed, an effect also occasioned by hy- drogen: sometimes an important blood vessel is ruptur- ed. If the shock be a stimulus, and destroy by excess of excitement, we might expect, that, in a less degree, it would prove useful as such. -It undoubtedly excites the action of a paralysed muscle, but produces no per- manent good effect; so that this mode of employing electricity is now almost wholly disused. In general, then, electricity must be considered as a simple stimulant; and it increases all the actions going on in the system, whether salutary or morbid. It pro- motes suppuration, and more firmly impacts the fluids in infarcted glands. But it also discusses tumours not .too firmly fixed, and assists the recovery of the nervous power of a debilitated organ. From this view of the subject, it will be obvious that electricity is chiefly useful in asthenic diseases, and in obstructions not yet insurmountable. It must be hurt- ful in inflammatory disorders ; Avhere, Avith an inflam- matory diathesis, there is a strong determination to any part; when the irritability is considerable, or the ob- struction firm, and of long standing. In febrile diseases, it has been seldom employed, ex- cept to terrify on the approach of intermittents; when, by the unexpected shock, it often succeeds. In infla7nmatio7is, it has been sometimes employed to discuss phlegmons; occasionally to relieve ophthalmiae. In both cases the shocks are inadmissible. In the for- mer sparks may be drawn; but, in the latter, the points tinust be used to solicit the aura. In the tooth ach it has been also sometimes employed, as well as in the ■gout and in inflammatory cynanche, but with very little effectual relief; and it is now, in general, disused. The chief complaints in which advantage from elec- tricity has been expected are the palsies. It was first used at Geneva; and was said to have cured a lock- smith and one other person of haemiphlegiae. It is now Avell knoAvn, that the relief obtained by each Avas tem- porary only; and though it continues to be employed, generally in the form of shocks, its utility is inconsider- able and temporary. In many instances it has cer- tainly been injurious. In the more partial palsies, drawing sparks has been occasionally beneficial, though in no considerable de- gree: and the power of debilitated organs, as of the eye in gutta serena; Of the ear in deafness; or of a palsied muscle, has been sometimes, in part, restored. Elec- tricity has been also tried in chronic rheumatism, a species of palsy, and in amaenorrhcea. Slight shocks, in each, have been sometimes useful. In the last com- plaint, the fluid must be directed through the pelvis. We have sometimes succeeded in procuring a return of the menses by these means; but we have more often produced leucorrhcea. Electricity has been also often employed to restore suspended animation from apparent drowning, and is supposed to be a powerful and ef- fectual remedy; but we have never found it of the slightest use. A physician at Brunswick, M. Friske, has directed the shocks, through the abdomen, to kill the tape Avorm; in which he thinks he has succeeded. On recurring to the authors on medical electricity, in almost all we observe a very prudent remark, that dur- ing its course the proper medicines are by no means to be omitted. ELECTRO'DES, (from vXexrpov, amber, and etfos, likeness). An epithet for stools which shine like amber. ELE'CTRUM, (from eXxu, to draw, because of its attractive power. Amber. (See Sucoinum.) It is also a mixture of gold Avith a fifth part silver. Ele'ctrum minera'le; a mass of tin and copper, with double its quantity of martial regulus of antimony, melted together. This mass, powdered and detonated with nitre and charcoal, powdered again Avhile hot, and then digested in spirit of wine, produces a tincture of a fine red colour, accounted a deobstruent. ELECTUA'RIUM e SE'NNA. See Senna. ELE'GMA, (from Xeix&, to lick). See Linctus. ELELI'SPHACOS, (from eXei^u, to distort, and o-q>xxos, sage,) the name of a species of sage, from the appearance of its leaves and branches curling spirally: its virtues are the same with those of sage. See Salvia. ELEME'NTUM. Element, (quasi elicimentum, quod omnia ex iis elicita sunt et extracta). A simple body, from Avhence any thing is first constituted, and which may be resolved into parts not of a different nature, but homogeneous. Empedocles and Aristotle acknowledged as elements, air, earth, fire, and water; an. opinion noAv proved fallacious. Paracelsus, with other chemists, considered earth, salt, sulphur, and mercury, in the same sense; but these are allowed to be the result of theory without the support of experiment. Principles which cannot be subdivided by art are called elements or first principles; and the principles made up of these, secondary principles. Some writers carry this order much further; but it must be confessed, no means have yet been devised to shoAv, unequivocally, Avhether any such subordination of principles exists. , We may indeed discover the component parts of bodies, but Ave know nothing of their arrangement; and what are considered at one time as the simplest form of bodies, are at others found to be compounds. Hence it is said that the word ought not to be used, but as an ex- pression denoting the last term of our analytical results. Galen observes, that the element is the smallest and most minute part of any thing Avhose element it is. But the Avord elements, in a figurative sense, is used for the principles and foundations of any art or science, as ELE $97 ELE Euclid's elements, the elements of chemistry, elements of medicine: sometimes, as in Haller's great work, the Elementa Physiologiae, it implies the minutest compo- nent parts; while the abstract, or rudiments, are styled " First Lines." E'LEMI; called also icicariba, icica, and gum ele7ni, is a dry resinous substance, brought from the East In- dies and -Ethiopia; but an inferior sort is the produce of an olive tree in the Spanish West Indies; the amyris elemifera Lin. Sp. PI. 495. The elemi tree is also called myrobalanus Zeylanicus ; elemnifera Curassavica ar- bor ; kekuria. What is brought from the east is wrap- ped in flag leaves ; is softish, somewhat transparent; of a pale whitish yellow colour, inclining to green; inflam- mable, and of an agreeable flavour when melting; to the taste bitterish ; dissolving totally in rectified spirit of wine; and yielding, by distillation with water, about one ounce of essential oil from sixteen of the gum. Dr. Wright informs us that a resin, not apparently differ- ent from the elemi, is obtained fronuthe bursera gum- mifera Lin. Sp. PI. 471 ; the tree supposed to afford the simarouba. Of this resin, alcohol dissolves 0.94; and it contains also about 0.06 of essential oil. It is chiefly used as a digestive in the form of an ointment: the London college gives the following pre- scription, in which it is the chief ingredient.— Unguen- tum elemi, Ointment of Elemi. Take of mutton suet prepared, two pounds; of gum elemi, one pound ; of common turpentine, ten ounces. Melt the gum with the suet; and Avhen all is quickly removed from the fire, add the turpentine ; and, while the mixture is fluid, strain it. Arcaeus was its first prescriber, and it was formerly called linimentum vel balsamum Arcei. (See LeAvis's Materia Medica. Neumann's Chem. Works.) When two ounces of olive oil are added, it has been called un- guentum elemi compositum. It is the best of the terebin- thinate applications for encouraging a salutary diges- tion in ulcers. If to half a pound of this ointment one drachm of aerugo aeris is added, it becomes unguentum elemi cum arugine. The verdigrise must be mixed with a little oil, and gradually stirred into the ointment whilst in a melting state. This remedy has been long used as a stimulant to foul ulcers. ELEMNI'FERA CURASSA VICA A'RBOR (from elemi, and fero, to bear). See Elemi. ELE'NGI. A tall tree which grows in Malabar, and bears fragrant floAvers, esteemed for their cordial qua- lity. Mimusops elengi Lin. Sp. PI. 497. ELEOSELI'NUM, (from eAes, a fen, and e-eXtvov, parsley). See Apium. ELEPHA'NTIA, (from elephas, on account of the great enlargement of the body in this disease). An ana- sarca. Elepha'xtia A'rabum. In Dr. Cullen's Nosology it is synonymous with elephantiasis. The term is, how- ever, occasionally confined to this disease, Avhen it af- fects the feet. ELEPHANTFASIS; lazari 7norbus vel malum; Pheniceus morbus, is generally ranked as a species of leprosy (see Lepra Arabum); but is distinguished from the leprosy by being seated in the flesh, while the lep- rosy only affects the skin, or, at the most, the integu- ments. This disorder receives its name from its often affecting the legs, so as to make them resemble those of an elephant; but in many instances the legs are riot affected. Dr. Cullen places this genus of disease in the cla$s cachexia, and order impetigines, and defines it a con- tagious disease, wherein the skin is thick, Avrinkled^ rough, and unctuous, divested of its hair; the extre- mities insensible, with respect to feeling ; the face dis- figured with hard tumours, called tubera ; the voice hoarse and nasal. In different parts of the skin some- times arise fungi, having the appearance of mulberries or raspberries. Dr. Towne assures us, that negroes are very com- monly the subjects of this disorder, and that it bears a great affinity to the best account we have of the lepra of the Arabians. He says those are the most subject to it, who, after severe acute fevers, long continued inter- mittents, or other tedious diseases, are either much ex- posed to the inclemency of rainy seasons, and the cold dews of the evening, or Avho are constrained to subsist on bad diet. On the first attack the patient complains of shiver- ings; these continue a feAv hours, and are succeeded by a pain in the head, back, and loins; a nausea and vomiting soonTollow, with pain in one of the inguinal glands (never in both): a severe fever follows; the gland reddens, becomes hard, but seldom suppurates ; a red streak runs down the thigh, from the SAvelled gland to the leg, almost an inch broad, and of a flesh colour: this streak soon swells, and then the fever abates, and the matter is thrown upon the leg by an imperfect crisis. By degrees the leg is more and more tumefied, and the veins are formed into large varices, which are very apparent from the knee doAvnward to the toes. Soon after, the skin grows rugged and unequal; a scaly sub- stance soon forms on it, with fissures interspersed. These scales do not dry, but are daily protruded for- Avard, until the leg is greatly enlarged. Though this scaly substance appear harsh and insensible, if it is very superficially touched with the point of a lancet, the blood freely oozes out. Notwithstanding the monstrou> size of the diseased leg, the appetite remains good, and in all other respects the patient is healthy: many con- tinue in this state for twenty years or more, and make no other complaint than what the enormous size of the leg occasions. It rarely happens that both legs are affected. White people suffer from this disorder when in the same circumstances which produce it in the negro. The disease is infectious, and often found to be hereditary. The cure is uncertain : after cleansing the first pass- ages, warm diophoretics may be mixed with antimo- nials, and administered with the bark. The diet and mode of living should conduce to increase the vis vitae. Mercury is said to be injurious; but experience has occasionally shown its utility, when joined with the re- medies just mentioned. Aretaeus describes the elephantiasis Avith great ac- curacy. Towne is particular in the account of it. See Turner also in his Diseases of the Skin, and Brook's Practice of Physic. In the London Medical Transactions, vol. i. p. 23, is inserted a description of the elephantiasis, as it appears in Madeira, with the method which in one instance Avas at- tended with success. In this country the disorder appears at first in the form of tubercles on any or all parts of E L E 598 ELI the body ; in time they ulcerate : if they occur on the beard or eye brows, the hairs fall off; but this does not always happen on the head. The legs swell, and are hard; white scales cover them, and fissures occasionally appear, though the legs are sometimes emaciated and full of ulcers. The alae nasi are swollen and rough ; the cartilage of the nose sometimes destroyed; the lobes of the ears are swollen; the voice hoarse;, the nails are thick and scaly ; the skin Avhite, shining, and insensible; the breath offensive; the pulse weak and slow. Many other very disagreeable symptoms occur in different patients. None are observed to receive this disorder from others by contact; but generally the children of the diseased are subjected to it. It usually appears here as a chronic disease on the decline of life, and every circumstance shows a great deficiency of nervous power. We never saAv, in the few cases that have occurred to us, any advantage from medicine; but the bark, with the following embroca- tion and blistering, is said to have relieved after mer- curials and antimonials had failed. The following is the mode recommended: Applicetur emplastrum epispasti- cum nuchae. R. Cort. Peruv. pulv. 5 i ss. cort. radicis sassafrae pulv. | ss. syr. q. s. fiat, electar. cap. q. n. m. majoris bis in die. R.Spt. vinitenuior. g viii. lixiv. tart, g i. spt. sal am- mon. 3 ii. m. f. embrocatio qua inungantur partes af- fectae mane nocteque. The disease was, however, apparently mistaken, or the event unfaithfully related. The cause is often indigestion, and it has been at- tributed, in the island of Madeira, to the poison offish. Sometimes emetics, and in some instances cooling antiphlogistic medicines, are said to have been there serviceable. In the elephantiasis of the East (see Asia- tic Researches), white arsenic is said to have succeeded. Dr. Semplc advises mercury and antimony, with an embrocation consisting of eight ounces of spirit of wine, an ounce of aqua kali, with twice as much aqua am- moniae. ELEPHA'NTINUM EMPL. A plaster described in Oribasius. Celsus describes one of the same name, but very different in qualities. E'LEPHAS,(from the HebreAv term, eleph). In che- mistry it signifies aquafortis; in zoology, the large animal called an elephant; in nosology, the elephantiasis. ELE'RSNA. See Molybd^na. ELE'TTARI. See Cardamomum. Ele'ttari primum. See Amomum. ELUTHE'RIA. See Thuris cortex. ELEVA'TIO, (from elevo, to lift up). See Subli- .MATIO. ELEVA'TOR AURI'CULA. This muscle arises Irom the external termination of the frontal muscle, it be- ing formed of different fleshy fibres covering the tempo- ral muscle; and being thin and membranous, is carried over it; then growing narrower, is inserted into the upper part of the ear, bringing it upward and forward. Eleva'tor la'bii inferio'ris. See Levator labii inferioris. Eleva'tor labii superioris. See Levator labii superioris. Eleva'tor labio'rum. See Levator com- munis. Eleva'tor na'si ala'rum. These muscles arise from the top of the bone of the nose near the lachrymal cavity, with a sharp and fleshy beginning, and falling down towards its sides in a triangular figure, not much unlike the Greek letter A, run doAvnwards the length of the bone, and are inserted broad and fleshy into the alae nasi. Eleva'tor o'culi ; superbus, attollens, and rectus superior. This muscle rises from the bottom of the socket, near the hole which gives a passage to the optic nerve ; then passing over the upper part of the globe of the eye, is inserted into the superior and anterior part of the sclerotica. Eleva'tor pa'lpebr,e superio'ris. See Levator palpebra superioris. ELEVATO'RES A'NI. See Levatores ani. ELEVATO'RIUM, (from elevo, to lift up). An elevator. An instrument to raise a depression in the skull. ELHA'NNE A'RABUM. See Ligustrum Indi- cum. ELICHRY'SUM. Helychryson, (from »Xi<§h, the sun, and XPV™S, gold; from their shining yelloAV appearance). Goldylocks. It is a small, shrubby, downy plant, clothed with long very narrow leaves, producing on the tops of the branches several small round heads of bright yellow scaly flowers ; a native of the southern parts of France; floAvers in May and June, and holds its leaves all the Avinter. Elichry'sum, coma aurea, called also linaria au- rea, linosyris,virga aurea, conyza, gnaphalium luteum, and German goldylocks, gnaphaliwn stechas Lin. Sp. PI. 1193. It is cultiA'ated in gardens, and floAvers in May. The floAvers are said to be diuretic. Elichry'sum, called also chrysocome, coma aurea, GOLDEN MAIDEN HAIR, GOLDEN STCECHAS, GOLDEN Or yellow casidony, goldylocks, chrysoco7na coma aurea Lin. Sp. PI. H77. The flowers, naturally dry. and firm, retain their hgure and glossy yellow colour for years. Both the flowers and leaves, if rubbed a little, smell stromriy, and have the flavour of musk; but to the taste are Avarm, pungent, bitterish, and astringent. Water and rectified spirit take up their flavour in distillation and infusion. It is not much used in medicine, although it lias been esteemed as astringent and tonic. See Lewis's Materia Medica, or Neumann's Chemical Works. Elichry'sum montanum. See Gnaphalium mon- tanum ; g. dioicum Lin. Sp. PI. 1199. ELI'DRION. Rulandus says, it is mastich; mercurv; rapontic; or a mixture of silver, brass, and srold ELI'GII MO'RBUS. See Fistula. ELIQUA'TIO, Ehqation, (from eliquo, to. melt down,) an operation by which a more fusible substance is separated from one less fusible, by means of a heat sufficiently intense to melt the former, but not the lat- ter. 1 hus, an allay of copper and lead may be sepa- rated by applying a heat which shall melt the lead, but not the copper. ELITHROI'DES. See Testes. ELI'XIR, (from the Arabic term al-ecir, or che- mistry, an appropriate production of the chemical art,) sometimes, according to Lemery, called enchyloma. An . elixir is only a compound tincture. Eli'xir a'loes, and Eli'xir propriety tjs r«- tnolicwn. See Aloes. E M A 599 E3IB Elixir my'rrhje comp. and eli'xir uteri'num. See Myrrha. ELI'XIS, (from XeiX*>, to lick). See Linctus. ELIXIVIATIO, (from elixo, to boil). Elixivia- tion ; the operation by which a fixed salt is extracted from the ashes of vegetables, by an affusion of water. E'LLEBORINE. See Hellerorus niger hor- tens. E'LLEBORUS. See Helleborus. % E'LLOBOS, (from ev, in, and XoZos, a lobe). An epi- thet for such seeds or fruits as are in pods or lobes. E'LLY'CHNION, and E'LLYCHNIO'TOS, (from Xvx*°s, a lamp). The wick of a lamp or candle. These were made of the papyrus, of the fruit of the ricinus, Sec; used by the ancients instead of cotton. ELMI'NTHES, (from eiXeu, to involve ; from their contortions). , See Vermes. ELO'DES, from tXos, a swamp; from the great moisture attending it). This is a species of tritaeophya, or remittent fever, of the typhous kind, which usually terminates in fourteen or twenty-one days : it is epide- mic, though not strikingly contagious; and from the beginning of the disease, through its course, profuse SAveating attends. It differs from the sweating sickness, supposed to be peculiar to England, in its type, duration, and degree of debility. ELO'GIUM,forELLOGIUM, (from ev, and Xoyos, ratio). See Rf.vumoiatio. ELONGA'TIO,(from elongo, to lengthen out). See LuXATIO. ELOPHOBO'SCUM. See Cara Brasiliensibus. E'LITZ. See .Eris flos. ELUTRIA'TIO. Elutriation, (from elutro, to decant). This is an operation performed by washing solid substances with water, stirring them well together, and hastily pouring off the water, Avhile the lighter part remains suspended in the agitated fluid, that it may be separated from the heavier part. By this operation metallic ores are cleansed from the earth, stones, and other lighter unmetallic parts adhering to them. ELU'VIES, (from eluo, to wash out). The humour discharged in a fluor albus. Pechlinus. ELUXA'TIO. See Luxatio. ELYMAGRO'STIS, (from eXetftos, the herb panic, and xypuirlis, wild). See Panicum- E'LYMOS. The herb panic, (from eiXeu, to in- volve ; because its seeds are covered by an involucrum). ELYTHROI'DES or ELITHROIDES, (from eXev- rpov, vagina, and ei fos, form). The tunica vaginalis of the testis. Sec Testes. ELYTROCE'LE, (from eXvlpov, vagina, and xqXv, hernia). See Hernia vaginalis. ELY'TRON, (from eXvu, to involve, or cover). A covering or sheath. Hippocrates calls the membranes which involve the spinal marrow eXvlpx. EMACIA'NTES, (from emacio, to make lean). Dis- eases that occasion a wasting of the whole body. EMA'NSIO. Etmuller uses this word instead of suppressio, when speaking of suppressed menses. Emansio mensium, is the retention or absence of the menses beyond their usual period of appearing. See Menses deficientes. EMARGINA'TIO, (from emargino, to cleanse the edges,) cleansing a wound of the scurf about its edge. EMARGINA'TUS. Emarginate, (from e, front, and margo, margin,) deficient in its margin : Avhen ap- plied to the apex of a leaf, it signifies terminating in a notch, the margin being discontinued or broken. EMASCULA'TUS, (from emasculo, to castrate). See Malazissatus. EMBA'MMA, vel BA'MMA, (from pxirla, to im- merge, or dip,) apobamma. A sauce or pickle to dip victuals in. Mustard is a kind of embamma. It some- times means a slight tincture, and is applied to Avater in Avhich hot iron hath been quenched. EMBA'PHION. A cruet for containing embam- mas. E'MBASIS, (from ev, and pxiva, to go). See Dexa- MENE. E'MBLEG. See Myrobalani emblici. • E'MBOLE, (from et*.pxxxu, to put in). The reduc- tion or setting of a dislocated bone. See Luxatio. EMBORI'SMA. See Aneurisma. E'MBOTUM. A funnel conveying fumes into any part of the body. EMBRE'GMA, EMBROCA'TIO, (from et*Pptx*>> to moisten, sprinkle, or soak in). Embrocation, em- pluvium, embroche, and cataclysmus. It is an external fluid application, usually prepared of volatile and spi- rituous ingredients, and mostly used to relieve pains, numbness, or palsies. See Lotio. E'MBROCHE, (from ep.£pix*>, to make wet). See Emukocatio, and Fotus. EMBRONTE'TOS, (from /9f«»7*, thunder,) thun- derstruck. See Apopleutici. E'MBRYO. An embrio, (from ev, in, and Ppvu, to bud). A child in the womb; but Hippocrates con- fines the term to the child in its third stage, that is, be- fore it is complete. See Conceptio. Galen remarks that the Greeks did not call the foetus under two months old by the name of embryon, but named it cuema ; but others styled it embryon during the Avhole time of its being in the womb. Homer ap- plies the term embryon to the foetus of brutes, and Theophrastus to the seeds of plants; and they are fol- lowed by all the moderns. EMBRY'ONUM BALSAMUM vel SPT. It is a prescription of Bates; but in point of excellency is ex- ceeded by a mixture of the spirituous aniseseed Avater and simple cinnamon water, in equal parts. EMBRYOTHLA'STES, (from eptpvov, a fetus, and §Xxu, to break). An instrument to break the bones of a foetus, in order to its more easy delivery; or a crotchet for extracting a foetus. See Embryulcia. EMBRYOTO'MIA. Embriotomy, from ifJSgv*, a fetus, and refMu, ta cut). It is the division of the child Avhile in the Avomb, in order to its easier de- livery. EMBRYU'LCUS. (from e/*.Sgvov, a fetus, andeXxa, to draw). The instrument required for artificial delivery, or embryulcia. EMBRYU'LCIA, (from efiGgvov, a fetus, and eXxu, to draw). A hook for the extraction of a child when labour is difficult. In the present practice of midwifery, as circumstances vary, the foetus is drawn from the uterus by the blunt hook, the straight forceps, the curved forceps, or the crotchet: the latter would be fatal to the child, if alive, so that it is seldom employed E M B 600 K M E unless it is knoAvn to be dead ; but its delivery is only expedited and facilitated by the other three. The blunt hook is used Avhen the child presents with its breech, and the pains are not sufficient for effecting its delivery. In this case the hook is carefully to be fixed in the groin of the child, and, as the pains return nature must be assisted by gently pulling Avith the hook; but if much strength is required, it is still better to leave the delivery to the usual assistance of the hands only with the labour pains, because the hook may dislo- cate or break the thigh of the child. When the hook is used, it should be taken away as soon as the finger can be fixed in the child's groin. * The crotchets are used in the same manner as the forceps, except that the crotchet, having a hook at its point, is forced into the part to which it is applied. The straight forceps are used for bringing the head of the child forward, Avhen,by reason of its size, or the want of pains, it cannot otherwise be protruded ; but much care should be taken in using them. They are never to be employed while the head is above the brim of the pelvis, and indeed very rarely when it has de- scended loAver. Dr. Hunter absolutely forbids their use, if they can possibly be avoided, consistently with the safety of the child ; for, if time is allowed, the parts Avill dilate, and the head will be moulded so as to pass Avith the least possible violence. The forceps, as improved by Smellie, are the best; he reduced their length, to prevent their being used before the head is sufficiently low. They should not be applied before the ears can be felt, and previous to their use the following rules should be observed : 1. The external parts should be sufficiently dilated. 2. The exact situation of the child's head should be knoAvn; and this is best discovered by feeling one ear. 3. A finger should be in the os internum to guide the forceps, lest a part of the uterus itself should be in- cludedtin them. When the finger cannot be thus in- troduced, great care is required in passing the forceps along the side of the child's head. 4. The blades of the forceps should be well greased before they are introduced. 5. If possible, apply the blades over the child's ears; for thus they are placed on the narrowest .part of the head ; when this cannot be done, fix one before one ear, and the other behind the opposite one. 6. The forceps should be passed up in the direction of a line that may be supposed to pass through betwixt the navel and the scrobiculus cordis ; at the same time keeping the handles as far back as the perinaeum will easily admit. When the forceps are secure, pull them from blade to blade ; for otherwise they are apt to slip off. 7. The handles should be tied tight before the opera- tor begins to pull downwards with them ; and when the two blades are locked, the lock should be about an inch from the child's head. 8. As the child's head advances, the operator should alternately rest and pull Avhile the perinaeum is on the stretch, and until the vertex is brought from under the os pubis; then the handles of the forceps being gradu- ally raised towards the mother's belly, and the pulling repeated with caution, Avhilst with one hand the peri- nae urn is supported, the forehead will be freed from it. The forceps are iioav to be taken aAvay, and the delivery- finished, as is usual, with the hands alone. The different cases in which these forceps are requir- ed may be seen under the article PrjESentatio. The long curved forceps Avere invented by Smellie, with a view to save the life of the child, when, the body being delivered, the head could not be brought away in the usual manner. In this case the crotchet was for- merly used. These forceps are longer than the straight ones, because they are applied when the head of the child is above the brim of the pelvis; but as it can very rarely happen that where the buttocks have passed (es- pecially when doubled, as in breech presentations) the head will be detained, these instruments are scarcely ever necessary. Indeed, when the head is separated from the body, and left in the uterus, if the pelvis be much distorted, the long curved forceps may sometimes be preferable to the straight ones; but in this case, if the size of the head is lessened by emptying it of part of the brain, the delivery may generally be effected by one hand and one blade of a crotchet. Notwithstand- ing the advantages proposed by the use of the foregoing instruments, in some cases they are unavailing: it is then advised to open the head by the use of a large pair of scissors, with a stop put on the outward edge of each blade, about the middle; the inner edges of which are blunted downwards. These contrivances are, first, to stop the scissors before they are expanded in a proper situation, and to prevent cutting the vagina or uterus, in occasionally closing them. See Prjesen- tatio, cases Avhere the head presents, which will show the utility of these instruments more clearly. See the figures of these instruments represented in plate 5 of MidAvifery, No. 3, 4, 5, 6, 7, 15. E'MBULA. A pipe. EMBULA'RCHI SUFFUMI'GIUM. A suffumi- gation, described by .Etius. E'MERUS, also colutea, scorpioides major, and sena, scorpium, colutea humilis, colutea scorpioides humilis, colutea siliquosa minor, coronilla montana, and lesser scorpion sena ; coronilla emerus Lin. Sp. PI. 1046. It grows on hilly places; its leaves are cathartic, and poor people sometimes gather and use them for that purpose. E'merus America'nus. See Indicum. EME'SIA, EME'SMA, and EME'TOS,(frome^«, to vomit). The action of vomiting. EME'TICA, emetics, (from e&eu, to vomit,) ano- cathartica, and vo77iitoria ; medicines which excite vo- miting. The use of these medicines is so extensive, and their effects often so important, that they will justify our considering them at some length. The most simple vieAV Ave can take of emetics is, that they evacuate the stomach by the inverted action of its OAvn motions with those of the oesophagus, assisted by the contraction of the diaphragm and abdominal muscles. This alone is an object of no little importance when we consider the extensive influence of this organ, and the very danger- ous consequences Avhich arise from its acrimonious or vitiated contents. But the advantages do not rest here. The same inverted motion is communicated to the duo- denum, and, in some degree, to the inferior parts of the EME 601 E ME canal. Into this second stomach, as we have described it, the bile and pancreatic juice are poured; and, Avhile the joint action of the diaphragm and the abdominal muscles compress the gall bladder to evacuate its con- tents, the inverted motion of the duodenum and stomach evacuate it. Emetics, in this way, unite with cathar- tics in assisting the secretion and discharge of bile ; in relieving or preventing infarctions of the liver: for, while the latter promote the secretion by stimulating the ducts, the former contribute to the same purpose by an action more strictly mechanical. We have often had occasion to remark the extensive influence of the stomach in the animal economy, parti- cularly its connexion with the state of the brain and the extreme vessels. The first effect of emetics, in con- sequence of this connexion, is to produce a general re- laxation, approaching sometimes to faintness. In this state the extreme vessels sympathise and yield, with little resistance, to the force of the circulation. Per- spiration follows, which by the action of vomiting is still further increased; and, if this is kept up by other means, the most salutary changes are often produced. We perceive the connexion of the stomach with the head, rather in the morbid than the salutary effects. During the action of vomiting, the return of the blood from the head is impeded, and all its vessels are dis- tended; which has occasioned 6ome hesitation in the use of emetics, when these vessels Avere previously distended, as in apoplexy and palsy. In such circum- stances, however, we find the irritation on the brain communicated to the stomach, and vomiting excited. The agitation of vomiting has been considered as use- ful ; but this is a vague, indistinct indication. Medi- cines of this kind have, hoAvever, been employed Avhere obstructions have been suspected; and, in the brain, the alternate filling and emptying their vessels may contri- bute to excite and support their action. We see some traces of such an influence from their utility in nervous diseases, particularly in those attended Avith general languor, as hypochondriasis, and in obstructed menses ; but more strikingly in the good effects of very active emetics, particularly of vitriolated mercury in the cure of gutta serena. Another distant effect of emetics is more certain: their increasing the action of the ab- sorbent system. Their operation, in this way, is not easily explained, but such effects are well established ; and, on this account, Ave shall find them extremely ser- viceable, when Ave Avish to promote the absorption of purulent matter that we cannot with ease or safety eva- cuate. They cannot be employed to relieve the more extensive accumulations of dropsies. A very important effect of emetics, referrible in part to their action, and sometimes, perhaps, to the nature of the medicine, is their poAver of emulging the bron- chial glands. On the first access of nausea, we find a floAV of saliva, and a little discharge from the bronchiae ; but, when the emetic begins to act with some violence, this discharge is considerable; and no remedy is more poAverful in producing a complete evacuation of those glands, or relieving them from the infarctions of viscid mucus. In part, this effect may be owing to the medi- cine ; for we shall find some of the most active emetics to be expectorants also. Emetics are of very different kinds. Some are purely VOL. I. stimulant, as mustard, volatile alkali, and horse radish root. Others are sedative or relaxant. Opium, in large doses, acts as an emetic. Foxglove, tobacco, putrid substances, oil, and warm water, are emetics of different strength, nearly in their order. The greater number, however, act apparently by a peculiar stimulus. In some of these the stimulus is obvious; and, when the stomach is not affected, acts on other secretory organs. The principal emetics of this kind are the antimonial preparations, which affect the bowels, the skin, and sometimes the bronchial glands. The mercurials are similar in this respect; but the copper, zinc, and platina, Avhich in all their forms are emetic, seem not to affect any other glands. The acrimony of the squill and the seneka root is very general: they are not only emetics, but cathartics and expectorants. The asarabacca and the groundsel juice are more limited in their stimulant powers. The former, besides its emetic property, acts chiefly as an errhine, and the latter only on the intes- tines. The ipecacuanha is the connecting link between these more general stimulants and medicines, which. seem to act from a specific influence on the stomach. There are certainly emetics which may be referred to this head. The vitriols of zinc, already mentioned, not to separate the metallic substances, have little general stimulus; and the air of the lungs which, Avhen SAval- lowed, proves certainly emetic, is wholly without any- other power. Every nauseous taste tends to excite the action of the stomach ; and to this head may be referred the bitters, as wormwood, camomile flowers, the seeds of the carduus benedictus and broom. Putrid sub- stances, and the liver of sulphur, act apparently in the same way. Other causes of vomiting are more obscure in their action. Association of ideas is a mental operation ; yet a very frequent and certain cause of vomiting is, the re- collection of objects connected with the evacuation of the stomach at a former period. Motion in a circle, in a ship, or in an unaccustomed direction, has the same effect. The motion of a Avheel carriage, especially if the windows are closed, or the person sits in the back seat of a coach, will often produce vomiting. This effect, as connected Avith the changes in the common sensorium, must remain in obscurity. The principle on Avhich emetics act is not readily explained. It has been said that they are constantly sedatives; and, as plausibly, that they are always sti- mulant. Very powerful emetics belong to each class, yet, perhaps, a different principle influences their opera- tion. The affection of the stomach is apparently in- creased action ; but, in medicine, increased action is sometimes owing to a defect. It is, more obviously, irregular action ; and we might thus attribute vomiting to the principle we have already endeavoured to esta- blish, that irregular action is connected with a diminu- tion of tone. We certainly, in this Avay, approach, at least, very near the truth ; and the facts will in general support it. In every instance, hoAvever, except Avhere vomiting is owing to an affection of the brain, there appears to be a substance inimical to the constitution, which the sto- mach, influenced by. the vires medicatrices, attempts to discharge; and the necessary motions are conse- quently excited. Yet Ave must keep in our view, that languor and faintness, from any cause, will produce the 4 H E M E 602 EME same effect; and'we thus see why causes of extreme de- bility will equally excite this organ, independent even of the presence of any medicine, certainly by the interven- tion of any violent commotion. In this way may, pro- bably, be explained the experiments of those Avho have excited vomiting by injections of emetic medicines into the veins. In fact, every foreign substance in the blood vessels excites such commotions, with faintings and convulsions; nor is it surprising that the stomach should equally suffer. In general, then, the most active emetics are the most powerful sedatives; and the whole class of poisons, particularly the narcotic cathartics, are violently emetic. The motions of the stomach during the operation of emetics are, as we have said, inverted. This has been proved by ocular observation; and it is equally certain, that the action of the muscular fibres of the oesophagus is equally inverted. A nauseous draught, the repeti- tion of an emetic, will sometimes excite the action of the oesophagus only; and we once saw it so permanently excited by a crystal of emetic tartar sticking in it, that the mildest fluids could not, for a long time, pass into the stomach. The action of the fibres of the stomach surrounding the cardia is* in some instances, exclusively excited: as in those who discharge wind, a small por- tion of acid, of oil, or any substance swimming on the surface of the contents of the stomach, and producing cardialgia. The more violent exertions of this organ alone discharge its whole contents; and such exertions must be strong and long continued before they are com- municated to the duodenum. These are not facts merely of curiosity, but of great importance in the exhi- bition of vomits. It is in vain to expect benefit from them, if only the slight ineffectual discharge of a little of the tea, which has been drunk, takes place. The strain, such as arises from the action of the greater cur- vature, is necessary, if any viscid mucus is to be evacu- ated ; if any effect on the liver can be expected. The evacuation of bile appears towards the end of the ope- ration, sometimes after the interval of two or three hours; frequently on taking in the first draught of ne- gus, or a similar cordial. The expediency of the re- medy is then triumphantly pointed out; but, in reality, the bile was the effect, and was not previously in the stomach. The assisting actions of the diaphragm and abdominal viscera are sufficiently felt during the opera- tion, if the facts were not ascertained by the experi- ments of Mr. Haighton. These observations are of some importance in the administration of emetics. If the medicine is not for some time in the stomach previous to the vomiting, the whole organ is seldom excited. It has been usual to direct that the emetic shall be first discharged, pro- bably from its apprehension of doing some injuryv The practice is, however, proper, from its thus exciting every portion; but, as the vomiting, Avithout some con- tents, is painful, on the first oppearance of sickness a little camomile tea may be allowed. In the whole operation, hoAvever, if more than a half pint of any fluid is contained in the stomach atone time, the greater is the probability of its acting incompletely. In cases of poisons the vomiting is extremely violent, and Ave then only want to dilute, and to render the action as easy as is consistent with the discharge. The dry vomits, as they are called, where all drinking is pre- cluded, are painful remedies, but of great importance in assisting the bronchial discharges, or in relieving visceral obstructions. Opposed to the severity of dry vomits, are the milder nauseating doses of antimonials or squills. These assist, in some degree, the discharge from the bronchiae, but not so effectually as full vomiting. Their chief ad- vantages are in the earlier state of fevers; in which they, in some degree, contribute to relieve the dryness of the skin, and to mitigate, by this effect, the great heat. The use of emetics is very extensive. In fevers of every kind they are most powerful remedies. In in- termittents, the vomiting, sometimes excited on the . accession by nature, has taught us to lessen the vio- lence of the paroxysm by emetics; and occasionally to prevent it, by their previous exhibition, and continuing to support the perspiration they excite. In every inter- mittent, and remittents also, Ave find bilious congestions, which active vomiting contributes to relieve. By this means the paroxysms of each gradually become milder; and there have been many instances vvhere no other remedy was required. In continued fevers emetics are highly useful, but their effects are not equally striking. The debilitating power of every febrile attack affects the stomach, and produces those irregularities of the digestive process Avhich Ave have already described. The wholesome aliment is, in this way, converted into an injurious load; and emetics are not more useful in determining to the skin, than in removing the acrimonious or putrid saburrae. When contagion also has been received, though breathed with the air, it immediately affects the stomach, producing a bad taste in the mouth. This, with all the subsequent bad consequences, an emetic, folloAved by a brisk cathartic, will often remove. The particular kinds of fever offer few remarks of import- ance. In the synocha, bleeding, if it be at all admiss- ible, should be premised ; but the young practitioner, eager with his lancet, should reflect, that every throb- bing pulse is not a strong one; nor does every headach portend approaching delirium. Emetics have often been of service even in the most inflammatory fevers, when bleeding has not preceded; and we should always consi- der, that the most putrid fevers are sometimes ushered in by symptoms seemingly inflammatory. In the lower putrid fevers, emetics are useful; but the nauseating doses, Avhich may be continued in inflammatory fever, should soon be omitted in the latter, as they debilitate in a considerable degree. In the next order, the phlegmasia, emetics are less essentially necessary; and, in these, bleeding must be frequently premised. After vomiting, the nauseating doses may be continued with the best effects. In the pneumonia they are often important remedies, from their power of emulging the bronchial glands. In phre7iitis, though dangerous from increasing the accumulation in the head, we are sometimes obliged to employ them. In cynanche they are inconvenient, though useful, re- medies. When the inflammation terminates in sup- puration, suffocation often impends, and then vomiting, a precarious remedy, Avhich may even bring on the fate it is intended to avert, may at once rescue the victim from the grave. Firm and steady must be the physician E M E 603 EME who prescribes it; but he who would for a moment hesitate when his patient's life is at stake, whatever risk he may personally run, merits not the name of man, nor the character of aphysician. In the other pyrexiae we find little room for the use of this remedy. In hepatitis, for obvious reasons, it is doubtful, though sometimes useful; in enteritis the natural vomiting is often the most troublesome symptom; but in the peritonitispu- erperarum, emetics, given early, have been considered as a most certain remedy. It would give us the greatest satisfaction could we confirm these assertions. On trial we have, however, found them useful. In gout, emetics have been employed to obviate the return of paroxysms; and in rheumatism, if bark be useful in this view, vomits must be equally so. If the explanation we have offered of febrile cutane- ous diseases be correct, emetics must be a remedy of peculiar value and importance in the order exanthema- ta. We need not enlarge on the different kinds, for in each these remedies are useful on the first appearance of fever. In those, however, attended Avith nervous or putrid fever, the repetition must be attempted Avith caution. In hemorrhages, emetics are supposed of doubtful efficacy ; but they are more generally useful than has been supposed. With respect to the hamorrhagia ce- rebri we shall reserve our observations for the present; and in epistaxis we need not have recourse to an active, uncertain remedy, Avhen we have more safe ones Avithin our reach. In hamoptysis, emetics have been for- bidden; but Avith little reason. Dr. Robinson, near sixty years since, recommended them as safe and effectual remedies; and we know that there are none Avhich more certainly deserve this character: yet the general opinion is so decidedly in opposition to their employment, that, unless in emergency, we think they should not be exhibited ; or even in emergency not pro- fessedly as emetics. One of the most obstinate haemop- tyses the author of this article ever saw, yielded only to the digitalis, which acted as a violent emetic; and its action was continued for several days. The bleed- ing only ceased during the operation of vomiting, and Avas finally stopped. Vomiting has been employed with success in manorrhagia; but a physician may brave po- pular prejudice more safely in any disease than in female ones: nor is their utility in this complaint very clearly established. We speak, hoAvever, only at present of febrile maenorrhagia. In every other kind, emetics are decidedly injurious. Of the profiuvia, the only genera, catarrh, and dysen- tery, are greatly benefited by these remedies; nor can Ave add to Avhat we have already remarked respecting their utility, or offer any observations to limit their em- ployment. The order neuroses offers abundant subject of discus- sion, was this a place for extensive inquiries; and had Ave not, in part, anticipated every essential remark. It will be at once obvious, that we refer to apoplexy and palsy, and the disputes which have arisen on the subject. In our former article (see Apoplexia) Ave gave the result of our observations; and then remarked that, though we had been ourselves cautious in the ex- hibition of emetics, we had seen them employed by others without injury; adding, that their inconveniences Avere slight and transitory, their good effects consider- able and permanent. To this Ave may noAV subjoin what has since occurred in the progress of our work, that the venous system of the brain is apparently calculated to admit of distention, without any essential injury. The coats of many of the sinuses, particularly those at the base of the brain, admit easily of distention, are tor- tuous, and anastomose freely. On the whole, then, though we must consider emetics as remedies some- what precarious, we think that they ought to be em- ployed in such circumstances; and on taxing, most impartially, our recollection, Ave cannot find that, in a single instance, in our hands, or those of others, the} have been hurtful. On the contrary, Ave have very often found them beneficial._ In the adynamia, emetics are of very extensive utility. They are of doubtful efficacy in syncope, when the disease arises from a topical affection of the heart and larger arteries, or when owing to debility, or an ex- hausted constitution. In many, perhaps the greater number of instances, fainting proceeds from accumula- tions in the stomach, and emetics are then absolutely necessary. In dyspepsia, hypochondriasis, and chlorosis, they are. remedies nf the greatest importance. The order styled spasmi is a group of diseases scarcely- connected. Palpitatio, hoAvever, like syncope, more commonly depends on accumulations in the stomach and boAvels than on any other cause; and asth7na, Avith dyspnea, as we have seen, is greatly relieved by the operation of emetics, when not owing to any topical affection of the heart and arteries. If any medicine be useful in pertussis, it is occasional vomiting; but the pyrosis is a spasmodic complaint, and ultimately cured by a very different plan. Emetics are often useful as temporary palliatives. In colica, in cholera, and dia7-r- hea, we have had occasion to point out their utility; but in hysteria, though sometimes necessary, they are of doubtful efficacy. In the other genera they are not employed, or only occasionally useful. In the vesanie, emetics are the most important re- medies. When the disease is not connected with the stomach, which generally happens, they are probably useful by the agitation formerly mentioned among their effects. In the first order of the cachexia, the marcores, we find little foundation for their employment; yet, as in tabes the hectic fever is mentioned, they may appear to be indicated. But the fever, in this case, is from debility only, the exacerbation of the common evening paroxysm. It reminds us, hoAvever, of an omission, which Ave must supply, the utility of emetics in phthisis; a disease that has no appropriate place in the system of Dr. Cullen, Avhich we have chiefly followed. Whether we consider the fever as a remittent, the bronchial glands as infarcted, or the existence of purulent matter in a concealed abscess, emetics appear to be medicines of the greatest utility. In fact, they are so; and could phthisis be ever cured, it Avould be by the joint action of emetics and blisters. No remedy is so gene- rally useful as a slight emetic, frequently repeated; it checks the fever, relieves the burning heat, renders the respiration more free, and the cough more loose. Yet haeret, lateri lethalis arundo, emetics will not cure. In dropsies we have mentioned the occasional utility of natural vomiting, and stated that we have not yet been able to imitate it by art; but in hydrocephalus and ti ME 604 E M O hydrothorax it is inadmissible. We find a few solitary cases where the Avater in hydrocele, a partial dropsy, has been evacuated in this way. For the various genera of the order impetigenes we find little room for the use of this remedy. Ifframbasia, as Dr. Adams thinks (Memoirs of the Medical Society, vol. vi.), be an exanthema, emetics may be of service, as they very certainly are in icterus. Even where the pain at the pit of the stomach is violent, and the exist- ence of a calculus unequivocal, though emetics may for a time increase the pain, the relaxation which they produce assists its passage. Neither in accidental nor in artificial vomiting have Ave ever found, in this case, any inflammation (the great source of alarm) folioav. Emetics are of more importance in the last class of dis- eases, than from their local nature might be expected. In every case of obstructed sense, where the cause is not so firmly fixed as to resist every power, these remedies are useful; in the caligo for instance, a wmwrosz's, dysacia, and ageustia; in the greater number of depraved and deficient appetites; and in some of the depraved or ir- regular motions. In the apocenoses, the passive haemorr- hages, or mucous discharges, they are certainly injurious. In the epischeses, if we except the amenorrhea, and in the tumores, except the purulent ones, they are hurtful. The choice of emetics is a subject of some importance; but it is chiefly regulated by the quickness or the vio- lence of their action. The most quickly operating emetic, in cases of emergency, is the white vitriol; the most violent is the turbith mineral. It is common to select the mercurial emetics in venereal cases; but this plan is not attended with peculiar advantages. We have often thought it singular that the squills are riot more frequently employed for this purpose in asthma or pneumonia. They indeed produce a very permanent and distressing nausea, and are often employed as nauseating remedies; but we suspect that they might be particularly useful if given in these cases so as to produce full vomiting. In such instances physicians seem to prefer the antimonial emetics, and it must be allowed that the squills are very uncertain in their operation. Emetics are injurious when there is any original defect in the head, in the heart and larger arteries, or, perhaps, in the abdominal viscera, if we except the liver; in the aneurisms of the larger vessels, in the delicate and the weak, if particularly plethoric. If no plethora exists, debility is seldom so considerable as to contraindicate vomiting, should there be any foundation for thinking it may produce real good effect. With respect to the administration, Ave have little to add to Avhat we have already remarked. In cases of fever we prefer the evening; in asthmatic cases, the morning; in hectics, the period when the febrile ac- cession is most strongly marked. In the other disorders there is little choice of time. The preferable form is a liquid; and were the preparation of the ipecacuanha wine to be always depended on, this would be the best form of a medicine almost universally employed as an emetic, since the powder, apparently entangled in the coats of the stomach, sometimes occasions a continuance of painful retchings. Those Avho have repeatedly taken this medicine often find even the smell or taste sufficient to excite vomiting; and, from Avhat has been said, it will be obvious that such vomiting will be ineffectual. To patients of this class it may be given in pills, or the tartarised antimony may be substituted. Vomits, taken in the morning, should be allowed to produce their operation in bed. In the evening, if not taken in bed, the patient should immediately retire to it, without exposing himself to any chill. At any other period of the day, cold, after the vomiting, should be carefully avoided. Any warm liquid may be employed to facilitate the action of the emetic; but the camomile, the carduus tea, mustard infusion, or whey, or the volatile alkali added to the bitter infusions, greatly facilitate it. EMETI'CUM MI'TE. The mild emetic of Boer- haave is made by deflagrating one part of crude anti- mony with two of nitre. By this process all the sul- phur is consumed, and a large proportion of oxygen combined with the metal, which reduces it to the state of an inert earth; it is therefore, in every sense, mild. Eme'ticum vi'num. See Antimoniale vinum. EMETOCATHA'RTICUM, (from e^uu, and xx. Dxiga). A medicine Avhich operates both by vomit and stool, F.MTSSA'RIUM, (from emitto, to send forth). An emissary. In medicine it is any outlet, whether natural or morbid, from which any thing is discharged. EMMENAGO'GA, Emmenagogues, (from ewtwx, the 7nenstrual discharges, and xya, to propel,) meTiago- ga; medicines suited to promote the menstrual flux in women; or to excite and restore it when retained or suppressed. The establishment of this class has occasioned much hypercriticism; yet, as pointing out a change to be pro- duced, it is equally proper with emetics or cathartics; nor is it an objection that we must produce the change through some medium, and not by any direct action on the vessels themselves. Emmenagogues are general or partial stimulants, tonics, or antispasmodics. We cannot, however, en- large on their utility or application, while the cause of the discharge itself has not been investigated. We are compelled, therefore, to defer the consideration to a future part of the work, and trust then to be able to give a comprehensive account of the whole subject: we shall endeavour to give a satisfactory one. See Menses. EMME'NIA, (from jmjv, a month). See Menses. EMMCPTOS, (from (tolos, lint). An epithet for persons, parts of the body, or disorders, that require lint for the cure. EMO'DIA, (from tv, and ofovs, dens). A stupor of THE TEETH. EMOLLIE'NTIA, (from emollio, to soften). Emol- lients, malacticos. Medicines which lessen the force of cohesion in our simple solids, and therefore soften and diminish the hardness and rigidity of the parts to Avhich they are applied. They not only relax the solids, but also sheath and defend them from the acrimony of the fluids. When externally applied, they are termed emollicntia; internally administered, de7nulcentia. (See Demulcentia.) Dr. Cullen thinks that emollients act upon the parts to which they are immediately ap- plied, either by insinuating themselves into the sub- stance of the solid, and diminishing the density and force of cohesion of the mixt; or, by being insinuate*! EMP 605 EMI1 into the interstices of dry particles, they diminish the friction that might othenvise occur, and thereby render the whole more flexible. We have not, however, the slightest evidence that any permanent change can be made in the mixt, by the temporary application of oil or warm Avater. The nervous system is relaxed by warmth, and the simple solids partake of the change; but it is temporary only. A permanent change is only produced by a warm climate, or some relaxing occupation. In the simple solids we only find a greater flexibility, in consequence of emollients, which in Dr. Cullen's system appears to be correctly explained. Emollient topics are formed of water, oily and mu- cilaginous substances. Water, particularly when assisted by a moderate heat, is plentifully absorbed from the whole surface of the body. It powerfully relaxes and dilutes, being miscible, though it does not enter into the composition of the solid, with almost every animal fluid. Oil relaxes and obtunds what is rigid and acri- monious ; and mucilage equally sheaths sharp humours. In compositions of this kind, the aqueous part should be freely admitted, for the mucilages require to be largely diluted; gentle friction on the part increases their effi- cacy, by promoting the circulation; but the heat with which they are applied should not exceed Avhat pro- duces a pleasing sensation. From the relaxing and de- mulcent quality of emollient topics, they are useful sedative applications, when pain from tension, or from irritation, is excited : from the sympathy of the nerves, their efficacy is conveyed to distant and deep seated parts; and thus the warm bath proves so powerful a sedative. From the same principles these applications are also antispasmodics. Emollients, by relaxing the fibres, and promoting the circulation, hasten suppura- tion. See Aikin's Observations on the external Use of Preparations of Lead, p. 29, 8cc. EMO'TIO, (from emoveo, to move out). When used with respect to the mind it signifies a delirium; Avhen relative to some bone, a luxation. EMPA'LEMENT. See Calyx. EMPA'SMA, (from srxo-o-a, to sprinkle upon). See Catapasma. EMPE'ROS, (from e\uxei^a, to mutilate). Muti- lated. E'MPETRUM, (from ev, and -nelpos, a stone). See Alypum. E'mpetrum thymelje'^e fo'liis, also called sana77iun- da, and sea heath spurge; daphne thymelea Lin. Sp. PI. 509; grows on the coast of Andalusia, and flowers in February. A drachm of the root purges violently. About Gibraltar it is called burhalaga; but only used to heat ovens. EMPHRA'CTICA, (from e^xTe-a, to obstruct). Such topical applications as obstruct the pores Avhen applied to the skin; also named emplastica, ei7iplat- tomena. EMPHRA'C IMA, (from e^^xFo-u, to obstruct). An impediment or obstruction ; the parts of a child which present in an unnatural posture, and obstruct the birth. Hippocrates. EMPHYSEMA, (from e^vFxu, to inflate,) infiatio; and sometimes leucophlegmatia ; is any flatulent tu- mour; but it means generally a soft tumour arising from air being admitted into the cellular membra.ie. In Hip- pocrates it signifies an inflation of the belly, and some- times a tumour in general. When ruptures or tumours are of the flatulent kind, they are calledphysocele. Dr. Cullen means by the word pneumatosis, which is his general name for this disease, the swelling formed by air, a flatus, or rarefied fluids. He places it in the class cachcxie and order intumescentie, anddeSnes it, a tense, elastic tumour of the body, making, on pressure under the hand, a crackling noise. The species are, 1. Pneumatosis spontanea, when it happens without manifest cause; 2. Pneumatosis traumatica, when from a wound in the thorax; 3. Pneumatosis venenata, Avhen from the swalloAving or external application of poison; 4. Pneumatosis hysterica, when accompanied with hys- terics. The most frequent cause of this disorder is the pierc- ing of the plura by a sharp pointed instrument, or wounding the lungs by the pointed fragments of broken ribs; though it sometimes happens that an emphysema is produced by internal lacerations of the air vessels of the lungs, without any injury to the pleura. Putridity separates air both in vegetable and animal substances; and, consequently, emphysema is the consequence of mortifications, and sometimes attends putrid fevers. It more seldom happens from pointed instruments than might be expected, as the blood instantly stops the passage. An emphysema is known by a soft puffy swelling: the skin appears glossy, the tumour gives way on pres- sure, but it instantly returns; a crackling is perceived on pressing the emphysematous tumour. When the lungs are wounded, a troublesome cough attends, and the matter expectorated is mixed with blood; some- times air escapes from the lungs into the cavity of the pleura, and occasions great difficulty of breathing, anxiety, a sense of suffocation, stupor, a livid colour in the face, and, if relief is not speedily obtained, death. The air detained in any part of* the cellular membrane may produce a mortification in it. When these tumours occur in putrid disorders, fo- mentations may be applied, made with equal parts of sharp vinegar and rectified spirit of wine; but Avhen a wound is the cause, if the breathing is quick and labo- rious, blood must be taken, and the operation repeated as often as this symptom renders it necessary. Punc- tures, or rather small incisions, may be made into the cellular membrane with a lancet, or in different parts of the body ; the air will thus be evacuated, if gentle pressure is also made on the tumour: after its evacua- tion, a compress may be dipped in vinegar, and applied over the part where the wound is supposed to be, se- cured by a tight bandage; and the patient should be directed to lie on the injured side, to prevent a fresh afflux of air. Nitre, and pectoral emulsions, may be given to prevent internal suppuration. When the air is detained in the cavity of the breast, Mr. Hewson proposes to discharge it by a small opening made with a knife on the fore part of the chest, which, if on the right side, must be betAveen the fifth and sixth ribs, because there the integuments are thin : but if on the left side, the opening must be betAvixt the seventh and eighth, or betwixt the eighth and ninth ribs ; the better to avoid wounding the pericardium. See Le Dran's Observations, N° 29 ; James's Medical Dictionary, art. Fractura; and London Medical Observations and In- quiries, vol. ii. p. 17, vol. iii. p. 2S—36, 372—399; White's Surgery, p. 78. E M P 606 E M P EMPI'RICA SE'CTA, (from ev, and tfeipx, experi- entia). The empiric sect. It was begun by Sera- pion of Alexandria, or by Heracleon, about 278 years before the birth of Christ. The empyrical physicians conducted themselves wholly by experience, without study or theory, like the quacks of the present day. , See Celsus de Medicina, p. 3, 8, 8vo. Lugd. Bat. 1746. EMPFRICUS. An empiric, (from weipxa, to expe- rience, or eftveipxa, to try,) an epithet applied to practi- tioners who founded their practice on experience only, or rather "on incontrovertible facts, totally freed from all speculative ideas. In a bad sense, it is an appellation bestowed on quacks, who, without knowledge, pretend to perform miracles by some desperate nostrum; care- less of the destruction they create, and eager only to pillage their unfortunate patients, generally at the ex- pence of their health, and too often of their lives. For the difference between the empiric and dogmatist, see Percival's Essays, Medical and Experimental, vol. i.; which is, however, nearly a copy of one of Dr. Cullen's early introductory lectures. EMPLA'STICA, (from efiTrXxc-o-a, to spread upon). See Empractica. EMPLA'STRUM. (from the same). Plaster. Plasters are compositions for external use: they are not ahvays applied for any medical virtue; but chiefly used to retain other dressings, or to keep the parts to Avhich they are applied warm and tight. These effects they produce more equally and steadily than a bandage of linen, especially if there be no swelling. They are composed of oily and unctuous substances, united with powders, into such a consistence, that the compound may remain firm in the cold without sticking to the fingers; that it may be soft and pliable in a gentle heat; and that, by the warmth of the human body, it may be so tenacious as readily to adhere. When a plaster is softened to the consistence of Avarm wax, it is called cerate ; though the term is generally confined at present to such plasters as contain Avax in their composition: when so soft as to spread easily whilst cold, yet not to run with the heat of the body, an ointment; and if betwixt the consistence of an ointment and oil, a lini- ment. Calces of lead boiled with expressed oils unite into a plaster of a good consistence, and are a proper basis for several other plasters. Plasters may also be made of resins, gummy resins, 8cc. without wax, especially in extemporaneous prescription; but for officinal com- positions they are less proper, as they Soon grow too soft in keeping, and lose their form in a warm air. As some difference is observed in the hardness of a plaster for the breast or stomach, and one that is to be applied to the limbs, the following proportions are ge- nerally directed. For a soft plaster, take one ounce of expressed oil, one ounce of wax, and half an ounce of any powder; for a harder, add an ounce more of wax, and half an ounce of powder. M. Deyeux, in the 33d volume of the Annales de Chimie, has added some chemical refinements with re- spect to this officinal preparation, which merit our at- tention. He considers plasters to consist merely of the union of oil, or a mixture of oil and wax with metallic oxides. Those in which these substances are united Avith vegetable juices he styles ointments. The union of oils with metallic oxides he supposes to be a true chemical combination, which some pharma- ceutical authors have styled soaps ; he thinks without reason, as they are neither soluble in water nor alcohol. In proof of the chemical union, he adds, that some me- tallic oxides, particularly those of iron, refuse to unite with oils; for, though they apparently mix, yet, when diluted, the oxide separates, which is by no means the case with similar combinations. The oxides of lead, bismuth, and mercury, unite with oil, though not with equal facility. There are three methods of uniting oil with metallic oxides: the first is by agitation, without heat. In this way the oxide of lead combines with oil; but the operation is slow and laborious: and, though the union appears to be complete, the plaster never attains a proper consistence. The second is to boil the oxide and oil with water, and in this case the Avater acts only as a balneum mariae, to facilitate the union, by bringing the particles of the oil and oxide together in an at- tenuated state. By this process we usually obtain a plaster of a proper consistence. The third is the com- mon method of uniting the oxide with the heated oil by agitation. Plasters, thus made, are always dark in their colour, and exhale a peculiar odour, which dis- tinguishes them. In every process the oxide should be in the minutest state of division, particularly in the last, since the metal would be otherwise revived, which sometimes happens, particularly in a saturnine oint- ment, called by the French pharmaceutists, unguentum de la mere; an event in part owing to the large propor- tion of animal oils which it contains. The only method of avoiding this inconvenience is to hasten the union, which is best effected by a minute division of the oxides. Though all oils unite with metallic oxides, the results' are different. With oxides of lead, for instance, parti- cularly litharge, linseed oil unites freely, and softens by the heat of the hand only: while, Avith olive oil, it is so dry as to admit of being powdered, and must be heated to be properly spread. In general, drying oils afford the softest plasters; and olive oil, digested with the root of althaea, gives a softer ointment than it would have done, previous to the process. Those oils which are not drying are preferable ; but the olive oil, gene- rally sold, is seldom uniform in its properties. The metallic oxides differ perhaps as much as the oils. Litharge affords drier plasters than minium or the white oxides of lead. Other oxides may unite readily with oil; but a sufficient number of experi- ments has not yet been made. M. Deyeux suspects that the very pure red oxide of mercury, if finely powdered, so as to prevent its being deoxydated, might advantageously supersede the oxide of lead in many plasters. When plasters, from age, become too dry, they .must be moistened with a due proportion of oil; but, in ge- neral, the proportion of oil in those liable to become brittle by age is too small. The access of air often changes the colour of plasters, and very probably their qualities; so that they should be carefully guarded from it, especially those subject to such a change. Empla'strum adh.esivum nigrum. The black STICKING PLASTER, LADY'S COURT PLASTER, and the Chichester plaster. Dissolve twelve ounces of gum benjamin in twelve ounces of rectified spirit of Avine: in a separate vessel EM P 607 EMP dissolve a pound of the best isinglass in five pints of pure water; strain each solution; mix them, and let them stand in a narrow vessel, that the grosser parts may subside: when the clear liquor is cold, it will form a jelly; and it must be Avarmed when spread. This quantity suffices for covering ten yards of half-yard- wide silk: the silk must be stretched in a frame, and the mixture spread on it with a brush. As each spreading dries, it must be repeated to the tenth or twelfth time; and a gloss is obtained by a light touch of the brush at the last operation. Its use is generally knoAvn; but the following is an easy substitute: Dissolve a pound and a quarter of fine isinglass in five pints of water; and before it cools spread it on silk in the manner above directed. Emplastrum ad contusa Boerhaavii. R. Bryoniae in farinam reductae 5 ij. florum sulph. 5 i. hydrargyri cum sulphure 3 iij- galbani puri, et s. a. soluti | iv. emplastri de meliloto $iv. ol. chamaemeli q. s. ut fiat emplastrum. The three last ingredients are to be melted together, and the powder stirred in. Modern practice adopts this, only using the emplastrum cerae compositum, instead of that of melilot; and one ounce of olive oil in the place of the oleum chamaemeli: it is supposed to be a beneficial application, particularly in scrofulous indurations. Emplastrum anodynum. Take four pounds of com- mon plaster; melt it over a gentle fire, with an ounce and a half of common black pitch. When this is to be applied, mix Avith each ounce, weight, half a drachm of opium, and the same quantity of camphor in fine pow- der. It is said to be very efficacious in relieving old pains; but the proportion of camphor and opium may be doubled. Empla'sthum a'ttrahens. See Emplastrum cerjE, under Cera. Empla'strum vesicato'rium. See Cantharides. Empla'strum cu'mini. See Cuminum. Empla'strum commu'ne; formerly called diachylon, noAv lithargyri emplastrum. Take of olive oil, one gallon; of litharge finely pow- dered, five pounds; boil them together Avith about a quart of water over a gentle fire, continually stirring till the oil and the litharge are united, and acquire the due consistence of a plaster; and if the Avater is wasted be- fore the operation is finished, more water (previously heated) must be poured on. As soon as the mixture is warm, begin to stir it: in about four hours the boiling will be completed; but to ascertain this, drop a little on a tile to cool, by which you will easily discover whether the litharge be dissolv- ed; the boiling must be continued very gently, or the plaster will be black ; perhaps boil over suddenly. If Avater should be added that is not very hot, the plaster Avill explode Avith violence, and be Avasted ; an accident Avhich will happen Avith hot Avater, if the plaster is too hot. If the composition proves discoloured, the addi- tion of a little white lead and oil will improve it; but if expected to be very white, true olive oil must be used. Emplastrum nigrum Domini Sharp, seu Emplastrum cerussa.---]$,. Olei olivarum 5xij.cerae flavae$ij. ss. cerussae | x. Let the oil and Avax be melted together, the ceruss added, and the whole boiled to a consistence of a plaster. Sharp used it as an application to diseas- ed knees; but Kirkland employs a plaster of red lead and oil, boiled to a dark brown colour, for the same purpose. Emplastrum stimulans, seu ammonia, stimulant plas- ter, or plaster of ammonia.—§». Saponis 3 ij. em- plastri lithargyri % ss. ammoniae muriatae ^ i. Let the soap and litharge plaster be melted together, and when nearly cold, the muriated ammonia, in fine poAvder, be stirred in. This plaster must be made at the time of application, else the alkali, set at liberty by the decom- position of the muriated ammonia, will fly off, and frustrate the intent of the remedy. In delicate and irritable skins, the quantity of the ammonia must be lessened, lest the plaster blister the part. In chronic enlargement of the joints, or tumours without inflam- mation ; in some scrofulous affections of the knee or elbow joints ; but particularly in those gelatinous sAvell- ings which frequently form on the olecranon, it has been of singular service, probably by stimulating the absorb- ents, and increasing their power of action. Empla'strum sapo'nis. R. Saponis ^ ij. emplastr. lithargyri f^ iij. These, melted together, must be boil- ed to a proper consistence. It is a mild discutient, and to tumours of various kinds is considered as an useful application; but as soap is much more advantageously used in liquid forms, the practitioner will rarely be in- duced to apply it in that of a solid. Empla'strum stoma'chicum. Stomach plaster. Now called emplastrum labdani compositum, compound PLASTER OF LABDANUM. Take of soft labdanum, three ounces ; of frankin- cense, one ounce; cinnamon and expressed oil of mace, of each half an ounce; of essential oil of mint, one drachm : add to the frankincense, first melted, the lab- danum heated, till it becomes soft, and then the oil of mace; afterwards mix the cinnamon' with the oil of mint, beat them together in a warm mortar, and keep the whole in a vessel well closed. The plasters should be frequently renewed, and ap- plied on the five lower ribs of the left side, towards the back. It has been supposed of use also to promote the suppuration of indolent tumours. EMPLATTO'MENA, (from e^vXxo-Fu, to obstruct). See Emphractica. EMPNEUMATO'SIS, (frome^vea, to blow into, or inflate). An inflation of the stomach, the womb, or other parts. EMPO'RIUM, (from efuxo^os, negotiator, from e^ Tope a, to negotiate). See Cerebrum. EMPRION, (from ot£<«, io saw). Saw-like. A kind of pulse mentioned by Galen, in which the artery is un- equally distended in different parts. EMPROSTHO'TONOS, (from e^posUv, forwards, and retvu, to bend). A spasm which bends the body forward, and confines it in that position. Celsus, lib. iv. cap. 3, restricts the term to a convulsive stiffness of the neck, by which the chin is fixed on the breast. Sec Tetanus. E'MPTYSIS, (from trlvu, to spit out). Spitting of blood ; a discharge which comes only from-the mouth, fauces, and parts adjacent. Aretaeus. EMPYE'MA, (from ev, ^within, and srvov, pus, or matter). The ancients called all internal suppurations e7npye7na, (see ecpyema) ; but at present this name is confined to a collection of purulent matter, lying loose in the cavity of the breast, and lodging on the dia- E M P 608 EMU phragm. Dr. Cullen considers it as a consequence of pneumonia, and says, its symptoms are, a remission of pain, after a pleurisy has terminated in suppuration, often after a vomica; whilst a difficulty of breathing, cough, uneasiness in lying doAvn, and hectic fever, con- tinue : frequently attended with a sensation of some fluid fluctuating in the breast, and symptoms of a hy- drothorax. Aretaeus, lib. i. De Causis et Signis MorborumChro- nicorum, cap. 9, says, " They who have purulent ab- scesses in the cavities of the body, whether within the thorax or below the diaphragm, if the pus be discharged upAvards, are called eivxvoi (empyi); if doAvnwards, apostomatici. And if there be a suppuration in the tho- rax, and the pus be discharged through the lungs, it is called ennvri." But the moderns styled it only an e7npye- nia when purulent matter floats upon the diaphragm. If matter is lodged on both sides of the breast, there are tAvo empyemas. The pus, that forms an empyema, may be from an abscess in the lungs, pleura, mediastinum, pericardium, or diaphragm; or perhaps from that inflammatory ex- udation, or inspissated serum, which, Dr. Hunter ob- serves, resembles pus, often found in large quantities in the cavitie"s of the breast, belly, &c. Wounds in the breast may also evacuate their matter into its cavity, and prove a cause of this disease. Le Dran informs us, that he met with instances of abscesses in the liver making a way through the diaphragm, and emptying themselves into the breast. Some instances of this have occurred in modern times, and small apertures in the diaphragm, through which pus has passed, anatomists have observed and described. (Pemberton on the Dis- eases of the Abdominal Viscera, p. 36). From Sauva- ges may be collected six varieties, although they are not always capable of being distinguished, viz. Empyema a peripneumonia ; and vomica ; empyema pleura ; medi- astina ; diaphragmatis ; and intercostale. When any fluid matter is collected in the cavity of the breast, ft may be known by the following signs : the breathing is short and laborious; expiration is more dif- ficult than inspiration ; the patient perceives a fluctua- tion Avhen he changes his position from side to side, or presses the abdomen against the edge of a table; some- times there is an enlargement of the cavity of the tho- rax, and an cedematous fulness of the skin and flesh of one or both sides of the chest; a dry cough; a slow fever; heat at the extremities of the fingers; and hollowness of the eyes. The patient cannot lie on the sound side, though in hectics he can only sleep easily on it. The kind of matter can only be known by the nature of the disorder, Avhich preceded an accumulation, and from the concomitant symptoms. The matter may be blood or pus : and the latter of these may be suspected, when there hath been an inflammatory disorder in the lungs, pleura, or other parts in the breast, attended with symp- toms of suppuration, and particularly if viscid sweats attend. If the matter of an empyema be not speedily expecto- rated, the patient dies of a consumption, Avith a hectic fever, a\ hich is always exasperated at night. If the me- diastinum is corroded, upon opening the thorax a sud- den suffocation must ensue. If the empyema is of long standing, the strength decayed, Avith a colliquative diarr- hoea, and a wasting of the body, the operation, instead of relieving, hastens the death of the patient. When this disorder is merely local, the operation may succeed, but if the habit be strumous, or otherwise unsound ^ if fever, coughing, thirst and other symptoms, are either numerous or considerable in their degree; there is but little hope of recovery. The operation is also ineffec- tual if the lungs adhere considerably to the pleura, or if the matter lodged on the diaphragm was emptied from a cyst. The chirurgical method by which relief is obtained is called the operation for the empyema. The fluid to be voided by this operation is matter. In this case, therefore, only the assistance of a surgeon is required; for blood will be gradually absorbed, and need not be removed by any artificial opening. Gooch relates a case in his Medical Observations of air in the thorax pro- ducing the symptoms of an empyema: it passed through an ulcer in the lungs; but the ulcer healing, the air was evacuated by the operation for the empyema, and a complete cure effected. The manner of operating is to fix on the part for the perforation ; then, with a knife or a trochar, a passage may be formed for the offending air. Whether an opening is made by means of a knife or a trochar, as Albinus hath observed that the diaphragm on the right side ascends higher into the thorax than on the left, it may be proper to pierce it on the right side betAveen the third and fourth spurious ribs; but on the left, between the second and third, and at about half or two thirds of the distance from the sternum to the vertebra ; for here the muscles are thinnest, the artery is concealed under the rib, and the diaphragm at a due distance. The puncture must be made with the utmost caution, lest there should be an adhesion of the lungs to the pleura; a canula for a time left in the wound, and the wound itself kept open. Matter, lodged in both cavities of the thorax, requires that the operation be performed on each side. See Hippocrates, Galen, Aretaeus, Boer- haave, with Van Swieten's Comments, Le Dran's Ope- rations, Sharp's Operations, Heister's Surgery, Bell's Surgery, vol. ii. p. 383, Kirkland's Medical Surgery, vol. ii. p. 175, Pearson's Principles of Surgery, vol. i. p. 94, White's Surgery, p. 303. EMPYE'MATA, (from £ft«?fi*). So the ancients called suppurating medicines ; for they named an inter- nal collection of pus empyema. E'MPYI. Purulent or suppurated, or those who have purulent abscesses internally. EMPYREU'MA, (from efMevpeva, to kindle, or ewvp), in the fire). In chemistry it is the offensive smell and taste which distilled waters, or other substances, re- ceive from being too much exposed to the fire, when their mucilage is burnt. EMPYREUMA'TICA, O'LEA, (from e^vpev^). Empyreumatic oils. Oils both of the animal and ve- getable kind, distilled Avith a heat greater than that of boiling water ; and thus receiving a burnt smell. These oils are sometimes considered as of a distinct class ; but they are only burnt, and dissolve more or less in recti- fied spirit of wine ; are acrid ; by repeated distillations volatile, and almost free from their disagreeable smell.. In some respects they resemble the essential oils of ve- getables. They are considered as powerful antispasmo- dics: that chiefly used is the oleum Dippeliianimale. E'MPYROS, (from ev, and wS, fire). One labour- ing under a fever. EMU'LGENS, (from emulgo, to milk out). Emul- ti N C 609 E N C gem-, milking out. The term is applied to the arteries and veins, from the aorta and vena cava to the kidneys. According to the ancients, they strained and milked the serum through the kidneys. EMULGE'NTES ARTE'RIjE and VE'N^E. See Renales artery and ven^e. FMU'LSIO,(from emulgeo). Medicines of any kind resembling milk; though the London college has re- jected that term, and supplied it with lac. They are generally made from farinaceous seeds, beat up with some fluid, Avith which their oily parts are intimately blended; and chiefly used for common drink in acute disorders. For the e7nulsio com7nunis, or lac, amygdala, emulsio absorbens, and emulsio, camphorata, see Amyg. DAL£ DULCES. EMUNCTO'RIA. Emunctories, (from emungo, to clean, wipe away, or draw off,) the passages, particu- larly the glands, by which excrementitious matters -are evacuated. The parotides supposed to receive the excre- ments from the brain, the axillary glands from the heart, and the inguinal from the liver, were xxr e%ox>>v, thus named. It is, however, often the appellation of glands which separate useful fluids. #EN.E'MOS, (from ev, and x\/a.x, blood,) topical medi- cines appropriated to bleeding wounds. Hippocrates. EN^EORE'MA, (from xiup(&, sublime,) the pendu- lous substance which floats in the middle of the urine, subli7namentum, nubecula suspensa, sublimatio urina. ENA'MEL. See Dens. ENA'RGES, (from xpyr,s, white, or evident). Hip- pocrates applies this epithet to dreams. ENARICY'MON, (from ev, xpi, soon, and xvu, to con- ceive). See Aricimon. ENARTHRO'SIS, (from ev, in, and xpSpov, a joint). See Diarthrosis. ENCA'NTHIS, (from ev, in, and xxv6(&, an angle of the eye,) an encysted tumour on its inner angle. At the first a tubercle appears on the caruncula lachrymalis, or on the cuticle adjacent; afterwards this tumour ex- tends over the pupil of the eye. The tears in conse- quence trickle down the cheeks, the sight is impaired, the countenance deformed, and the eyes inflamed. When of a milder nature, it may be destroyed by gentle escharotics; the belly should be kept lax, and an issue in the arm, or a perpetual blister between the shoulders, should continue to discharge. When this tumour is malignant, it is attended Avith pain, is of a livid hue, and often cancerous. If manifestly cancerous, palliatives only are to be used; but other- wise, the whole tumour and its cyst should be dissected, raising it Avith the foreceps, to avoid cutting either the eye or the caruncle : if the latter is hurt, the tears Avill alAvays run dovvn the cheek; so that it is safer to leave a little of luxuriant flesh, and to destroy it aftenvards with a caustic. See Ectropium ; Heister's Surgery; and White's Surgery, p. 231. ENCA'RDION, (from ev, and xxpfox, the heart). See Meditullium. ENCA'RDIUM PRE'MNU. The heart and mar- row of the trunk of trees; the tender medullary sub- stance which groAvs on the tops of the great palm tree. Dioscorides. By Theophrastus styled encephalus. ENC ATALE'PSIS,(from ev, and xxlxXema, to leave). See Catalepsis. VOL. I. ENCATHISMA, (from eyxxBvpxi, to sit in). See Semicupium. ENCAU'MA, (from ev, and kxiu, to burn).. The scoriae of silver, as well as the mark left by a burn, and a pustule produced by the same cause. It is also the appellation of a superficial ulceration on the eye. Those ulcerations on the eyes, from defluxions of humours, receive, according to .Etius, different names: Avhen formed on the pupil, covering a great part of it, and oi a bluish colour, it is called caligo: Avhen the ulcer is less wide, but deeper, and seated in the pupil, nubecula: Avhen the surface of the pupil appears rough, and of an ash colour, epicauma: and when, after a fever, the ulcer has a sordid crust, seated either on the pupil or the white part of the eye, encauma; which Avhen fixed in the pupil, all the humours of the eye are mixed, and the organ is destroyed. In the beginning of these cases, relief is sometimes obtained by keeping the bowels loose. White's Surgery, p. 229. ENCAU'SIS, (from the same). A burn; or rather the inflammation caused by it. It is also that action of external heat upon the body, as of the sun, or fire, and a synonym with deustio; sometimes an appellation of the heart burn, with thirst; in Dr. Cullen's Nosology synonymous with erythema and a7nbustio. ENCE'PHALON and ENCE'PHALUS, (from ev, within, and xtQxXy, the head). The encephalon includes the cerebrum, the cerebellum, the medulla oblongata, with their membranes. ENCEPHALOCE'LE, (from eyxeQxXos, cerebrum, and xeXe, a tumour). See Hernia cerebri. ENCE'RIS, (from ev, and x^os,wax). Bits of Avax found in plasters as they cool. ENCHARA'XIS, (from ev, and xeiPxcr:r*fi to scarify). See Scarificatio. ENCHEIRE'SIS,(from ev, and x"?> the hand). This Avord imports the manual treatment of any subject, and is a part of the title of one of Galen's works on dis- section. ENCHO'NDROS, (from ev, and %«»^>«?, signifying both a grain and a cartilage,) granulated and cartila- ginous. ENCHO'RIOS, (from ev, and xaP0l>, a region, or country). See Endemius. ENCHRI'STA, (from eyxpt", to anoint). Linimcii'.s to anoint any part. ENCHU'SA. See Anchusa. ENCHYLO'MA, (from ev, and xv*°h juice). See Elixir. ENCHY'MA, (from tyxvu, to infuse). Infusion, or a sanguine plethora. ENCHY^M ATA, (from eyx^a, to pour into). Liquid, medicines to be poured into the eyes or ears. ENCHYMO'MA,(from the same). In the writings of the ancient physicians it implies that sudden effusion of blood into the cutaneous vessels Avhich arises from joy, anger, or shame, and, in the last instance, is usually called blushing. Dr. Hunter thinks it a nervous affection ; but Dr. Whytt, with more propriety, ascribes _ it to the increased action of the smaller vessels, Avhich has been attributed to a nervous connection, but which Ave suspect, though less obvious, is very general, over the Avhole surface. ENCTIYMO'SIS, (from the same). An extravasa- 4 I ENE 610 ENE tion of blood, Avhich makes the part appear livid; some- times synonymous Avith ecchymosis. ENCHY'SA. See Anchusa. LNCH Y'TOS, (from eyxvu, to infuse). An epithet for a fluid injected into any cavity of the body. ENCLY'SMA, (from ev, and xXv&, to clean). See Enema. ENC/E'LIA, (from ev, and xoiXix, the belly,) the contents of the abdomen. ENCOLPI'SMOS, (from eyxoXmlu, to insinuate). An uterine injection. E'NCOPE, (from ev, and xo-xtu, to cut). An incision; and, figuratively, an impediment. ENCRA'NION, (from ev, and xpxviov, the skull). See Cerebellum. E'NCRIS, (from eyxpts). A cake made of fine meal boiled in oil, and sweetened with honey. E'NCYMON, (from eyxva, to conceive). Pregnant. ENCY'STIS, (from ev, and xvrlis, a bag). See NjEVUS. ENDEDINE'MENOS, (from ev fovea, to turn round like a vortex,) an epithet for the eyes, which perpetu- ally turn in their orbits. ENDEI'XIS, (from evfotxwfM, to show). See Indi- CATIO. ENDE'MIAS, or ENDE'MIUS, (from ev, and hy.os, people^) enchorios, popularis. A term applicable to diseases common to the inhabitants living in one coun- try, from a cause connected with it, as intermittents with the marshes of Essex, and fens of Cambridgeshire; the swelled throat in the Alps; and the plica and per- tussis in Poland. It is opposed to Epidemius, q. v. E'NDESIS, (from ev, and ha, to tie). A ligature, BAND, Or CONNECTION. E'NDICA. A sediment at the bottom of a fluid; called also mose hazuania. Rulandus. E'NDIVA, (quasi eundo via, from its frequent oc- currence,) intybum sativum, seriola, cichoreum endivia Lin. Sp. PI. 1142. Endivia vulgaris, endive. This plant is in common use as a salad: it very much resem- bles succory, both in its appearance and virtues. It is etiolated, viz. blanched, by excluding the light. With- out this process it is bitter, and not eatable. The Ba- tavian endive, whose leaves are not deeply crenated, requires no previous etiolation. It is considered as Avarmer than lettuces, but differs little in its properties from other salads. E'ndiva erecta lutea napifolia. See Lampsa- na. ENELLA^'GMENOS, (from evxXXxrlu, to alternate). An epithet applied to the joints of the vertebrae, be- cause of their alternate or mutual receptions and in- sertions. E'NEMA. A clyster, (from evir,fii, to inject,) enclysma, catlaysma, and lotio. Any liquid medicine in- jected into the anus. Clysters are usually injected by means of a bladder and pipe, called elusma, fistula, auliscos; from whence fistula armata, pipe, and bladder: but in many other countries a syringe is always used, by which the liquor is throAvn up further into the boAvels. The quantity of liquor used in each clyster will vary according to the age of the patient and intention pro- posed. For infants, two ounces are sufficient; a child of six years old, from six to eight ounces; a youth of fourteen years, from eight ounces to a pint; and to an adult, from a pint to a pint and half. In general, the bulk should be considerable ; for they stimulate from their bulk alone, and a quart of milk and water will of- ten produce the appropriate effect; a circumstance of some utility, when the too anxious friends dread every evacuant. When the more active purgatives are thus combined with increased bulk, they seldom fail. Clysters seldom reach beyond the sigmoid flexure, or that turn of the colon, on the left side, before its straight direction obtains for it the name of the rectum. They thus operate chiefly by stimulating the lower part of the gut, and evacuate only to the extent which that stimu- lus reaches. They are of little use, therefore, as evacuants, unless a purgative has been taken, whose effects we wish to hasten. This is often of considera- ble service where only small doses of cathartics can be retained; for by these means they prove effectual; and frequent solicitations by clysters produce, in such cir- cumstances, the best effects. In diarrhoeas, and all disorders where the intestines are weak, or whenever the clyster is to be retained, the quantity for an adult should not exceed five or six ounces. In ardent fevers, and inflammations of the bowels, they ansAver the end of a fomentation, and should be ad- ministered from a pint to a quart. In putrid fevers, this mode of introducing the bark and fixed air into the constitution has been adopted, it has been said, Avith suc- cess. Nourishment may be conveyed by clysters, Avhen, from some complaint of the mouth, throat, or stomach, nothing can be swallowed or retained: many have been thus supported during several weeks. In such cases a quarter of a pint of rich broth is injected, with thirty or forty drops of tinctura opii, every five or six hours, and bark with port wine has been injected in the same way. The effects are not, however, so decidedly bene- ficial as they have been represented. Clysters should never be either hot or cold Avhen used; but so warm, that, when inclosed in a bladder, the heat gives only an agreeable sensation to the closed eye lid. When a clyster is intended only to evacuate, three or four ounces of common salt, or as much soap in a pint and half of water, are sometimes equally effectual with any quantity of the other purging medicines. When a very powerful stimulus is required in purg- ing clysters, it is usual to mix emetics with them, and of these the vinum antimonii merits, it is said, the pre- ference. But any of the more active purgatives will equally succeed; and there is not a more effectual purga- tive clyster than three drachms of the pulp of colocynth, boiled for a quarter of an hour in a sufficient quantity of water, to strain off a little more than a pint. To this should be added iavo ounces of oil, and as much vitri- olated magnesia. The usual method of injecting clysters is very inade- quate, and often ineffectual. An injecting syringe, which holds a pint and half, is the proper instrument; and it is sometimes of advantage to have a lateral pipe, by which it may be supplied without withdraAving. We might thus even fill the colon, and produce many benefi- cial effects; since a fomentation could be in this way ef- fectually applied to many important parts, Avhen in a ENS 611 ENT state of inflammation, or otherwise diseased. De Haen, by such an instrument, filled the colon of a dog, and in some experiments even conquered the obstruction which its valve offers. E'nema ex a'mylo. See Amyum. E'NEOS. Vain, empty, or useless. The Greeks call those who are unable to perform the common offices of life, as dumb, deaf, or foolish persons, eveoi. ENE'RGIA,(from ev, and tpyov, a work). Energy; force, vigour, efficacy. ENERVA'TIO, (from enervo, to weaken,) an equi- vocal term, signifying aponeurosis or debility. E'NFLURE DES JAMBES. See Lymph* duc- tus. E'NFONDE. See Cassada. ENGISO'MA, (from eyfi^u, to draw near). An in- strument formerly used about fractures of the cranium; and from hence employed to signify a fractyre of the cranium, in the middle of which the bone presses upon the membranes of the brain, resembling a yeio-ov, or pent house. ENGOMPHO'SIS, (from ev, and yo^os, a nail). See Gomphoma. ENGO'NIOS, (from ev, and yavix, an angle), the bending of the arm at a right angle. Hippocrates. ENGO'RGEMENT LAFTEUX. See Lymph* DUCTUS. ENH-E'MON, (from ev, and xipu, blood). Styptic The name of an astringent plaster in Myrepsus. . ENI'XA, (from enitor, to endeavour). A woman in CHILD BED. ENI'XUM, (from enitor, to produce); the appella- tion of a neutral salt. See Neutri. Eni'xum Parace'lsi sal. From the discoverer Pa- racelsus : kali vitriolatum. ENNEA'NDRIA, (from ewex, novem, and xvtip, ma- ritus): the ninth class of the Linnaean system, com- prehending such hermaphrodite flowers as have nine stamina. ENNEAPET'ALUS, (from ewex, novem, and velx- Xtv, a flower-leaf). Having nine petals. ENNEAPHA'RMACOS, (from au*\ nine, and Qxgf&xxov, a medicine,) a composition of nine simple in- gredients. It is also the name of a pessary mentioned by Galen and .Egineta; of the antidotus Heraclidis; and of several plasters mentioned by .Etius and Celsus. ENNEAPHY'LLUM, (from ewex, nine, and tpvXXov, a leaf). See Helleborus niger hortensis, Sec. ENOCHDIA'NA VI'TA. A very long life ; the life of Enoch. Paracelsus. ENRY'THMOS, (from ev, and pv6/Ms, number). See Arythmus. ENS. An entity, or thing really existing. In Pa- racelsus ens imports the power, virtue, and efficacy, which a thing exerts upon our bodies. , Ens pa'rvum sapie'ntum. It is soap made by mix- ing fixed alkaline salt with distilled vegetable oil. The salt must be quite hot when mixed with the oil, for the least portion of water prevents their union : after their combination they are to be placed some time in a subterraneous place. A small quantity of the salt re- maining on the surface of the oil will attract water, and prevent the success of the process. Ens pri'mum salium. See Circulatum. Ens pri'mum sola're. See Antimonium. Ens ve'neris. See Flores martiales, under Fer- rum. ENSA'TUS, (from ensis, a sword). In botany it means shaped like a sword. ENSIFO'RMIS CARTILAGO, (from ensis, a sword, and forma, a form). The sword like carti- lage, called also xiphoides ; mucronatum os, or mucro- nata cartilago ; by Hippocrates, chondros,- and when bifurcated,,/wrctt/a orfurcella inferior. It is the carti- lage at the bottom of the sternum; but the ancients often give the name of ensiformis to the Avhole breast bone. Dr. Hunter observes, that " if this cartilage be forced inwardly by a blow, it will occasion vomiting and violent pains, by pressing against the pylorus : in this case it would be proper to lay it bare and elevate it; but the diaphragm arising partly from it would probably replace it." From the form, or from accidents in this cartilage, many diseases arise; as a cough, pain in stoop- ing,- and difficult breathing. These symptoms are ac- counted for, when we consider that the diaphragm is attached to it, and that the great lobe of the liver and the stomach lie immediately under it. ENSTA'CTON, (from ev, and o-rx^a, to distil). In- stillation. The name of a liquid collyrium in Galen, which .Egineta calls stacticon. ENTA'LI. Fossil alum. See Vas. ENTA'TICA MEDICAME'NTA, (from evleivu, to strain). Medicines that provoke venery. Coelius Au- relianus calls them satyrica. ENTA'TICON. The name of a plaster in P. jEgi- neta. E'NTERA, (from ev?es, within,) the bags in Avhich were inclosed medicines for fomentation. Hippo- crates. ENTERADE'NES, (from evlepov, an intestine, and xh*, a gland). The intestinal glands. See Intes- TINA. ENTERE'NCHYTjE, (from tvlepx, the intestines, and efxvu, to infuse). Instruments for administering clysters. ENTERI'TIS, (from evlepx, intestines). See Inflam- MATIO INTESTINORUM. Enteri'tis mesente'rica, (from the same, and fteo-evlegix, mesentery). See Inflammatio mesenterii. ENTEROCE'LE, (from evlepov, an intestine, and xtjXri, a rupture). See Hernia scrotalis. Enteroce'le ovula'ris. A rupture of the intes- tines through the foramen ovale. ENTERO EPIPLOCE'LE, (from evlepov, emvXoov, the omentum, and xyXy, tumor,) when both the omen- tum and intestines protrude through the integuments of the belly. Entero-hydroce'le, (from evrepov, tfotg, water, and xyXvi, a hernia). A dropsy of the scrotum, with a de- scent of the intestine. ENTERO'MPHALOS, (from evlepov, and e^*^?, the navel). A rupture of the intestine at the navel. This seldom happens to women in labour, or from la- bour ; but it often occurs in those debilitated by numer- ous births; to women who are fat and indolent. E'NTERON, (from evros, within). Internal and intestine. In Hippocrates Epid. 6. § 4. ap. 3. e?ite- ron signifies simply the colon. 4 I 2 E i\ Ij 612 E P A ENTEROPIIY'TUM, (from evlepov, and Qvlov, a filant). 1 he sea chitteriing, Avhich groAvs in the shape of a plant. ENTERORA'PHE, (from evrepov, and pxty, a su- eat of the body is moderate, such as attends an excess of wine, or a violent passion. The pulse is somewhat full and quick, but soft and regular; the urine unchang- ed : neither is the complaint preceded by any sickness, yawning, propensity to sleep, or horror. It comes on suddenly, unattended with any pain of the head and stomach, nausea, burning heat, or inquietude. The disorder sometimes goes off without any apparent eva- cuation ; but oftener by a free perspiration, or at most a pleasant moderate sweat. It generally arises from watching, solicitude, sorrow, anger, inebriety, fatigue, heat of the sun, or inanition, and usually terminates in one, at the furthest, in two or three days. Nature commonly effects a cure. The fever described by Lom- mius, and other ancient authors, under this title, is evi- dently an exacerbation of the common febrile accession^ in consequence of some of the causes mentioned. There is, however, an ephemera of a different kind, marked by violent rigor, and succeeded by burning heat, which disappears at the end of the twenty-four hours, leaving only debility. It is the occasional recur- rence of such ephemerae which has induced nosologists to establish a genus which they style erratica, but which seems to have no existence. We have seen such ephe- merae frequently, without being able to trace their source. We have generally, however, had reason to suspect that they were owing to obstructed viscera, or at least con- nected with some internal disorder. They require no remedy but rest and warm diluting liquors. See Lom- mii Observationes Medicae. Sauvagesii Nosologia. Ephe'mera dichomene ; the febris erratica of noso- gists just mentioned. EPHEME'RIDES, (from eQ*)(te§is, an almanack, as they may be foretold by the almanack). Van Helmont calls those diseases which seize the patient at particular times of the moon, ephemirides agrotorum, the alma- nacks of the sick. EPHE'MERON, (from em, and iftepx, a day ; be- cause the flowers continue but a day). See Hermo- DACTYLUS. EPHE'SIUM. The name of a plaster described in Celsus. EPHIA'LTES, or EPIA'LTES, (from eQxXXoHMi, to leap upon). See Incubo. EPHIA'LTIA, (from ephialtes; because it occasions the night mare). See PjEonia. EPHIDRO'SIS, (from eQtfyoa, to break out into a sweat,) hydropedesis, desudatio and mador. Dr. Cullen places this disease in the class locales, and order apoce- noses; and defines it a preternatural evacuation of sweat, one species only of which he considers as idiopathic; ephidrosis spontanea. The rest are symptomatic, of which he enumerates nineteen varieties—seven according to the diseases which they accompany, viz. febrile, febri- cose, hectic,exanthematic, syncopic, scorbutic, saburral; eleven, from the nature of the SAveat; lacteal, melleous, vinous,green,black,pale yellow,urinous, bloody, bluish, acid, arenous ; and one, from the part whence the sweat is effused, viz. lateral; or, more properly, local. The idiopathic ephidrosis is most frequently the result of debility. Sauvages has three or four times observed men who were afflicted violently with night sweats, that continued for months without fever, bringing on emaciation, debility, and loss of appetite : these Avere cured by cathartics, the mineral waters styled acidula, and milk; but amongst boys the disease used to con- tinue long. These sweats seem to resemble Diabetes and Celiaca passio, q. v. The sweating sickness, said to be peculiar to England and to Englishmen, in every climate, Avas a fever. See Cullen's Synopsis, and Sau- vages's Nosolog. Methodica. EPI 614 EPI EPHI'PPIUM, a saddle. See Sella turcica. It is called ephippium, from its resemblance to a saddle. EPHO'DES, (from em and o&s, a way). In Hip- pocrates it means the ducts or passages by which the excrementitious fluids of the body are evacuated; the pe- riodical attack of a fever, from the common use of the term to express the attack of thieves; or the access of similar or dissimilar things which may be useful or hurt- ful to the body. EPI'ALOS. An epithet of a fever, (from amos, gen- tle, and xXs, the sea). Galen defines it to be a fever in which the patient labours under a preternatural heat, and a coldness at the same time ; called by the Latins quercera. Hesychius confines it to the cold shivering preceding a fever; and other authors enumerate it among the varieties of tertian fever. EPI'BOLE, (from em and pxXXa, to be cast upon). See Incubo. EPICA'NTHIDES, (from em, and xxv6os, the angle of the eye). See Canthi. EPICA'RPIUM, (from em, and xxpvos, the wrist). See Cataplasma. EPICAU'MA, (from em, and xxiu, to burn). See Encauma. EPICERA'STICA, (from em, and xepxvwp.i, to mix, or attemperate). Medicines supposed to dilute obtund acrimony, and relieve troublesome sensations. EPI'CHOLOS, (from em, and xo>">i bile). Bilious. EPICHORDIS, (from em, and %•&*, a gut). See Mesenterium. EPICHO'RIOS, (from em, and xu?*ta region). See Epidemius. EPICGL'LIS, (fromeTrt and xoiXis, the eye lid). The UPPER EYE LID. EPICO'LICE REGIO'NES, (from em, super, and xuXov, colon). The lateral or lumbar region; the parts of the body adjacent to the colon. EPICRA'NIUM, (from em, and xpxviov, the skull). See Occipito frontalis. EPICRA'SIS, (from em, and xepxwv^t, to temper). A critical evacuation, or an attemperation of bad hu- mours. When a cure is performed in the latter Avay, it is called per epicrasin. The term is often employed by the Galenists and Boerhaavians; but as we have no evidence of a depraved state of the fluids in the circu- lating system, we are neither anxious to " attemper" or " evacuate" them. EPICTE'NION, (fromfsn, above, and xreis, pubes). The part above the pubes; and the fine lint Avhich is Avafted in the air where flax is dressing. EPICYE'MA, and EPICYE'SIS, (from em,andxvu, to conceive). Epigonon. Superfs, the peo- ple). Epichorios ;pandemius, popular is, regionalis mor- bus. An epithet of diseases which at certain times are popular, and frequently attack; then for a time disap- year, and again return. The extensive influence of epidemic diseases has ex- cited the greatest attention to their causes. In almost every ruder age they have been referred to the anger of their peculiar divinities, and sacrifices were instituted to reconcile them. More lately Dr. Webster has attempted to connect them Avith the eruptions of volcanos, or the devastation of earthquakes. A more sound philosophy, and more attentive observation have shown, that they are owing very often to the effluvia of neighbouring marshes, and their occasional appearance is connected with the prevailing wind which passes from the marsh to the habitations. Another cause of their prevalence is, the wind from the marsh coinciding with the time when the moist ground begins to appear, from the waters subsid- ing. This is the period of sickness; for the marsh, while covered with water, is innocuous Another cause of epidemics is the weather. A long continued warm season, suddenly interrupted by a cold piercing wind, will produce a violent and extensive epidemic, which particularly attacks in the highest, and apparently the most healthy, situations; for this reason, that the inhabitants are there most exposed to cold. But if this interchange of weather occurs to the inhabitants of a crowded city, the epidemic will be highly putrid, and often fatal. Should contagion of a malignant kind con- cur, the devastation of the epidemic will increase in proportion. These are the concurring causes of the American yelloAV fever, and the late fatal epidemics in Spain. There are, however, causes which we cannot investi- gate. Extensive epidemics appear, and travel in succes- sion, with different severity, through every part of the globe that we are acquainted with. The destroying angel seems to move with a studied regularity, without our be- ing able to arrest his steps or alter his course. We often find these inexplicable epidemics without much danger, influencing the appearance of diseases and their treat- ment. Thus, Avhile some epidemics prevail, evacua- tions from the bowels are necessary in almost every complaint; even where, in appearance, unnecessary or contraindicated. In others, they are, with difficulty, borne in any disorder. This necessary attention to the prevalence of the constitution merits very particular at- tention ; and the more extensive a physician's experi- ence is, by so much will he be better able to treat the commonest disease. Epidemics connected with the seasons or prevailing temperature may be easily traced, and we shall find them occasionally mitigated or severe: sometimes ap- parently stopped; at others exerting their power with increased virulence. The peculiar treatment, however, suggested by a general epidemic, should not at once be discontinued. The human constitution does not soon change; the alteration is gradual, and almost imper- ceptible : nor should the medical plans be altered till they are decidedly injurious. When an epidemic has continued for some time, the body is habituated to the influence of the morbid cause; suffers less from it; and the health is more readily re- stored. At this time, remedies before useless are found to produce some salutary effects; and, at the end of an epidemic, we usually are told of a plan which never fails. On its return, these boasted plans are as ineffec- tual as before. In fact, they only combated, Avith suc- cess, a disease of reduced power. We greatly want a judicious and Avell connected EPI 615 EPI aecount of epidemics. Dr. Webster has lately brought together a very extensive collection of facts of this kind, with the vieAvs formerly mentioned ; but the chaff is so intimately mixed with the grain, that the salutary in- formation is Avith difficulty selected. See also Obser- vations on Epidemic Disorders, 8cc. We cannot give a better view of the epidemics of the two last centuries than in the comprehensive abstract of Dr. Sims. " 1. The first epidemic constitution was as follows : The years 1590, 1591, 1592, were all exceedingly dry; as was part of 1593; afterwards very rainy weather until the end of 1597. In 1593 the plague killed eleven thousand five hundred and three in London; the same year it Avas prevalent in Alcmaar. A catarrh prevailed in 1597. The rainy weather began in Florence in 1592, during which a pestilential fever raged there, attended with a whitish tongue, and an inflammation, Avith ulcers about the throat and mouth. " 2. There was, in 1598, an excessive heat and drought, which continued next year; 1600, a severe winter; 1601, a drought of five months' continuance; 1602, a cold spring and summer, cold dry harvest and winter; the rest of this constitution very rainy, until the end of 1608, except seven Aveeks' frost in 1607. In 1603 the plague Avas imported from Ostend, where, and in the Low countries, it raged much, and killed thirty-six thousand two hundred and sixty-nine in London. " 3. In 4609, three months most rigorous frost, wherein the Thames" became like a solid highway ; 1610, an excessive hot dry summer, as were those of 1611 and 1612; 1616, 1617, and 1619. The winters of 1614 and 1615 great frost and snow; the rest of this constitution wet until the end of 1624. In 1609 the plague broke out in Alcmaar, as also in Denmark. In 1610 the Hungarian fever commenced in many places, and made great havoc for several years, so as often to be denominated a plague. About the same time the ma- lignant sore throat is supposed to have commenced in Spain, Avhere it killed incredible numbers. In 1611 the plague is said to have destroyed two hundred thousand at Constantinople. In 1614 the most fatal small pox spread all over Europe. In 1618 the sore throat broke out at Naples, where it continued its ravages for twenty years; it was preceded by a similar disorder among cattle. In 1618 the plague existed in Bergen. In 1619 it broke out in Denmark and in Grand Cairo. " 4. In 1625, a hard frosty winter, summer wet and hot; 1626 and 1627 excessively hot summers; 1630 and 1631, a great drought; the other years wet until 1634. In 1625 the plague killed thirty-five thousand four hundred and seventeen in London ; it raged in Denmark both in 1625 and 1629; as also in 1625 in Leyden. In 1632 inflammations of the jaws prevailed, with an erysipelas in one or more parts of the body. "5. In 1634, an excessively frosty winter; 1635, 1636, 1637, and 1638, very hot and dry summers; then very rainy years until 1643. In 1635 the plague in Leyden, and the camp fever spread all over Germany. In 1636 the plague Avas in London, whereof died thir- teen thousand four hundred and eighty; in 1637, the plague in Denmark. "6. The years 1643 and 1645 Avere remarkable for hot summers, followed by inconstant rainy seasons until 1650. In 1648 a fatal malignant fever Avas spread by the armies all over England ; 1644, a malignant epide- mic fever in Denmark; a similar fever in England, in which there Avas a roughness and sliminess of the throat and jaws, with pain, but scarcely any sAvelling or inflammation: it seemed only a mere defluction, by which the sick seemed choked, and for Avhich astrin- gent gargles Avere useful. In 1650 a general catarrh prevailed. "7. The years 1651 and 1659 had both very hot summers, and proved mostly dry; thence to 1655 very- wet. The winters of 1651 and 1658 remarkably cold. In 1651, in the country about Rome, a contagious epi- demic quinsey prevailed, and made terrible slaughter among children. A small ulcer arose in the mouth, for which juice of wood sorrel, syrup of pomegranates, with the bark, and chiefly the acid of vitriol, were useful. All that took these medicines recovered; but those who were not tractable, and refused medicines, died: it did not seize adults, nor the aged. In 1654 the plague was in Denmark; and in 1655, and the two following years, it prevailed exceedingly in the south of Europe; the agues likewise of these hot years were malignant, and spotted fevers were very common. In 1664, after a mild rainy Avinter, a malignant purple fever raged in Prussia, and killed great numbers under twelve years of age, those only escaping who had no inflammation or oedematous tumour in the throat. Such as recovered, after sweating, had scales peeling off the skin; then adults had a SAvellingover their body and of their belly, which continued several weeks like leucophlegmatia, and then Avent off by sweat and urine. This epidemic seems a considerable deviation from their general pro- gress laid down in the scheme of them already men- tioned, and is, therefore, particularly noticed in this place. " 8. In 1665, an excessively severe frost, which con- tinued to the end of March, summer temperate; 1666, a very hot dry year, followed by two as Avet and cold. In 1665, immediately after the frost, began the plague in London, which killed, according to the least computa- tion, sixty-eight thousand five hundred and ninety-six. Since that time the plague has vanished from London, and all other epidemics seem to have become less ma- lignant, owing to many causes ; among which may, per- haps, be a greater use of fresh vegetable food, a less use of fish, an universal use of tea, superior cleanliness in our persons, a greater attention to the poor in times of scarcity, Avhich are now scarcely felt in any extreme de- gree, and, lastly, the tremendous fire in 1666, since which the streets have been very much widened, and the houses so enlarged, that the same number of inha- bitants now occupy above double the space. In 1667 an epidemic fever, Avith aphthae, prevailed in Holland, in which acids were useful, but neither bleeding nor purging. "9. In 1669, the summer intolerably hot, after Avhich the winter was as severely cold and frosty; 1670, a severe frosty Avinter; the rest of this constitu- tion bad and wet. In 1669 a most fatal fever prevailed, with slimy tongue, sore mouth, &c. in which bleeding was hurtful, but acids and laxatives very beneficial. Sy- denham does not mention this fever, nor its return in 1678, although, next to the plague, they Avere the great- est epidemics in his time; which, together Avith his E P 1 616 EPI little knowledge of putrid fevers, can only be attributed to his practice lying about the court; whilst Morton, who practised in the city, gives abundant proofs that putrid complaints were as prevalent then as at this time. The same year, in Norway, malignant measles are said to have prevailed, with thrush, Avhich, if mismanaged or neglected, ended in a fatal mortification. In 1675 a coryza, or cough, were prevalent. " 10. In 1678, summer and harvest droughty, hot, and clear ; 1679, Avinterlong, severe frost, and intensely cold ; 1680 and 1681, summer extremely dry and hot; the next iavo years rainy. In 1678 the same fever and sore throat prevailed as in 1669. In 1679, after a most deluging October, a catarrh was universal. In 1682, sphacelated tongues and angina maligna prevailed among cattle ; in the same year, in Dublin, a fatal pe- techial fever. "11. The year 1684 was remarkable for the severest frost remembered at that time, succeeded by a very dry and hot summer, to which 1686 bore a near resem- blance: the other years were rainy till 1691. In 1684 spotted fevers, particularly of the miliary kind, were common. This and the following year of 1685 are re- markable for the greatest number of burials; from 1665 to 1714, although 1684 does not contain St. James's, Westminster, and neither 1684 nor 1685 contain St. Ann's, Westminster, nor St. John's, Wapping, parishes, Avhich are inserted in every following bill of mortality, and which then buried above sixteen hundred annually at a medium. In 1688 an epidemic catarrh prevailed all over Europe. "12. A frosty winter in 1691, and excessively hot and dry summer. The same in 1694, the other years rainy and variable. In 1691 a fatal spotted fever pre- vailed; in 1693 an universal catarrh; and in 1695 the hooping cough. " 13. Of 1698, an exceedingly hard frost in the win- ter ; the rest of this constitution rather rainy. In Octo- ber, 1698, began a fatal contagious spotted fever, which spread all over England. Coughs attended most of the diseases in 1703. " 14. The year 1704 was excessively dry, so that the grass was burnt up; this continued until August 15,1705; the rest of this constitution cold and wet. In 1704 ma- lignant spotted fevers were common. In 1708 coughs and coryzas prevailed every Avhere, so that few escaped. " 15. In 1709, great frost all over Europe, and even in Portugal; 1712, a very frosty winter; the rest of this constitution variable. In 1709 the plague broke out in Dantzick, immediately after the thaw, and killed twenty four thousand five hundred and fifty-three. In 1710 the plague in Copenhagen killed twenty-five thousand. In 1712, sore throats universal in July and August, Avith dizziness and pains of the limbs, in London. " 16. The year 1714, and the six succeeding years, were all dry, with hot summers. In the winter of 1716 so severe a frost that the Thames was covered with booths; that of 1718 likewise very frosty; the rest to 1731, cold, wet, and variable, except 1723, which was cold and dry ; and 1729, which was a cold dry winter, followed by a hot dry summer. In 1720 the plague killed sixty thousand in Marseilles. In 1729 an univer- sal epidemic catarrh prevailed in November. " 17. The year 1731 was a very dry one, which con- tinued until harvest 1732; summer of 1733 rather dry and pleasant, as was most of 1 738; the remainder of this constitution extremely wet. In the beginning of 1733 was an epidemic catarrh; 1737, 1738, and 1739, were all much affected with catarrhal fevers, especially among children. "18. In 1740 Avas the severest frosty Avinter and spring that had happened for three hundred years; 1741, extremely dry hot summer; 1742, a variable, but dry, year; the rest of this constitution wet or variable. In 1740 a malignant petechial fever made great havock in Bristol, and in Galway in Ireland. In 1741 it reached London, where this and the last year were the most mor- tal ever known, except when the plague reigned, the burials amounting to sixty two thousand nine hundred and eighty. In 1742 the putrid sore throat broke out. In March, 1744, an epidemic catarrh Avas universal, and was more fatal than usual. " 19. In 1747, there was an excessively hot dry sum- mer ; r?50, a dry year throughout and intensely hot summer; the rest of this constitution moderate, variable, or wet. In 1747, and the succeeding years, the sore throat seemed to acquire new vigour, alarming the in- habitants of these kingdoms very much. In November, 1758, there was an universal epidemic catarrh. " 20. The year 1760 was droughty from June 26 to September 16; the end of that and the following year severely wet, as was the end of 1763 and beginning of 1764; the rest of this constitution moderate. In April and May, 1762, a most epidemic catarrh. "21. A very dry year, and rather hot summer in 1765, as was the next year, though not quite so much so ; the remainder of this constitution moderate years, rather inclining to Avet. During this constitution no very remarkable epidemic till the universal catarrh in November, 1775, unless we reckon such, the small pox of the year 1772, which, succeeding a hard winter, Avere more fatal than they had ever been before in London. "22. The year 1776 was dry, and 1778 still more so. The winter of 1780 Avas the most frosty since 1740: yet these deviations from what might be accounted mo- derate Aveather were so small as scarcely to deserve no- tice. In May, 1782, there Avas a very general epidemic catarrh; and early in 1783 began the constitution which produced the epidemic scarlatina anginosa, Avhich spread very considerably." See Dr. Wallis's Sydenham. EPIDE'RMIS, (from em, and hpxs, the skin); See Clitoris. EPIDE'RMIS, (from em, upon, and hp/tx, the skin). S.ee Cuticula. EPIDE'SMIS, (from em, and ha, to bind). A bandage by Avhich splints, bolsters, Sec. are secured. EPIDI'DYMIS, from em, upon and fohfuas, a tes- ticle). The epididymis may be reckoned a testis acces- sorius, called by Hippocrates, parastata. It is.abody on the upper part of the testicle, formed of a continua- tion of the tubes that constitute its body: the continu- ance of the epididymis upwards forms the vas deferens. See Testes. Epidi'dymis diste'nsa. See Spermatocele. EPIDO'SIS, (from emfofovptt, to increase). Preter- natural enlargement of the parts. EPI'DROME, (from em, upon, and SpefAM, to run). An afflux of humours, particularly from a ligature. EPI 617 EPI EPIGA'STRICjE ARTE'RIiE, (from epigastrum). The epigastric arteries. The external iliac artery divides into two branches at the ligamentum Poupartii; one of these is the epigastric, which runs to the inside of the rectus abdominis, at whose upper part it com- municates Avith the internal mammary. Dr. Hunter observes, that in the operation for the femoral rupture, Ave endanger dividing the epigastrica if we cut upAvards and outwards; and if upwards and inwards, the sper- matic, as the hernial sac lies in the angle betAveen the two. Epiga'strice ve'n.e. The epigastric veins. The external iliac veins, a little before their going out of the belly, send off from the inside the epigastric veins, from Avhence branches run to the neighbouring glands, up the musculi recti abdominis, and then, advancing, join the mammaria. EPIGA'STRIUM, (from em, upon, or above, and yxFr%p, the stomach). The upper fore part of the belly; reaching from the pit of the stomach to an imaginary line above the navel, supposed to be drawn from one extremity of the last of the false ribs to the other. Its sides are called hypochondria, and are covered by the false ribs, betAvixt which lies the epigastrium. EPIGE'NEMA, (from emyevxu, to generate anew). Sometimes it signifies an adventitious symptom; at others any thing added, as a fur on the tongue. EPIGINO'MENA, (from emytvopxi, to succeed, or supervene). Those symptoms which naturally succeed, or may be expected in the progress of a disease (Galen); but Fcesius considers them as accessions of some new affection, which never happened but in stubborn and malignant disease. See Epiph^exomena. EPlGLO'SSUM, (from em, upon, and yXurrx, the tongue; from a less leaf growing above a larger in the shape of a tongue). See Laurus Alexandrina. EPIGLO'TTlS, (from em, and yXurlis, the aperture of the lary7ix). See Aspera arteria. EPIGLO'TTUM, (from emyXarlis). An instrument mentioned by Paracelsus for elevating the eye lids, re- sembling in shape the epiglottis. EPIGLU'TIS, (from em, and yXovlos, the buttock). The superior part of the buttock. EPIGO^NATIS, (from em, and yow, a knee). See Patella. EPIGO'NON, (from emyivopMi, to proceed upon). See Epicyema. EPIGO'NIDES, (from em, and yow, the knee). The muscles inserted into the knees. EPILE'PSIA, (from emXxf&Gxvu, to seize, 'mvade, or oppress). The epilepsy ; Abas, 7norbus caducus, in- terlunius, ?nagnus, and attonitus morbus, analepsia; by Paracelsus, catalentia; by the Portuguese, cobrello; by Hippocrates, ecla7npsis, falling sickness ; heracleios, the great or herculean disease, from its violence and intractability; the sacred or divine disease, because it Avas supposed owing to the divine influence; 7norbus infantilis and puerilis, as happening most frequently to infants and children ; comiste, and comitialis morbus, since people were frequently seized Avith k Avhilst in the comitia. Dr. Cullen places this genus of disease in the class neuroses, and order spasmi. He defines it a convulsion of the muscles, attended Avith a loss of sense, terminat- VOL. I. ing in a state of insensibility, and seeming sleep. He- distinguishes three species: 1. Epile'psia cerebralis, when it ?.viuCo suddenly without any manifest cause; no uneasiness preceding, except sometimes a giddiness or loss of sight. 2. Epile'psia sympathica, Avhen it arises Avithout any manifest cause; but is preceded by a particular sensation, called aura epileptica, from some part of the body rising upAvards to the head. 3. Epile'psia occasionalis, when from manifest irritation, and ceases on the removal of that morbid cause. An epilepsy is a violent, involuntary, or convulsive contraction of the muscular parts of the Avhole body, at- tended with an abolition of sense, owing generally to some irritation in the common sensorium, producing insensibility, and consequently irregular action. When the cause is in the brain itself, it is called an idiopathic epilepsy; when in other parts, symptomatic. The idiopathic epilepsy is remotely occasioned by- external violence; by bony protuberances arising in- ternally in the basis of the skull, in the lateral or the falciform sinuses; from an obstruction of the jugular veins; from polypous concretions; the passions of the mind ; an ill conformation of the brain, 8cc. A symptomatic epilepsy is produced by cachectic and hypochondriac habits; flatulencies proceeding from the stomach and bowels ; spasms of the intestines ; irregular secretions and excretions ; the acrid matter of eruptive and other diseases conveyed to the brain; gout; pains that are violent and attended with spasms ; stones pass- ing through the ureters ; worms ; poisons, Sec. The diagnostics vary in different people: some are suddenly seized; others have a train of symptoms fore- boding the attack, such as Aveariness, an oppressive pain in the head, interrupted sleep, a languid pulse, a pale countenance, stupor and drowsiness, an unusual dread and terror, -a ringing in the ears, palpitation of the heart, inflation of the prccordia, disturbed respira- tion, rumbling in the boAvels, a discharge of fetid stools, coldness in the joints, and a copious discharge of urine. A cold vapour is sometimes perceived gradually ascend- ing from the extremities to the brain. Whether these symptoms precede the attack, or are absent, the fit ap- proaches suddenly, and as it Avere unexpectedly; the patient falls doAvn ; the thumbs are firmly fixed on the palms of the hands; the eyes are distorted, and the white part only appears; all sensation, both internal and external, is lost; a froth is forced through the closed lips, Avith a hissing noise ; the tongue is often lacerateet by the teeth; and the limbs are agitated with the most violent convulsive motions. In some, the distortions and gesticulations are ridiculous and distressing; in others, instead of convulsive motion, there is highly rigid spasm in all the members, by Avhich they are so fixed that no force can move them. The seed is occa- sionally ejected, and sometimes the urine is discharged to a considerable distance, and this, as well as the dis- charges by stool, arex involuntary. At length these symptoms remit; the patient seems to have a sort of respite* at intervals, but the eye lids remain immovable; the teeth grind upon each other, the tongue hangs out of the mouth. When the paroxysm ceases, the patient is entirely ignorant of every thing that happened during EPI 618 EPI it; he rolls on the ground; his countenance appears sad; he begins to yawn, and stretches himself Avith a kind of violent effort; he rises and Avalks sloAvly, seems uneasy, and the veins of his forehead appear distended. The recollection returns very slowly, and the symptoms which preceded the fit sometimes continue after it. The returns, in many instances, are regularly periodical; more frequently irregular and uncertain. By a frequent recurrence of this disorder the patient grows dejected; is indolent; subject to a vertigo and a trembling if he looks upward; is irritable, and quickly agitated. The epilepsy should be distinguished from the apo- plexy, convulsions, and hysterics. In apoplexy there are no convulsions; the breath is drawn with a stertor, and the pulse is unusually slow and laborious. If con- vulsions and hysterics are confounded with epilepsy, the inconvenience is not very great. The remedies do not materially differ; and those reputed epilepsies, at- tended with, and in part owing to, flatulencies in the stomach, are more nearly allied to hysteria. We may add also, that the epilepsies attended with stupor rather than convulsions, do not essentially differ from apo- plexy. Hereditary epilepsy is rarely cured; and when the disorder is chronical or habitual, success is scarcely to be expected. When the approach of puberty, the erup- tion of the menses, or the first delivery, does not remove an epilepsy in woman, an hereditary, cause-may be sus- pected, and a cure is not to be expected. When caused by frights, they are so rarely cured as to afford but little hope; for, when the patient seems recovered, trifles occasion a relapse. When the fit approaches - during sleep, the danger is greater. Hippocrates as- serts, that boys are relieved from this disorder about their seventh, fourteenth, or seventeenth year. There are hopes of cure when the case is not inveterate or hereditary, when the cause is in the primae viae, too great irritability, or some disorder translated to the brain. In all spasmodic diseases, the disease often continues from custom alone, after the original cause has long ceased to act; so that much depends upon breaking the habit. If several successive attacks can be prevented, it may never return. No medicine will so certainly prevent an epileptic fit, as a vomit given an hour before the attack. But this can only be employed when the disease is regularly periodical, as its approach is knoAvn by previous symptoms. In the epilepsia nocturna, a dose of ipecacuanha may be given at bed time. From the variety of causes, and the nature of some of thes'e, it is difficult to state the indications and method of cure. We may, Avith the generality of authors, pro- pose, 1. To prevent an impending paroxysm. 2. To shorten a present one. 3. To guard against future at- lacks. The first of these intentions is answered in ple- thoric habits by suitable evacuations and antispasmodics, as nitre, opium, musk, &c.; in languid constitutions, by Avarm, nervous medicines, as castor, valerian, camphor, fetid gums, volatile salts, the bark, and chalybeates. Cheyne thinks that the epilepsy differs but little in de- gree from the hypochondriac and hysteric fits; and observes, that, when the former abate, they end in the latter, and Avhen the latter are violent, they become epi- leptic: he therefore urges a free use of vomits, bitters, and steel. The second intention is supplied by sinapisms or blisters, if the fits are long; but before these are ap- plied, or when the fits are short, if the jaws are separated by a wedge as far as they can be opened in health, the fit, it is said, will be removed ; and in cases where the patient hath due notice of their approach, he may pre- vent them by introducing the wedge into his mouth. When the fits are preceded by a peculiar sensation in the toes, feet, or legs, a bandage applied tight below the knee will often prevent the paroxysm; or Avherever these sensations are felt, a bandage may be applied there, and continued from thence upwards. Instances of perfect cures have occurred, by cutting down on the part in Avhich those peculiar feelings were first perceived. (See an instance in the Edinb. Med. Essays, vol. iv. and the article Sesamoidea.) Coelius Aurelianus prefers the blowing of strong vinegar up the nostrils to volatile salts. The third intention requires, if possible, that the cause be known, in order to its being removed: but in some instances it cannot be discovered; and in others no remedy could be applied. In the article Convulsions we stated what appeared to us a correct view of the subject, and this is more particularly applicable to epilepsy. We there remark- ed that convulsions were irregular actions, depending chiefly on debility, though generally excited by some, often almost imperceptible, irritation. To prevent the return of the fits, both objects must be combined; and Ave have fortunately some medicines, or combinations of medicines, which will answer both intentions. Dissections have taught us that exostoses in the cra- nium, obstructions in the venous system of the brain, and various causes of irritation in that organ, frequently produce epileptic paroxysms. It will be obvious that no medicine has power over these; yet, in a very few instances, Avhere, from venereal complaints, the external injuries of the bone lead to a strong presumption of in- ternal ones producing the disease, long continued, gentle courses of mercury have succeeded: we say in a very few instances, for, in general, the bones are too inti- mately diseased to admit of very considerable relief. Yet where we find these mechanical irritations to pro- duce epilepsy, though we cannot remove them, we can often mitigate the paroxysms. In such cases we gene- rally find the fits increased by every circumstance which accelerates the circulation through the head; and, taking the hint from this fact, a drain from any part of the neck or head, by means of a blister or a seton; a free discharge from the bowels ; a milk diet, with the utmost tranquillity of body and mind, have given very considerable relief. Indeed, in almost every case of epilepsy, except where it is connected with great de- bility, or has been produced by debilitating causes, these means of relief will be found highly useful. Another cause of topical, nervous irritation occurs in those cases where the fit is preceded by a sensation of cold air, rising from some portion of either (though ge- nerally the lower) extremity. An instance of this kind is recorded where a hard body was found on the nerve, which was removed, and the fits ceased. In other cases a drain from that part, by means of a blister, has succeeded; but, as the cause is fixed and often within our reach, many remedies may be applied to the nerve, or if it be not a considerable one, it may be divided above the part whence the irritation proceeds. EPI 619 EPI These are unfortunately the very few instances on which our foundation is firm, and in which, if we can- not cure, we can often alleviate. In general, we must rest on the vague indications of counteracting irritability, or any concealed source of irritation. From the stomach and bowels the latter often unsuspectedly proceeds; and, in every instance, these organs should be kept free by occasional emetics, and the regular use of laxatives and anthelmintics, when Avorms, as sometimes happens, are the cause. From the observations under the article Cathartica, it will be obvious that these are means of removing many kinds of irritation fn different organs; and from their use in chorea and palpitations, it is pro- bable that they will be found extensively useful. Con- vulsions do not differ so greatly as autliors have gene- rally represented. In the diagnosis, which we hastily passed over because it did not admit of any practical application, they appeared to run into each other; and it is difficult, if not impossible, to distinguish epilepsy from other convulsions but from the violence, the obstinacy, and often the regularity, of the return of paroxysms. The foaming at the mouth is occasioned only by the convulsions of the muscles of the jaAvs emulging the salivary glands and combining the saliva with the air; yet this is the chief distinction. The paroxysms arising from a distant aura is a good mark of distinction; but it would greatly contract our vieAVs, and exclude many cases from the share of attention which they would otherwise receive. Another source of irritation, less obscure, arises from the suppression of the usual evacuations. The German physicians are uncommonly anxious to procure or re- store the haernorrhoidal discharge; but, in this country, we do not find it such an essential evacuation. The suppression of cutaneous affections has occasioned the disease; the repulsion of gout; and sometimes the de- ficiency of constitutional strength, which prevents its formation, has had the same effect. In some cases, the eruption of the menses will occasion pain and con- vulsive paroxysms. In all these instances, the knoAV- ledge of the cause will suggest the means of relief. When .causes of debility and irritability produce epilepsy; in other words, when the irritability is so great that the slightest irritation will induce the fits; the remedy is equally obvious. Wann generous diet, which may appear at first indicated, must be used with caution, since a fulness of the vessels is, alone, in ten- der habits, a cause of irritability. Tonics and narcotic bitters are the best remedies in such cases, anxiously guarding, as usual, against any accumulations in the head; but not by such remedies as will weaken. In the greater number of instances, however, we have only the vague indication formerly mentioned to direct us; and many are the nauseous disgusting reme- dies recommended by ancient authors, which act on the, mind by exciting horror, and thus, by fixing the attention, destroy the habit; for nervous paroxysms, after their cause is removed, are frequently renewed by habit only. These Ave shall not stay to enumerate : they are almost forgotten, and we wish not to revive their memory. Superstition has, however, employed one remedy, not yet Avholly disused, the misletoe, re- tained, perhaps, as a tonic from its connection with the pak. It jias, however, no such power: its taste is nauseous, and it may be sedative; but its quality is almost wholly mucilaginous. Tonics, in general, are freely employed; and, of these, the Peruvian bark is the principal remedy from the vegetable kingdom; yet alone it is seldom trusted, and would probably seldom succeed. The metals, avc have said, are very generally tonic, differing only in the degree of inflammatory stimulus, most conspicuous in iron. All have, however, been employed, viz. silver (argentum nitratum); iron (flores martiales, ferrum vitriolatum, rubigoferri, squamae ferri, and chalybs pre- paratum); copper (cuprum vitriolatum and ammonia- cum) ; zinc (zincum vitriolatum, ustum) ; tin (limatura vel pulvis stanni); arsenic (kali arsenicatum). Each has been used with success; but the silver, the copper, and zinc, have been preferred. These are more effectual when combined; but as we cannot suspect any chemical union, the increased power is probably owing to their being borne by the stomach in increased quantities. (See Combination of medicines). As a tonic, the cold bath is also an excellent remedy. The medicines which obviate irritation are the seda- tives and antispasmodics. Of these the chief is opium, and the valerian: camphor is similar in its poAvers; and the leaves of the orange tree, the extractum hyoscyami, the peony root, flowers of the cardamine pratensis, are medicines of the same class. We have found little benefit from any except the valerian and camphor. The flowers of the cardamine have failed in every instance; the leaves of the orange tree have produced only a temporary and inconsiderable benefit. The union, hoAv- ever, of these with the tonics has been particularly ser- viceable; and their effects seem to support the opinion we have attempted to establish. The bark and valerian united have afforded relief, which neither separately' could procure; and the camphor, with the zinc, been highly and deservedly commended. Opium has been combined with all the metallic preparations with ad- vantage. If, according to this idea, such combinations are pursued, much benefit will probably result. The tribe of antispasmodics has been employed; but not often successful. The ether, rectified animal oil of Dippel, oleum vini, musk, castor, and asafoetida, are the principal remedies of this class; but they are seldom trusted alone; and of their separate or comparative merits it is not easy to speak. We have placed them nearly in the order of their power. Of anthelmintics Ave have not spoken with sufficient distinctness. Worms are not an uncommon source of irritation in the tender habits of children; and epileptic paroxysms should always, in such cases, be attacked with this remedy, unless they arise from fright, or some more obvious cause. We have nothing to add at present to what we have remarked in the article Anthelmintics, q. v. See Hippocrates, Celsus, Coelius Aurelianus, Are- taeus, Hoffman, Boerhaave; and among the best authors on this subject, Threlfal's and Lyson's Essays on Epi- lepsy ; Cullen's First Lines, vol. iii. edit. 4. EPIME'LIS, (from em, and puiXoi, an apple). See Amamelis. EPIMO'RIOS, (from em, and futpa, to divide). In Galen it is an epithet of the difference of pulse with respect to the inequality of their time in beating. 4 K 2 EP 1 020 EPI EPIMU LIS, (from em, and pvXv, a knee). See Patf.lla. LPIXLNEU'COS, (from im, and veva, to 7iod or in- cline,) an epithet of a pulse Avhich beats unequally in different parts of the artery; also called perineneucos. Galen thinks it common in hectics. EPIXE'PHELOS, (from em, andveXxr). See Alica. FA'RINHA FRE'SCA, and RE'LADA. See Cas- sada. FARNESIA'NUS FLOS. See Battatas Cana- densis. FARRA'GO, corrupted from Favago, q. v. FA'RREA NU'BES, (from far, bran, and nubes, a cloud). See Furfurosi. FA'SCIA, ligatio, ligatura, alligatura. A bandage, fillet, roller, or ligature. Of bandages, in ge- neral, we have spoken in the article Deligatio ; and it now only remains to consider the different forms of bandages applied to particular purposes. The first of these is, The sling, echarpc. This appellation is given to several sorts of bandages. The sling with four heads should be four feet in length: the breadth that of six or eight fingers. Its use is to retain the dressing on the wounded head. It must be divided longitudinally, from each end, into two heads, so as to leave about two hands' breadth entire in the middle, and the four ends must be rolled up to where the division ends. Apply the middle of the undivided part upon the dressings; then tying the two posterior heads forward, and having secured their ends, the two anterior ends must be carried backward, and secured behind the head. This is sometimes called Galen's bandage. The sling with six heads, periscepastrmn, is about three feet in length, its breadth about twelve or four- teen inches. It must be divided from each end to within a hand's breadth of the middle, into three parts. Apply the middle undivided part to the vertex, and tie the two anterior tails behind the head, the two middle under the chin, and the two posterior upon the forehead. The sling for the nose hath four heads, is eight feet long, and two or three inches broad. In the middle it is left entire, but from thence, each way, it is slit to the ends. In the middle, where it is entire, an opening is made for the apex of the nose, that the bandage may be firm. The middle is applied upon the nose, the two upper heads to the neck, and then to the forehead; the loAver ones behind the neck, but a little higher than the first, and to the forehead also. The sling for the breasts is four feet long, six inches broad, and slit like the sling with four heads; about a foot in the middle being left entire. The middle is to be applied upon the dressings on the affected breast; then the two upper heads must be carried over the op- posite shoulder, and the two lower under the arm of the affected side, towards the scapula of the other side: they must there be fastened to the upper ends which are over the shoulder. The single bridle, capistry, is a single headed roller, fourteen or sixteen feet long, and two or three fingers broad, for securing the jaw Avhen fractured or luxated. It is applied under the chin, and over the head; called by Galen geneias. The double bridle is the same as the single, but rolled up with two heads: the single may, however, always be used instead of it. See Chevastre. Bandages for the lips, of a proper length and breadth, are formed as the sling with four heads. Bandages for the eyes or eye lids. See Monoculus. The divider for the neck is tAventy-four feet long, two or three fingers' breadth broad, and is rolled into tAvo heads. Its middle is placed on the forehead, and thence passes round the head two or three times.' When secured with pins, the rollers are carried under each armpit, and brought back over the shoulders, and cross the neck in the form of an X. It is then passed on to the forehead, 8cc. until the whole is taken up. The retentive bandage for the neck. Two distinct ones are usually directed, but one circular roller answers every useful purpose. When two bandages are em- ployed, one is a fillet about tAvo feet in length, laid across the head so as to hang down on the shoulders. Over these ends another fillet, five or six feet in length, and nearly three fingers broad, is rolled circularly round the neck. The ends of the first fillet are then doubled back, and secured to the circular turns by pins. Divisive bandage, to support the head, consists of a fillet laid over the head, so as to fall on the forehead and low on the neck. Another fillet, eighteen feet long, and about the breadth of three fingers, is rolled on tAvo heads. The middle part of this bandage is applied over the fillet on the forehead, carried over the ears, round the head to the back of the neck. Its heads are then crossed, brought under both axillae, carried backAvard over the shoulders; crossed again, and carried under the axillae over the breast. The heads are again shifted, and the remainder rolled with circular turns. The hanging ends of the first small fillet are then turned back over the head, and fastened by pins to the turns of the bandage. The uniting neck bandage consists of a napkin under the axillae, to whiph fillets, fastened to the nightcap, are pinned, to keep the head steady, Avhen placed in the proper position. It is used in wounds of the neck or trachea. The inguinal bandage, for luxations of the thigh, is only the common roller, eight or nine yards in length, and about four fingers broad. " - F A S 641 F E U The napkin and scapulary are used Avhen a bandage is required on the breast, belly, or back. It consists of a napkin pinned round the body, where the disorder ren- ders it necessary; and, to prevent its falling, the scapu- lary is applied, viz. a piece of linen, four or six inches broad, Avith a slit in the middle for the head to pass through; its length sufficient for one end to be pinned to the napkin behind, and the other end to the napkin before. The scapulary is sometimes fastened behind, and the other end slit far enough to bring each part over the shoulders to be fastened before. FA'SCIA. See Aponeurosis. Fa'scia lata is a large, membranous, tendinous, or ligamentary covering. WinsloAv describes it as a mus- cular ligament, fixed about the edge of the crista of the os ilium, from the large tuberosity, to the anterior superior spine, to the ligamentum Fallopii, and to the aponeurosis of the oblique external muscle of the belly. It is also fixed to the lateral inferior part of the os sa- crum, and to the neighbouring part of the ligaments by which that bone is connected to the bones of the ilium and ischium. From thence it advances over the glutaei and thigh, between the membrana adiposa and muscles, to the interior and outer part of the knee ; over the ex- ternal anterior part of the tibia, and is strongly inserted into the head of the tibia and of the fibula. It is in- serted also firmly into the linea aspera femoris, between the vastus externus and biceps, forming a sort of sep- tum betAveen these muscles. See Aponeurosis. Fa'sct^e la't^e mu'sculus rises from the outside of the ilium, runs downwards and outwards; and, below the trochanter major, joins with the tendons of the glutaeus maximus, and runs down laterally to the leg. This muscle stretches the fascia lata above described, and on this account Albinus calls it tensor fascia fe- moris. Fa'scia la'ta lumbo'rum is a strong tendon fixed to the lateral part of the os sacrum, from the spines of the sacrum, from the spine of the ilium, and the spines of the lumbar vertebrae. FASCIA'LIS, (from fascia, a ligament). See Sar- torius. FASCICULA'RIS, (from fasciculus, a little bun- dle). In botany it means tuberous, or having the knobs of the roots collected in bundles, as in the paeony. FASCICULA'TUS, (from the sanie,) in botany, leaves growing in bunches, as in the larch tree. FASCI'CULUS, (from fascis, a bundle). A kind of inflorescence, in which the flowers grow close to each other, forming a flat surface, as in the sweet-william. See Manipllus. FASCIO'LA. A flatfish round AV-orm, called the gourd worm, from its resemblance to a gourd seed ; and the fluke, from its resemblance to a Avorm found in ditches, is distinguished chieily by a vent hole at the extremity and on the belly. A worm of this kind is found in the liver, sometimes nearly an inch in its longest diameter, and about two thirds of an inch in the shortest. It is rounded on the back, and has eight deep longitu- dinal furrows in two series. The skin is soft, and in co- lour of a light broAvn. It is most commonly found in the livers of sheep Avhich have the disease called the rot, and sometimes in the human liver. Another spe- cies is found in the intestines of the bream, and some other fresh Avater fish. It is of an oval form ; But may VOL. I. be extended to some length. One other, the barbata, is white, and found in the intestines of the cuttle fish. FASTI'DIUMCIBO'RUM,(from/atfrtrfjo,/0/oafA). Loathing of food. Some barbarous Avriters, for this term, use abominatio. See Apepsia. FASTIGIA'TUS, (from fast igium, the top or roof of a house). In botany it is applied to the stalks when they grow so as to form the appearance of the ridge of a house. FATFGUE. See Copos. FATUI'TAS, (from fatuus, foolish, insipid). Insi- pid aliments Avere called by the Latins fatui, Avhence the term is applied both to foolishness and unsavouri- ness. In Cullen's Nosology it is synonymous Avith amentia. See also Morosis. FAU'CES,(the plural of faux,the top of the throat,) isthmion, a7nphibranchia. The top of the throat; the space about the openings into the larynx and pharynx, which can be seen when the mouth is open and the tongue depressed. Upon looking into a person's mouth when wide open, Ave see a soft curtain hanging from the palate bones, named velum pendulum palati; in the middle of Avhich a papilla projects from the velum, named uvula, or pap of the throat. From each side of the uvula, at its root, two arches or columns pass down, the anterior to the root of the tongue, the posterior to the entrance of the gullet. Between the arches, on each side, the cellular glands, called a7nygdala, or al- monds of die cars, are situated. The common opening behind the anterior arch may be named fauces, from which there are six passages, viz. tAvo upwards, one to each nostril; two at the sides, or one to each ear, called the Eustachian tubes; tAvo downwards: the anterior is the passage through the glottis and larynx into the tra- chea, which terminates in the lungs ; the posterior is the largest, named pharynx, or the top of the oesopha- gus, Avhich leads to the stomach. Inneson the Muscles. FAU'FEL. See Areca ; also Terra Japonica. FAUX. In botany it means the hiatus of the tube of the corolla. See F.\uces. FAYA'GO AUSTRA'LUS, (from favus, a honey- comb). A species of bastard sponge, like a honey- comb. See,ALCYONUM farrago. FAVUS. A honeycomb. See Achor. FEBRI'FUGA. Feverfew, (from februm fugare, to drive away a fever). See Matricaria. Such me- dicines also as mitigate or remove fevers. FEBRI'FUGUM OLEUM. Febrifuge oil. The floAvers of antimony, made Avith sal ammoniac and anti- mony sublimed together, and exposed to the air, Avhen they deliquesce. FEBRI'FUGUS PULVIS CR.E'NII. See Anti- monium. Febri'fugus pu'lvis. Febrifuge powder. The Germans give this name to the stypticus pulvis Hel- vetia In England a mixture of oculi cancrorum and emetic tartar, in proportions of half a drachm and tAvo grains, hath obtained the same appellation; in fevers it is given in doses of gr. iii. to iv. Febri'fugus Sal, i. e. Sal marines regem.ratls. See Marinum sal. Febri'fugus spi'ritus Do'mini Clu'tton. Mr. Clutton's tebrifuge spirit. ititi.e the oil of sulphur, by the bell, and rightly pre- pared, rectified oil of vitriol, and spirit of salt, of each ■ 4 X FEB 642 FEB equal parts; and .of rectified spirit of Avine, triple the quantity of the Avhole. Digest them together for a month, then distil to dryness. In some receipts, common salt is inserted instead of spirit of salt, which will make little difference in the result. The whole, however, is an imperfect ether, and may be imitated by adding any proportion of the mu- riatic acid to the sweet spirit of vitriol. As much of this spirit as renders pure water agree- ably acid is sometimes given in every draught of com- mon drink in ardent and inflammatory fevers; and in those of the nervous and putrid kind it is administered in cordial and antiseptic liquors. We have sometimes employed it, though Avithout any marked advantages. See the Certain Method of curing all continued Fevers, by Jo. Clutton. FE'BRIS, (from febreo, nroferveo, to be hot). Since the complaints of mankind have attracted the attention of practitioners, the cause of fevers has been a problem that they have in vain attempted to solve; and even the disease itself they have not been able to discriminate by any constant pathognomonic symptom. From the ety- mology of the term, its essence is supposed to consist in heat; but the skin is sometimes cold : in quick pulse; but the pulse is occasionally slow : in preceding horror; but such a symptom is often unobserved or absent. Cri- tical pathologists have filled pages Avith such (we think idle) disquisitions; but every physician has been able to distinguish fever by at least some of these symptoms, or a comparison of the different ones; and, among the innumerable mistakes and blunders that we have wit- nessed, we believe in no one instance has error been found to arise from mistaking fever. Within this fort- night we saw a woman of 82, generally allowed to be in a fever; but the pulse was only 70, the skin cool, the countenance apparently unchanged: it was, however, easy-to perceive, from the peculiar feel of the pulse, that it was in a morbid state, and the skin of the palms was tense. She recovered rapidly, the pulse sunk to less than 60, the skin became more genially soft, and the appetite returned. Dr. Cullen establishes a class of febrile diseases which he styles pyrexia. The symptoms assigned are, " after chilliness, a frequent pulse, increased heat, several of the functions of the body injured; the strength of the limbs particularly diminished." Fever, more strictly, is " pyrexia, with preceding languor, lassitude, and other signs of debility, without any local disease." Dr. Fordyce, though he has refined too much, and raised imaginary difficulties in the application of every de- finition of fever, has, however, shown that these symp- toms will not entirely and completely distinguish febrile diseases. One almost constant symptom may be added, a tension of the tendons of the wrist; and we are fully of opinion, with Dr. Fordyce, that in every fever there is some mental alienation. If these tAvo symptoms are added, the definition will be as complete as the most minute pathologist would require. The distinction will be, however, assisted by a more full description of the symptoms. Previous to the attack of every fever, if it do not come on during sleep, or the attention is not directed very strongly to some interesting object or occupation, lan- guor and debility are felt, with a sluggishness in mo- tion, and some uneasiness in attempting it. The face and extremities become pale; the features sunk : the bulk diminished; and the skin appears as if con- stricted by cold. Cold noAV comes on in the back, as if cold water was running down it, and soon extends over the whole body; though, in some instances, the pa- tient will feel to another person Avarm. The- cold in- creases to tremor; and this to rigors and shiverings,al- most convulsive. Even at this period, the mind is un- steady and confused ; attention and recollection are dif- ficult; and stupor is sometimes an early symptom. The pulse becomes weaker, and even sometimes slower, than before; but as the cold increases, it is always smaller, and almost constantly quicker. The respiration is, af this period, small, frequent, and laborious; appetite ceases; a nausea, sickness, and vomiting, come on; and, at last, the matter discharged is highly bilious. The se- cretions are, in general, checked; the urine is watery; the mouth dry and clammy; ulcers no longer discharge; and tumours diminish or disappear. In the cold stage, frequently, though more often in the hot, headach comes on ; but a constant symptom, though not suffi- ciently noticed by pathologists, is wandering pains over the whole body. Pain in the back is generally, men- tioned ; but pains are felt in every joint, seldom conti- nuing in any one part, but disappearing and returning. They are not sharp and pungent, but tensive and dull; evidently connected with the tension of the tendons, chiefly distinguished at the wrist. A striking change takes place in the features. In general they appear to be sunk ; but this description is by no means sufficient- ly precise. It has not been with accuracy noticed how greatly the appearance of the features depends on the state of the mind : it is the latter which gives character, and a different effect to features othenvise similar. It is sufficient in this place to remark, that the change in the countenance is the absence of all characteristic impres- sion, a vacant stare, accompanied with a kind of insen- sibility. This attends fever so often, or rather so uni- versally, in every stage, that the existence of the dis- ease may be thus known in a moment by a practitioner of even slight experience. The continuance of the cold stage is uncertain. The coldness previous to the shivering is, in the worst fe- vers, of long duration, and the shivering slight. In ge- neral the shivering soon comes on; and after a time, different in almost every case, it seems to remit or al- ternate Avith slight flushings. In this interval we have thought, by our own feelings, that the disease had dis- appeared; and we have even remarked that the powers of the mind have, for a short period, returned. The scene, however, soon changes. The alternate flushings become violent heat; the skin again fills; the face be- comes turgid ; the mind again confused, and this confu- sion often increases to delirium ; the pulse becomes more regular, hard, and full; the respiration more free, but still frequent and anxious ; the thirst increases; the vomiting abates; the urine becomes of a deep red, and gives pain in the discharge; tumours again enlarge ; and pus flows from ulcers. The sensibility is recover- ed, and often increased; the headach becomes excru- ciatingly violent. After an uncertain period these symptoms abate. Sweat gradually breaks out, and soon becomes profuse. The urine deposits a copious sediment, all the pain- ful symptoms disappear, and health is apparently ¥ EB 643 FEB -restored, with the exception only of some remaining debility. These are the phenomena of fevers in their acute, regular, and distinct form. In intermittents they appear regularly, nearly as described; and the most perfect un- disguised form of fever is the tertian. In remittents these various changes are less distinct; but the chief difference consists in the termination: the sweat is" in- considerable, and the relief imperfect, though the ex- acerbation is generally distinctly marked. In hectics the whole stage is often regular, and the intermission to- lerably perfect; but the remaining state of debility very considerable. In continued fevers the exacerbations and remissions are indistinct; but an attentive practi- tioner will generally, we believe always, discover them. Like critical days, they require a minute examination for their detection; a minuteness of discrimination which some do not possess; an acuteness which others will not exert. These three stages are evidently connected; and Dr. Cullen thinks, with great reason, that they are the causes of each other. In every fever each is probably present, though not ahvays observed. The immediate cause of these very singular appearances, physicians in every period have been anxious to discover; but to col- lect all the theories, all the absurdities, which the ima- gination has suggested, would extend our article very far. In justice, however, to some of the ablest of our predecessors, we shall notice a few of the principal opinions. When a violent commotion was observed in the sys- tem, followed by an evacuation from the skin and the kidneys, it was an obvious conclusion that something noxious had been introduced, which, at the conclusion of the paroxysm, was discharged. The opinion was at least innocent, if not ingenious ; but when to this first idea was added, that the morbid matter was prepared for expulsion by the febrile commotion, and particularly the hot fit, the opinion produced the most fatal conse- quences, as it led to every means of increasing the heat, in order to assist this unknown process which the mor- bid matter was to undergo. The simplest observations Avere couched in the language of this theory; and when, for instance, the authors had observed that, during the violence of the heat, it was injurious to attempt forcing any evacuation, they told us, that cocta non cruda sunt evacuanda. Many of the aphorisms of Hippocrates, which have thus a profound scientific appearance, are only the commonest remarks in the jargon of a system. As it could not escape the most superficial observers that, after an apparently complete solution, the disease returned, this morbid matter was supposed not to be Avholly discharged; but the little remains possessing an assimilating power, was augmented in quantity, till it Avas again sufficiently powerful to reproduce the pa- roxysm. At last, either by superior exertion, or some unknoAvn cause, it Avas Avholly evacuated, and health restored. In support of this, they usually found, Avhat is indeed true, that the last paroxysm Avas the most violent. The theory was certainly highly probable; but, as if impregnable, succeeding authors attempted only to pro- ceed another step, and the morbid matter was acid, al- kaline, earthy, inflammable; for a time any thing Avhich the predisposing causes could in the slightest degree support. At last Boerhaave supposed it no foreign sub stance introduced, but a lentor or viscidity in the blood itself; and it was no little triumph that the inflammatory crust on the blood was found peculiarly dense. In the latter period of his life, he wished to introduce a similar density, or rather inactivity, into the nervous fluid. The various theories respecting the nature of this mat- ter, each of Avhich is supported with equal plausibility, would immediately lead us to conclude that no such exists; for, after the lapse of near three thousand years, it Avould be singular if some lucky conjecture had not supplied what investigation was inadequate to, and re- vealed the secret. In reality, however, there is no real evidence of any such morbid cause. The discharges are the usual ones; the pus of abscesses, when such is the termination of fever, displays no peculiar qualities; the blood, Avhich in other cases apparently relieves the fever by flowing from the nose, is equally pure with that taken from the arm. That it is concocted or me- liorated by the hot fit is less probable; for if from the hot fit of fevers any change is produced on the fluids, it is of a kind perfectly different; nor is there any simi- lar process in any part of the animal economy. We find that fevers may be often checked in their attack, Avithout Avaiting for this process; and by mitigating the heat, the supposed great agent in producing this change, we cure the fever more quickly and more safely. Any change in the physical qualities of the blood is wholly gratuitous. It has been examined by every test, and all its properties are found with scarcely any altera- tion. The buffy coat is now known to be owing chiefly to a more perfect state of mixture of the incongruous portions of the blood rather than viscidity. Allied to these systems is an equally dangerous error, that fever is a cure of other *disorders. Intermittents have been considered as such; and a practitioner of the Boerhaavian school is said to have asserted, that if he could produce a fever as easily as he could cure it, he should be well satisfied Avith his OAvn skill. Luckily for his patients, this power was denied him ; for Ave know no disease, which, if at all Avithin the reach of art, may not be at least as soon and as perfectly relieved Avithout its assistance. A later opinion has been, that fever is heat only ; and to be cured by its opposite, cold. Cold undoubtedly mitigates the increased action of the sanguiferous sys- tem, and if it does not cure, greatly relieves fever. Like the best of our remedies, it contributes to conduct fever safely to its termination; but we receive no information from this system respecting the cause of the heat, or its connection Avith the other symptoms. While the system of Boerhaave prevailed in the south of Germany, different views arose in the north. The patient and industrious Hoffman thought he saw in fevers a change in the state of motion, and an inaction, Avhich he styled a spasm (spasmus periphericus), in the extreme vessels. His colleague and rival, rather than his enemy, Stahl, carried the idea further; and gavi some sufficiently distinct views of altered determination as the cause of many disorders. The fonner, hoAvever, deeply immersed in the chemical pathology, though he decidedly referred all diseases to altered motions and the state of the nerves, gave no fixed determinate sys- tem of pathology on this foundation, but intermixed these ideas with the different kinds of chemical acri- 4X 2 V E B 644 F E B niouy; and the latter involved it so deeply in a logical form, and mixed it so intimately Avith his peculiar me- taphysical doctrines, that they have hitherto escaped notice, and will not probably again engage the patholo- gist's attention. As the symptoms of fever are so exclusively nervous, and as the vital poAver is so particularly affected, it is sin- gular that they should not have been at once referred to the nervous system, and its peculiar animating principle. Dr. Cullen, taking the hint certainly from Hoffman, started, as usual, into a track at once bold, comprehen- sive, and original. The cold stage he considers as the source of the subsequent phenomena; and this he sup- poses owing to debility. A state of debility is evident, he thinks, from the previous symptoms of languor and lassitude; and occasioned by some sedative powers, which are the more remote causes of fevers. These diminish the energy of the brain and the whole system, particu- larly of the extreme vessels in every part, inducing the symptoms of the cold fit, and a spasm on these vessels. This spasm excites the action of the sanguiferous system by the intervention of the vires medicatrices naturae, thus restoring the energy of the brain, and overcoming its cause. The discharge of sweat, and the relaxation of all the excretory vessels, are the consequence. One great defect in this system, which Ave shall first notice, is, that the return of the paroxysms is not ac- counted for. Debility confessedly precedes ; but, ac- cording to this doctrine, the debility is conquered. The return can only be explained then by the cause continu- ing to act. When this is a material one, as marsh miasmata or contagion, the reason may be admitted; though it militates against a succeeding opinion of Dr. Cullen, that, when once the disease is produced, the influence of the remote cause ceases. When, however, the cause is not material, when the fever is excited by emotions or passions, the explanation will not avail; but this subject we shall resume. In this system the production of spasm by debility is an isolated fact, without a support; and the introduc- tion of the vires medicatrices naturae is the interposition of a divinity in an epic, when no probable resource is at hand. Yet each may be perhaps easily reconciled by a little change. Dr. Danvin's explanation of fever is less distinct. He considers the causes as producing a quiescence of the arteries, and the subsequent heat as an exertion of the sensorial power, in consequence of accumulated irrita- bility. We have admitted this author's principle of ac- cumulated irritability; but have some doubts whether it is applicable to this purpose. From the language and the illustrations we can expect no further increase than we have found of previous diminution; no more can be col- lected than has been lost: but Avhat proportion does the very feAv hours shivering bear to the burning heat of seven days, during which the shortest inflammatory fever continues ? Added to this, at the end of fever we find every symptom of exhausted irritability, as if not only the accumulation was expended, but the former stock diminished. Again, in every case of accumulated irritability, sometime is required for the temporary re- pression. In the human body it is accumulated, but in no extraordinary degree, after some hours sleep; in some animals after the torpor of a Avhole Avinter; on cap- tain Bligh's creAV, after Aveeks of abstinence and con- finement. These facts bear no proportion to the short- ness of the cold fit, compared with the continuation of the heat; and, though it be admitted in a certain de- gree, it must be with some modifications and explana- tions. We have often hinted that we differed in some re- spects from Dr. Cullen, and shall now state what Ave think a more probable view of the subject, connecting, in some measure, both the opinions just stated. Not the slightest doubt can exist but that the first symptoms of fever are those of debility—of a debility of the senso- rial power, in other words, of the energy of the brain. This may arise from actual or from partial debility, oc- casioning an unequal excitement in different parts of the brain, which seems to produce the same effects. Under the article Convulsions, and other places, Ave have endeavoured to shoAv that either real debility or un- equal excitement is the cause of irregular action of the muscles; and this appears in the tremors and rigors, and in the spasm of the capillaries, not only of the sur- face and glands, but of every other organ. The irrita- bility thus accumulated may occasion the exertion of the sensorial power; but the*heat, for the reasons as- signed, is not wholly owing to this exertion. In fact, the greater activity of this power, or of the vires medica- trices, implies increased energy; but through the whole course of fever we see only debility, and its conse- quence, irregular action. Even the boasted sensorial power is weakened, or irregularly exerted; and while the sanguiferous system acts with vigour, the voluntary- muscles and the brain shoAv every mark of diminished energy. There is then no contest between these rivals, the spasm and the vires medicatrices; but the debility continues, though varied in its form. Obstruction to the circulation increases its activity; for the vessels are excited by distention, and, when the extent of the circuit is curtailed, those behind act with greater energy. Thus tying up the finger will bring on inflammation in the whole hand. While, then, the ac- cumulated irritability first excites the sensorial power, the spasm contributes to accelerate the circulation; and, in the weakened state of the brain, this increased action diminishes the nervous power in other parts of the body. The paroxysm is closed by the spasm relaxing, since there is no instance of continued spasm, except by con- tinued irritation; and the spasm relaxes at different pe- riods by the laws established in the system, which we explained under the article Dijeta. It is a fact, that fevers attack at the periods of the regular exacerba- tion, and yield at the times these constantly regular pa- roxysms are resolved. Every paroxysm is either re- solved or remits at the end of twenty-four hours; the diurnal revolution, established by the regularly return- ing periods of sleep and watching; the discharge of the alvine excretions, of appetite, &c. It is not so easy to as- sign a reason Avhy, in a fever consisting of successive pa- roxysms, the disease should yield only at a given time; except that a septenary period prevails, at the end of which the solutions of the usual exacerbations are more perfect. Of this, however, we have no certain evidence. It appears singular that increased action should ever have formed a part of the theory of fevers. It is ob- vious in the sanguiferous system; but the opposite state is singularly conspicuous in every other part. Even when in delirium, the voluntary muscles are, for a time, FEB 645 FEB \iolently exerted; it is the energy of a moment, generally accompanied Avith tremor, and succeeded by the most considerable debility. A tone, an apparent temporary strength, is seemingly kept up by fever, as greater weakness is felt at its solution than during its course. But it can only be said, that, if the debility is in excess afterwards, it is considerable Avhile the disease con- tinues ; and this apparent tone is evidently kept up by the increased action of the vessels in the brain, from Avhich also the delirium proceeds. In short, after watching fevers with attention for thirty-five years, we have never seen any appearance of increased action, except in the sanguiferous system, and even in these vessels the circulation is not apparently free. It has been objected to the doctrine of spasm, that sweats are sometimes copious. Undoubtedly, at the first view, the argument seems invincible. Yet, if we examine fevers, we shall usually find the skin dry and hot. If we press the palms of the hand, though the hand appear othenvise cool, a heat will be felt there: and the impression communicated to the fingers is not the soft unctuous feel of the healthy skin, but the harshness of dry parchment somewhat warmed. In the profusest sweat, excited by stimulants, the same sensa- tion is perceptible; and as Ave find this so constantly in fevers; as we find, too, that such sweats not only do not relieve, but add to the oppression, while the soft healthy perspiration is attended with freedom and cheer- fulness ; we have been led to think these cutaneous eva- cuations arise from different sources. We have pointed out the distinction under the article Diaphoretica ; but whatever be the opinion formed of it, the proper perspiration certainly does not come on till the solu- tion of fever, and it is equally certain that SAveating does not supply its place. The objection that debility is not a cause, since great debility often occurs without fever following, is of still less importance. In this case the sensorial power is affected; the energy of the brain is lessened. In hectics, in dropsy, and in the various nervous dis- eases Avhere the debility is very considerable, the vital and animal functions only suffer: the mind remains free and unaffected. In fever, the alienation of mind oc- curs in the first attack; and it is remarkable that in hectics the mind only suffers during the paroxysm. The principal effect of this state of debility, inde- pendent of the irregular action, which is its most con- stant consequence, appears to be the altered determina- tion. The fluids are confined to the larger vessels; and as the veins, which, by their union, form the vena portae, have no power of impelling the increased load, it is chiefly felt in the liver. We pointed out also the ap- parent anxiety of nature to keep the vessels of the brain in a state of sufficient tension, and the structure of the sinuses adapted for this purpose. It will be obvious, from these considerations, that the head also should largely share in this accumulation. These circum- stances should be kept fully in view, as they are of the greatest importance in practice. From debility, then, and an altered determination, or, in other words, from a change in the balance of the circulation, all the ap- pearances in fevers may be deduced. When, at the con- clusion, an apparently putrid dissolution of the blood 'akes place, it is OAving to a diminution of the principle of life, which alone prevents the usual changes of dead animal matter taking place in the living system. When fevers were supposed to consist in increased action, the remote causes were sought in stimuli of every kind; but if stimulus would alone produce fever, exercise and heat Avould be its most frequent causes, and common language might be safely trans- ferred to science. But if the effects of exercise and heat are fevers, fever is not a disease; for the warmth and accelerated circulation produce no inconvenience, no function is injured, and, with common precautions, they disappear without the slightest inconvenience. More attentive observation has shown the remote causes to be contagion, and the effluvia fro7n marshes; nor do Ave distinctly see the exclusive operation of any other, at least of very few others. Contagion, in this place, has a very extensive mean- ing. If many men are confined in a comparatively small place, their health is gradually undermined; their com- plexions become salloAV; their appetite and spirits fail. No real disease may be observable in them; yet, to others, they will sometimes in this state communicate fever, and fever will appear to arise spontaneously among themselves. We see that this poison under- mines the springs of life; and though its gradual increase , accustoms its action, yet in another it will produce the disease. When the fever is actually formed, it is well known that it may be communicated by its effluvia. Another kind of contagion produced in the body, is that of purulent matter absorbed from an abscess. This we know from its effects to be of an highly sedative na- ture ; and we have much reason to think that.it may, in some cases, be communicated to others by effluvia. There are various peculiar and distinct contagions, Avhich excite fevers of a particular form, attended with cutaneous affections. The jail and hospital fever may- be considered as the consequence of a peculiar conta- gion; but no cutaneous inflammation is the conse- quence. The plague connects this with the other exanthemata; but in each the prior appearance of fever, often Avith peculiar marks of debility, shows that the virus is of a sedative nature. The profluvia of Dr. Cullen also arise from contagious effluvia peculiarly their own. The effluvia from marshes is now fully ascertained to be a remote cause of epidemics, and of some of the most destructive debilitating kinds. Their sedative tendency is, therefore, sufficiently obvious; and, as they proba- bly consist of hydrogenous gas, which destroys the irritability of the fibres, its real nature may be easily understood. Marshes covered with water are not inju- rious ; but when the earth begins to appear above the Avater the epidemics commence. Bile has been enumerated among the remote causes; but its appearance may be easily accounted for from the explanations already given. When we know it to be diseased, either in quantity or quality, symptoms very different from fever arise. Putrid vegetable substances have been supposed to exhale effluvia injurious to life, and to be particularly active in producing the worst fevers. This we believe to be sometimes the case; but they more frequently give some peculiarity to the nature of the fever, ren- dering it more asthenic or putrefactive. "ETlV-e- 6 46 'i«f-r Cold is undoubtedly also a remote cause ; but in pro- ducing fever it must be actively applied Avhile the body is heated, and the effects can only be considered at length when we treat of inflammation. It is, however, espe- cially when united with moisture, an exciting cause. See Causa, Cold, and Contagion. Fevers, from- a variety of circumstances often not easily explained, assume many different forms. Every fever seems to consist of distinct paroxysms, almost uni- versally concluded Avithin twenty-four hours; and the existence of a continent fever, one which proceeds with- out any changes, is not at present admitted. To the termination of each paroxysm within tAventy-four hours there have been some objections; but the fallacy arises from the existence of double tertians, or the combina- tion of two kinds of intermittents. In these cases the cold fit of the second disease sometimes attacks in the middle of the hot fit of the former, and thus in appear- ance protracts the paroxysm. Many such instances are recorded by Torti and Senac. Fevers, then, may be divided into thcae which have distinct paroxysms, and those in which the accessions and terminations are less distinct. The first include the intermittents and remittents ; the second the CONTINUED FEVERS. The symptoms of intermittents are the regular pa- roxysms, which we have described. When these dege- nerate into remittents, the cold fit becomes shorter, and is less distinctly marked; the heat is less considerable, and longer protracted; the sweat comes on; but before the complete termination another attack supervenes. In the more continued forms we lose the attack, and. in .some degree the solution, by sweat. We find only occasional exacerbations of heat, and remissions in Avhich the pulse is more soft and full; the hands cooler and more moist. In every attack of a continued fever we find, in the commencement, apparent remissions, particularly in the morning. The day passes with tolerable ease; the patient thinks his disease at an end, and the physician flatters himself that he has been too soon alarmed. The succeeding evening, however, ends the delusion, and each folloAving morning the remission is less distinct; though on every morning there is usually a visible amendment. In the early state of a continued fever there are often wandering pains, which have been considered as rheu- matic; and we suspect have occasioned the nosologists to introduce the genus synochus. These pains are ap- parently often the tensive ones, which we have attributed to irregular action; but they are undoubtedly sometimes rheumatic, and have occasionally, as in one of the epi- demic nervous fevers described by Sydenham, attacked the chest, with pleuritic or peripneumonic symptoms. Much inconvenience has arisen from this symptom, since it has led to bleeding in fevers of the worst tendency. We recollect, indeed, but one epidemic in which similar pains were wholly absent, and this was a malignant remittent at Breslaw, described by De Haen, on the attack of which, even previous rheumatic pains disappeared. When these symptoms no longer occur, continued fevers proceed many days, with little change. Symp- toms of debility, to be described by the prognosis, in- crease ; the head becomes more loaded; the patient more insensible, or more delirious; the character of the features is lost, or they are enlarged so as to disguise every former appearance. The pulse becomes more quick; the abdomen more distended; stools at times less frequent, but occasionally numerous, watery, and involuntary; the tendons of the wrist more tense, and sometimes starting with a convulsive motion. The tongue, at first brown only in the middle, is dry, furred, and of a dark red or a livid colour. Its action is lost, and the patient can either not put it out, or it is pushed fonvard with an unequal, tremulous exertion. The edges, which for some time continue moist, are at last equally dry Avith the rest; and, for examination, it must be drawn by the fingers beyond the teeth, and replaced. The inability to SAvallow keeps pace with the changes in the tongue, and at last the poAver of deglutition is wholly lost. The insensibility increases; the starting of the tendons is followed by convulsive catchings; the patient attempts to pick off some objects from the bed- clothes, then sinks into insensibility, from which he is only roused by the last convulsive struggles. This is a faithful picture of the general progress of continued fever, either fatal from its violence, from ne- glect, or from improper treatment. In more favourable circumstances, or with proper management, the head is less loaded; the tension of the epigastrium is inconsider- able ; the tongue continues clean at the edges; some refreshing sleep is obtained every day ; and, about the fourteenth, after an unusually restless night, sleep more sound and natural occurs ; the pulse becomes softer and slower; the edges of the tongue appear of a more healthy redness; the palms of the hands more moist; the recol- lection clearer. Sometimes these changes are very gradual, and the experienced practitioner perceives them two or three days before they are conspicuous to the attendants. It is not uncommon to find the first ap- pearances of returning health in a Avhimsical capricious appetite. The patient wishes for something savoury. If brought, it is rejected with disgust. The next object may be more singular, and this may be tasted; a small portion of the next is perhaps swallowed. In other in- stances, some particular food, very frequently that least pleasing when in health, is eagerly longed for, and as voraciously devoured, without injury. In general, to long for a particular food is a favourable symptom, and a certain proof of returning health. Intermittents and remittents arise from the same causes, are relieved by the same remedies, and pass into each other. In the former the intermissions are dis- tinct, and no inconsiderable period intervenes in Avhich the patient is free from fever; but on some occasions, from different causes, this period is considerably re- stricted. Double intermittents, in the circumstances just assigned, often assume the form of remittents; but the error which this confusion would occasion will produce no practical mischief. It is a general fact, that the longer the paroxysms are protracted, they are sooner repeated; as well as that the access and the fever are violent, in proportion to the short- ness of their duration. From this universal laAv, it is easy to see how intermittents, particularly quotidians, become remittents, and, in their progress, continued fevers. Dr. Cullen explains the variety by the proportional FE B 647 FEB strength of the opponents, spasm and reaction, in dif- ferent circumstances. It seems to us to depend rather on the Aveakness of the cause. The fever comes on Avith the usual diurnal period of febrile exacerbation, remits with its decline, and disappears on its solu- tion. There is, however, a regularity Avhich is not easily explicable. The quotidian attacks with the morn- ing exacerbation, the tertian Avith the noon, and the quartan Avith the evening. Are these diseases of dif- ferent violence in the same order ? There is no other evidence of such an opinion than this, that the quoti- dian is in general the milder, and the quartan the more obstinate disease; but the appearance of each, in dis- tinct epidemics, is so striking, that there is little de- pendance on such reasoning, and we must leave it with the numerous arcana of the medical science. Remittents, we have said, are diseases in every re- spect similar to intermittents, except that fever is never wholly absent; yet there is one remittent which nosolo- gists have reluctantly admitted, and one which, in a na- tural system, imperiously demands admission : the first is the irregular intermittent or remittent, the erratica, and the second the hectic. So far as we have been able to in- vestigate the former, it is only an irregular hectic, either from visceral obstructions, or from absorbed matter; and the latter is Avell known to proceed from the ab- sorption of pus. The continued fevers are probably quotidians only, Avith protracted paroxysms. In these what is styled re- action is not considerable, and this certainly proves an increased action of a debilitating power; in other words, the introduction of a more deleterious poison. The worst fevers are introduced by the longest cold, and the mildest by the most violent rigors: a circumstance which leads Dr. Cullen to conclude, with great apparent rea- son, that the rigor is an effect, probably a measure, of the reaction. Perhaps the explanation is nearer the sur- face : the reaction is in proportion to the irritability; and a poAverful debilitating cause will not only weaken the sensorial power, but impair the irritability also. We have decisive evidence of the truth of this explanation, since those who die rapidly from fevers have the irritability of the muscles destroyed as completely as those who are struck by lightning. On the opposite side, it does not appear that the diathesis phlogistica greatly increases the spasm, since the true inflammatory fevers are the short- est. Irritability, we know, is not in proportion to the inflammatory diathesis ; and we should not, from our views, suppose such fevers peculiarly obstinate. We are unwilling to admit any other variations of simple fever, since those introduced by medical authors seem to be only accidental varieties. Indeed Ave consi- der fever as a more simple disease than it is usually re- presented ; and shall endeavour to show, that what are termed genera are only, in a strict systematic vieAV, species, and the reputed species, varieties, But these considerations must not now interrupt us. The princi- pal distinctions, in the best Avorks, have been into bilious and putrid fevers; the former comprehending the yellow fevers in all the variety of denomination; the latter the malignant, the petechial, 8cc. Etc. The bilious fevers are, however, those of the tertian type, distinguished by evacuations of bile, from the causes formerly explained; and the autumnal remittents of Avarm climates. The putrid fevers are the worst kinds of the jail and hospital fevers, Avhere the deficiency of the vis vitae no longer checks the tendency of animal substances to putrefac- tion ; and where, in some instances, even a septic fer- ment may be suspected. The prognosis of fevers has occupied many vo- lumes. We can give only the outline. Consistently with the vieAvs offered, our prognostics must be taken from the signs and degree of debility, or the diminution of irritability. When Dr. Cullen endeavours to antici- pate the event by the degree of reaction, he betrays the weakness of his system, as this state affords feAV prognostics, and those rather to be attributed to debility. When congestions in the 1iead or in the lungs, for in- stance, occasion effusion or rupture, these only occur in the last stage of a protracted disease, though attributed by him to the violence of reaction. Our prognostic must then be taken from the degree of debility. This is obvious often to the sight: and the young practitioner should exercise his acuteness by care- ful and attentive observation at the bedside. Every cir- cumstance which regards a patient in a fever will give him information. The situation of the patient is dan- gerous, if the character of the countenance is soon lost; if the eyes apparently glare on vacancy; if the ansAvers are rambling and incoherent; if slight, partial, involun- tary contractions occur in the features; if the tongue trembles, or is soon dry and dark ; if he soon declines turning on his sides, lies on his back, and sinks down on his bed ; if the extremities are cold and benumbed ; if the tendons are particularly tense, and occasionally start; and if he appears to pick off or remove any dark spots on the bedclothes, or wishes some supposed dark object to be removed. Each of these symptoms is a mark of debility; and the earlier they occur in fever, the dan- ger is greater. In the vital functions there are many marks of consi- derable debility,which prognosticate a dangerous disease. These are a very quick, low, intermitting pulse; fre- quent faintings, particularly on being raised to an erect position; short and inefficient respiration. The fre- quency of the pulse is relative, and the degree which denotes danger uncertain. An irritable female will often, from the beginning, have a pulse from 108 to 120 \ and the pulse of a very old person, in a dangerous- state, may not exceed 80. If, hoAvever, in the first eight or ten days of a fever, the pulse exceed 112, there is danger, unless the constitution be othenvise ir- ritable. If, at any period, it exceed 120, serious appre- hensions of the event may be entertained. If it strike the finger weakly, and can be stopped by a slight pres- sure, it is a mark of great debility. On the contrary, a weak pulse will be sometimes apparently strong. It seems to throb, or the artery, on its dilatation, hangs reluctantly on the finger, as if unwilling to leave it; and the apparent strength of the impression appears to be caused by irritation. This is a state, however, only to be learned by experience ; and Ave Avould recommend the most careful attention to the state of the pulse in every period of fever, not the mere number counted by the stop watch. This is a little parade of which young phy- sicians are fond ; but the experienced practitioner dis- covers more in the peculiar beatof the artery than any watch will convey. In the natural functions, the symptoms Avhich shoAv considerable debility are sickness and vomiting ; a dif- F E B 648 F E B ficulty of deglutition; and involuntary discharges. Of these the vomiting is least dangerous; and diflicult deglutition most so. Involuntary discharges we have known to continue for more than a week, and the pa- tients have recovered. Sometimes deglutition is difficult, merely from the state of the tongue, Avhich is occasion- ally hard, shrunk, and immoveable. Formidable as this symptom may appear, Ave have not found it dangerous. At this moment a man is recovering, whose tongue was not only as just described, but of the most livid black- ness. We have mentioned, among the symptoms of de- bility, a partial palsy in the retina; for to this is owing the appearance of small black bodies which the patient wishes to pluck off. An equally, perhaps a more, dan- gerous symptom is double vision. Deafness has been esteemed a favourable sign: Ave can at least observe that we have not found it unfavourable. Depraved taste is very common, and offers no particular prognostic. We have said that a putrid state of the fluids is a sign of considerable debility. This is ascertained by effusions of blood from the different organs, without any peculiar commotion in the system; dark spots oh the skin, of different sizes; sometimes dark or livid stripes, like weals from the lash of a Avhip; effusions of yellow serum; but, above all, by a cadaverous offensiveness of the breath, sweat, urine, and the other excretions. If, however, in a fever, the pulse, during the first ten days, does not exceed 108 ; if the expression of the countenance is unchanged; if the subsultus of the ten- dons do not come on ; if the mind is steady and unruffled; the sleep, though short and interrupted, refreshing, and the patient is sensible of having slept; if the tongue is clean at the edges; the epigastric region neither tense nor painful; if the patient lies on either side, and aAvakes without hurry or confusion; we may prognosti- cate a safe termination. But every prognosis in fevers should be made with much hesitation and reserve. Many accidents occur in the progress, which the greatest acuteness cannot foresee, nor the most guarded caution prevent. We have said "during the first ten days," because we are convinced that fevers proceed in a regular course, and that the changes happen on the days usually styled critical, as already explained (see Crises). In the more usual cases of fevers that we observe, if the dis- ease is properly managed in its earlier period, and the circumstances are on the whole favourable, there are few instances in which a salutary change does not take place on the fourteenth day. Where this is not observ- able, a gradual amendment takes place, which is clearly conspicuous on the seventeenth, and the fever has dis- appeared before the twentieth. In common fevers we have not found the disease grow worse after the tenth day ; and if no aphthae or any unexpected accident oc- cur from that period, we have usually led the friends to expect a favourable termination. Prognostics are also occasionally derived from the pulse, the urine, and the tongue. We have already mentioned the judgment which we may form from the number of pulsations; but numerous other changesoc- casionally occur, scarcely to be conveyed by description, and which have been pointed out by the ancients as in- dicating particular critical discharges. Galen, it is said, on feeling the pulse, called immediately for a basin, Avhich Avas scarcely brought when the blood gushed from the nose. Critical discharges are, in this climate, less common; nor can avc easily distinguish the variety of pulses Avhich authors have described. In general, the favourable signs are, a pulse more soft, somewhat fuller, and in a slight degree more slow-: they seldom, at the first change, sink considerably in number. The unfavourable signs are, a more thready pulse, as if the artery Avas- smaller, pulsations quick, weak, and irregu- lar. The redoubled pulse, which strikes the finger twice during the space of one diastole, we have seen in two instances, Avithout its being followed by any particular change. The state of the urine has also afforded numerous prognostics, and the discrimination of its clouds, its se- diment, &c. have been peculiarly minute. The greater number of these appearances may be disregarded. In general, a scum on the top, in the early period of fevers, seems to shoAv considerable debility; and we have usually found such fevers slow and tedious. A cloud, suspended at first near the top, and afterwards falling lower till it in succession reaches the bottom, of the glass, are favour- able signs ; and a suspended cloud, previous to the four- teenth day, shows that the disease will terminate at that period. If it appear after the fourteenth day, the dis- ease terminates at the twenty-first, gradually lessening on the intervening days. The red sediment is almost peculiar to intermittents and gouty habits; but a salu- tary sediment is usually of a reddish cast, though it is sometimes white, and of the consistence of mucus. The appearances on the tongue are more obvious. The fur on the tongue, in fevers, is a change which takes place in its papillae: it is by no means, as has been represented, inspissated mucus ; nor will any rubbing take^t away. The fur first appears in the back part of the tongue, and extends from thence in a long stripe through the middle. For many days the top and the edges are clean, the fur white, or of a light brown. Af- ter sometime the colour becomes dark, and often, at last, the Whole tongue dry, hard, insensible, and inca- pable of motion. The first favourable change is a little softness at its edge, or tip, which gradually extends in a direction opposite to that in Avhich the tongue was covered. Every softness is not, hoAvever, equally fa- vourable. About the eighth or tenth day the tongue will sometimes grow soft, and apparently clean; but instead of the healthy speckled appearance, it is uni- formly red and shining. In these circumstances it again grows dry, but not furred; and this usually happens Avhen the fever is protracted to the twentieth day. A blackness of the tongue is considered as a fatal symp- tom ; but we have seen in such circumstances as many recoveries as deaths. The cure of fever is a subject of peculiar difficulty, and to examine it in all its details Avould extend this article very far beyond its due proportion. We shall prefer giving a comprehensive outline; and will ad- mit that we have unreasonably misspent the reader's time, if the whole that has been said on this subject does not shorten and elucidate our present inquiry. The first question which arises is, whether fever is a disease or a remedy ? Had not this been started by authors of credit, it would have appeared too ridiculous to have merited a moment's notice. In fact there is but one case in which increased heat has been suspected FE B 6 19 FEB of a salutary tendency; viz. in cases of obstruction. The old opinion was, that obstructions in the liver, or other viscera, arising/rom agues improperly or prema- turely stopped, might be removed by a return of the fever. They might be, perhaps, removed by a more judicious treatment of the disease ; but the fever itself would rather tend to increase them. Another case in Avhich increased action of the sanguiferous system seems of service is palsy; and it was the former practice to increase the heat, which after a few hours from the attack supervenes, by stimulants of every kind. Modern refinement has anxiously endeavoured to remove ple- thora, or congestion, previous to the stimulating plan; but their success has not, we think, kept pace with the plausibility of the idea; and the former practice, ex- cept in the young and the strong, who are very rarely victims of such a complaint, seems more advantageous. As we have stated that fevers consist in debility, it may be supposed that our cure is simple; and that the modern practice of " throwing in" the bark will be at once enforced. Tonics, however, act chiefly on the moving fibres, and remotely, as Avell as weakly, on the nervous system ; but the debility of fevers is that of the sensorial poAver, Avhich, from the vieAvs stated (see Ce- rebrum), Ave cannot separate from the medullary system of the brain. If, hoAvever, our tonics were effectual in restoring activity to this part of the body, they would be inadmissible in these diseases. The first effect of the debility is, we have said, to confine the fluids to the larger vessels, particularly, for the reasons assigned, to the liver and brain. No axiom in medicine is, however, more certain, than that to constringe over distended vessels is to add to their de- bility. For such reasons, in all cases of plethora, par- ticularly where it is connected Avith an inflammatory dis- position; in all cases of obstruction, the bark is injurious. (See Cortex Peruvianus.) It is necessary therefore; in all fevers, to overlook for a time their cause, and attend to its effects. Even the remote causes, when they have once produced the disease, seem neither to add to nor modify it, and may be equally neglected. Two methods of extinguishing fever at once have been employed; the one consists in evacuations, and the other in the application of cold. We are confident if, on the first shiver, an emetic be given, followed by a Avarm sudorific, and within three or four hours an active laxative, so that the' operation of the whole shall have been completely effected within the limits of the first period, the fever will, in almost every instance, be stopped or disarmed of its severity, and be no longer a disease. If the second period has commenced, the chance of success is less; but Ave have succeeded. Beyond that time Ave can only regulate the progress of the disease, and conduct it safely to its termination. Cold, it has been said, by Dr. Kirkland and our prede- cessors, will have the same effect of at once checking fevers. It is not true. Cold is a remedy of singular importance ; it will greatly mitigate the symptoms ; it Avill render the solution of a paroxysm more complete ; and in remittents or eruptive fever, so far lessen the complaint as to be no longer dangerous; but it will do no more. Our chief indications in fever are to lessen the heat ; to restore, as far as Ave can, the balance of the circula- tion ; and to support the strength. vol. i. 1. To lessen the heat.—We have considered the heat as the first change in the series of causes and effects, arising from the " quiescence of the capillaries:" it must of course be the first object of our attention; and the numerous advantages arising from cool air and cool drinks evidently shoAv that the increased action cannot be a salutary exertion. This subject includes the whole that Ave have to remark regarding the general manage- ment of fever, with respect to diet, air, &c. The chamber should be high and airy: the bed, if possible, neither betAveen the door and the Avindow, or the latter and the fire, so that the patient is never ex- posed to a current of air. No pictures, or other objects, should be on the Avails, to fix their attention, or sug- gest incoherent images. It should be quiet and uncon- nected, if possible, Avith the house. The bed should have curtains, but they should not be draAvn, except where the patient is exposed to the light. The Avindow should be shaded rather than darkened. The bed clothes may be regulated according to the weather, and former habits ; but should be cooler than usual, and still further diminished if the heat is considerable. Except in very severe weather, the sash should be a little open; nor need the door be solicitously closed. When fires are otherwise Avanted, some may be kept up for the sake of the nurses rather than the patient. In general, Avhen a person enters the room from the open air, he should neither feel it warm nor more close. In a long fever, the room may be occasionally mopped; but, on the whole, we disapprove of sprinkling it Avith vinegar. The professed object is to prevent infection; but we fear it is sometimes employed to conceal the bad smells of Avhat ought to be removed. These should be coun- teracted by the most unremitting cleanliness in the bed and body linen; the former of which should be changed every two or three days, and the latter every day ; in case of involuntary discharges, as often as may be ne- cessary. It is not unusual for patients to throAv aside the clothes, or to be anxious to come out of bed; and they are greatly irritated at being prevented from doing either. We have never found such indulgences injuri- ous ; and when they are no longer opposed, they seldom persist in their Avish. If their clothes are immediately brought they will again lie down. It has not been uncommon, in the early periods of fever, to carry persons into the air. If this can be done Avithout any, or with very slight, bodily exertion on their side, it is generally useful; but to Avalk any dis- tance, or to travel many miles, has been frequently in- jurious ; and even fevers, apparently slight in their com- mencement, have ended fatally Avhen considerable fatigue has been experienced in the early stages. The surgeons of the army have given an opposite opinion, which Ave can only reconcile by reflecting, that we have very different constitutions as the objects of our practice. Generally, on the first attack of fever, patients should preserve the greatest tranquillity of mind and body. They should either keep in bed or on the sopha, Avith free air and in a moderate temperature. FeAv visitors should be admitted and no strangers; conversation should be general and easy; and those Avho come should be cautioned to stay only a short time. If, by the means lately stated, the fever should be crushed in the bud, the same precautions will be useful during, at least, the first septenary period. FEB 650 F E B The diet should be equally calculated to avoid excit- ing heat. The appetite is lost, and solids cannot be swalloAved. The liquids taken should be cool, and not highly nutritious: barley water, tea, toast and water, bread jelly, or weak broths, are sufficient for the early periods of fever; and this very light diet should be kept up during the first six days. If the debility is consider- able, a diet somewhat more nourishing may be allowed earlier; but the loss of strength should be indeed very great to admit the use of wine during this period. The patient should be supplied frequently with these liquors; and if he complain of coldness they may be given warm. After about the sixth day the diet should be more nourishing, and good broths, jellies, and occasionally a little wine, may be allowed; but the latter should be in moderate quantities, lest we exhaust the powers of the best cordial that we can at a future period employ. The ancients gave the coldest water freely in the earlier stages of fever ; and we have often indulged our patients in this practice, always without injury, and often Avith the most striking advantages. Some late trials would suggest the question, whether, in the earlier stages, cold may not be employed more actively than in these plans. We allude to Dr. Currie's recommendation of cold affusions, and particularly their effects in scarlatina. In his practice they are only em- ployed to counteract violent heat; and the heat is greatest in those inflammatory fevers which are gene- rally accompanied with local inflammation, or where we expect hourly local inflammation to take place. We own that we have hesitated in using this remedy with that spirit and decision from which alone we can expect salutary consequences. In a less degree, spong- ing the body with cold water has been found useful in mitigating the heat. It is also highly refreshing and agreeable to the patient. 2. To restore the balance of the circulation.—This is the most important indication in the cure of fevers ; and to this object our chief attention must be directed. The natural, and sometimes the bilious, vomiting will point out the necessity of giving emetics. These are our chief dependance in the early stage of fever; and from our view of their effects, the force of their benefits will be sufficiently obvious. (See Emetica). The chief advantages are, however, relieving congestions in the liver, and determining to the skin. The former is ob- tained by active vomiting; but it has been supposed that the latter may be secured by means less violent, and more permanent in their effects. Active vomiting is seldom employed more than once; but if the first emetic should not act completely, it mu*t be repeated. The antimonials are preferred in fevers, but without sufficient reason, as we seem to gain all the benefit of full vomiting from the ipecacuanha. Dr. Fordyce at- tributes some of this benefit to the medicine; for the vomiting, he remarks, procured by squills, is not equally successful. On this subject we cannot speak from ex- perience. In general, after the operation of vomiting, Ave should endeavour to secure the determination to the skin by some mild diaphoretic with which opium is combined. To support the action of the extreme vessels by nau- seating doses of emetics, is a practice introduced from the theory of Dr. Cullen. There are no doubts of the utility of this practice ; but we are confident that it has been carried too far in the Cullenian school. To ex- plain the action of the nauseating doses of antimonials— for to these we would confine, with Dr. Fordyce, the advantages we derive from such medicines in fevers—is not easy, when have found that their relaxation is the effect of a sedative power, and that the spasm, if we may still use the expression, arises from debility. It must be, however, recollected, that when we spoke of the quiescence of the capillaries, we did not object to the spasmodic state of these vessels if considered as the ef- fect of irregular action. From all the phenomena, from the effect of every remedy, it is not mere inactivity. Whatever becomes of theory, medicines exciting nau- sea really promote perspiration, often of a most salutary kind; and whatever fills the extreme vessels, and, more particularly, Avhatever promotes any discharge from them, relieves internal congestions. Experience, how- ever, limits their use, and perhaps they should not be continued beyond the third or fourth day. They un- doubtedly produce, after some time, debilitating effects; and in the long protracted fevers have been injurious when too far pursued. When we spoke of Cathartics, we explained at some length their advantages in relieving congestions of the viscera and the head. In this way they are well adapted for the relief of fever; and that article, as well as its application, was formed long before the appear- ance of Dr. Hamilton's work. In fact, for more than twenty years we have given cathartics freely in fevers, Avith the most salutary effects; and Ave consider them as medicines of the greatest importance. In the larger number of epidemics, though active in their operation, they do not weaken the patient, for they take away the cause of, at least apparent, weakness; and we have often found patients in fevers taking bark and wine in profusion, to support them under this apparent debility, Avho, after the operation of an active laxative, required neither. Let not the young practitioner be terrified by the number of evacuations, but attend to the effects, and to his patient's feelings. If he is relieved after each stool, if the pulse becomes softer, the hand more moist, and the head less loaded, he need not be apprehensive, however violent the discharge. On the contrary, if the pulse becomes smaller and more frequent, if the face sinks, and faintness comes on, however little the dis- charge, it has been too much. We trust, that Avhen Ave have laid down this obvious criterion, we shall not be acccused of pushing a theory too far: Ave have at least given an antidote, should we have administered a poison. It is necessary, however, in the employment of this remedy, to attend to the discharges. The nurses will often report frequent, numerous evacuations; and if examined, these may be found mucous and inefficient, or a watery fluid, scarcely coloured. It is necessary that the stools should be truly faeculent; and these should be continued while any tension can be felt in the epi- gastrium and abdomen, or while the discharges conti- nue to be dark and offensive. Such they always are in the early stages of fever. The use of cathartics in fever Avas the practice of the most ancient physicians; and they were apparently disused, in consequence of the idea that they prevented the discharge by sweating. Hippocrates and his fol- loAvers depended more on clysters and suppositories. In FEB 651 FEB fact, they had only the more violent cathartics, as the milder ones were introduced by the Arabians; and these very active medicines were injurious by the debility they occasioned. Hippocrates, Galen, Aretaeus, and their followers, employed purgatives early ; and their chief reason Avas to prevent the diarrhoea, which would, they supposed, supervene on the fourteenth day, when the patient Avould be too Aveak to bear the discharge. The methodic sect only discouraged their use ; but they apparently supplied the defect by enjoining strict abstinence for the first three days. In more modern times, Borelli, Baglivi, Donckers, Sydenham, &c. &c. employed them, though we suspect not to the extent which we have found salutary. Fevers, hoAvever, in different situations may greatly differ; and we Avould anxiously deprecate the application of the practical rules suggested in one situation to diseases of a different country, without exact attention and a due discrimina- tion of the circumstances. We suspect, however, that this class of remedies will always be found very import- ant auxiliaries in fevers of almost every climate. The choice of the purgative is of some importance. The more violent drastics debilitate too powerfully; and, on the other hand, the salts, the castor oil, the tamarinds, and manna, appear not to excite the action of the moving fibres of the intestines sufficiently- to eva- cuate the more hardened contents. The purgatives which we have found most effectual are, the senna, with a small proportion of the scammony ; or the jalap, ge- nerally united with the cream of tartar, sometimes with calomel. Nearly similar in effects is a mixture of rhu- barb, with some neutral, in equal quantities. It has been too common to depend on clysters; and in those fevers where Dr. Hamilton has Avith so much success procured numerous motion's, we have known practitioners of eminence content with daily clysters, if stools did not otherwise occur. In general, clysters evacuate only the contents of the rectum, unless they are of a highly stimulating nature, Avhere their peculiar irritation is communicated to the superior portion of the canal; and clysters of warm water, and the usual preparations for this purpose, are inert and inefficient remedies. They certainly give some relief; but this is temporary only, and far inferior to that procured by the operation of an active cathartic. In cases of great de- bility, where we are apprehensive of the effects of a too copious evacuation, clysters only can be employed. Diaphoretics are remedies of equal utility ; but un- fortunately they have been improperly chosen, and the process has been most erroneously conducted. The only salutary discharge from the skin, as we have al- ready explained, is the halitus in the form of gas, or rather of a thin, probably of a vesicular, vapour. When in a fluid state, it increases'the oppression it was in- tended to relieve. This salutary diaphoresis is incon- sistent with increased heat; and to promote it in fevers, the heat must be diminished as near as possible to the Ftandard of health. Cooling medicines are consequently the most effectual diaphoretics; and cold water one of the most powerful. Nitre and the other 7ieutrals act chiefly in this way; and the citras potassae, the com- mon saline draught, which it is usual to ridicule, cer- tainly refreshes the feverish patient by the coolness which it imparts to the stomach. Vegetable acids pro- duce a similar effect; and of these vinegar is preferred, as more poAverful in its action on the skin. The native acids (the acid fruits) are, from their coolness, salutary and refreshing, and moderate the heat to the proper degree for this discharge. The mineral acids act, avc think, differently; and, if the febrifuge spirit of Clutton is useful, it probably is so in an advanced period of fevers of the lowest kind : the spirit of salt, recom- mended so warmly by Recht, is certainly not referrible to this head. Nauseating doses of antimonials operate powerfully and safely as diaphoretics. Dr. Fordyce supposes this effect to be owing to the medicine, and not to the action on the stomach. For this reason, perhaps, antimonials are continued in the early stages of fever, Avith little anxiety respecting the nausea they produce; and if not persisted in too far, they are undoubtedly useful. They sometimes appear inconvenient from their purgative effects; for we think we have found that the purging produced by antimonials is not equally beneficial with the discharge produced by other medicines. The union of the nauseating doses with calomel, lately fashion- able, has not in our hands succeeded so fully as, from the warmth Avith which they were recommended, wc had reason to expect. The more active and heating sudorifics are inadmissible in the greater number of fevers; and wine, which sometimes acts in this way, will be more fully considered under another head. We chiefly want these last medicines when it is our object to prevent the accession of the paroxysms of an inter- mittent, or to relieve the pains of rheumatism. The semicupium pediluvium or warm fomentations to the lower extremities are often safe, and highly useful, diaphoretics. See Bathing. Blisters very powerfully restore the balance of the circulation, and diminish morbid congestions in the head and the liver; but, except the latter organ is in- flamed, they are applied only to the head and neck. We have under this title fully explained their opera- tion, so far as it is understood. In all cases of fever there is, as has been observed, fulness of the vessels ; and we find the vessels of the eyes red, the face flushed, and the eye ball itself apparently enlarged; but this con- gestion produces also irritation, and often a less degree of phrenitis. The usual wanderings of the mind are more rapid, the voice quick, the temper irritable, un- reasonable, and occasionally violent. In each state blisters are indicated, and often produce the happiest effects: sleep frequently coming on, as soon as the plaster begins to stimulate. The milder symptoms of congestion, first described, yield frequently to purga- tives ; and when these have been freely used, blisters are often necessary. Sedatives.—Congestions in the brain, as we have just remarked, produce considerable irritation; and the state of irritability thus occasioned requires often the most active sedatives and antispasmodics. In other views, remedies of this kind are highly useful. They check often the too impetuous current of the blood to the head; they produce a calmness and serenity, Avhich greatly assist the action of medicines that determine to the surface; and they remove a very troublesome symp- tom, flatulence in the stomach and intestines. The chief of these are camphor and opium. Camphor is a medicine of considerable utility in fevers, as already shown. The calmness Avhich it often seems to inspire; 40 2 F EB 652 P EB the scmtity, and even the temporary ease, Avhich are among its first effects, render it peculiarly valuable. As it sometimes appears to increase the heat of the body in the earlier stages, a little nitre may be added, with an antimonial; in the latter, the sal c. c. the aro- matics, or the bark. There is, however, apparently no period of the disease to which it is not adapted, and no species of fever in Avhich it is not beneficial. Opium is a medicine of more doubtful efficacy: it often irritates instead of calming, and produces agitation instead of a serene freedom of spirits. With those in Avhom it produces its mild sedative effects, it is a very valuable remedy, and, united Avith camphor, it seldom disagrees. In the later periods of fever, when subsultus and convulsions come on, opium and camphor are the best remedies. Some practitioners have been violently averse to the use of this medicine. They observe that it debilitates ; but the true reason of their dislike, we suspect, is the probability of its suppressing critical dis- charges. They have contended that the most restless night is less injurious than the stupor produced by opiates; and that even the chance of their hurrying the spirits, is more to be dreaded than any advantage to be derived from them can compensate. While Ave own our predilection for this remedy, the accusations are not wholly groundless. Opiates check all the evacuations, except those by the skin; and we certainly neither gain so much by the tranquillity they procure, nor lose so much by a sleepless restlessness, as may be at first sup- posed. Yet Ave think if the patient's strength is preserved by their use ; the hours pass away more comfortably ; time insensibly wastes; and if we can annihilate one fourth of the patient's suffering by procuring six hours in the twenty-four, if it be no more, of torpor and in- sensibility, we amply compensate for the risk. The ne- cessary evacuations Ave must be careful to restore. Other sedatives have been employed to procure sleep; and Hoffman is profuse in his commendations of his anodyne 7nineral spirit, which we now know to be ether only, with a somewhat larger proportion of the oil of wine. We are surprised that this last medicine has not been tried alone, or in union with opium. The anodyne spirit generally fails in other hands; and though it is still given in fevers, no one seems to have found it strikingly advantageous. Amongthe soporifics we must not forget the the pillow of hops ; nor breathing hydr o car- bonate gas. Some hectic patients who have been confined to a stable, or whose room has been covered, for a similar purpose, with dung, have informed us, that they think they have slept more quietly in such situations. These effusions of quackery have not been, we believe, often em- ployed by any scientific physician ; and the interested re- ports of unprincipled pretenders Ave need not enlarge on. The chief of the other antispasmodics are ether, musk, castor, and asafoetida. Ether is very active in this vieAV, and at the later periods, when subsultus comes on, and convulsions threaten, is often of consi- derable service. Musk, if in perfection, is an active antispasmodic, but it is seldom genuine; and, as a me- dicine peculiarly dear, is reserved for the last desperate stages : it here sometimes obtains the credit due to the operations of nature. Castor is less powerful; but seems occasionally to correct the injurious effects of opium ; and asafetida still less so. The effects of the latter are chiefly confined to the stomach ; though it sometimes appears useful as a general sedative, and occasionally as an expectorant. It may appear singular, that among the means of lessening heat, or removing topical congestion, Ave have omitted bleeding in all its forms. The consideration Avas postponed to introduce it in this place, where the Avhole subject may be more advantageously considered in one vieAV. Bleeding has been a general remedy for fevers of every kind; and when the increased action is so violent as to threaten the rupture of a vessel, this evacuation is essentially necessary: it is equally so, when with, or soon after the attack of a fever, with inflammatory symp- toms, local inflammation appears. Here then we would stop, did not the conduct of some practitioners in every fever, and of some respectable ones, in fevers highly asthenic, suggest to us that our limits are too narroAvly restricted. Sydenham recommended bleeding in the early stages of every fever; and we are told by almost every practical author first to take off some blood; oc- casionally limited to patients in the prime of life, te robust constitutions, or to fevers from cold. Yet we find Dr. Dover bleeding in a highly putrid fever, not only in the commencement, but in the progress: the older surgeons have employed this remedy with little apprehension in a highly asthenic fever, the puerperal; Dr. Rush bleeds repeatedly in the yellow fever; Dr. Moseley and Dr. Jackson in similar fevers, in the West Indies, employed the same remedy. Must we con- demn the practice of physicians so respectable, or must we resign all the pathological views we have attempted to inculcate? We will do neither; but may, by the way, inculcate an useful lesson: that empiricism—for such we will venture to style it—Avith a happy boldness will sometimes succeed, by means Avhich the timid dog- matist will scarcely dare to follow. Modern practitioners have taken blood to moderate the increased action, and to prevent accidents from its violence when the vessels are weak. In this way, by ineffectually employing an active remedy, they have in- jured by debilitating, while they have only imperfectly moderated the stimulus which they attempted to op- pose. The physicians mentioned, if they had any views, employed it with different ones. If the practice of each author be examined, it will be found that they bled when the system was over loaded with the accumulated fluids from the surface; and they bled boldly, because it Avas necessary to relieve each part: and the quantity drawn from the arm can affect each according only to the proportion of the Avhole mass which it receives. We have stated, in many parts of this work, with a view to this subject, and particularly in the article of Blisters, q. v. the effects of only a slight evacuation in relieving distended vessels; effects not only derived from the di- minished quantity, but from the spring this relief im- parts to the muscularfibres. Whoever reads Dr. Dover's animated, but somewhat quaint, description of the case, in which hesuccededso completely, Avillatoncesee that bleeding could have relieved only in the way we have ex- plained ; and Dr. Rush's descriptions strongly elucidate the same ideas. Mr. Coleman, in his Avork on suspend- ed animation, has recorded a fact which illustrates our explanation; as he found, that taking blood from the jugulars restored the action of the right side of the heart, which Avas suspended from distention. F E B 653 F E B If general bleeding then be useful, it must be in cases where the internal congestion is considerable, and where, from distention, the irritability of the muscular fibres of the internal vessels is for a time suspended. It will not be difficult for the experienced practitioners to distinguish this situation; and Ave would recommend extreme caution in this respect to the less experienced, who are, in general, too fond of the lancet. Whatever may be the opinion of general bleeding, topical evacuations of blood have been employed to re- move internal congestions. Blisters and purgatives best relieve those which occur in the abdominal viscera; but to the head, besides blisters, leeches are applied : and cupping glasses, with previous scarifications, to the neck. These are remedies which many are fond of: but, except in sudden attacks of phrenitic delirium, which sometimes come on in the progress of fever, we have found little room for evacuations of blood. To sum up the whole of this intricate subject, the general practice of bleeding at the commencement of every fever appears highly improper. If not certainly from cold, if the patient is not in the prime of life, and if no topical inflammation apparently impends, it should certainly be avoided. In some of the Avorst fevers, pains in the limbs, we have said, occasionally appear on the attack, and sometimes in the progress. These should be carefully distinguished from true inflam- matory ones. The reigning epidemic, the symptoms of general debility, the period of life, and the apparent cause, will assist the distinction. The features afford an excellent criterion. If these are sunk, and the cha- racter of the countenance lost in a greater degree than can be expected from the duration of the disease, gene- ral bleeding should be avoided. Even topical bleeding we would not particularly recommend, unless the con- gestion appear inflammatory. Blisters will supply its place more safely. 3. To support the strength.—This indication, appa- rently the most obvious and necessary, is not easily followed. Bark is a tonic; and bark has been given in profusion, with little discrimination, and with most de- cided injury. If, by the prudent and judicious use of the medicines already described, we can lessen the congestions in the liver and the head; if we can pre- serve the strength by the due regulation of temperature, and support it, after the first days, by more nourishing broths and jellies; we shall find little opportunity for administering tonics. Let us repeat, that the largest doses of bark and wine will not so effectually give strength and spirits as two or three loose motions; and no cordial will be so refreshing as free cool air. If at the conclusion bark must be given, it should be in the inefficient forms of the decoction and tincture. We mean not, hoAvever, in every instance to discou- rage the use of tonics; but merely to allege that they are not alone adapted for the cure of fever, and often injuri- ous before the infarction of the viscera is completely removed. In general, Ave think the simple bitters more useful than those medicines which, like the bark, unite an astringent principle. The gentian, the quassia, the camomile flowers, and even the cascarilla, if debility ap- pears early, may be early employed; and with a neutral salt, so as to prove purgative, or sometimes with the kali only, they have appeared to be febrifuges. Though they are chiefly adapted to the sIoav fevers, apparently of the hectic kind, we have thought that, in many cases, they act with sufficient energy as tonics, even in typhus, except in the desperate cases to be soon men- tioned. The metallic tonics have not been fairly tried, and the most powerful, the arsenic, seems to require for its success a complete apyrexia. Cordials are, however, often necessary; and Ave re- peat only the opinion of the ablest practitioners, that the most efficacious cordial is wine. Unless called for by early debility, we seldom wish to give it till the eighth day, and very moderately till the tenth. Even between this and the fourteenth, unless in emergencies, we rarely order a pint in twenty-four hours. If the fever proceeds, it may be increased. Other cordials are the aromatics and ether; the former, in the usual preparation, the confectio cardiaca; the latter, except in cases of convulsons, in an occasional cordial mix- ture. The strength is also for a time supported by the more simple stimulants. The contrayerva and the serpentaria, with ammonia, were the preparations for- merly used, Avith a view of concocting the matter; and we once thought that we could support the strength for a day or two by their means, when a crisis was expect- ed : but we.have long learnt to " pull in resolution, and doubt the equivocation that palters with us in a double shape." These stimulants only contribute to.destroy the excitability, and Ave fear to hasten the last fatal ter- mination. They may be employed in cases of tempo- rary debility; but should be carried no further than to bring back the previous state. The great errors in the management of fevers have Ijeen the ideas that tonics, which restore muscular energy, will equally restore the sensorial power; and that which confounds temporary heat and more rapid circulation with increased strength. Each is a fatal misapprehension. It has been an error equally dangerous, Avhen debility comes on, to rouse the patient by light and noise. Life is a forced state, says the ignorant and mistaken Brown, and the lamp must be excited by additional powers : it will be excited only to exhaust more rapidly the pabulum which supplies its existence. Among the more unexceptionable tonics we may mention the mineral acids. These are of importance when considerable debility comes on; and a German physician, M. Recht, has endeavoured to raise their value by representing the muriatic acid as a general remedy in fevers. The secret was magnified by inte- rest or collusion till it became a national object, and it Avas purchased by the king of Prussia. The muriatic and vitriolic acids had been long used in this kingdom in Ioav, nervous, or putrid fevers, and considered as use- ful,^but by no means infallible, medicines. There are cases, however, where the strength is greatly lessened, and where a putrid dissolution of the blood becomes a most dangerous symptom. The .mi- neral acids are, in such cases, remedies of considerable importance; and the bark becomes an indispensable medicine in the largest doses. These circumstances, hoAvever, seldom occur in general fevers; and, indeed, within a feAv years, we have scarcely seen an instance of this kind, except when a topical gangrene, as in the ulcerated throat, has concurred. We cannot then be FEB 654 FEB too active in the employment of cordials and tonics, among Avhich the mineral acid must be ranked; for if we do not gain some ground Avithin a few hours after the appearance of these symptoms, the patient is lost. The other tonics formerly mentioned are not of suffi- cient poAver for such emergencies. We cannot leave this subject without noticing the necessity and the means of obviating some of the more troublesome symptoms. The chief of these, the Avant of sleep, has already been the subject of our notice. The state of the stomach is also the source of consider- able inconvenience. Acid eructations and heart-burn are relieved by absorbents, as magnesia, chalk, or kali; but Ave must recollect that we have already dis- tinguished a species of heart-burn arising from oily substances, not mixed with the contents of the stomach, relieved only by mucilages. Nidorous eructations show the stomach to be in a putrid state, and this is corrected generally by vegetable, but more effectually by mineral, acids. Flatulent distention will seldom be troublesome, if the discharge of the bowels be kept up. Should it be so, asafoetida and galbanum, or their tinctures, with peppermint water, will relieve. Hiccough, at the latter end of fever, is sometimes highly distressing; and for this we have no certain remedy. Oil of cinnamon, camphor, musk, and opium, are given by turns; and one or other of these occasionally succeeds, though of- ten all fail. Applications of opium, or of a blistering plaster to the stomach, will, like the others, in turn succeed and fail. But though a distressing symptom, hiccough is not, as has been represented, a fatal one. Did it not fatigue and weaken the patient, we should scarcely think it dangerous. Palpitation of the heart is sometimes troublesome, but not always dangerous in fevers. It sometimes pro- ceeds from the state of the stomach and bowels, and may then be relieved: but it arises also, in many cases, from a diminution, or an irregular distribution, of the nervous poAver; and shows that the degree of de- bility is considerable. The Ioav, muttering, wandering delirium, is a symptom of the same kind ; but this is so strictly connected with the state and progress of fever, that it scarcely merits our notice in this place. Strangury, though often the effects of blisters, some- times occurs in" fevers without their application, and arises from a spasmodic irritation of the neck of the bladder. In this case opium, particularly in clysters, is the most effectual remedy. Haemorrhages sometimes occur in fevers, which oc- casion no little difficulty. If the pulse be full and hard ; if much headach has preceded; if faintness does not follow the evacuation; but, on the contrary, the pulse becomes softer and slower; the bleeding may go on. If it happen at the conclusion of fever, and be attended Avith faintness, it is highly dangerous. Cold, bark, and the mineral acids, have been accounted the best reme- dies ; but even in this low state we have found nitre successful in repeated doses. It is indeed one form of employing cold. See Hemorrhagic. Longings for particular foods are sometimes trouble- some. These must be distinguished from the caprice of the moment; and if the patient continue to desire, with much anxiety, any particular food, we have found that he may be more safely indulged than contradicted, even should the desired food appear highly injurious. We have knoAvn Avine anxiously longed for; and a very large quantity drunk in a short time, not only with im- punity, but advantage. Among the sequelae of fever are cough, night sweats, an irritable and irregular state of mind, a capricious and often an inordinate appetite. These are, in gene- ral, marks of debility only, and disappear with returning strength. Bark and tonics are usually employed for a time with little effect. The constitutional poAvers are at last exerted, and the patient gains in hours the strength which, with the most powerful tonics, it did not attain in days. The powers of digestion, however, do not return in the same proportion as the appetite, and relapses are not uncommon from unlimited indul- gence. See Sydenham; Grant's Observation on the Nature and Cure of Fevers; Kirkland's Essays towards an Im- provement in the Cure of those Diseases which are the Causes of Fevers; Fordyce on Simple Fever; Cullen's First Lines, vol. i. The great varieties of fevers we shall in a future part of this work endeavour to bring within more strict limits. It would be to anticipate what can only be then detailed Avith advantage to add any thing at pre- sent on the subject, and we shall of course preserve the various references in the former edition with little change. Fe'bris acu'ta sangui'nea. See Inflammatory febris. Fe'bris a'lba. See Chlorosis. Fe'bris amato'ria. See Chlorosis. Fe'bris angino'sa. See Scarlatina anginosa. Fe'bris ca'rcerum. The jail fever; a severer kind of typhus, called typhus carcerum. See Amphe- merina Hungarica, and Typhus. Fe'bris castre'nsis. The camp fever ;. a remittent tertian, called typhus castrensis, from its resemblance to typhus. See Typhus. Fe'bris conti'nua pu'trida. See Putrida febris. Fe'bris non pu'tris. See Inflammatory fe- bris. Fe'bris depurato'ria Sydenha'mi. A variety of synochus. Fe'bris epide'mica contagio'sa. Epidemic fever of the West Indies and Philadelphia; malignant pesti- lential fever of Chisholm ; bilious remittent yellow fe- ver of Rush; synochus icteroides, or yellow fever of Currie. See Biliosa febris. Fe'bris erra'tica. Erratic fevers, irregular ter- tians or the quartans. Fe'bris fla'va. See Biliosa febris. Fe'bris Hunga'rica. See Amphemerina Hun- garica. Fe'bris intermittens. See Intermittens. Fe'bris lenticula'ris, also petechialis. A typhus, or synochus, attended with spots in the skin, about the size of lentils, called from these appearances spotted fevers. See Petechialis febris. Fe'bris hydrocepha'lica. See Hydrocephalus. Fe'bris mali'gna Barbade'nsis. See Biliosa je- bris. FEM 655 FEB Fe'bris mali'gna he'ctica: a mild kind of ty- phus. Fe'bris nau'tica pestilentia'lis. See Miliaris NAUTICA. Fe'bris puerperalis. See Puerperalis fe- bris. Fe'bris remittents. See Remittens, Fe'bris urtica'ta. See Urticaria. FE'CULA. See F*x. FEL, (quasi foliis, a bag). See Bilis. Pel natu'rc See Aloe. . FELLI'FLUA PASSIO, (from fel, bile, and fluo, to flow, and passio, affection). See Cholera mor- bus. FE'MEN, (quasi ferimen, from fero, to bear). See Femur. FEMINUS, (from fe7nina, a woman). In botany it means producing female flowers only on the same root. FEMORA'LIS ARTE'RIA,(from/cmwr, the thigh). The femoral artery is the external iliac after it has passed from under Poupart's ligament, and is continued along the thigh into the popliteal. Besides ossification and wounds, this artery may be the seat of an aneurism; a disease distinguished in its early stage by its being circumscribed and small, though the pulsation is suffi- ciently remarkable; but as the tumour enlarges, the pulsations are more obscure, and at last no longer per- ceived. When the aneurism is arrived at this stage, the loAver part of the leg becomes oedematous ; the limb is gradually more useless ; and, if relief is not afforded, a mortification will follow. The operation for the aneu- rism will rarely succeed in this case, for in general the artery is also diseased above the dilatation; and the want of collateral branches to carry on a due circulation is another impediment to the attempt. Amputation, in this instance, as well as when this vessel is wounded near the belly, or near the ham, is the only relief. In case of an aneurism, if, on performing the operation and tying the artery, pain follows, with fever and ten- sion, the issue will be fatal if amputation is not per- formed. If the aneurismal tumour is about the middle of the thigh, and but small, it may be laid bare, and the artery tied above and below; but if the tumour is large, the artery is diseased above, and the ligature will fail. If the tumour is near the groin, amputation itself will- scarcely save the patient's life; if low, near the ham, or in it, amputation is the only means of preventing a fatal mortification. See Mr. Pott's Works, and his Ne- cessity, &c. of Amputation in certain Cases. FE'MORIS OS, (from the same). Thigh bone; ancha os. In the thigh there is only one bone; it is the largest and strongest of those which are cylindrical. On its outside, near the neck, is a large tuberosity, the trochanter major, rotator major, rotator natis; and a lesser one, on the inside, the trochanter minor, rotator minor. The posterior concave surface of this bone hath a ridge rising in its middle, called the linea aspera, di- vided below into two. The inferior extremity of this bone is formed into two condyles, between which a con- siderable cavity- is found, especially at the posterior part: these are contiguous fonvards, but at a distance back- wards. The os femoris is articulated to the acetabulum by enarthrosis; to the tibia and the patella by gingly- mus. WinsloAv observes, that all the processes from this bone are cartilaginous in new born children. Though the thigh bone supports the whole body it is by no means, in appearance, advantageously constructed, since it bends inward towards the knee, and outwards at the top; but the former was necessary to avoid a rotatory motion of the leg, and the latter to form a sufficient space for the organs at the bottom of the abdomen. As the great trochanter passes off at nearly a right angle to enlarge the cavity just mentioned, any shock of the trunk renders it liable to fracture, and this is often mistaken for luxation; an error with difficulty corrected, as the muscles are so thick and so numerous in this part. FEMUR, (from fero, to bear; as being the support of the body). The thigh ; femen, (quasi ferimen,) coxa, agis, ancha, crus, meron. FENESTRA OVA'LIS et ROTU'NDA, (from fenestra, a window). See Auditus. FERE'NTIS. See Arbutus. FERI'NA, MANIODES, (from p«»i«, and furor, eifos, forma,) a violent and furious delirium. FERI'NUS, (from/s, green). A flower is that part of a plant in Avhich the parts of generation of either sex reside. In some floAvers are the parts proper to one sex only ; in others both sexes are included in the same flower. A floAver, when complete, consists of a calyx, corolla, stamen, and pistil; but the essential parts are the anthera at the top of the stamen, and the stigma : these are suffi- cient to constitute a flower. Tournefort's system, which alone could be the rival of the Linnaean, depended on the form of the flowers : as it is not yet wholly disused in France, though super- seded rather by Jussieu's natural arrangement than the Linnaean system, Ave shall shortly give its outline. The vegetable kingdom is divided into herbs and trees. Herbs are such as have flowers with petals or without them. The petalodes are simple or compound. The simple-leafed flowers are divided into monopetalous andpolypetalous; the former into regular and irregular; the regular flowers into the campaniformes and infundi- buliformes ; the irregular into labiqti and anomali. The polypetali regulares are the crucifonnes, rosacei, umbel- lati, caryophyllai and liliacei). The irregulares are the papilionacei and anomali. The compound petalodes are the fiosculosi,the semifiosculosi, and the radiati. The apetali are either those without leaves and without a flower, or without flower or fruit. The floAvers of trees are similarly divided. The apetalous ones are the apetali and amentacei; the peta- lodes monopetalicontainonly the monopetali; the others are the rosacei and papilionacei. Accordingto Linnaeus, the calyx is the expansion of the epidermis, the corolla or flower of the liber or inner bark. FLO 670 FLO Flos abo'rtiens. Abortive floaver, producing no fruit. Flos amentaceus. See Amentum. Flos ape'talus; is without a corolla; often called stamineous, incomplete, imperfect. The parts of ge- neration are covered only by the calyx. Flos campanifo'rmis, shaped like a bell. Those whose edges spread wide, are termed open bell shaped flowers; those less spread, tubulous bell shaped flowers. Flos caryophylle'us, resembling a single carnation, having five regular petals, ending at the bottom in a long narrow claw. Flos compo'situs ; a species of aggregate flower, containing several florets, inclosed in a common peri- anth, and on a common receptacle, with the anthers connected in a cylinder. Flos crucifo'rmis, is composed of four equal petals, placed in the form of a cross. Of this sort are the cab- bage, the wall flower, and mustard. Flos fcemi'neus. Female flower, which has pis- tils or stigmas, without stamens, or at least antherae. Flos flosculo'sus. A flosculous flower. By Linnaeus called tubulosus, a tubulous compound flower, composed wholly of tubulous florets, exemplified in tansy, and the camomile flowers. Flos infundibulifo'rmis. A funnel shaped flower, as the primrose, &c. Flos labia'tus. Lip shaped flower. A mono- petalous corolla, Avith a narrow tubular basis, ex- panding at the top in one entire, or in two lips: Lin- naeus uses the term ringens, including under it both labiated and personate flowers. This creates a con- fusion, which, according to Martin, would be re- moved, if Ave put labiate for an irregular monopetal- ous corolla Avith two lips, and appropriate the term ringens to such as have the lips gaping and open, personate to such as have them closed. Sometimes the upper lip is wanting, and then the style and chives sup- ply its place, as in the ground pine, bugula, 8cc. This is sometimes called an unilabiated flower. In some species, the upper lip is turned upwards, as in the ground ivy; but most commonly the upper lip is con- vex above, or turns the hollow part down to the under, representing an helmet, whence they are called galeate, cucullate, and galericulate. Flos lilia'ceus. A lily shaped flower, is gene- rally composed of six petals, which resemble those of the lily, the tulip, and the asphodel: and is a natural order of Murray. Flos monope'talus. A flower composed of one leaf; or whose leaves are joined at the bottom, so as to fall off entire. Flos ma'sculus. Male flower; bearing sta- mina only, Avithout pistils; or at least wanting the stigma. Flos monope'talus anomalus. An irregular flow- er, consisting of one leaf. Flos papiliona'ceus, (from papilio, a butterfly). The papilionaceous, or butter fly shaped foaver, is irregular and usually four petalled. The lower petal is shaped like a boat, and is called carina or keel; the upper, which spreads and rises upwards, is called vexillum, standard or banner; the two side ones are separated by the keel, and are called ala, the wings; the keel is sometimes split, and then this corolla is properly five petalled. These flowers are called pea blossomed, because the pea is the most common example. Flos persona'tus, a masked flower, is an irre- gular monopetalous floAver, in Avhich the pistil becomes a capsule entirely distinct from the calyx: it has a simi- lar appearance with the labiate floAver; but does not ill represent a mask, the snout of some animals, or the beaks of fowls. Flos petalo'des, a petalous flower, has organs of generation surrounded with petals. Flos polype'talus, a polypetalous floaver, is composed of several petals. When these agree in figure and position, it is called regular polypetalous ; but when they do not agree, irregular polypetalous. Flos pyramida'lis farne'sianus. See Battatas CANADENSIS. Flos radia'tus, a radiated flower, consists of two parts, viz. the disk and the rays, Avhichare several semiflorets set round the disk in the form of a star : these are called radiated disco us fiowers ; but those which have no rays are called naked discous fiowers. Flos rosa'ceus, rose shaped flowers, consist of four or more regular petals inserted into the receptacle by a short broad clawr, as in the Avild rose. Flos rota'tus, is a flower in the form of a Avheel; wheel shaped corolla; monopetalous; spreading flat, without any tube; such as that of borrage. Flos sangui'neus mona'rdi. See Nasturtium Indicum. Flos scorpioides. Those flowers are ranged on one side of the pedicle, Avhich twists at the top, in the form of a scorpion's tail. Of this sort is the heliotro- pium. Flos semifloculo'sus, a semifloculous flower, is composed of several semiflorets, included in one common calyx. Flos so'lis pyramida'lis. See Battatas His- panica. Flos spica'tus, spiked flower, is one whose Aoav- ers are set thick on the pedicle, so as to form an acute cone. Flos stamineus, a stamineous flower, is compos- ed of many chives included in a calyx, having no petals, Of this sort is the bistort, &c. Flos ste'rilis. Barren flowers. These have no embryo adhering to them, and are called male fiowers. Flos te'rrje. See Cosli flos. Flos tubulo'sus. See Flos flosculosus. Flos ventricula'tus. Whorle shaped flower. These grow closely united, surrounding the stalk at the joints. Flos umbella'tus. An umbellated flower. When the extremity of the stalk or branch is divided into several pedicles, or rays, beginning from the same point, and opening in such a manner as to form a kind of inverted cone, like an umbrella, it has this appella- tion. When the pedicles, into which the stalk is divided, are subdivided into others of the same form upon Avhich the flowers are disposed, the first order is called rays, the second pedicles. When it consists of pedicles only it is called a single, when composed both of rays and pedicles a compound umbel. Flos urceola'tus. Pitcher shaped floaver, bellying out like a pitcher; applied to the calyx, corolla, F L L 671 F L V and nectary. Of this sort are the arbutus and Avhortle- berry flowers. FLO'SCULUS,(a dim. offlos,a flower). A floret, or little flower, one of the distinct florets which compose an aggregate flower. FLUID A. The fluids of the body have been classed according to their form, or their qualities. In the for- mer vieAV, they may be arranged under the heads of gaseous, watery, oily, glairy, or mucous. The gaseous fluids are the insensible perspiration from the surface, and the lungs; some gas combined loosely with the blood; the contents of the pericardium ; of the ventri- cles of the brain; of the duplicature of the peritonaeum, perhaps of the sheaths of the nerves ; more certainly of the stomach and intestines. The watery fluids-are, the circulating, the secreted, and the absorbed fluids: the oily, the contents of the adipose membrane, the bile, and cerumen; the glairy, those contained in the cavities of the joints; the mucous, those which line sur- faces contiguous to each other, generally such as admit of occasional dilatation for the passage of any body, as the throat, the vagina, &c.; often those whose accretion this fluid is designed to prevent, as the eye lids, the prepuce, &c. Dr. Hooper divides the fluids from their qualities into the crude, more properly the alimentary, as the chyme or chyle; the sanguineous, as the fluids of the heart, arteries, and veins; the lymphatic, or the contents of the lympliatic system; to which he adds the nutri- tious gelatine; the secreted and the excrementitious. The secreted fluids may be again divided according to their form, as stated above; but the varieties are nu- merous, and the shades of distinction often minute. Thus milk unites the Avatery and the oily; the semen approaches an albumen, and the liquor of the prostate remains to be more accurately examined. The dis- eases of the fluids are numerous, but must be the subject of a separate consideration. See Morbi flui- dorum. FLU'OR, also FLU S, (fromfiuo, to flow). This word, when used adjectively, is applied to signify the habitual fluidity of any substance, implying that it cannot be rendered solid; e. g. a volatile alkali treated with quick- lime is always liquid, and cannot be made to concrete or crystallize, so is called fluor volatile alkali, to dis- tinguish it from the common carbonated ammonia. When the word fluor is used substantively, it signi- fies a fusible mineral, or one which facilitates fusion. Of this kind are many spars, Avhich are called fluors; and by the Avord fluor, spar is generally understood. Spar appears like crystal; but less bright, colourless, and pellucid; it commonly rises in triangular points, and is calcareous: it is the same with stalactite. The spar fluor is a fluate of lime; or calcareous earth Avith the fluoric acid. Of this spar the ornamental vases and columns from Derbyshire, are made; but it is never employed in medicine. FLU'OR A'LBUS. The white flux, the whites, eluvies, cachexia uterina, leucorrhea, leucorrhois, &c. is a flow of matter from the vagina, of different colours and consistencies, but generally of a pale or whitish colour. Astruc distinguishes, by an useless refinement, this discharge into the lymphatic, semilacteous, and lacteous. In Dr. Cullen's Nosology it is the menorr- hagia alba; the fifth variety of his menorrhagia. He defines it " a serous menorrhagy, without any local in- jury in women not pregnant." He places it under this head, because the leucorrhcea is usually joined Avith me- norrhagia, or soon follows it; and because it is highly probable that the serum flows from the vessels Avhich supply the menses. The causes of leucorrhcea also are often the same as those of menorrhagia. The seat of this disorder seems to be in the uterus, near the os internum, though principally in the vagina. Astruc thinks its seat to be in the glands, situated on the third or internal tunic of the uterus, and that they are vesicular bodies about the fundus uteri; these glands he calls colatoria lactea, and adds that this disease consists in a preternatural discharge from them. The v uterine exhaling vessels, according to Hoffman, " be- come blood vessels at the menstrual period, and when emptied they contract to their former dimension and tone; but if by immoderate evacuations, or other causes of debility, their power is weakened, they separate the serous part of the blood, which, by stagnation, or from a particular state of the body, acquires various degrees of acrimony and consistence." As pregnant women are liable to this complaint, it does not appear that in them the discharge proceeds from the uterus, except from about the os internum; for the spongy chorion firmly adheres to its inner surface in almost every part. Some women have, indeed, a return of the menses in every month of pregnancy, which, though deficient both in quantity and quality, confirms Hoffman's opinion, as well as that the vagina may be a principal seat of the discharge. Women who abound with serum, with lax fibres, or at the decline of life, and girls at the approach of the menses, are most subject to this disorder; though it sometimes occurs from infancy to old age. Hoffman observes, that women who are subject to a mucous de- fluxion at the nose are, on a suppression of the menses, affected with a fluor albus. That the immediate cause of a fluor albus is debility of the vessels from which the menstrual discharges flow, or a retarded circulation of the blood through them, appears from some women having always a leucorrhcea whenever their menses are detained. In languid habits the disease returns periodically, instead of the proper menstrual evacuation, until the patient's con- stitution is sufficiently invigorated; and in many in- stances it is manifest only during the absence of the menses. The more remote causes are, cold moist air, a se- dentary life, poor diet, excessive menstrual discharges, abortions, violent extraction of the placenta; indeed, every circumstance which Aveakens the constitution in general, or these vessels in particular. From Hippocrates' description, it appears to have a great affinity to a cachexy. He says, " that the matter discharged resembles the white urine of an ass; Avhite swellings appear in the patient's face, the part beloAV the eyes swells, the eyes are disordered, and appear as if the patient was dropsical; the colour of the skin is whitish, and the lower part of the belly tumid; in the legs appear tumours so lax and so soft, as to retain the impressions of the finger; a biting pain is perceived in the stomach, and a sensation of an acid water lodged FLU 672 FLU in it, either when the patient is fasting or happens to vomit; when she goes up a steep place, she is seized with short breathing; her legs are cold, her knees feeble, her uterus preternaturally opened, with a sense of weight at its mouth. This discharge is sometimes daily, and occasionally it appears two or three times in a month, and continues, each time, only a few days; the humour is serous and limpid in some, and in others more viscid: sometimes it is acrid, and occasions an itching, pricking, or even an excoriation ; in its greater degrees of virulence, it appears of different shades, from the slightest yellow to a green or even a blackish green colour, and it is then more or less fetid. When the case is mild, it is often not regarded; but Avhen more violent, a cachexy is the consequence. There is in that case a pain and sense of weight in the loins, turbid urine, longings and loathings, indigestion, swelling of the face in the night and of the feet in the day, palpitation of the heart, fainting, symptoms ending fatally in dropsy, or a consumption." This disorder should be distinguished from a cachexy, a gonorrhcea, pale and ill coloured menses, and from ulceration, abscesses, and cancers in the parts of gene- ration. Leucorrhcea is often a symptom of cachexy, and the treatment is the same, so that distinction is not neces- sary. It is frequently mistaken for gonorrhoea; and in turn the latter is styled the whites. Leucorrhcea, when violent, is attended with a discharge as thin, as discoloured, and as acrid as gonorrhoea; and the cha- racter of the woman or her husband will, at times, be the only means of distinguishing the complaint. This similarity is, however, advantageous in another view, as it enables the practitioner to preserve the peace of a family, by giving a safer name to the effects of impru- dence. If a woman is regular, it will be found that, during the discharge of the menses, the whites disap- pear; but the matter of a gonorrhoea is found combined with the blood; and except in very old women, whom we cannot suspect of gonorrhoea, the discharge is sel- dom so acrid as to occasion pain in making water. Ulceration and abscesses in these parts have been usually preceded by inflammation, or may be traced to some violence; and the discharge of cancers is attended by the violent lancinating pains at the bottom of the belly. The discharge from cancers also, we believe, is the only fluid from those organs, which discolours bright silver. If this disorder is moderate, it is supported a long time without much inconvenience; but if considerable, it soon spoils the beauty, weakens the digestive powers and the whole system, occasions sterility, and more > frequently a disposition to miscarry. If the flux is un- seasonably checked, the belly is said to swell, a hectic fever to come on, and a train of the most disagreeable symptoms to follow. We suspect, however, that to check it quickly is no easy task. The indications of cure are, to promote digestion, increase the strength, and restrain the preternatural discharge. The diet should be light, cordial, and nourishing; isinglass ^dissolved in milk is useful, with moderate quantities of red port. Leucorrhcea is with great difficulty removed. If it proceeds from partial debility of the vessels of the womb and vagina, from frequent births or miscarriages, remedies can scarcely be brought to act on such remote organs ; and to remove partial debility by general re- medies is a-tedious, and often an unsuccessful, task. Avoiding irritation of body and mind is highly ne- cessary ; and it is equally so to guard against topical irritation. The bowels must therefore be kept free, and every excitement of the uterine system avoided. Moderate exercise in cool air, cool rooms, and light clothing, food nourishing, but not highly spiced, or flatulent, are useful. The most scrupulous cleanliness is essential; and injections of milk and water, or green tea, should be frequently thrown up, cold. Tonic medicines are principally employed; and the chief of these is cold bathing. The chalybeate mineral waters are remedies of considerable importance, among Avhich the Cheltenham and Tunbridge springs are most useful. The bark is often employed, and is frequently salutary; but the more powerful astringents are said by Hoffman to be injurious. The humoral patholo- gists, in almost every disease, suspected acrimony; and this idea has led to the use of absorbents and of altera- tives and mercurials, in leucorrhcea. The former are at least innocent; and as, in such circumstances, acids often abound in the stomach, they may be useful. Mercurials are, we believe, injurious, if we proceed beyond the slightest doses, to give a general tone to the arterial system. For the same purpose chalybeates are generally and freely employed. They have been used also for injections; and smiths' forge water has been recommended. This fluid, however, soils the linen, and as a powerful astringent may be injurious. The alteratives employed have been the Lisbon diet drink, antimonials, and sarsaparilla. They have been supposed useful Avhen the discharge is highly acrimo- nious; but we have seldom employed them, and scarcely in any instance found them effectual. The disease is peculiarly obstinate, and to relieve it our almost only chance. See Cullen's First Lines, vol. iii. p. 24, 31. Hamil- ton's Midwifery, edit. 2, p. 119, 137, 140. Hoffman's Dissertation on the Fluor Albus. Leake's Medical Instructions, edit. 5. FLUS, (from fluo, to flow). See Fluor. FLUVIA'TILIS, (from fiuvius, a river). Belonging to a river. FLUX, synonymous often with fusion; and frequently implying the substance by which fusion is promoted. It has various names from its appearance or nature, as black or white flux, crude flux, &c. In general it consists of a mixture of nitre and tartar. FLUXIO. See Catarrhus. FLUXUS, (from fluo, to flow). A Flux. Some- times it signifies a defluxion, and in this sense it is sy- nonymous with catarrh. Sometimes it is used in a more limited sense, as fluxus ventris, a continued eva- cuation of thin faeces, without either tenesmus or lien- tery; or a fluxus hepaticus, when the excrements are like water in which flesh hath been washed. Hippocrates uses the word po<&>, fluxus, in his work de Natura Muliebli, of which there are the fluor albus, and fluor ruber, i. e. menses. Fluxus pvo-ts means a loss of the hair, in A. Trallian. (lib. i. cap. 2.) In Cullen's No- sology, it is synonymous with Apocenoses. FCEN 673 FCET FOCA'RIUS, (from foveo, to burn). Bread boiled on the hearth or gridiron. FO'CILE MA'JUS et MI'NUS. Arabic Bar- barous appellations of the ulna and radius in the arm; the tibia and fibula in the leg. FO'CUS (from foveo, to burn). The burning point of the speculum, or rather the point at Avhich all the rays of light converge when bent towards the perpendi- cular by a convex lens. Focus morbi is the supposed principal residence of the disease, from whence it com- municates its noxious influence. Some ancient anato- mists gave this name to the first lobe of the liver. See Auriga. FODI'NA, (from fodio, to dig). See Labyrin- thus. FGL'DULA, (from fedus, foul; from its stinking smell, when rotten). A species of fungus. FCENI'CULI, vel FCENICULA'TUM LI'GNUM. See Sassafras. FCENI'CULUM; a diminutive of fenum,hay ; be- cause when dried, it is preserved; or quasifenum ocu- lorum, the hay or herb good for the sight. Fennel. Wine impregnated with it is called marathrites. Fceni'culum xulga.'re, feniculum Germanicum, 7na- rathrum, common fincle, or fennel ; Anethum fenicu- lum Lin. Sp. PI. 377. This plant is so common that a description is unne- cessary : its seeds are small, and of a blackish brown. The plant is perennial, native in the southern parts of Europe, but thrives in our gardens; supposed to be the marath7-on of the Greeks, highly esteemed among them for promoting the secretion of milk. The experience of Bergius seems to confirm this opinion. The seeds are more warm and pungent, but not so pleasing, as those of the sweet kind. They are sto- machic and carminative, commended against nauseas and loathing; and if eaten in the morning fasting, sup- posed to help the sight. Dill, anise, and carraway, are, however, allowed to be superior in these respects. The leaves have the same flavour Avith the seeds, and smell stronger, but to the taste are weaker and less agreeable. They impregnate water sufficiently with their virtues by distillation, and by the same process afford a considerable quantity of essential oil. Rectified spirit of wine is rendered agreeably aromatic by them, and the extract retains the whole strength after eva- poration. The roots, taken up in spring, have a pleasant sweet taste, are slightly aromatic, and are ranked amongst the aperient roots. Fceni'culum dulce. Sweet fennel. This variety of the anethum foeniculum, var. x, is annual, a native of warm climes, and cultivated in gardens. The seeds are larger, paler, and sweeter than those of the former sort; contain a gross oil, easily obtained by pressure, and have been esteemed pectoral and diuretic: when freed from the essential oil, they are perfectly insipid. The London college directs us to distil a simple water from the seeds, and from a pound to draw off a gallon ; which is said to be diuretic and carminative. See Lewis's Materia Med. Neumann's Chem. Works. Fceni'culum Alpi'num. See Meum. Fceni'culum a'nnum. See Ammi verum. Fceni'culum erraticum. See Saxifraga Angli- ca. vol. I. Fceni'culum mari'num ma'jus et minus. See Crith- mum. Fceni'culum orienta'le. See Cuminum. Fceni'culum porci'num. See Peucedanum.. Fceni'culum sine'xse. See Anisum Indicum. Fceni'culum sylve'stre. See Meum latifolium ADULTERINUM. Fceni'culum tortuosum. See Seseli Massili- ENSE. FCE'NUM CAMELO'RUM. See Juncus odora- tus. Fce'num Gr/e'cum, (fromfenum, hay, and Grecus, Greece ; because it grew there in the meadows, like hay). Fenugreek ; buceras, because the fruit is corniculated; and agoceras, because the pods were sup- posed to resemble the horns of a goat, trigonella fenum gracum Lin. Sp. PI. 1095. It is a plant with serrated, roundish leaves, whitish papilionaceous flowers, follow- ed by long, slender, crooked, flattish pods, containing yellowish rhomboidal seeds, furroAved from one angle to the other; or, as Neumann observes, oblong, flattish, quadrangular, and roundish at one end. These seeds are sown annually in the south of Europe, from whence they are brought to us, and are the only parts of the plant employed; their prevailing principle is mucilage, and an ounce renders a pint of water very mucilaginous. They are chiefly used in emollient cataplasms and fo- mentations, and in emollient and carminative clysters. They are slightly bitter, and have a disagreeable smell. See Lewis's Mat. Med. and Neumann's Chem. Works. Fce'num gr^e'cum sylve'stre. See Glaux vulgaris leguminosa. FCETA'BULUM, (from feteo, to become putrid,) a foul ulcer; and an abscess with a cyst. <• Severinus. FCE'TIDA TINCTURA, See Asafcetida. FCE'TUS, (from feo, to bring forth). See Voss. Etymol.) Epicyema, and epigonion. The young of all viviparous animals whilst in the womb, and of'ovi- parous animals before they are hatched. (See Con- ceptio). The name is transferred by botanists to the embryos of vegetables. In the human foetus are several peculiarities not to be found in the adult. 1. The ductus, or canalis, arterio- sus. (See Arteriosus ductus). 2. The arteries of the navel string, which are continuations of the hypo- gastrics, after the birth, are shrivelled up, and form the ligamenta umbilicalia inferiora. 3. The veins of the navel string, which are formed by the union of all the venal branches in the placenta, and passing into the ab- domen, become the falciform ligament of the liver. 4. The ductus venosus, q. v. 5. The lungs, which, before being inflated Avith air, are compact and heavy; but af- ter one inspiration become light, and as it were spon- gy. When the lungs swim in Avater, it is supposed that the child has breathed; and the conclusion is drawn that it has been murdered. But the uninflated lungs become specifically lighter than water as soon as any degree of putrefaction comes on, Avhich quickly hap- pens after the death of the child; and where the utmost care hath been taken to preserve the child, it hath breathed once or twice, and then died ; and on the other hand, they may sink, though the child has breathed, if tubercles have formed in them. (See Medicina forf.n- sis.) 6. The thymus gland is very large in the foetus, but lessens as vears advance, 7. The foramen ovale in 4R F iK T 6 7 I F Sec Fok- tanella. FOB 678 F O li FORAMEN, (from foro, to pierce). An hole. See Os and Caput. Fora'men c w W ->. Vi • £< W^ X "*» *3 © » >• s s ■< CD < ORDER I. Functions which assi- milate the aliment by which the body is nourished. (Assimilating, internal, or digestive functions.) GENUS I.—Digestion Extracts the nutritive part. GENUS II.—Absorption Carries it into the mass of hu- < mours. GENUS III—Circulation Propels it towards the organs, GENUS IV.—Respiration Combines it with atmospheric < oxygen. GENUS V.—Secretion Causes it to pass through several modifications. GENUS VI.—Nutrition Applies it to organs, to which it is to supply growth, and re- store their loss. Reception of the food. Mustication. Solution by the saliva. Deglutition. Digestion in the stomach. --------------duodenum. --------------intestines. Excretion of the faeces and of the urine. Inhalation of chyle. • lymph. Action of vessels. --------■ glands. .--------the thoracic duct. ' Action of the heart. ----------- arteries. capillary vessels. veins. " Action of the parietes of the thorax. lungs. Alteration of the air. in the blood. ^ Disengagement of animal heat. *" Exhalation. Secretion by follicles. —•■—- glands. 1 Different in every part according to the peculiar composition of each. F U K 687 FUN 3 .s e o U C/3 CD ORDER II. Functions which form connexions with sur- rounding objects. (External or relative functions.) GENUS I.—Sensations Inform the being of their pre- sence. GENUS II.—Motions Approach towards or remove it< from them. GENUS III.—The Voice and Speech Cause it to communicate with si- << milar beings, without change of place. "llie Sight. Hearing. "Organs^ Smell. Taste. Feeling. Action of nerves. --------the brain. Human understanding. Sleep and watching. Dreaming and sleep walking. Sympathy. Habit. " Organs and muscular motion. The skeleton. Articulations. Place. "Walking. Runnings ProgressiveJ Jumping. motions, j Swimming. Flying. ^Creeping. The C Articulated, or Speech. Voice \ Modulated, or Singing. Stammering. Lisping. Dumbness. , Ventriloquism. o s o -JS O 0s wT ? w a So * u o§ s g.«a H w vj ORDER I. Functions which require the con- currence of both sexes, as { ORDER II. Functions which exclusively be-< long to females, as Growth Conception and Generation. Gestation. ' General differences of the sexes. < Hermaphrodism. w Systems relative to generation. " Of the uterus in a state of impregna- tion. History of the embryo. ——-——— foetus and its mem* branes. C On the uterus after delivery. \ The lochias. Action of the breasts. , Milk. S Infancy.—Dentition.—Ossification Puberty.—Menstruation. Adolescence. Delivery. Lactation. * Youth. "Temperaments. < Virility.< Idiosyneracy. ..Human race. {Age of decrease. Old age. Decrepitude. Death. Putrefaction. "Sanguine. Muscular. Biliary melancholic. Lymphatic. ^Nervous. {European Arab. Negro. Mongul. Hyperborean. FUN 688 FUN The splendid work of M. Vicq d'Azyr on the Brain furnishes us with the following table of the functions, or the proper characters of living bodies. These are, DIGESTION, NUTRITION, CIRCULATION, RESPIRATION, SE- CRETIONS, OSSIFICATION, GENERATION, IRRITABILITY, and sensibility. Every body in which one or several of these functions are observed must be regarded as an organized or living body. I. Digestion. Which have one or many stomachs di- stinct from the oesophagus and intes- tinal canal: man, quadrupeds, cetacea, birds, and Crustacea. g Whose stomachs are distinguished from 3 the oesophagus and intestinal canal only § by some enlargement: oviparous ani- £ MALS, SERPENTS, CARTILAGINOUS and 2 PROPER FISH. b Who have only an alimentary tube : in- sects, WORMS, ZOOPHYTES. Who have neither stomach nor intestinal canal: plants. II. JVutrition. Whose nutritious juices are absorbed by the vessels opening into the ex- 's g ternal cavities; animals of every £ g KIND. 3 g Whose nutritious juices are absorbed by vessels opening externally: plants. III. Circulation. Having blood, blood vessels, and a heart with tAvo ventricles and tAvo auricles; man, quadrupeds, ceta- cea, and birds. A single ventricle, internally divided into several cavities and two auri- £ cles: oviparous quadrupeds and £ serpents. o A single ventricle, and auricle: carti- a laginous and other fish'. § Whose heart is formed by a long con- p. voluted contractile vessel containing 3 a white fluid: Crustacea, insects, and avorms. In some Crustacea there are traces of a heart. Who have no heart, but vessels filled with fluids of different kinds: zoo- phytes and plants. IV. Respiration. Who breathe by free unconnected spongy lungs: man, quadrupeds, CETACEA. Who breathe by free cellular muscular lungs: oviparous quadrupeds and SERPENTS. w By lungs adhering to the ribs provided with appendices : birds. By gills of different forms: fish and CRUSTACEA. By holes placed on different rings: in- sects and EARTH WORMS. By a trachea and external fringes: AQUATIC WORMS. By tracheae: plants. In which neither holes nor tracheae are discernible: polypi. V. Secretion. This takes place in different forms or degrees in every living body. VI. Ossification. Which have an internal bony skele- ton : MAN, QUADRUPEDS, CETACEA, BIRDS, OVIPAROUS QUADRUPEDS, and fish. - An internal cartilaginous one: car- £ TILAGINOUS FISH. o An external horny : perfect insects M and LITHOPHYTES. ? Calcareous: Crustacea,shell fish, £ the greater, number of madre- 3 PORES, zoophytes. Woody: plants. Which have no skeleton: insects in their larva state, worms, polypi. VII. Generation. Viviparous: man, quadrupeds, ce- ~ TACEA. £ Oviparous, whether hatched inter- § nally or without the body : birds, & OVIPAROUS QUADRUPEDS, CARTI- ^ laginous and other fish, ser- £ PENTS, INSECTS, CRUSTACEA, WORMS, 3 PLANTS. VIII. Irritability. Wholly muscular or contractile : the greater number of the larvae of in- o SECTS, WORMS, POLYPI. ^ Whose muscles cover their skeleton: MAN, QUADRUPEDS, BIRDS, CETACEA, OVIPAROUS QUADRUPEDS, FISH, SER- PENTS. Whose muscles are covered by their skeleton: perfect insects and CRUSTACEA. Who have some contractile parts, but no spontaneous motions : plants. IX. Sensibility. Who have nerves, and a brain dis- tinct from their spinal marrow; ^ all animals, except those in the 3 following sections. o Who have nerves and a brain scarce- n ly distinct from their spinal mar- § row : insects, Crustacea, worms. £ Without discovered nerves, brain, 3 or spinal marrow: zoophytes, plants. See Animal. FU'NGUS, (a-7royyes, sponge; from their spongy contexture). Toadstool, besacher; is the lowest, and a very imperfect vegetable genus, having neither visible seeds, flowers, leaf, nor the structure of a plant. Most of them spring up from, and are soon dissolv- ed into, mucous matter. See Ray's Synopsis, and Amanita. Fu'ngus, in surgery, is a spongy excrescence, which arises in wounds and ulcers, commonly called, though often improperly, proud flesh. In general, dry lint is the best application. A spongy lax flesh, rising from the bottom of ulcers, differs much from the fungus in heal- ing wounds, and often requires the knife, or a caustic: the former is in one mass, but the fungus in healing wounds in many little protuberances. When this ill- conditioned spongy flesh arises, it is of very little use to attempt its destruction before the general habit is im- proved ; and when this is effected, dry lint, or other gentle means, will be generally sufficient. The fungus F U X 689 FUR over a carious bone cannot be removed before the ca- ries is stopped, and the exfoliation completed : the fun- gus then disappears spontaneously. If fungous excrescences arise from the brain after trepanning, they may be cut away with a knife, or sup- pressed Avith lint dipped in rectified spirit of Avine, and gentle pressure. If the tumour appear to increase internally, a circum- stance known by symptoms of compression On the brain, it has been sometimes advised to enlarge the opening of the bone; a precarious measure, often attended with dan- gerous haemorrhage. Pressure in this case is inadmiss- ible ; but Mr. Abernethy suggests the application of vegetable astringents. Some benefit has, it is said, re- sulted from sprinkling these tumours with equal parts of myrrh and lapis calaminaris. Fungus is also the name of a tubercle about the anus, occasioned and cured like a condyloma. White SAvellings are called fungi by some authors. In Vogel's Nosology it signifies a soft (edematous tu- mour of the joints. Dr. Gottlieb Richter observes, that in consequence of external bruises, sometimes after catching cold, and often spontaneously, a round, pretty regularly circumscribed SAvelling arises round the pa- tella : it is not painful, and a fluctuation is obvious. It sometimes occupies both sides of the patella, is some- times confined to its ligament, and frequently surrounds the Avhole knee pan. The patient feels no complaint, except some degree of stiffness in the motion of the knee joint. This tumour must not be opened; and he recommends the following plaster, taking also tartar emetic in small doses, and rubbing the knee Avith the volatile liniment. R. Gum. ammon. ii. solv. in aceti scillitici, q. s. ad. consistentiam unguenti tenuioris. This must be spread thick upon leather, applied over the whole knee. Similar tumours on the joints of the elboAv have been observed. Fu'ngusalbusacris, Fu'ngus pipera'tus albus. See Agaricus piperatus. Fu'ngus articuli. See Spina ventosa. Fu'ngus ignia'rius and la'ricis. See Agaricus and Agaricus quercus. Fu'ngus melite'nsis. Cyno7norion coccineum Lin. Sp. PI. 1375, supposed to be an astringent, and used in diarrhoeas and dysenteries. Fu'ngus salicis, boletus suaveolens Lin. Sp. PI. 1646. It has at first an acid taste, and is then bitter. It has been employed in hectics, but is noAV disused. Fu'ngus h^ematodes. This singular complaint Avas first distinctly described by Mr. Hey, in his very excel- lent work, entitled " Practical Observations in Sur- gery." It is a bloody tumour Avhich forms in every part of the body, painful when seated in the muscles; but producing little inconvenience when in the cellular sub- stance. It distends the integuments; but does not,like an abscess, render them thinner. When pressed with the hands, one part will give the sensation of a deep- seated fluid; in another the tumour is hard and uneven. When the integuments burst, the appearances are some- times those of an excoriation only ; sometimes a dark, bloody mass protrudes through the aperture. Where the fungus comes into contact Avith the muscles, they lose their natural redness and their fibrous appearance, becoming brown, and like the adipose membrane. When the fungus appears through the skin, it bleeds VOL. I. copiously, and the haemorrhage is frequently repeated till the patient sinks ; neither the hydrargyrus nitratus ruber, the hydrargyrus muriatus, antimonium muria- tum, or undiluted vitriolic acid, can repress its growth. Amputation is the only remedy; and if* the tumour has begun at the lower part of a limb, and the slightest por- tion is left at the upper, the disease returns. It appears to be an organised, and is probably a living, parasitic animal, nourished by the vital fluid of the patient, and capable of absorbing from the subjacent vessels what is effused from its OAvn. Fu'ngus ma'ximus rotu'ndus pulverule'ntus. See Lycoperdon vulgare. Fu'ngus membrana'ceous, and sa^ibu'ci. See Au- riculae JuD-ffi. Fu'ngus, petr^'us mari'nus. See Androsace. FU'NIS BRA'CHII. See Mediana vena. FU'NIS velFUNI'CULUS UMBILICALIS, (from its resemblance to a rope). The navel-string. It is of very different lengths, commonly about half a yard; usually fixed near the middle of the placenta, but occa- sionally near its edge. It is composed of two arteries and two veins: though sometimes the vein, and at others the artery, is single. These vessels are convoluted, and surrounded by a fine net work of fibres of a gelatinous texture. The arteries are continuations of the internal iliacs or hypogastrics; the veins are formed by the union of all the branches in the placenta ; they are continued into the abdomen at the navel, and so on to the vena portae in the liver. (See Fcetus). After the birth, the remaining parts of the arteries in the abdomen form the ligamenta umbilicalia inferiora, and the veins the falci- form or suspensory ligament of the liver. There is ahvays a point where the funis begins, and where the integuments separate from it: it is indiffer- ent where it is divided, as it always drops off at the same place. If the funis be torn off from the child, so that a liga- ture cannot be applied, LeMotte assures us he succeed- ed in preventing an haemorrhage by applying pledgets of lint, and confining them with proper compresses and bandage; but some recommend the needle and liga- ture. Animals stop the haemorrhage by draAving the r funis with their teeth; and, in such cases, Ave might imitate the practice by employing the forceps. If the child descends to the os externum, but seems to be drawn up and down as if suspended by a rope, the funis is probably too short, or entangled: in this case some practitioners have cut it about five or six inches. from the child's belly; but Avith a little patience it will stretch sufficiently. FURCE'LLA, FU'RCULA INFE'RIOR, (a dim. of furca, a fork). See Ensiformis. FU'RCULjE, (fromfurca, a fork). See Claatcu- LJE. FU'RFUR, (from the HebreAv term farfarah, to break into small pieces). Bran. Called by C\elius Au- relionus cantabrum leptopityron. It is commended as ex- cellent for removing offensive sordes from the head ; and for relieving headachs, Avhen rubbed Avarm on it. It has been used also as an expectorant, in decoction, or rather in infusion; and, sweetened Avith honey, is said to relieve violent and obstinate coughs. We have al- ready remarked that it is almost exclusively gluten and of an animal nature, producing, by distillation, ummonia 4 T FUR 690 F U S FU'RFURA, (from furfur, bran). Scurf. Small exfoliations of the cuticle from exudation, like bran, which follow some eruptions on the skin : a new cuticle is formed underneath during the exfoliation. FURFURA'TIO. See Furfurosi. FU'RFURES,(from furfur, bran). The appellation of urine, whose sediment resembles bran. It is also called petyroides; and is synonymous with furfurosi. FURFURO'SI, (from the same). Those afflicted with a scurf on the head, which, upon combing, dis- charges a scaly substance like bran, sometimes called porrigo, and farrea nubes. FU'RNUS. See Fornax. FURIO'SUS, (from furio, to enrage ; so called from the violence of pain). See Ambulo. FU'ROR UTERI'NUS, (from furo, to be mad, and uterus the womb,) acrai, brachuna, astromania, aras- con, arsatum. Dr. Cullen calls it nymphomania ; and places it in the class locales, and order dysorexia. He defines it an unrestrained desire for venereal enjoyment: but there is one species, varying only in its degree. It is a kind of madness, or an high degree of hysteria ; and its immediate cause a preternatural irritability of the uterus and pudenda of women, or an unusual acri- mony of the fluids in these parts. The disease is known by the wanton behaviour of the patient: she speaks and acts with unrestrained obscenity, and, as the disorder increases, scolds, cries, and laughs, by turns. While reason is retained^ she is silent and melancholy; but her eyes discover an unusual wantonness, which is soon manifested by every word and action. In general, it is relieved by time and medicines, more often by matrimony; but it sometimes degenerates into mania. Bleeding is sometimes useful; but the best remedy is camphor, in doses of ten to fifteen grains, with nitre, and small doses of the tinct. opii, at intervals. The cerussa acetatta has been given in doses of three to five grains; and cooling purges have been repeated in pro- portion to the violence of symptoms with advantage. Injections of barley water, with a small quantity of hem- lock juice, have been recommended; but we know not with what success they have been employed. The re- gulation of the mind; avoiding improper company, either of young men, or, what is infinitely more danger- ous, wanton women; is of the highest importance. See Riverius's Practice of Physic. FUR'UNCULUS, (from furo, to rage; from the violence of the heat and inflammation previous to sup- puration,) called dothein ; and by Paracelsus, chiadus, chioli ; a boil, is a phlegmonous tumour which com- monly terminates in a suppuration of a peculiar kind. It is a variety of thephlogosis phlegmone (Culleni), dis- tinguished on account of the form in which it appears. A boil is a small circumscribed inflammation, arising in the external parts, and terminating in an acute tubercle, about the size of a pigeon's egg, attended Avith vrdness and pain, and sometimes with a violent burning heat. These inflammations cannot be discussed; but for the most part suppurate spontaneously, but slowly, and break at first on their top, or the most pointed part, when some drops of pus, as from an abscess, come out. The germ, or what is commonly called the core, is next seen : it is a purulent substance, but so thick and tena- cious that it appears like a solid body, which may be drawn out in the shape of a cylinder, like the pitch of an elder branch, sometimes to the length of an inch. The separation of this core is usually folloAved by the discharge of some liquid matter, spread through the bottom of the sore. As soon as this is discharged, the pain entirely ceases, and the opening heals spontane- ously : if it should not, the cure may be effected by a small quantity of Peruvian balsam. Suppuration is the best method of removing this kind of tumour; for if repelled, it almost as certainly returns on some other part: but indeed the surgeon is seldom applied to on account of it, the common me- thod of applying a poultice of flour and honey, some- times a plaster of shoemaker's wax, answering every purpose. If, however, they do not come forward to suppuration, this process should be assisted by fomen- tations, a gum plaster, or any warm application. In other circumstances, emollient cataplasms, mixed occa- sionally, if the pain is violent, with extract of hemlock, or with opium, are useful. The root of the white lily is supposed to unite a stimulus with its emollient pro- perty. These complaints are seldom attended with any dan- ger; they are more frequently signs of a strong consti- tution, capable of throwing some morbid matter out of the habit. They have been considered sometimes ha- bitual ; then alterative medicines are necessary. Rose- mary has been recommended: and the burdock root has been even considered as a specific. See London Medical Journal, vol. i. p. 332. Pearson's Principles of Surgery, vol. i. p. 66, &c. White's Surgery, p. 17. See Abscess. FUSA'NUS, orFUSA'RIA, (from fusus, a spindle: because its wood is made into spindles). See Euony- mus. FUSIFO'RMIS, (from fusus, a spindle, and forma, likeness). Botanically, it is applied to the root, and means tapering like a spindle. FU'SIO, (from fundo, to pour out). Fusion, dia- chysis. It is the reduction of .solid bodies to a state of fluidity by fire. Fusio and solutio, per ignem, mean the same; but, by fusion, we usually understand a solu- tion or liquation of metals or minerals : by liquefaction, a solution of pinguious and concreted substances; by solution, the union of a body with a menstruum into a transparent fluid. 691 GAL VJTABIA'NUM O'LEUM. See Petroleum vul- gare. GABIRE'A. See Myrrha. GA'BRIEN. See Beya. GACI'RMA. See Cumana. GA'GEL. See Myrtus Brabantica. GALA'CTIA, and GALACTIRRHCE'A, (from yxXx, lac, and pea, fluo). An excess or overflowing of milk. GALA'CTINA, (from yxXx, lac). See Lactici- nia. GALACTITES, a fossil employed by the ancients, sometimes as an astringent, but more frequently as a promoter of the secretion of milk, Pliny xxvii. 59. It derives its name not from its colour, but from its white- ness when triturated with water, Dioscorides lib. v. c. 150; and seems to be the same with the morochites of Pliny, ofMpox^os of the Egyptians, the moroxite of Kar- sten. The ancients discovered it in Egypt on the banks of the Nile. Abilgaard found it to contain sixty parts of lime, twenty of alumine, four of magnesia, and four of carbonic acid. It differs from the dolomie in having a less proportion of the acid, and no iron. GALACTO'DES, (from the same,) milk-warm, and a milky colour. Hippocrates. GALACTO'PHORA, and GALACTOPOIETICA MEDICAME'NTA, (from yxXx, milk, and vm, pain). Ga8trica,periadysmia ; pain in the stomach ; usually a symptom of dyspepsia. When it arises from flatu- lence it has been sailed pneumatosis. GASTRO EPIPLOFCA, (from yxo-1^, the stomach, and eTi7rXoov, the omentum). An epithet for the arteries and veins that go to the stomach and omentum. Gastro epiploi'ca vena. A branch of the gastrica sinistra. Gastro de'xtra. See Gastrica recta vena. Gastro sini'stra arte'ria. See Splenica ar- teria. GASTRORA'PHIA, (from yxrlvp, the belly, and px

i, a suture). Gastroraphy. This word strictly sig- nifies the sewing up any wound of the belly; yet in common acceptation it implies that an intestine is wounded as well as the belly. This operation is useless in small wounds, but necessary in large ones. The best method is to pass double ligatures in one needle, in order to include the rolls at one end, and to be tied upon them Avith bow knots on the opposite side, which gives an opportunity of straitening and loosening the knots at pleasure. After passing as many ligatures as seem ne- cessary, the lips of the wound are brought gradually together, and kept so until the knots are tied. The operation of stitching the bowels can only take place where they fall out of the abdomen, so that we can see the situation and nature of the wound in the intestine. It requires no particular direction; but the end of the ligature must be suffered to hang without the external wound, that it may be more easily removed. See Sharp's and Le Dran's Operations. GASTROTO'MIA, (from yxo-lnp, belly, and re^vu, to cut). Gastrotomy. Opening the belly and uterus, as in the Caesarean operation. GATRI'NUM. See Clavellati cineres. GAU'DIUM, (from chadah, to rejoice). Joy. Is one of the exciting passions, and, in a moderate degree, animates the Avhole system; renders the pulse free and soft; excites the action of the capillaries; and assists digestion: but if sudden and immoderate, like all vio- lent excitements, it exhausts the irritability, so that madness or sudden death sometimes ensues. GA'ZAR. See Laurus Alexandrina. GAZE'LLA. (Indian.) The African wild goat, which affords the oriental bezoar. Gazella Africana is the antelope. See Antelopus. GECCO; Poison,peculiarly violent in its operation, procured, it is said, by irritating the most poisonous serpents. With this the Indians infect their arrows. GE'DWAR, or GEI'DWAR. See Zedoaria. GEI'SON, (yeio-ov, the eaves of a house). See Vallum. GELA'SINOS, (from yeXus, laughter). An epithet for the four middle fore teeth, because they are shown in laughing. GELA'SMUS, (from the same). See Sardonicus -RISUS. GELATINA, (from gelo, to congeal). Gelatine is an ingredient in the vegetable as avcII as the animal kingdom; though the former is more properly styled gum or mucilage. It is transparent, soluble sloAvly.in cold water, and rapidly at 90°. Alkalis dissolve it, es- pecially when assisted by heat; acids more rapidly. With the nitric acid it is partly converted into malic and oxalic acids. It is insoluble in alcohol; but a small portion may be added to the Avatery solution Avithout any precipitation. With tanin, a yellowish Avhite precipitate is thrown down from a solution of gelatine, which forms an elastic adhesive mass, not unlike vegetable gluten, and is a compound of the tanin and gelatine. Indeed the tanin is the most certain test of mucilage in any body. By heat it is decomposed, and yields, in a retort, ammonia, a foetid oil, zoonic acid, and a porous charcoal, leaving phosphat of lime, muriat of soda, and potash. Gelatine soon becomes sour, and quickly putrefies. The animal mucilage, which greatly resembles it, is not precipitated by tanin, nor does it become a jelly by eva- poration. The jellies of ripe fruits are denominated only from their consistence, which is obtained by sugar. GELA'TIO, (from the same). Freezing; some- times the rigidity of the body which happens in a ca- toche or catalepsis. GEMA'NDRA. See Gambogia. . GEME'LLjE CY'STICjE, (from geminus, double). See Cystice Ven*. GEME'LLI, (from the same). See Gemini musculi. GEME'LLUS, (from the same). See Gastrocne- mii, Geminus, and Brachieus externus. GEMINA'TUS, (from ge7ninus, a twin). In botany it signifies having two growing from the same part. GE'MINI; the name given by Albinus to the two muscles which Winslow calls gemelli, sometimes named marsupiales, because they resemble a purse. They are two flat, narrow, small muscles, situated almost trans- versely one above the other, between the tuberosity of the ischium and the great trochanter, immediately below the pyriformis; parted by the tendon of the obturator internus. (See also Quadrigemini.) The appellation also of twins (see Generatio); and a name of the extensor carpi radialis. Twins are also called gemelli and didymi. GE'MMiE, GEMMEUS, (from gemma, a jewel). Fossilis sal, lucidum sal, maltheorum, almene, cibarius sal, salrupeus, rock salt, fossil salt, common salt, and sal gem, from its transparency. It is found in the mountains of Poland, Catalonia, Persia, and the East Indies; and is purified by solution in water, when it be- comes the common or alimentary salt. In the mines of Wilizca it is sometimes hard enough to be turned in the lathe into toys and vases. The kind naturally pel- lucid is chiefly used in medicine ; and supposed to be more penetrating than the salt formed by evaporation. GEMS. See Capra Alpina. GEMU'RSA. The name of an excrescence betwixt the toes. GE'NA, (from yews, the cheek). The upper part of the face between the nose and ears. GENE'IAS, (from the same). The downy hairs which first cover the cheek; the name also of a bandage mentioned by Galen, that comes under the chin. See Fascia. GEN 699 GEN GENE'ION, (from the same). See Anthereon. GENERA'TIO, (from genero, to beget). Genera- tion. This peculiarly curious and interesting subject has employed the ingenuity and sagacity of physiolo- gists of every age, though with little success. They have approached only the sacred fane; destroyed many ill-founded fabrics ; exploded many ridiculous theories; and established the question at least on a secure basis. Every animal propagates its like; and each being proceeds from ah egg. In the loAvest classes of animals, however, nature providently guards against the destruc- tion of the species, by an impregnation continued through several generations : and, in some instances, has accu- mulated individuals in an apparently single body. To take, then, an accurate survey of the whole subject, we must commence at the earliest stage of animated exist- ence. Naturalists have, at last, agreed, that plants have dis- tinct sexes ; and the common experiment in the east on the date tree is admitted to be a general example of what takes place in the animation of the seed, styled its fecundation. We find this animation so perfect, that time scarcely destroys it if the access of the air is pre- vented. The ground, Avhich has been covered for ages with buildings, will, if turned up, produce the peculiar plants of the soil, and those only. Where gardens have once been an exotic will spring among indigenous-plants, claiming the distinction of a denizen. The impregnation of the ovum of an animal will be oc- casionally, in similar circumstances, lasting; for the tanks in India, though dried for months, will, after the first rains, swarm Avith eels similar to its former inha- bitants. Where the sexes are separated by the force of winds, or other accidents, the former impregnation is continued to many, sometimes even six successive generations. In all these instances, the unvaried form and properties of the species show that the succession is not fortuitous; that the generation is not equivocal. There is, however, a vicarious mode of reproduction, or rather a mode of increase by buds, where, as we have said, numerous individuals are collected in a sin- gle body. This mode is well knoAvn in the vegetable kingdom ; but it is also found in the lower classes of the animal. The polypus is an instance of this kind. Some snakes possess a similar power of sprouting from buds, and can reproduce a considerable portion after mutila- tion : many animals of a higher order can reproduce a lost limb. In these cases, some appearances of suc- cessive impregnation may be suspected ; but as we ad- vance in the scale the power is less. When the opera- tions of nature are more perfect, common resources have no longer an effect; the poAver of the bud, which can produce a neAV polypus, is not able to form another man, nor even reproduce the smallest portion. We find also life more profusely bestowed in propor- tion to the simplicity of the structure. The production of mites mocks calculation : the elephant seldom pro- duces more than two. Millions are contained in the spaAvn of a herring; but the human being produces one only. This simplicity of structure does not, how- ever, depend on that of the muscles, for in a caterpillar Lyonnet enumerated some thousands, but on the con- struction and functions of the nervous system. Two or three years bring the greater number of animals to their perfection: man requires at least tAventy. Yet impregnation is equally the work of an instant; and, in these years, man, by the exertions of his OAvn constitu- tion, by his own efforts, brings forward his body and mind, till the result is a Locke, a NeAvton, or a Leibnitz. Life then, as by the touch of a Promethean torch, is the illumination of the moment: the constitution of the speck that is animated completes the Avork. When we survey in this atom the future being, its minuteness surpasses the conception, and its supposed increase ap- pears an impossibility. It is a trite remark, that every thing is great or little by comparison ; but it is of more consequence to observe, that our idea of" little" is re- gulated by our organs. What we can scarcely discern is very minute: what the greatest aid of glasses dis- covers appears to our minds the limits of existence. But we knoAv it is not so. Light, for instance, has an almost insensible momentum ; and we knoAv its velocity is in- capable of being measured, and is estimated at an im- mense rate. What then must be the body? It must be as far beneath the smallest atom that our glasses can discover, as that is to the column of a cathedral. When, then, Ave reach the smallest point Avhich our organs, with the aid of lenses, can convey to the mind, it is our conceptions only that have attained their limits', in consequence of the imperfection of those channels by which ideas are conveyed. The world beloAV us is ap- parently as extensive as that above; and Ave know not but that it may sink to atoms as minute, compared to the smallest Ave can perceive, as the Avhole solar system is vast and superior to it. These reflections will not, Ave trust, appear mis- placed, as they will facilitate our progress in the present consideration, and be applicable in many future dis- quisitions. We are noAV prepared then to repeat, Avith more confidence, that generation consists only in ani- mation ; and that the growth is the progressive evolution of organized parts, by the interposition of inorganic matter. To suppose that in the first created animals Avere contained the genns of every future generation (the Swiss hypothesis styled emboitement,) is appa- rently too extravagant, even with the assistance of our former reflections. It is probable that so " wonderful a piece of work as man" must be for ages forming by the concurrence of second causes. Such is the pro- fusion with.which the Creator seems to have bestowed life, that though Ave would reject the molecules or- ganiques of Buffon in their immediate operation, ac- cording to his system, we think it highly probable that in the successive arrangements of the component parts of the more perfect animals they may have some share. The philosopher will perceive the tendency and end of these reflections, which it is unnecessary at present to pursue farther, as inapplicable to the present subject. From the first exertion of philosophical investigation, it is reasonable to suppose that the source and means of our existence must have employed the reflections of those who were capable of penetrating in their inquiries beyond the narrow sphere which surrounded them; and, at different eras, it was believed that both the male and female contributed to the production ; that the male was the only agent, while the female afforded support and nourishment; or that the fuetus was produced and 4U 2 GEN 700 G E N nourished by the female, and animated only in the mo- ment of generation. We shall speak of each opinion, and its authors, very shortly, in their order. The first and most obvious opinion was that of Hip- pocrates and Harvey. It is indeed highly reasonable, and supported by every appearance: though the more modern systems of Haller, Bonnet, and Spalanzani,must,. in some measure, modify and extend this theory, it will not be easy wholly to deny it. The discovery, however, of animalcules in semine masculino, for a time directed the views of physiologists to the second opinion ; and Leuenhoeck, its author, eagerly supposed that he could discover among these embryos of each sex. Animal- cules, however, are found in every fluid ; and these ap- pear only after some time, when a degree of putrefac- tion has probably taken place. More modern dis- coveries, also, respecting the changes progressively oc- curring in incubation, have wholly destroyed this sys- tem. Buffon, in his fanciful doctrine of the molecules organiques, has improved on this theory, and apparently attributes the production of the foetus to the union of animated particles from each parent. The whole is embellished by his fancy, and adorned by his eloquence; but we can scarcely admit of their influence, except in more remote arrangements; and indeed the existence of these molecules must be considered rather as a proba- ble idea than a fact, which admits of proof or application. The discoveries of Haller and of Bonnet respecting the origin and independent life of the chick, in ovo, have greatly altered the views of physiologists on this subject: these have been assisted by Dr. Hunter's ob- servations on the human gravid uterus atvarious periods of impregnation, and the result is the third of the opinions stated, which as the more recent and fashionable, we shall proceed to explain, with its various modifications suggested by different authors, and by the facts them- selves. According to this system, the foetus pre-exists in the ovarium of the female; and in the moment of im- pregnation Is detached from it. A vesicle remains (the corpus luteum), from whence it was apparently separated, a cavity peculiarly vascular, as is always found when any loss is to be supplied. To this is added, that when twins are contained in the womb, two of these vesicles are found. The ovaria are two sphe- roidal flattened bodies, inclosed between the folds of the broad ligaments, by which the uterus is, in part, suspended. They have no immediate connection with the uterus; but near them the extremity of a tube, Avhich opens on either side into that organ, hangs with loose fimbriae in the cavity of the abdomen. It is sup- posed, then, that in the venereal orgasm these extre- mities are erected, that they grasp the ovarium, and re- ceive the ovum. This would appear fanciful and hypo- thetical, but that a perfect foetus has been found in the ovarium, in these tubes, and even been discovered in the cavity of the abdomen, having apparently eluded the grasp of the fimbriae. In neither case could the foetus have ascended from the uterus, for whatever difficulty attends the hypothesis now to be explained, Avill act with equal force against this idea; and to it must be added, that on the latter supposition the embryo must depart from its nidus, where it is to be supported and nourished; on the former he approaches to it. We may conclude, then, that the foetus really pre- exists in the ovarium; but the question remains, how it is animated. The access of the male semen is known to be necessary; but the difficulty which attends the passage of the foetus into the uterus equally militates - against the progress of the semen into the ovarium. It has been eluded by Harvey, who supposes a seminal .aura to reach the ovary; and by a Mr. Johnston, who suspects that the semen is absorbed, and carried to this organ through the medium of the circulation. The latter, for many reasons improper to be detailed in a" popular work, is not probable ; and the aura, when speaking of the foetus, we have shown to be a vague and unsupported medium. In short, every view of the subject seems to show that the semen has a ready ac- cess to the embryo. In the same moment that the one is detached from the ovary and conveyed to the uterus, the other may reach that organ. But the foetus when in the Fallopian tubes, or the abdomen, is ani- mated, so that it is more probable, that by some action of the uterus and its tubes the semen is conveyed to the ovarium; and every fact shows that the muscular fibres of the uterus are at that moment most highly ex- cited. It is certain, that for the purpose of impregna- tion the semen must reach the cavity of the womb. Here then induction ends; and difficulties begin. From this view it may appear obvious, that generation is only the animation of a pre-existing germ; and that as we have shown the foetus to be an independent be- ing, at least dependent only on the mother for a supply of fluids, we have no difficulty in accounting for its growth, and the successive evolution of its different organs. Such, however, would be the conclusion of a shallow, uninformed physiologist. The union of a male and female of different species, even in the vege- table kingdom, is followed by an hybrid production, partaking the properties of both. The mule, the off- spring of a horse and an ass, is a familiar example. In a large family, some of the children will partake the form, the temper, the diseases of the father; others of the mother. This cannot be owing merely to the means of excitement, much less to the small portion of nutriment which the semen can afford, supposing it a nutritious fluid, an idea anxiously supported. Bon- net's mechanical system of a net-work, the meshes of which the semen fills, thus modifying the form, is still less tenable; nor can we escape from the opinion first stated, that the male as well as the female contributes to the formation of the future offspring. The primordial embryo is undoubtedly in the female; but the " man stamps an image of himself," the " world's first won- der," either by an union of principles, or a modifica- tion of those which pre-existed, in a manner which will probably never be explained. We have thus given, in a few words, the substance of numerous extensive disquisitions, endeavouring to distinguish facts from hypotheses. We shall be grati- fied if it should appear that we have explained the subject comprehensively, so far as it will admit of ex- planation; more so, if we shall be found to have avoided the pruriencies, which, under the veil of science, are so often indulged, and whose only purpose is to gratify sensuality. See Haller's Physiology, lecture 33; also the article Conceptio in this work. GEN 701 GEN GENEVA. Gin. A spirit distilled originally from juniper berries; but at present flavoured by oil of tur- pentine. GENIA'LIS ARTE'RIA, (from geneion, maxilla). See Maxillaria arteri-c. GENICULA'TUS, and GENI'CULUM, (from genu, a knee, or joint). It is strictly a joint Avith an articulation; but frequently a joint in general, and sy- nonymous with nodus, a knot: hence all roots and pods of plants, divided into joints, are said to be geniculated. GENIO GLO'SSI, (from yevetov, the chin, and yXuTvXivos, staphylinus). These two muscles are fixed in the low- er and lateral part of the basis of the tongue, Avhence they run obliquely backward, along the anterior arches of the septum palati, and terminate insensibly on each side near the uvula. They form the substance of the two anterior arches of the palatum molle. GLO'TTA. See Lingua. GLO'TTIS, (from yXurrx, the tongue,) is the nar- row aperture at the upper part of the aspera arteria, and covered by the epiglottis when we hold our breath, or swallow. The glottis, by its dilatation and contrac- tion, contributes to the modulation of the voice. GLU'CINE. An earth lately discovered, but not yet employed in medicine. It is denominated from the sAveetness of its salts. GLU 710 GN A GLUE. Inspissated animal gluten. A good glue impermeable to water may be made by boiling a hand- ful of quick lime, with four ounces of Hntseed oil, to the consistence of a paste, and then drying it on iron plates. GLU'MA, (from yXvq>a, to scrape or bark). Husk, chaff ; a species of calyx peculiar to corn or grass, in- folding the arista: it is either uniflora; multiflora; univalvis; bivalvis; multivalvis ; colorata ; glabra; or hispida. GLUS. See Dysuria mucosa. GLUTiE'A ARTERIA, (from yXovjos, the buttock,) is a branch of the hypogastric artery, and generally the largest: near its beginning it sometimes sends out the iliaca minor, and sometimes the small branch that goes from that artery to the os sacrum, and other parts fixed to it; afterwards this artery passes out of the pelvis, in company with the sciatic nerve, through the upper part of the great sinus of the os innominatum, below the mus- culus pyriformis, and is distributed in a radiated man- ner to the three glutaei muscles. In its passage it gives branches to the os sacrum, os coccygis, the musculus pyriformis, the muscles of the anus, and to the neigh- bouring parts of the rectum, forming a particular hae- morrhoidalis interna. It sends twigs to the bladder, and parts near it: and detaches a pretty long branch, Avhich runs down with the sciatic nerve. GLUTEUS MA'XIMUS, (from the same,) glute- us major, is a muscle which rises from the posterior lateral part of the os coccygis, from a ligament extend- ed between the os sacrum and the latter bone; from the flat surface of the ilium, where it is connected to the os sacrum ; and from the spine of the ilium. Its anterior portion grows tendinous, where it runs over the tro- chanter major, and makes part of the fascia of the thigh : the posterior is inserted into the hind part of the femur, to assist its extension. This muscle with the glutaeus medius and minimus, make up the fleshy part of the buttocks, from which they are denominated. Glutje'us me'dius, rises as high as the spine of the os ilium, and is inserted into the very uppermost part of the trochanter major, bringing the thigh backward and outward. Gluta'us mi'nimus, rises rather lower than the preceding, and forms a middle tendon inserted into the trochanter major, blended with the medius. It is an abductor of the thigh. GLU'TEN, (quasi geluten, from gelo, to congeal). Glue, lentor; the part of the blood which gives firmness to its texture. (See Blood). It is also a component part of vegetables, and is particularly found in the husks of grain. It is soluble in alcohol and alkalis ; in its properties it approaches very nearly the nature of animal substances, and affords, in distillation, ammonia, containing hydrogen, carbon, and nitrogen. It is obtained also by boiling the expressed juice of cresses, scurvy grass, and many other plants of the tetradynamia class, after it has stood till the colouring matter has separated. GLU'TIA, (from yXovJos, the buftock). See Cere- bellum. GLU'TO S, (from the same). A buttock, GLUTTUPA'TENS, (from gluttus, the throat, and pateo, to extend). An appellation of the stomach, Avhich is only a dilatation of the oesophagus. GLYCYME'RIDES MA'GNA. See Chama. GLYCYPI'CROS, (from yAt/xt;?, sweet, and vixpos, bitter, from its taste). Woody night shade. GLYCYRRHI'ZA, (from yXvxvs, sweet, and pi£«, a root). Liquiritia; dulcis radix; and adipson; glycyrr- hiza glabra Lin. Sp. PI. 1046. Smooth legumined, or common liquorice, is a plant with oval leaves, set in pairs along a middle rib; the flowers are small, bluish, and papilionaceous, standing in spikes on naked pedicles; followed by smooth pods, containing flat kid- ney shaped seeds: the root is long, slender, flexible, of a brownish colour on the outside, and yellow within. The plant is perennial, a native of the southern parts of Europe, and cultivated in England. The roots may be taken the third year after the slips or offsets have been planted. An inferior kind, the glycyrrhiza echinata, is sometimes substituted. The English liquorice is equal to the foreign; and the root, when carefully dried and powdered, is of a richer and more agreeable taste than when fresh, of a dull yellow colour, but often adulterated by a mixture of flour. The dry root is not inferior to the fresh: but it may be kept moist even in dry sand; Avet sand rots it. Liquorice is almost the only saccharine substance that does not produce thirst; and it vvas consequently called adipson: but this quality arises from the necessity of chewing the root, and partly from' the stimulus of a slight bitter combined with its sweetness. It covers the offensive taste of many unpalatable medicines, and does not readily ferment: it has been esteemed attenu- ant, detergent, diuretic, expectorant, and demulcent; though it has only properties similar to sugar, and is preferable only as a demulcent, since its expressed juice dissolves slowly. It yields all its virtue to water; but spirit dissolves less of the mucilage, and the spirituous tincture and extract are the sweetest. The extract of liquorice, ordered to be prepared like that of camomile, would be best made by pressing the fresh roots betAvixt iron rollers, and inspissating the juice. The usual extract is adulterated by a mixture of the pulp of prunes. See Lewis's Materia Medica, and Cullen's Materia Medica. Neumann's Chemical Works. Glycyrrhi'za sylve'stris flo're lute'o. See Glaux vulgaris leguminosa. Glycyrrhi'za trochi'sci. See Bechica. GNAPHA'LIUM, (from yvx^xXov, cotton, from its soft downy surface). Cudweed; albinum. -Gnaphalium dioicu7n Lin. Sp. PI. 1199. Gnapha'lium alpi'num. See Leontopodium. Gnapha'lium lute'um. See Elychrysum. Gnapha'lium mari'timum; called also gnaphalium marinum, gnaphalium cotonaria; athanasia maritima Lin. Sp. PI. 1182; cotton weed, or sea cud- AVEED. All the species of cudweed are astringent, and sup- posed to be useful in fluxes and haemorrhages; but not used in this country. Gnapha'lium monta'num ; pes cati; hispidula; el- chrysum montanum fiore rotundiore; pilosella minor; a variety (p) of the g. dioicum. Mountain cudweed, or cat's foot. It is very common in France, and a syrup made of it hath been celebrated under the name of syrupus de hispidula seu aluropo. GON 711 GON Gnapha'lium veterum. A species of bastard dit- tany. See Pseudo-dictamnus. GNA'THOS, (from yvx^lu, to bend, from its curva- ture). The entire cheek, sometimes only the lower part, between the angles of the mouth and ear, which the Latins call bucca; occasionally the jaws and the jaw bones. GNI'DIA GRA'NA, (from Cnidus). See Cnidia GRANA. GOACO'NEZ. The name of a large tree in Ameri- ca : it affords the balsamum purius, vel album; but the source is unknown. See Raii Hist. GO'AN. The name of a tree in Persia, of whose ashes putty is made. GO'BIUS, or GO'BIO, (from goba, HebreAv). The fish called the gudgeon. See Amygdaloides. GO'GGLES. Spheroidal bodies made of horn or black ivory, to cover the eyes, which are fixed by means of a black ribbon round the head. In the front is a small aperture, and sometimes a glass. They are used to defend weak eyes from dust, and, in cases of squint- ing, to keep the optic axes in the same direction ; but in the latter case they seldom succeed, the patient pre- ferring to see with one eye only. GOMPHI'ASIS, (from yopjpos, a nail). See Agom- PHIASIS. GO'MPHIOI, (from the same). See Molares. GOMPHO'MA, GOMPHO'SIS, or ENGOMPHO- SIS, (from yoi*.0os, a nail; clavatio). A Greek term for that species of synarthrosis which resembles a nail driven into a piece of wood, of which the teeth in their sockets are an instance. GONA'GRA, (from yow, a knee, and xypx, a pain,) gonyalgia. The gout in the knee. GO'NE, (from yiyvopxi, to generate). The seed; in Hippocrates the uterus. GONGRO'NA, (from yoyfeos, a round tubercle in the trunk of a tree). Any hard tumour, but particularly a Bronchocele, q. v. GONGY'LION, (from yoyfvXes, round). See Pi- LULA. GONOI'DES, (from yovv, seed, and eifos, form,) re- sembling seed. Hippocrates often uses it as an epithet for the excrements of the belly, and for the contents of the urine, when they resemble seminal matter. GONORRHQZ/A, (from yov*, seed, and pea, to flow,) an involuntary efflux of seminal juice: but this is not the proper appellation of the disease to which it is ap- plied, and the term now commonly used is blennorhagia, from pxewos, mucus, and pea, to flow, i. e. mucifiuxus ; and to gleets the name blenorrhea, or mucifiuxus pas- sivus, without phlogistic symptoms, is assigned. Dr. Cullen places this disease in the class locales, and order apocenoses ; and defines it a preternatural flux of fluid from the urethra in males without any libidinous desires. The first species is gonorrhe1 a pura, or be- nigna, a mucous discharge from the urethra, without dysuria, or lascivious inclination. 2. Gonorrhce'a impu'ra, maligna, syphilitica, a dis- charge resembling pus from the urethra, with heat of urine, See. after impure coition, to which often succeeds a discharge of mucus from the urethra, Avith little or no dysury, called a gleet. 3. Gonorrhce'a laxo'rum, libidinosa, a pellucid discharge from the urethra, without erection of the penis, but with venereal thoughts while awake. 4. Gonorrhce'a dormientium, oneirogmos, when during sleep, but dreaming of venereal engagements, there is erection of the penis, and a seminal discharge. The gonorrhea benigna is defined by Dr. Fordyce, " an increased secretion from the mucous glands of the urethra, without infection." The matter discharged is whitish and mild, producing no excoriation, or other disorder, on the parts through which it passes, or on which it falls. The principal cause is a weakness in the parts which are the seat of the disorder; occasional causes are too frequent purging, violent exercise on horseback, too fre- quent indulgences, cold, excess of spirituous liquors. The virulent gonorrhoea is a local inflammation, at- tended with the discharge of a puriform matter from the urethra in men, and from the vagina in Avomen, pre- ceded by a slight sensation at the end of the penis, like a flea bite ; accompanied with a frequent desire of mak- ing water, Avhich occasions a scalding, or pricking and burning pain, during the time of its passage, particular- ly felt at the orifice of the urethra, and a little below it, arising from a stimulus applied to these parts. The lips of the urethra appear full and inflamed; a tension is felt in the penis, and the urinary passage is seemingly strait- ened, particularly at one part, viz. about half an inch below the orifice of the urethra. At this place also the urine, Avhich is felt like scalding water, gives a hot pun- gent sensation, almost insupportable, and Aoavs in a small interrupted stream. A little whitish mucus appears about the orifice of the urethra, and, if pressed a little above its extremity, the discharge is increased. The mucus soon assumes a greenish hue, verging to a yel- low, and is thin. The disease sometimes appears with- in twenty-four hours after the infection, and is then pro- portionally slight; generally between the fourth and fourteenth days. Sometimes, by the violence of the ir- ritation, the secretion of mucus seems to be considerably diminished, so that a very small discharge only takes place, though the other symptoms be extremely violent. In this case the disease hath obtained the very improper name of gonorrhea sicca. When the inflammation is extremely violent, the ir- ritation produces frequent erections, particularly in bed; and as the fraenum is usually inflamed, and will not ad- mit of the usual distention, the penis is incurvated Avith intolerable pain. In this very exasperated inflammation, the perinaeum is red and swollen, and all the parts around the trunk are distended and uneasy. The glans penis swells, and is transparent; the prepuce inflames, and cannot be drawn back, or if back, cannot be brought forward, constituting the disease styled Phymosis or Paraphymosis, q. v. In the former case a hard cord is sometimes felt extending along the back of the penis, which is an inflamed lymphatic, and sometimes the forerunner of a bubo; but almost universally some ul- ceration precedes the appearance of a bubo. The seat of the disease is in the urethra, near its extremity ; but it sometimes extends to Cowper's glands and the pro- state. In the greater number of cases the inflammation goes on gradually increasing for ten days or a fortnight, and then as gradually recedes : the tightness grows less; the mucous discharge thickens and groAvs whiter, and GON 712 GO N at last wholly disappears. In women the seat of the complaint is in the vagina, attended with the pungent sensation as in men; but, except when violent, so that the nymphac and meatus urinarius are affected, not with such a painful heat of urine. See Fluor albus. The matter of the discharge hath a purulent appear- ance ; but is only the mucus of the urethra or vagina secreted in an unusual quantity, and changed in its co- lour and consistence by the stimulus applied to the parts; like the mucous discharge from the nose or lungs on taking cold. The discharge from the urethra or va- gina was long supposed to arise from an ulcer, and va- rious arguments were adduced in favour of an opinion now rejected. Much stress has been laid on the fol- lowing fact recorded by Swediar, from Dr. Stoll; but numerous observations of a similar kind have been made in England, and we want not to go to Vienna to dissect persons Avho have died while affected with gonorrhoea. "Dr. Stoll had, about the year 1782, the instructive opportunity of dissecting a man who died while labour- ing under a virulent gonorrhoea. On opening the ure- thra carefully, he found its internal surface preterna- turally red; two of the lymphatics preternaturally white and enlarged; and the puriform matter oozing out from the internal membrane, especially at the lacunae, where the seat of the disorder was, Avithout the least appear- ance of an ulceration or excoriation." A discharge of mucus, if not connected Avith a ve- nereal taint, even when accompanied with inflam- mation, is not infectious; and the common gleet, when inflammation is secondarily excited, by high living or violent exercise, is equally innocent. Yet when it has preceded a venereal taint, the greatest caustion is ne- cessary. A degree of virus, which makes no impres- sion on a part habituated to its stimulus, may convey infection to another unaccustomed to its action. The gonorrhoea was for many years considered to be a local effect of that poison which, when introduced into the system, produced syphilis. The conclusion Avas obvious, as it was received in the same manner, and in the same organs. More attentive discrimination led to doubts on the subject, and to some experiments which, though personal, were scarcely justifiable. It was recollected, that the syphilis appeared more than a hundred years before the local inflammation was ob- served or described; that the latter often continued for several months Avithout being attended by the former; and that the alteration from syphilis to gonorrhoea was a rare occurrence, not without suspicion of a new infec- tion. These doubts suggested two important altera- tions in practice. Mercury was disused in gonorrhoea, and cooling medicines, with laxatives, only employed; or the inflammation was at once boldly checked, either by astringents, or by exciting a greater inflammation with a more violent and temporary discharge. The result of these plans is more decisive than a host of ar- guments. They were, for a long time, treated as danger- ous innovations, and numerous are the cases of syphilis said to have been produced by their means. Mercury, however was gradually considered as less essential to the cure, and no great inconvenience has resulted. Syphilis sometimes apparently arises from gonorrhcea; and it is not surprising that, in such persons, either plan of checking the latter should be also attended with the for- mer. In fact, both diseases are introduced at the same time; and the criterion of future syphilis, the chancre, sometimes appears very early in gonorrhcea. It is, we believe, absolutely certain that the matter of chancre in- troduced into the urethra will not produce a gonorrhcea, and the discharge from the urethra inserted under the skin will not produce syphilis. Yet there is little doubt but that the diseases are nearly related ; and were we to indulge in speculation, we should suppose that the gonorrhoea was at first derived from syphilis; but that in a series of years, and successive introductions to different constitutions, it assumed a milder form, and became specifically distinct. In the same way it is not improbable that the vaccina may have been originally small pox. The gonorrhoea is undoubtedly, at present, a much more mild disease than on its first appearance, and in many persons can scarcely be called a disease. In former periods, the distressing train of symptoms rendered it truly terrible; and its consequences were swelled, often scirrhous, testicles; fistulae in the perinae- um ; unconquerable strictures in the urethra; inconti- nence of urine, &c. These, excepting probably the strictures, are now comparatively uncommon. Various are the preservations from gonorrhoea re- commended and advertised as nostrums. We should perhaps not greatly assist the cause of morality were we to show how its precepts might be violated with impu- nity ; but perhaps the fatal effects of a momentary de- viation from the path of virtue may be sometimes ob- viated, Avithout holding out encouragement to vice. There is, in fact, no certain preventive; though the dan- ger of infection may be certainly diminished by the most scrupulous cleanness, washing with soap and wa- ter,or water to which a small proportion of the aqua kali puri has been added. The proportion should be such as to make a very slight impression on the tongue; and, in producing this effect, the alkali must be very gradu- ally added; if it be first made strong, and afterwards di- luted, the stronger alkaline'solution dissolves the mucus of the tongue, so that each successive addition of Avater scarcely makes any difference in the taste, as the tongue is more tender. The poison of the gonorrhoea is ap- plied apparently to the orifice of the urethra; but, in the erected state, when the corpora cavernosa urethrae are distended, the urethra itself is a little inverted; and, when collapsed, the part which before appeared the ori- fice is the upper portion of the canal. This collapse assists the progress of the poison still a little loAver, and it at last rests about a finger's breadth in the urethra. In the use, therefore of preventatives, some of the fluid must be insinuated into the urethra, and a little may be even injected in a more diluted state. When the idea that this disease Avas distinct from sy- philis began to prevail, practitioners attempted to cure it, at once, by dissolving and discharging the mucus. The means employed was an injection of what was then called the caustic alkali, a weak solution of the kali pu- rum, proportioned in the manner just mentioned. It certainly cured the disease, without any remaining in- convenience ; but the inflammation it excited was some- times so considerable as to be more troublesome than even gonorrhoea, and we are apprehensive that strictures in the urethra have been a frequent consequence. Injec- tions of a solution of hydrargyrus muriatus have been GON 713 GOT\ also recommended,and employed Avith success ; not in- deed as a mercurial, but as a stimulant. Each.stimulates the mucous glands of the urethra, increases the secretion of miicus, and Avashes aAvay, in the discharge, the remain- ing poison. The proportion varies; but about two grains to eight ounces of distilled water is sufficiently strong for men. The vagina is less sensible than the urethra ; and in women the proportion should be increased, till it produces a smart pungent pain. This remedy is said effectually to relieve the most obstinate gonorrhoeas in that sex. Another method of extinguishing the disease has been attempted, viz. by exhibiting a large dose of the cor- rosive sublimate internally. It produces a very violent commotion in the system, in which every spasm, every obstruction, yields; but the remedy has not been suffi- ciently tried to enable us to decide on its efficacy, or indeed on its safety. In the cure of gonorrhcea, venesection has been freely recommended. The earlier practitioners used it liberally; but we have said that the disease Avas, at that time, probably more violent. At present the young and the eager surgeon is so fond of his lancet, that we often find blood drawn, when little necessity appears for any evacuation. The inflammation is, in general, local, and requires rather a steady antiphlogis- tic plan than any decisive interference. If, however, general fever should come on, should the erections be painful and frequent, bleeding must be freely used, to diminish the general tone. Purging, another general remedy for active inflammation, has been too rashly employed. It was usual to give a large dose of calomel at bed time, and the colocynth pill, or some other dras- tic early in the morning. This plan debilitated the constitution, occasioned gleets, and left the most dis- tressing hypochondriacal complaints. It has been ac- cused also, though perhaps without reason, of producing hernia humoralis and strangury. Yet a plan, which Avas for so many years continued, could not have been wholly useless, or highly injurious. From its abuse arose probably the chief inconveniences; for we noAV find an active laxative, about twice in a week, with cooling diet and perfect rest, a ready way of removing even trouble- some gonorrhoeas. In the general treatment of the disease, rest is of the greatest consequence; and this alone, with little assist- ance from medicine, will complete the cure. But, with this, every part of the antiphlogistic plan should be em- ployed. The diet should be cooling, and even the mild- est animal food should be eat sparingly. Milk, vegeta- bles, ripe fruit, and the different farinacea, should con- stitute the principal nourishment; and the drink consist of barley Avater, Avith gum arabic, lintseed tea, toast and water, capillaire, or orgeat with water. It has been usual to dissolve nitre in the drinks; but this remedy is not Avithout suspicion of irritating the urinary organs; and, if given, it should be largely diluted. Cream of tartar is more useful, and may be admitted. Whatever increases the flow of urine renders it less acrimonious, if the medicine is not conveyed to these organs; and a gentle diuresis will do little injury, as it will not weaken the tone of the parts. The usual laxatives, now re- commended, are the neutral salts, castor "oil, or senna; and with these two or three motions may daily be pro- cured. Opiates should be given at night, to prevent the VOL. I. painful erections, and to relieve the pain of the chordee, if it exist; and, to the opium, camphor forms an useful addition. Topical remedies are important. Frequent bathing the part, and the greatest cleanliness, are requisite; par- ticularly washing under the glans, to prevent the accu- mulation of the fluids from the odoriferous glands, which produces irritation, inflammation, and often ulcers. In- jections are now freely used, perhaps too freely. If emollient only, or gently sedative, they do little injury; but astringent injections in the early periods often prolong the disease, and Ave suspect, occasion the too frequent consequence of gonorrhoea, strictures. It is not sufficiently considered, that even the introduction of the pipe of the syringe often occasions a greater irri- tation than the injection itself can relieve. In the earlier stages, the aqua lithargyri acetati, largely diluted, is only admissible ; and, with this, sometimes the mucil- age of gum arabic, occasionally oil of almonds, may be added. Opium often forms a useful ingredient in such injections, and Ave have usually added it to milk, separating the curd ; but the opium, finely poAvdered, and united with the oily injections mentioned, is equally useful. To four ounces of distilled water, or oil of al- monds, eight drops of acetated litharge is sufficient, and about fifty drops of tincture of opium, or three grains of the substance. One part of acetated ammonia to eight or ten of water, forms a cooling pleasant injec- tion. When the scalding of urine is troublesome, four drops of muriatic acid, added to two ounces of Avater, is often useful. When the hydrargyrus muriatis is em- ployed, one grain may be added to six ounces of water: sometimes a drachm of purified mercury is mixed with an ounce and half of water, by the means of as much mu- cilage; but this injection seems to possess no peculiar virtue. When the inflammatory state is removed, astringent injections are employed. Of the metallic astringents, zinc and copper are the principal; but the astringent bal- sams are sometimes recommended. Ten grains of vitriol- ated zinc may be dissolved in four or six ounces of wa- ter; a drachm of the cuprum ammoniacale in six ounces of rose water; or ten grains of the blue vitriol in two or three ounces, according to the sensibility of the patient. When the inflammation is considerable and long con- tinued, amixture of syphilitic infection may be suspected, and mercurials are sometimes, though rarely of service. In such cases, Plench's powder, or calomel, has been suspended in mucilage,and injected into the urethra, or mercurial ointment has been rubbed in the ceurse of the urethra or the perinaeum. When the balsams are em- ployed in injections, about one drachm of the balsam co- paibae may be united with two ounces of water. When the inflammation is slight, the pain inconsi- derable, and the matter glairy, the Peruvian bark may be freely administered, the diet rendered a little more nutritious, and the cold bath employed. See Aretaeus de Causis et Signis Chron. Morborum, lib. ii. c. 5; Fordyce's Elements, part ii.; Howard on the Venereal Disease; Bell on Gonorrhcea; SAvediaur on Venereal Complaints; Cullen's First Lines, edit. 4. vol. iv. p. 386, &c; London Medical Journal, vol. ii. p. 233 ; White's Surgery, p. 400. Gonorrhce'a bala'm. See Gonorrhcea spu- ria. 4Y GON 714 G O N Gonorrhce'a beni'gna. See Goxorrhcf.'a pura. Gonorrhcea chorda'ta, when accompanied by a chordee. Gonorrhce'a libidino'sa. Gonorrhcea laxo- rum. Gonorrhce'a muco'sa. A gleet. Subsequent to gonorrhcea a discharge of matter frequently continues, incapable of conveying any disease, and not attended with inflammation. It appears to be, in general, a discharge from the mucous glands of the urethra, in consequence of the relaxation which has followed in- creased action; and is occasionally owing to the irri- tation of very violent purgatives, sometimes to strains, or the various causes of debility. The general reme- dies are, tonics of every kind, particularly bark and cold bathing, astringent injections, regular and con- stant exercise. It has been removed by a blister to the sacrum, and, in one instance, by a blister to the perinaeum. Though this disease sometimes yields with the great- est facility, yet a similar complaint, a gleet, is often pe- culiarly distressing and obstinate. Doubts have lately arisen, Avhether it be the same as the true mucous dis- charge, from a weakness of the glands of the urethra, or whether it is a vitiated secretion, from some change in their organization. The language of Mr. Hunter is high- ly exceptionable, in a philosophical view, as appearing to assign a reason from merely varying the expression of the fact. To " take on diseased action," or " a habit of action," is saying no more than that a part is diseased, or that a discharge continues from habit; and indeed it has been doubted, by a very respectable author, Avhether Mr. Hunter has not retarded the progressof science by such jargon, and his inconsequential reasoning, more than he has assisted it by his observations. We have premised these remarks, chiefly as an apology for not employing Mr. Hunter's language, while we are availing ourselves of his facts. That a gleet arises from weakness of the glands, is highly probable from the nature of its causes; but, were this true, we should find tonics and stimulating applica- tions generally effectual. We need not, however, tell every practitioner how often he is disappointed in the best concerted plans of this kind. If we look at some of the more peculiar causes, they will not greatly assist us. We find a gleet, for instance, generally accom- panying a stricture in the urethra; and frequently a swelling of the prostate gland. In each case it cannot be wholly owing to Aveakness, and we are rather led to suspect some local irritation. If we look at the nature of the discharge, we shall find "little additional informa- tion ; for it consists of globular bodies, floating in a slimy mucus, rather than a serum. From this circle of difficulties we cannot escape but by conjecture. Mr. Hunter supposed it to be owing to a state of the glands, not unlike what occurs in scrofula; and thinks the continued discharge from the eyes, or the tonsils, in consequence of a cold falling on these parts in a scrofu- lous habit, analogous cases. The discharge of gleet, however, differs in its nature, and in the obstinacy with which it resists the remedies useful in the other com- plaints. Sea Avater injected into the urethra has no ef- fect : small doses of mercurials more frequently fail than succeed; nor is it certain that the sea water bath is more effectual than one of fresh. We should rather suspect that it arises from some obstructions of the glands, from a thickening of their coats during the pre- vious inflammation of gonorrhoea, or the continued ir- ritation of the other causes; but that gleet will some- times insensibly cease without evident reason, or from remedies Avhich could not make so considerable a change in a short period. It is better, however, to at- tend to the effects of remedies. Practitioners have attempted to cure gleets by gene- ral medicines, or topical applications. The general medicines are tonics and astringents, or stimulants; but the latter, though they deserve the title by being circu- lated through the arterial system, act only in consequence of their topical determination. The tonics are, cold bath- ing, the Peruvian bark, and the preparations of steel: these will sometimes succeed, and as often fail. Each has been occasionally tried for several months without success; and they have been combined with as little effect. Yet the general constitution ahvays derives be- nefit from this plan; and should we fail in our principal object, our labour is not wholly in vain. The astrin- gents or stimulants are the turpentines and the balsams, the astringent gums and cantharides. The effects of these medicines are not very striking ; but Mr. Hun- ter thinks that if they produce no ksalutary effects in a short time, they will be useless; and he limits this period to the first six or eight days. They often in this time remove the complaint which recurs on their being discontinued, so that they should be employed long after the discharge has ceased. Of the astringent gums we have little experience, and believe their poAver to be inconsiderable; but the sti- mulus of cantharides has often succeeded. This reme- dy must be cautiously employed, beginning with very small doses, about fifteen drops of the tincture, which may be gradually increased; as in the irritable state of these organs even a common dose may excite dan- gerous inflammation. / The topical remedies are, tonics, stimulants, or those of other topical inflammations. The decoction of bark, the solutions of copper, of iron, zinc, and lead, are oc- casionally employed. There is little room for-choice; and we succeed with one or the other apparently by acci- dent. Nothing is so capricious as this disease ; varium et mutabile semper. The stimulating applications are equally uncertain. 'We once cured an obstinate gleet by the injection of punch, a remedy suggested in a con- vivial moment; at another time by green tea. Mr. Hunter mentions a case in which the undiluted extract of Goulard succeeded, apparently by producing a vio- lent inflammation. The introduction of a bougie has had the same effect, and riding post has been equally beneficial. It is, however, an useful precaution, sug- gested by Mr. Hunter, that previous to the use of sti- mulant applications, the irritability of the patient should be known; and it should be ascertained Avhether any inflammation was likely to be conveyed along the ure- thra to the testes or the bladder. Bougies are sometimes rendered stimulant, by covering them with some active liniment or ointment. In general, the distention irri- tates sufficiently; but turpentine, mercurial ointment, or a camphorated liniment, will add to their powers. While the use of a bougie is continued, the discharge usually proceeds ; but, after some time, about three Aveeks or a month, it should be omitted, and we may GRA 715 Gil A then judge whether it has succeeded. If the running stops, the cure is usually effectual: if it continues, the remedy, if repeated, will be unsuccessful. The remedies for topical inflammation are stimulants in the vicinity. Blistering the urethra, in its course, has succeeded. Drawing the electrical sparks, in the course of the canal, has had an equally beneficial effect. The.discharge has been stopped by a recent gonorrhoea, and by the recent infection of syphilis, on the appear- ance of chancres. Venereal connections will sometimes occasion a return, and a recent infection has been sus- pected; but, in this case, the renewed discharge follows almost immediately, and a mistake is nearly impossible. Violent exercise and free living will also occasionally .bring it back, with suspicious symptoms of inflamma- tion; but its quick appearance, the nature of the dis- charge, its vanishing on rest and low living, soon destroy every apprehension that may have been entertained. In women, gleets are equally obstinate; but they ge- nerally pass under the appellation of leucorrhea. The greater number of remedies mentioned are inapplicable in such cases; and general tonics, with astringent or stimulant injections, can only be employed. But leu- corrhcea is so common, and so little disgraceful, that, in such cases, medical assistance is seldom required, unless the discharge is in excess. Gonorrhce'a oneiro'gmos. The discharge of se- men during sleep. Gonorrhce'a spuria, vel balani, a discharge from the corona glandis. GONYA'LGIA, (from yow, the knee, and xXyog, pain). See Gonagra. GORDI'US. A genus of vermes, which infest the inhabitants of hot climates by burrowing under the skin. There are two species, the g. aquaticus, and g. medinensis. The former requires no medical treatment: for the latter see Dracunculus. GORGO'NIAS. Coral. When taken from the sea it hardens into a stony substance: an effect sup- posed to be produced by looking on the gorgons. See Corallium. GOSSI'PIUM, (from gotne, whence gottipium, .Egypti). See Bombax. GO'TTA. See Gambogia. GOU'TIER. See Bronchocele. GRA'CILIS, (from gracilesco, to become small). The name of some thin and flat muscles. Gra'cilis inte'rnus See Rectus internus. Gra'cilis ante'rior. See Rectus cruris. GRADA'TIO, (from gradus, a progression). Gra- dation is an exaltation of the qualities of metals in degree, by which their Aveight, colour, and consist- ence, are brought to greater degrees of perfection; for it has not the power of changing the substance, but only elicits their hidden qualities. Rulandus, Johnson. See Excitatio. GRADUA'TIO. The solemn academical process, by which a degree of doctor of medicine is obtained; a process eluded by some venal universities, and perhaps not always conducted with sufficient strictness. It is eluded also by individuals, who call themselves doctors; and the public give them implicit credit for the title and their pretensions to it. In the university of Edinburgh the following regulations are observed :— 1. No person shall be promoted to the degree of Doctor of Medicine, except on one or two stated days in every year, viz. on the 24th of June, or 12th of September, or the days immediately thereafter. 2. No person shall be received as a candidate, until he has applied during three complete years to the study of medicine, in this or some other university, and has attended to all the branches of the science of medicine; viz. anatomy and surgery, chemistry, botany, materia medica, and pharmacy, theory and practice of medi- cine, and clinical lectures delivered by professors of medicine, on hospital patients. 3. Whoever is desirous of obtaining a degree, must deliver, before the 24th of March, or 12th of June, a medical dissertation, composed by himself, to some one of the medical professors, that he may peruse it, if necessary correct it, and affix to it a Avritten tes- timony that he has perused it, with the date when he received it. 4. Then, whoever is desirous of a degree in medi- cine must communicate his intention to the Dean of the Faculty of Medicine, on or before the 20th of April or June, and at the same time deliver to him his inau- gural dissertation, with the testimony of the professor who perused it, to be subjected to the consideration of the Faculty of Medicine. 5. After this he is to undergo a medical examina- tion by the faculty, either viva voce or in writing, that no person may be received as a candidate avIio is not Avell acquainted with polite literature and the science of medicine. As the professors think themselves bound in honour not to divulge the unfavourable result of an examination, a candidate may be remitted to his studies in this stage of his trials, without injury to his reputa- tion or interest. 6. On the 18th of May, or 6th of August, the candi- date shall, in an examination by two professors, in the presence of the Faculty of Medicine, give a farther proof of his advancement in the various branches of medical knowledge enumerated above. 7. To the candidate, after having passed these trials, shall be proposed, by one of the professors, an aphorism of Hippocrates, and, at the same time, by another pro- fessor, a medical question; the former of which, ex- plained by himself, and illustrated by a commentary, and the latter, along with an answer to it, supported by proper arguments, he shall return to the professors, by whom they were proposed on the 28th of May, or 11th of August, and shall defend his commentary, and an- swer, before the Faculty of Medicine, on the 30th of May, or 18th of August. 8. If, by having duly fulfilled these conditions, the candidate shall deserve to be promoted, he shall receive from two of the professors, two histories of diseases, with questions annexed to them, for the purpose of writing an illustration of the one, and answer s to the others. These histories, with the illustrations and an- SAvers, he shall deliver on the 12th of June, or 1st of September, to the professor who proposed them, and defend them before the Faculty of Medicine on the 15th of June, or 3d of September. 9. After the candidate has been approved of at his first examination, on the 18th of May, or 6th of August, he shall-be permitted to send his dissertation to the 4Y 2 GRA 716 GRA press, and shall deliver eight copies, accurately printed, to the Dean of the Faculty of Medicine, on the 15th of June, or 3d of September. 10. If the candidate, after having printed his disserta- tion, shall be approved of by the Medical Faculty at his third examination, all these proceedings shall be reported to the Scnatus Academicus, by the Dean of the Faculty of Medicine, Avith whose approbation and authority he shall be ordered to publish his dissertation, and defend it in a meeting of the university, on the 24th of June, or 12th of September; when, if the Senatus shall think fit, the highest medical honours, that is, the degree of Doctor in Medicine, shall be conferred on him, with the usual solemnities, as the reward of his diligence and study. 1T. To give greater solemnity to all these proceed- ings, the Faculty of Medicine shall always meet within the university on each of the above mentioned days, at nine in the morning. And if any candidate shall ab- sent himself at the hour appointed, without sufficient reason, he shall not be permitted, on this occasion, to proceed with his trials, or obtain the degree of Doctor in Medicine. It is required that all the abovementioned exercises shall be performed in the Latin tongue. The regulations enacted by the Senate of the Uni- versity of Glasgow, respecting degrees in medicine, are the following: 1. That before any person can be allowed to be a candidate for a degree in medicine, in this university, ke shall appear personally before the senate, and lay be- fore them evidence that, during the space of three years, or sessions of six months each, he has regularly attended in some university or universities, or in some medical school or schools of reputation, the following medical classes, viz. anatomy and surgery, chemistry and phar- macy, the theory and the practice of physic, materia medica, and botany. 2. That he shall bring forward evidence that, during one year at least, he has attended medical classes in this university. 3. That the candidate shall undergo three separate examinations in private, by the medical professors of the university, and write a commentary on an aphorism of Hippocrates, and another on a case of disease pro- pounded to him by the said examiners. The first examination shall be on anatomy and physiology; the second on the theory and practice of physic; and the third on chemistry, materia medica, pharmacy, and botany. 4. That the examiners shall report to the senate their opinion respecting the medical knowledge of the can- didate ; and if their report be favourable, his name, as a candidate for a degree, shall be entered in the minutes of the senate, and a day fixed, when the candidate shall read his commentaries on the aphorism and case, and answer such questions on the several branches of me- dical science, as shall be put to him by the examiners, in presence of the senate. If the senate be of opinion that the candidate has shown himself Avorthy of a de- gree, itshall be conferred, in presence of the senate, by the vice-chancellor, provided the candidate has not pub- lished a thesis, which he may, or may not do, accord- ing to his own option; but if he has published a thesis, he must defend it, and the degree must be conferred in the contitia. 5. The whole of the examinations shall be carried on, and the commentaries on the aphorism and case must be written in the Latin language. GRA'MEN, (quasi gradimen, from gradior, to creep along, from the extension of its roots). Grass. Grasses are one of the seven natural families, into which all vegetables are distributed by Linnaeus. They are defined to be plants Avhich have very simple leaves, a jointed stem, a husky calyx, termed glwna, and a single seed. In Tournefort they constitute a part of the fifteenth class, termed apetali; and in the sexual system of Linnaeus they are mostly contained in the second order of the third class, termed triandria digynia. Wheat, oats, barley, and rye, are grasses improved by culture. Grasses form the fourteenth order in the frag- ments of a natural method in Philosophia Botanica, and the fourth of the natural orders at the end of Ge- nera Plantarum. Gra'men avena'ceum. See .Egylops. Gra'men cani'num ; also called gramen Dioscoridis; gramen repens, and loliaceum radice repente; quick grass ; cough grass ; and dog's grass. The French call it chien-dent; triticum repens Lin. Sp. PI. 128. It is a creeping perennial grass, of a whitish green colour, with knotty stalks, bearing a spike of imperfect flow- ers, somewhat resembling a wheat ear; the roots are whitish, or of a pale yellow, long, slender, jointed at distances, variously bent and interwoven. The roots are sweetish, mildly aperient, and supposed to be deobstruent, diuretic, useful in ulcers of the blad- der, strangury, and calculus biliaris. A considerable quantity of the expressed juice of fresh roots must be taken every day, if any benefit is expected. Sheep and cattle greatly improve in spring by the fresh grass, which produces a diarrhoea, and a discharge often of calculi. Gra'men cru'cis, cyperio'idis, and jEgyptia'cum, neiem-elsalib, are roots in medicine named cyperi. The plants which produce them grow in watery places, have leaves and flowers in some measure resembling the water grasses, and are called cyperus grasses; .Egyptian cock's foot grass, or grass of the cross. The roots and plants possess the same virtues as the dog's grass, and are serviceable in the earlier stages of dropsy. They are supposed to correct the bad smell of the breath; to relieve nephritic disorders, colics, and uterine complaints; and are taken in powder and decoction, though the present practice properly disre- gards them. The long and round cyperus are produced from the c. longus and esculentus Lin. Sp. PI. 67. Some other species, particularly the c. odoratus, are employed, and some species of the carex occasionally substituted for them. Gra'men da'ctylon; also called dactylon radice re- pente; gramen dactyloides; gra7nen canarium ischami paniculis; gramen legitimum; cock's foot grass. Panicum dactylon Lin. Sp. PI. 85 ; grows in fields and vineyards, in sandy places: its virtues are the same as those of dog's grass. See Gramen caninum. Gra'men da'ctylon aroma'ticum. See Juncus ODORATUS. GRA 717 GR A Gra'men lolia'ceum. See Lolium. Gra'men ma'nnje; gramen dactylon esculentum; ischemonsativum.-festucafiuitanshin.Sn.PI. 111. Rus- sia seeiJ and manna grass ; grows in Germany and Poland: its seeds are small, oblong, pellucid, white, of a faint taste, and, Avhen decorticated, similar to rice. Gra'men parna'ssi. See Parnassia. Gra'men spica'tum. See Phalaris. GRA'MIA. The sordes of the eyes. GRA'MMA. See Scrupulus. GRA'MME, (y%xnfM), a line.) See Iris. A French weight. See Weights. GRA'NA INFECTO'RIA KERMES. See Cher- mes. GRANADI'LLAPERUVIA'NA,(dim.of5-rc«ccfo, a pomegranate). See Cataputia major. GRA'NAL. An evergreen tree in America of a poisonous quality. GRANA'TA MA'LA, (from granum, a grain ; be- cause full of small seeds). Granatum ; mala punica ; malum granatum ; malicorium ; pomegranate: punica granatum Lin. Sp. PI. 676 ; is a prickly tree or shrub, with long narrow leaves, deep red flowers, set in bell- shaped cups of the same colour: the fruit is about the size of an orange, with a thick, tough rind, externally brownish, internally yellow, Avith a juicy pulp, and nu- merous seeds, called coccones, in cells like a honey comb. It is a native of the south parts of Europe. The flowers are a mild astringent, similar to those of the wild pomegranate, which are preferred on account ■of their being larger. The pulp of the ripe fruit is a grateful subacid sweet, and of the same general quali- ties as the summer fruits. The rind is moderately astringent, called cortex granati; malicorium ; psidium, and sidium : it yields its qualities copiously to water, but the flower most freely to spirit. Dr. Cullen asserts, that the strong styptic taste of this bark, and the black colour it strikes with green vitriol, show sufficiently its astringent poAver; and it is commonly supposed to be among the strongest of this kind.' He has frequently found it useful in gargles; in diarrhoeas; and in exter- nal applications; nor does he think it, internally used, more dangerous than other astringents. That it can suppress the catamenia, as has been supposed, seems to him very doubtful. Its dose, in powder, is from 3 ss. to 3 i- of the infusion, or decoction, an ounce and half. See Raii Hist. Lewis and Cullen's Materia Medica. GRANATRI'STUM. See Carbunculus. GRANA'TUS SYLVE'STRIS. See Balau* STIUM. GRANDE'BAL^E, (quod in grandioribus etate, nas- cuntur). The hair under the armpits. GRA'ND-GOR. The vernacular Scotch appellation of Lues venerea, q. v. GRANDI'NES. Tumours on the eyelids, resem- bling hail stones. See Chalaza. GRANDINO'SUM, (from its resemblance to a hail stone,) Os. See Cuboidesos. GRA'NDO, (qubd, similitudinem granorem habeat). Hail. See Chalaza and Crithe. GRANULA'TIO, (from granum, a grain,) the re- duction of metals into small grains, (see Comminu- tio,) and the raising of the fleshy parts of ulcers in a healing state. GRA'NUM, (from gar an, corn, Hebrew). A grain weight; the weight of a wheat corn. Gra'num ra'gium. See Cataputia major. Gra'num ti'glia. See Cataputia minor. Gra'num mo'schi. See Abelmoschus. GRAPHIOI'DES, (from ypxpts, a pencil, and eifos, a form). See Styliformis processus : the name also for a process of the ulna towards the Avrist. GRAPHI'SCUS, (from ypxtpis, a style or dart). An instrument to extract darts. Diodes invented, and Cel- sus describes it. GRAPHOI'DES, or STYLIFORMIS, (fromypxtpis, stylus ; supposed to originate from this process of the temple bone). See Biventer musculus. GRA'PHOY. Broad leaved leopard's bane. See Doronicum Germanicum. GRA'TIA DE'I; the name of the herb robert, of the hedge hyssop, and of several other vegetables, from their supposed salutary qualities. See Gera- nium ROBERTIANUM. GrATIOLA. Gra'tia de'i Germano'rum. See Geranium ba- TRACHIOIDES. GRATIO'LA, (see Gratia Dei). Digitalis mi- nima ; centaurioides ; water hyssop, and hedge hys- sop, gratiola officinalis Lin. Sp. PI. 24. It is a Ioav plant, Avith finely serrated leaves, set in pairs on the stalks Avithout pedicles; the flowers are whitish, jointed, and surrounded with fibres; perennial; a native of .the south of Europe; raised in our gardens. The leaves have a nauseous, bitter taste, but no re- markable smell; they purge and vomit briskly, in the dose of half a drachm of the dry herb, and of a drachm infused in wine or water. A slight decoction in milk operates the most mildly; an extract made from wine is given to two scruples, or 3 h and is said to be more efficacious than the plant itself. Cramer thinks this root similar to ipecacuanha, and equal to it in diarrhoeas and dysenteries, as well as in the cure of intermittents, and superior to the decoction of the woods in the lues ve- nerea. (See Raii Hist. LeAvis's Materia Medica). It has been thought also a powerful diuretic and sudorific, as well as beneficial in mania, gonorrhcea, ozena, ulcers in the fauces, &c. Edinburgh Medical Commentaries, vol. v. p. 6i Grati'ola cceru'lea. See Cassida. GRATTERO'NA. See Aparine. GRAVA'TIO, (from gravo, to burthen). See Caros. GRAVATI'VUS, (from the same,) a pain of the head, attended with a sense of weight. GRAVE'DO, (from gravis, heavy). A Cold. Gravedo imports a load in the head, or the running from the nose, experienced in catarrhus or coryza. Celsus translates xopv^x by the word gravedo ; and Coe- lius Aurelianus by the words catarrhus ad nares. Pliny applies this term to the disease called caros ; but it is, properly, that weight or listlessness which accompanies a diminished perspiration, and, as Dr. Cullen observes, is generally a symptom of catarrh. By a cold is usually understood a sudden check of perspiration, from an improper exposure to cold; the consequences of which are the lesser degrees of a ca- tarrh : in its farther advances it is productive of fever, consumption, and similar disorder. Persons who easily take cold should use frequently moderate exercise, and such medicines as strengthen GRI 718 G R Y the general system ; as cold bathing, &c. The disposi- tion to take cold may be lessened, by gradually acquir- ing the habit of being exposed to sudden changes of heat and cold ; but this attempt should be conducted with caution, lest the remedy might prove the source of the disease. Disorders of this kind, in their early period, are speedily relieved by immersing the feet in cold water, just before going to sleep. See Catarrhus ; Dr. For- dyce's Elements, in the article Catarrh; Heberden's Observations in the London Medical Transactions, vol. ii. p. 521; and Stern's Advice to the Consumptive, &c. edit. 7. p. 9. &c. GRAVI'DITAS, (from gravida, to be with child). Pregnancy; and the extraordinary distention of the abdomen in that state. The period of gravidity or ges- tation is about nine months, or forty weeks, equal to two hundred and eighty days. It is sometimes, however, pretty certainly prolonged to ten months; and the law, Ave apprehend, alloAvs eleven, as the utmost limits of possible gravidity. On the other hand, a child lives if born at the end of seven months, probably not earlier. See Medicina forensis. GRAVIDITY SPURIOUS. Water in the abdo- men; polypi, or water in the uterus; a mola, or unformed mass; and steatomata in the uterus, or Fallopian tubes; Avill often produce appearances of gravidity. The uterus itself will enlarge, the breast* swell, and all the appear- ances of real impregnation take place. We have partly spoken on this subject under Ascites, q. v. and no situation in which a physician can be placed requires greater delicacy. In general, he should Avait till all probability of impregnation is at an end, and then act according to the prevailing circumstances; but by all meansbe cautious of declaring his opinion till it be fixed on a secure foundation. GRENE'TTE, (a dim. of graine, corn, French). See Santonicum. GRESSU'RA, (from gradior, to proceed). See Pe- rineum. GRIEF, is one of the depressing passions ; it stops perspiration, renders every musoular action languid ; and thus checks the intestinal and biliary discharges, renders the skin sallow, and, by lowering the activity of the nervous power, renders the body more accessible to the influence of infection. It has occasioned death, and the persons are said to die broken hearted. One instance is recorded, if we mistake not, by Dr. Whytt, where this organic change was produced by grief. We can easily conceive that the diminished power of the vital may be accompanied with such a diminution of the resistance of the simple solid, as to admit of the impulse of the blood when accumulated in the heart and larger vessels, from the altered determination, to occasion a rupture. Grief, if indulged, produces all the changes which distinguish hypochondriasis. The mind soon recovers its elasticity; but the bodily effects re- main often during life, frequently terminating in me- lancholy and mania. Fretfulness, often confounded Avith grief, is not dangerous to the constitution, and rather referrible to excess of irritability. GRIE'LUM. See Hipposelinum. GRINDERS' ROT. Scythe grinders are subject to a disease of the lungs, from the particles of sand mixed Avith iron filings. Cork cutters and lime burners are subject to a similar complaint; and we once saAv it in an elegant and delicate young female, from an internal cause. See Calculus. GPIPHO'MENOS, (from ypipos, a net, surrounding the body.) Pains which extend from the loins to the hypochondria. GROSSULA'RIA, (from grossus, an unripe fig,) uva crispa, and gooseberry bush. It flowers in April, and its fruit ripens in July. The unripe fruit is said to abate the longings of pregnant women. The ripe fruit, if the skins are not swallowed, is nutritious, digestive, and cooling. Grossula'ria non spino'sa. See Ribes. GRO'SSUS, (from garas, HebreAv). See Ficus SATIVA. GROTTO DEL CA'NI. A grotto near Naples, in which dogs are suffocated. The deleterious vapour is carbonic acid air, which rises only about eighteen inches. A man, therefore, is not affected; but a dog forcibly- held in, or who cannot rise above it, is soon killed, un- less taken out. He is recovered by plunging him in an adjoining lake. Grotto del serpi. The grotto of the serpents, described by Kircher who visited it. It is near the village of Sassa, not very distant from Braccano, in Italy, filled with warm vapour, from some subterraneous apertures, without any apparent gaseous or other im- pregnation. Patients affected with lepra, elephantiasis, palsy, or gout, are said to be relieved by these vapours; and the relief is, in part, attributed to some serpents, Avhich are not venomous, but which are numerous in this cavity, particularly in the spring, and are said to lick the diseased parts. The exuviae of serpents abound in the grotto, and are suspended on the trees, appa- rently to cherish the delusion; but the benefit is wholly- derived from the warm water. GROUND NUTS,arachishypogeaLin. Sp. PI. 1040, is a leguminous plant, originally from Africa, but now cultivated in all the European establishments. Its calyx is divided into two parts, the upper of which is semi- trifid, and the inferior lanceolated ; the corolla papi- lionaceous, almost reversed. It has nine monadelphous stamina, and the tenth free and barren; a superior ovarum, which becomes an oblong, cylindrical, reticu- lated pod, opening with difficulty, and containing two or three seeds. The leaves are alternated, winged, without an odd one ; each composed of four oval leaf- lets, with a membranous stipula at their base, divided into two. The flowers of the arachis are placed in the axillae of the leaves. The upper ones, though perfect, are abor- tive ; but the lower bend and hide themselves in the earth. They are there sought after by the negroes, who eat them boiled in water, or roasted in the ashes. The seed is of the size of the little finger, with the taste of an almond, but with a flavour of dry pitch, at first un- pleasant. An oil equal to that of olives, which does not grow rancid, may be obtained from it, by pressure; and a bushel of the seeds, which, in the year 1768, were valued at only eight pence, produced a gallon of oil. Philosophical Transactions for 1769. GRU'MUS, (from garam, a clot, Hebrew,) a por- tion of the coagulum of blood or milk. GRU'TUM. Decorticated unbruisedoats. Groats. GRY'PA. An ointment described by N. Myrepsus. GUA 719 GUA GRY'PHIUS PES, (from ypvxoa, toincurvate). An instrument mentioned by Parey for extracting a mole from the uterus, bent like an eagle's talons ; the griffin, from Avhich it is denominated, is the appellation of a vulture. GRYPHUS. See Adamas. GRYPO'SIS, (from y^vxoa, to incurvate,) an incur- vation of the nails. GUA'BAM. A sweet cooling fruit-which grows in the West Indies. See Raii Historia. GUACA'TANA; scrophularia Indica; is a plant which grows in New Spain, and which eases the piles, in the form of a cataplasm (see Raii Historia); but it is unknown to the systematic botanists. GUA'CU. See Cebipira Brasiliensibus. GUAIA'BARA. A tree that grows in Hispaniola; the Spaniards call it uvifera; the leaves are large, and used as paper. Cocoloba uvifera Lin. Sp. PI. 523. GUAI'ACUM, (Indian). Guaiacon, hagioxylon, lig- num benedictum, vite lignum, palus and palma sancta, euonymo adfinis occidentalis, ibirace, &c. The darker kind the Americans call hiacan,or huiacan; the yellowish they call hoaxecan;guaiacum officinalelAn. Sp. PI. 546. Common guaiacum, or pockwood. This wood was introduced into Europe early in the sixteenth century from Jamaica, Mexico, and the An- tilles. It is brought over in large pieces, each weighing from four to five hundred weight, hard, compact, and so heavy as to sink in water, of a pale yellowish colour Avithout, but black, of a deep brown, or marbled, within. It hath little or no smell, except when heated, and then its odour is slightly aromatic. When chewed it is slightly pungent, a quality which resides in its resin, and which it yields, in some degree, to water by boiling, but wholly to spirits. Of the bark there are two kinds, one smooth, the other unequal on the surface : both are weaker than the wood. In the choice of this medicine, the freshest, most ponderous, of the darkest colour, and the largest pieces are preferred; and, as -the finer parts are apt to exhale, they should be rasped only when used. The wood was first introduced into Europe as a re- medy for the venereal disease; and, as it warms and stimulates, promotes perspiration and urine, proving occasionally a gentle purgative, it assists the operation of mercury. When the excretory glands are obstructed, the vessels flaccid, the habit cachectic, in many cutane- ous and catarrhal complaints, female weaknesses, in gouty and rheumatic disorders, it is often useful. The hectic fever, which sometimes follows a salivation, yields to a decoction of the woods. Guaiacum seems to stimu- late the exhalent vessels more than the heart and great arteries; and is consequently safer than those which act more powerfully on the sanguiferous system. It is of course esteemed more effectual than other sudorifics in the lues venerea, in all cases of rheumatism, perhaps in gout. A long use of this medicine hath been supposed to produce a yellowness of the skin. In thin emaciated habits ; in an acrimonious state of the fluids; in hot bilious habits, and where the fibres are very tense, it is suspected to be injurious. Three ounces of the wood, or four ounces of the bark, may be boiled in ft, iv. of water to ffj ij. and if a little liquorice is added to the latter end of the boiling, it will abate the disagreeable pungency of this medicine, which affects the throat in swallowing. Of this decoction at least half a pint should be taken in a day. If the thin shavings of guaiacum are distilled in a retort, at first an almost purely watery fluid arises; on increasing the fire, an acid, reddish, empyreumatic liquor passes over, with a little fluid reddish oil, and much air is separated: the residuum is a coal. A pound of guaiacum wood, distilled on an open fire, gave ^ iii. ss. of acid, and 5 i. ss. of empyreumatic oil. The extract of guaiacum, soft and hard, is prepared by boiling lb i. of guaiacum shavings in a gallon of wa- ter until half the liquor is wasted, repeating the opera- tion by adding the same quantity of fresh water to the same shavings four or five times. The several decoc- tions passed through a strainer, are to be mixed and in- spissated ; adding, when the aqueous parts are almost exhaled, a little spiritus vini rectificatus, that the whole may be reduced into'an uniform tenacious mass. This extract is called soft when of the consistence of a mass for pills, and hard Avhen it can be powdered. The spi- rit is added at the conclusion of the boiling, that the re- sinous part may be perfectly mixed with the gummy. The harder extract is an excellent errhine. The resin of guaiacum is prepared in the same man- ner as the resin of jalap, q. v. and is the only active part of this wood: it is obtained pure by means of recti- fied spirit of wine, both from the wood and the gum, and is procured by wounding the bark in different parts of the body of the tree, from whence it exudes copiously. This natural resin, which is exported, is never pure; and about | xii. of pure resin is obtained from 5 xvi. of what is styled gum. This is partly accounted for by its being sometimes procured by boring billets of the wood longitudinally, and then burning them at one end, while the resin exudes from the other. It is also occasionally obtained by boiling the chips in water and common salt. This gum is of a brown colour, partly reddish, often greenish, brittle, having a glossy surface when broken, of a pungent taste, affecting the tongue and palate in the same manner as the wood. It is chiefly brought in irregular masses, of a dusky green colour,: that in the form of drops is the best, but rarely met with. In choosing the gum, those pieces which have slips of the bark adhering to them, and that easily separated from them by percussion, is the best. When held against the light it is transparent, breaks with a smooth uniform shining fracture, of a bluish green colour. It is fusible in a moderate heat, but not softened by the heat of the fingers; insoluble in Avater, but soluble in alcohol; without smell or taste, but on hot coals diffus- Ning an agreeable odour. When the powder is swallow- ed, it occasions a very painful burning and pricking in the throat. Neumann assures us, that a composition of colo- phony and balsam of sulphur is imposed on the unwary for the true gum; but the cheat is easily detected, by exposing each to a due degree of heat, by which the odour of the false is perceived to be different from that of the true. The wood and resin only are in general use as medi- cines ; and as the efficacy of the former is supposed to be derived merely from the quantity of resinous mat- ter which it contains, they may be considered indis- GUL 720 GUM criminately as the same medicine. Of the gum, or ex- tracts, the dose may be from gr. v. to 9 i. but in the latter dose it is often actively cathartic. It should be combined with a fluid by means of an cggx or some mucilage, as it is otherwise uneasy in the stomach. In- deed, if given in the form of an electuary or bolus, a si- milar medium is necessary. Bolsam of guaiacum consists of gum. guaica. ffo i. bal- samum Peruv. 3 iij sp. vini rect. lb i. ss. It was form- erly called polychrestum; and from one to three drachms were given every night and morning in milk, or any convenient vehicle. Tincture of gum guaiacum, commonly called the vo- latile tincture, is a solution of four ounces of the gum in a pint and a half of the compound spirit of ammonia. Pharm. Lond. 1788. The dose is from a small tea spoonful to a large table spoonful two or three times a day, and it is very con- veniently given in milk, though a proportion of the tinctura opii should be added, to prevent the larger dose from purging. Dr. Dawson frequently directs the latter dose with great advantage in rheumatic and ar- thritic complaints, in which cases, and against palsies from lead, he considers it almost as a specific. It should not, hoAvever, be given while any inflammatory diathe- sis remains. See Raii Historia Plantarum ; Lewis's Materia Me- dica; Neumann's Chemical Works ; Cullen's Materia Medica. GUAI'ANA CORTEX. See Simarouba. GUAJA'CANA, diospyros, faba Greca latifolia, pseudo lotus; diospyros lotus Lin. Sp. PI. 1510. It is not much known ; but its leaves and fruit are astringent. GUA JA'VA. The gudva, guajdbo; psidium pomife- rum Lin. Sp. PI. 672. The name of a tree in the West Indies, whose fruit is cooling and moderately astringent; the root is also astringent. See Raii Historia. GUA'O. Comocladia dentata Lin. Ed. Wildenow, vol. i. p. 189. A West Indian tree, called thetlatian; its effluvia are so acrid as to be injurious to those who sleep under it. It has the odour of dung, and its juice is so black that it cannot be washed out of linen. GUAPARAI'BA. The mangrove tree of the West Indies ; mangle, and paletuvier. The mangrove tree of the East Indies appears to be the rhizophora gymnorrhiza Lin. Sp. PI. 634; that of the West, the g. mangle Lin. Sp. PI. 634. If the root is split and toasted, then applied to the punctures made by the poisonous fish called niqui, it is said to cure. See Raii Historia. GUARE'RVA-O'BA. See Cucumis agrestis. GUARIRIGUIMY'MIA. Bignonia pentaphylla Lin. Sp. PI. 870. A shrub in Brasil, like a myrtle, whose seed is supposed by Lemery to destroy Avorms. GUA'SSEM. Certain black scorbutic spots men- tioned by Avicenna. GUATIMA'LA. See Indicum. GUA'VA. See Guajava. GUIDO'NIS BALS. See Anodynum bals. GUILA'NDINA MOR'INGA. See Nephriticum LIGNUM. GUI'TY-I'BA. A tree groAving in Brasil, and bear- ing the fruit called guity coroga, which contains a stone as large as a goose's egg, the kernel of which is astrin- gent. The tree is not known to scientific botanists. GU'LA, (from ytvouMi, to taste). See Oesophagus. GU'MA. See Argentum vivum. GU'MMA,(from,cfum™z, gum, plur. gummata, from the resemblance of the contents to gums,) is a tumour arising from the substance of a bone, so soft as to yield to the finger. As they increase in hardness, they are progressively styled tophi, nodi, and exostoses. In vene- real cases, such tumours often happen on the head, and even in the middle of the hardest bones, apparently pro- duced by an obstruction, and probably a dilatation, of the interstitial vessels raising the incumbent laminae. A softness of the bones sometimes succeeds abscesses of the adjacent parts, and sometimes the seat of the dis- order is in the substance of the bone, as in the lues ve- nerea; but gummata have, however, been discovered, when no adequate cause could be observed. An acid has been suspected in the blood, or perhaps the phos- phoric acid of the bones may be in excess. See Petit on Diseases of the Bones. Lues venerea. Bell's Sur- gery, vol. v. p. 541. GU'MMI, (tsamah, pronounced ghamah; Hebrew,) gvu, gisisim, is a concrete vegetable juice, of no parti- cular smell or taste, viscous and tenacious when moist- ened with, and wholly soluble in, water;, insoluble in alcohol or in oils; burning in the fire to a black coal, without melting or inflaming, and not volatile in the heat of boiling water. The true gums are gum arabic, tragacanth, and se- nega : the gum of cherry and plum trees : the others contain a proportion of resin. The virtues of gums are those of mucilages in gene- ral, which are only gums with a proportion of water. When the ancients used the word gummi, or commi, without any epithet, they meant gum arabic. The Kofipi Xevxov, (Hippocrates De Morbis Mulierum,) is the same. Gu'mmi Ara'bicum, called also acanthinu7n; gum lamac; gum Thebaicum and Serapionis, gum arabic, and the true gum acacia. It exudes from the Egyp- tian acacia, or thorn tree, whose fruit affords the inspis- sated juice of that name. Mimosa nilotica Lin. Sp. PI. 1506. (See Acacia.) It is brought from Turkey in small irregular masses, of a clear whitish or very pale yelloAV colour. Though insoluble in spirit, and in oil, yet, when formed into a mucilage, it is miscible with both, and with resins rendering them miscible with water. Dr. Grew first taught us to mix essential oil with water by means of gum; and in the London Medical Observa- tions and Inquiries, vol. i. we find that oils, both express- ed and distilled, resins, and balsams, may, by the same means, be mixed uniformly with water or with spirit. Alkaline salts, both fixed and volatile, though they ren- der pure oil miscible with water, prevent the mixture of gum with oil. Acids do not in the least prevent the effect of gum in combining oils with water. Animal glues Very unlike vegetable gums are more nutritious, and apt to become putrid; and they will not combine oil with water. In a chemical view their difference is very great; those of the animal kind are changed by fire into a volatile alkaline salt, and a fetid oil; the vegetable into an acid liquor, and a very minute portion of oily matter, considerably less fetid than the former. Gum arabic is glutinous and demulcent; consequently useful in tickling coughs, diarrhoeas, hoarseness, in car- ' GUM 721 GUS dialgia, when from any oily aliment, and in almost every disease of the urinary organs. In dysuria the true gum arabic is preferable to the other simple gums. Though its action has been supposed not to extend be- yond the glottis and the alimentary canal, it is certainly conveyed with little change to the kidneys; and, when used in moderate quantities, even checks the urinary discharge. To be effectual as an internal demulcent, two ounces a day should be, at least, taken. Dr. Has- selquist informs us, that a caravan, whose provisions were exhausted, found it very nutritive. One ounce of gum arabic renders a pint of water con- siderably glutinous; but for mucilage, one part of gum to two parts water is required, and for some purposes an equal proportion will be necessary. See Lewis's Materia Medica; Neumann's Chemical Works. Gu'mmi fu'nerum. See Bitumen. Gu'mmi gu'tta, and ad podagram. See Gambo- gia. Gu'mmi re'sina lu'tea. New Holland has fur- nished tAvo neAV medicines; the red and the yellow gum. The first is astringent, and not unlike the kino described in the following article. The yellow is not very dissimilar; but the plant from which each is procured has not been reduced to its place in botanical systems. Gu'mmi ru'brum astri'ngens Gambie'nse. The red astringent gum from Gambia ; Kino; sanguis draconis officinalis, or the finest and true dragon's blood. Dr. Oldfield calls it true gum Senegal. In the inland parts of Africa it is called pau de sangue: pau is said to be a corruption of palo, wood; and, with the addition of sangue, to be the name of a tree in the in- land parts of Africa which produces it. Gum kino is very friable, easily breaking between the fingers; without smell, of an opake, dark, reddish co- lour, appearing almost black in the mass, and, when powdered, of a-deep lateritious red. In chewing, it first crumbles, then coheres slightly, and seems soon to dissolve, with a very astringent slightly sweet taste. It differs from the red lumps of the common gum Senegal in being much more brittle; and from the dra- gon's blood in its affinity to water; and from both in its stypticity when tasted. It dissolves both in spirit and in water; each taking up about two thirds of the Avhole. This gum seems useful in many disorders from laxity, as in chronic diarrhoea, leucorrhcea, and maenorrhagia. It contains a larger proportion of gum than any other astringent drug, and, joined with alum, in the propor- tion of one part to three, (as in the pulvis stypticus, Ph. Edin.) is considered to be one of the most powerful as- tringents which has been employed. In a liquid form, however, the kino is said by Tromsdorff to decompose the alum; but this effect appears to depend on some accident, as the experiment does not always succeed. Cullen's Materia Medica; London Medical Observa- tions and Inquiries, vol. i. p. 358, &c. Gu'mmi Senegale'nse, gum Senega, and gum Ori- entale, is brought from the island Senegal, on the coast of Africa, and is said to be the production of the tree Avhich affords th*e gum arabic. This gum is generally in larger and darker pieces than the gum arabic, and rough on the outside: the gum arabic also is dry and brittle, but the Senega VOL. I. clammy and tenacious. The clearest pieces are sold for gum arabic, and their qualities are nearly similar; but the gum Senega is certainly more adhesive. Gu'mmi tragaca'ntha, (from rpxyos, a goat, and xxxvOx, a thorn, because its pods resemble a goat's beard,) adraganth, and dragantum; gum dragant, or tragacanth. This gum exudes from a prickly- bush, which groAvs in Crete, Greece, and Asia. Astra- galus tragacantha Lin. Sp. PI. 1073. Goat's thorn. or milk vetch. It is chiefly brought to us from Tur- key in irregular lumps, or in long vermicular pieces. In Candy it begins to exude about June, and is more or less pure and white, according to its accidental mixture with dust. That which is white, light, smooth, and transparent, in vermicular striae, of a sweetish taste, and without smell, is preferred. A yellowish or brownish colour is no mark of imperfection or impurity. It differs from all other gums in giving a thick con- sistence to a larger quantity of water, probably from being insoluble in this fluid, which it slowly imbibes in a large proportion, swells into a considerable bulk, and forms a soft, but not liquid mucilage. On the further addition of water a fluid solution may be obtained by agitation, but the liquor is turbid; and, on standing, the mucilage subsides, the limpid water on the surface retaining little of the gum. It is more powerful as a mucilage than other gums, but not as a demulcent, though it softens and thickens acrid humours. The pulvis e tragacantha compositus of the London college is made in the following manner: R. Tragacan- thae in pulverem tritae, gum. arabici, amyli, singulorum § i. ss. sacchari purificati § iij. simul in pulverem tere. Ph. Lond. 1788. It is mild, emollient, and useful in tickling coughs, and supposed to mix oils and resins more smoothly than the gum arabic. See Lewis's Materia Medica; Neumann's Chemical Works; Cullen's Materia Me- dica. GUMMO'SiE PFLUL.E, (from gummi, gum). See ASAFCETIDA. GUMMO'SUM ELECTA'RIUM,(fromthe same). See Dysuria. GURGEA'TIO, (from gurges, a stream of water). See Sudor anglicus. GURGU'lAOJj^yxpyxpeav, from gargarah, the throat, Hebrew). See Uvula : the insect also called a weavil. GUSTATO'RII. See Hypoglossi externi. GUSTATO'RIUS, (from gusto, to taste,) the name of the third maxillary branch of the fifth pair of nerves. GUSTE'RANAX. See Bithnimalca. GU'STUS, (from yivof/uti, to taste). The taste. Upon the tongue, towards the apex and sides under the skin, are obtuse papillae of various figures; promi- nent in the tongue of a living person, when applied to the object of taste; but not discovered in the dead body. They rise from the nervous substance which covers the muscular flesh in the tongue, pass through the perfora- tions of the corpus reticulare, as in the skin, and are covered with small vaginae, formed by the exterior membrane of the tongue. These vaginae are seemingly porous, that the substance tasted may, by pressure, be applied to them. Bellini has shown that these papillae only are the medium of taste; and that the other parte G U T ' 722 G U T of the mouth, tongue, and palate, contribute nothing to it, except as resisting surfaces to assist the application. It is, however, highly probable that the back part of the palate is also sensible of the impression Avhich conveys the taste. It hath been generally said, that salts are the true ob- jects of taste; and that the diversity of taste is OAving to the different figures Avhich are natural to salts: but Haller, on the contrary, asserts, that the reason of the diversity of flavours seems to reside in the intrinsic fa- bric or apposition of their elements, which do not fall under the scrutiny of the senses. In general, he thinks Avhatever contains less salt than the saliva is insipid; but that the nature or disposition of the covering with Avhich the papillae are clothed, together with that of the juices, and of the aliments lodged in the stomach, have a consi- derable share in determining the sense of taste; so that the same flavour does not equally please or affect the organ in all ages alike, nor persons of the same tempera- tures, nor even the same person at different times. In fact, the sense of taste is more closely connected with the state of the stomach than is generally supposed; and the languor or indisposition of that organ destroys or de- praves the sense of taste. Other nervous affections have a similar effect. In fevers the taste is depraved or lost, and the substance of the papillae, or of their vaginae, seems to be organically changed; for Avith whatever care the tongue is cleaned, it never attains a healthy appearance. In general, the taste determines what aliment is sa- lutary; for the most part, whatever offends the taste is injurious in the stomach. See Haller's Physiology, in his Lecture of the Taste. GU'TTA, (from #««, to pour out). A drop; alun- sel. Drops are an uncertain form of administering me- dicines; and, where great exactness is necessary, they should not be prescribed. The shape of the bottle, or of its mouth, from whence the drops fall, as well as the consistence of the fluid, occasions a considerable dif- ference in the quantity administered. Gutta is also a name of the apoplexy, from a suppo- sition that its cause was a drop of blood falling from the brain upon the heart. Gu'tta ga'mba. See Gambogia. Gu'TTiE ni'gr-e. The black drops, occasionally called the Lancashire or the Cheshire drops, is a secret preparation of opium, more active than the common tincture, and supposed to be less injurious, as seldom followed by headach. One drop of this medicine is equal to about two and a half of the tincture of opium. We are informed by Dr. Cassells, that there 'are two preparations in use under this title. In the first, five ounces of purified opium, with pimento and cinnamon, of each two drachms; saffron and Seville orange peel, of each one drachm; are digested for a Aveek in rectified spirit of wine, which is separated from the faeces by pressure. In the other, four ounces of opium are di- gested for three weeks in as many pints of the juice of quinces or verjuice, to which saffron, cloves, nutmeg, and cinnamon, of each an ounce, are added, and the digestion continued another week. Neither appears to us the real preparation; but we shall resume the subject in another article. Vide Opium. Gu'tta opa'ca. See Cataracta. Gu'tta rosa'cea, according to Dr. Cullen, is syno- nymous with varus, and bacchia; and these are placed as varieties of the phlogosis phlegmone. It is sometimes called simply rosacea, from the little red drops, or fiery tubercles, dispersed about the face and nose; rubedo maculosa, Ionthos, butiga, gutta rubea, ruonia, and ro- sea. Nicholaus Florentinus distinguishes three degrees of it, viz. 1. rubedo simplex, seu fades rubra; 2. pus- tulosa; and, 3. ulcerosa. The cause is supposed to be in the liver, and this idea is supported by observing, that often on the disappear- ance of fiery pimples in the face, an indurated liver and a dropsy folloAV; on the contrary, disorders of the liver are sometimes relieved by eruptions in the face, so that repellents should be carefully avoided. Whe- ther it be the cause or effect of a diseased liver, those addicted to spirituous liquors are most subject to this complaint; but the most abstemious are sometimes af- fected with it, by suddenly drinking a draught of cold water when they are hot, or by any partial suppression of the perspiration. The disease is peculiarly obsti- nate, and often resists every attempt to relieve it; nor will the eruptions disappear till the constitution is completely ruined. In general, a temperate regimen is proper; but if the patient is accustomed to generous diet, a sudden alteration is not advisable: violent exercise should be avoided; and the mind kept as calm as possible. Scar- borough water is generally esteemed very useful; spi- rits, spices, and every thing but the mildest food, should be avoided. Practical writers abound with variety of topical ap- plications; but great caution is required in their use. The hydrargyrum nitratum, if cautiously employed, is sometimes safe, and is the medicine called the golden ointment. Internally, mercurial deobstruents, with antimonials; saline, acidulous, and ferrugineous Avaters, are useful. The decoction of sarsaparilla, of mezereum, or of ether, with that of the elm bark, or the root of the water dock, adding as much of any neutral salt as will keep the bowels loose, are the best assistants of the mercu- rials and antimonials. See Heister's Surgery; Turner's Diseases of the Skin; Medical Observations and In- quiries, vol. i. p. 189. Gu'tta sere'na. (See Amaurosis.) On recur- ring to this article, we perceive that we omitted to men- tion Mr. Ware's very ingenious remark, that it may be sometimes occasioned by a dilatation of the circulus arteriosus, that circle which surrounds the sella tur- cica, and which on the fore part passes over the optic nerve. The anterior arteries are branched from the ca- rotid; but others rise soon after, Avhich, passing back- ward, join the basilar artery, and form the posterior portion of the circle, Avhich lies over the nervi motores oculorum. This cause probably produces the disease when it is accompanied by an inability of moving the upper eye lid; and Ave can easily suppose that it may affeet the optic nerve, Avithout producing any change on the motory nerves, as the larger portion of the blood may be carried off by the anastomosing branches of the basilar artery. We need scarcely apologise for omitting the singu- lar fancy of Richter, Avho attributes gutta serena to infarcted viscera, and combats it by deobstruents and antispasmodics. G Y 31 723 G Y P Gu'riit at'tje. Bals. traumaticum. See Ben- zoinum. Gu'tta anglica'nje. A famous remedy of Dr. Goddard, which, we are assured by Lister, was only the spirit of raw silk rectified with oil of cinnamon. The secret Avas sold to Charles II. for the enormous sum of 5000/. GUTTA'LIS. See Aryt^enoides. GUTTE'TA, (fromgoutte, the cramp). Castellus informs us that the word goutte in French signifies con- vulsion ; hence the name of a preparation called pulvis adgutteta/n, which consisted of dittany, human skull, con- trayerva, 8tc.; in general equal parts of peony and va- lerian roots are only mixed. It was originally an in- vention of Riverius, and often called epileptic powder. GU'TTUR, (from %va, to pour out). The throat ; brochthus. See Bronchocele. GUTTURA'LIS ARTE'RIA, (from guttur, the throat). The first considerable branch of the external carotid is the superior guttural, which arises where it parts from the internal, and runs to the thyroid gland, to the muscles, and other parts of the larynx or pharynx, hence called laryngea. The inferior guttural artery is the Trachealis ar- teria, q. v. Guttura'lis ve'na, trachealis. The right goes from the under part of the bifurcation above the mam- maria of the. same side, and sometimes from the subcla- vian. The left from the left subclavian near its origin. GUTTURIFO'RMIS CARTILA'GO, (from gut- tur, the throat and for7na, likeness). See Arytje- noides. GYMNA'STICA. Gymnastics; exercises of the body which were proposed for the restoration and pre- servation of health, and for the cure of diseases. They were of Greek origin; and are so called from the Avord yvfMos, naked ; for they were performed by naked men in the public games. These exercises Avere originally designed to accustom the youth to feats of activity and strength. War was a laborious occupation from the Aveight of the armour, and strength must be acquired by exertion, and supported by constant exercise. The games Avere consequently connected with their religion, and victory in them was politically rendered an object of the highest importance. ---------------Palmaque nobilis Terraruni dominos cvehit ad Deo?. The gymnastic art had attained no considerable de- cree of perfection in the days of Homer, as we find from the description of the games at the funeral of Pa- troclus. It was introduced, however, into medicine only about the time of Hippocrates, or rather ajittle before his era by Hcrodicus, probably his father. The gymnastics of the warriors were too violent for the dis- eased, or even for the preservation of health in those not naturally strong; and Hippocrates, in his work on regimen, speaks of exercise in general, of Avalking, of races either on foot or horseback, leaping, Avrestling, the corycus, or exercising the suspended ball, with the usual additions of unctions, frictions, and rolling in the sand. Boxing, the pancratia, hoplomachia, running, quoits, the exercise of the ball, hoop, and javelin, driv- ing the chariot, and swimming, seemingly required too great exertion to be admitted into the medical depart- ment; though Avalking, vociferation, recitation, and holding the breath, seem to have been among the me- dicinal gymnastics. Hoffman mentions fifty-five kinds of medicinal exercises, which it were tedious to enume- rate. Vide in loco. The ^Egyptians considered gymnastics not necessary; they thought that by them a genuine health was not procured, but in its stead a short-lived strength, highly dangerous to young people. See Hieronymus Mercu- rialis de Arte Gymnastica Fabri Agonistpn; Fuller's Medicina Gymnastica; Hoffman de Athletis Veterum, vol. v. p. 377, &c. GYMNOSPE'RMIA, (from yv^vos, naked, andcra-^- t*.x, seed). The name of the first order in the class didynamia, in Linnaeus's system, comprehending those plants Avhich have four stamina ; of Avhich the two mid- dle are shorter than the two outer ones, Avith a ringent floAver, succeeded by four naked seeds. GYN^E'CIA, (from ywti, woman). See Lochia and Menses. GYN^E'CIUM, (from ywn, a woman). A sera- glio; an appellation of antimony, and the pudendum muiiebre. GYNvECOMA'STON, and GYN/ECOMA'STOS, (from ywy, a woman, and (*.x, a vein, and to stand). A general stagnation of blood from a plethora- H.EMOSTA'TlCA, (from xiyM, blood, and o-lxa, to stop). Medicines which stop haemorrhages. H^E'RMIA. An Indian fruit, said to resemble pep- per (see Lemery des Drogues;) notnoticed by botanists. HAGIOSPE'RMON, (xyios, holy, and o-*epi*x, se- men; from its reputed virtues). See Santonicum. HAGIO'XYLON, (xyios, holy, and %vXov, wood; from its virtues). See Guaiacum lignum. HAIR. See Capillus and Pilus. Hair worm. See Gordius. Hair lip. See Labia leporina. HALCHE'MIA, (from xXs, salt, and %ea, to pour out). The art of fusing salt. HA'LCYON, (from xXs, the sea, and xvtt, to bring forth; a bird which lays its eggs in the sea). See Al- cedo. HALCYO'NIUM, (from xXxvav, the king's fisher, which is supposed to build its nest with it). The spume or froth of the sea. HA'LEC, harengus, the herring. Pickled herrings are applied to the soles of the feet as sinapisms. Fresh herrings are supposed to be alkalescent, and are useful when an acid prevails in the stomach. It is an oily food, and often disagrees. See Aliment. HALICA'CABUM, (from xXs, the sea, and x«x«ee$, nightshade; because it grows on the banks of the sea). See Alkekengi. HA'LICES. Yawning after sleep. HA'LIMUS, (xXs, the sea; from its brackish taste); portulaca maritima; atriplex maritima a7igustissi7no folio; atriplex portulacoides Lin. Sp. PI. 1493; com- mon SEA. PURSLANE, and TREE SEA PURSLANE, is found in marshes; flowers in July and August. Dioscorides tells us that the leaves are eaten as food; and .Etius, that the buds are used as pickles. The plant is warm, and when pickled is supposed to assist the appetite and digestion. HALINI'TRON, (from xXs, and vilpov). Nitre ; more probably rock salt. HALLUCINATIO'NES, (from hallucinor, to err). See Dysesthesie. H A'LMYRAX, (from xXs, salt). The nitre produced in the valleys of Media. HALMYRO'DES, (from xXpvpos, salted). An epi- thet of some fevers, in which, according to Galen, the external parts communicate to the touch such an itch- ing sensation as is perceived from handling salt sub- stances. When applied to the skin, it signifies a roughness as if salted. It is also an epithet for many excretions that are salt and acrimonoius. HA'LO, (from xXus, an area, or circle. See Are- ola. HA'MBARA, and HA'MBRUS. See Succinum. HAMPSTEAD WATERS. See Aque mine- rales. HA'MULUS. An anatomical term applied to any process resembling a hook, as that in the pterygoid bone. HA'MUS. A hooked instrument for extracting a dead child from the uterus. HA'NDALA, (from handal, Arab.). See Colo- cynthis. HAOU'VAY. See Ahovai theveteclusii. HA'PSIS, (from x7r]u, to connect). The sense of feeling. It also signifies the connection of bandages ; and x-fyis «, anus). An epithet for remedies appropriated to the anus. HEDY'CROON, (from *)fo>s, sweet,) a mixture of a number of aromatic ingredients, formed into troches, said first to be invented and described by Androma- chus. Their composition is in some of the later dis- pensatories. HEDYO'SMOS, (from nfo>s, sweet, and ae-^, smell). See Mentha. HEDY'PNOIS, (from ifovs, sweet, and zrvea, to breathe). See Dens leonis. HEDY'SARUM GLYCYRRHIZA'TUM. See Glaux vulgaris leguminosa. HEDY'SMATA, (from nfovs, sweet). See Stym- MATA. HEL'CONIA, (from eXxes, an ulcer). An ulcer of the cornea. HELCY'DRION, (from tXxos, an ulcer, and vJty, water). A small ulcerous pustule. HELCY'STER, (from eXxa, to draw). A hook for extracting the fcetus. HELE'NIUM, (from Helene, where it grew. See Enula. Hele'nium I'ndicum. See Battatas Canad. HELEOSELI'NUM, (from eAe that of the powder is the same, though the extract is thought milder; but as an altera- tive, the tincture is usually preferred, of which a tea spoonful twice a day may be considered a common dose. See Neumann's Chemical Works. Tourne- fort's and Lewis's Materia Medica. HELMINTHIASIS. A disease in which worms are bred under the skin. HELMI'NTHICA, (from ixmvs, a worm). Medi- cines which destroy worms. HELOCAPO'LLIN. A sort of cherry. See Ca- POLIN MEXIC HERNAN. HELO'DES, (from ixos, a fen). An epithet of fe- vers, generated from marsh miasma, attended in the beginning with profuse but not salutary sweats. The sudor Anglicus is of this kind. See Typhodes. HELO'SIS, (from eixea, to turn). A disorder of the eye, consisting in an eversion or turning up of the eye lids. HELO'TIS. See Plioa polomca. HE'LXINE, (from ixxa, to draw; so called because it sticks to whatsoever it touches). See Parietaria. HEMALO'PIA, for Hemalopia ; q. v. HE'MERALOPS, (from wepx, a day, and a^, the eye,) by Rhazes dorea. A defect in the sight, which consists in being able to see in the day only, but not in the evening. See Nyctalops. HEMEROCA'LLIS, (from wepx, day, and *<**«?, beautiful; because its flower opens in the day and shuts at night). See Lilium rubrum. HEMICERAU'NIOS, (from nt^io-v, in composition, *iiu, half, and xeipa, to cut; because it was divided half way down). The name of a bandage, in Galen, for the back and breast. HEMICRA'NIA, (from «y*i, half, and xpxviov, the skull). See Cephalalgia. Hemicra'nia luna'tica. An erratic fever. HEMINA, (tkjuvx,) an ancient measure which differ- ed in its contents. That used in medicine was equal to about ten ounces. HEMIOBO'LION, or HEMIO'BOLON. Half an obolus, or the twelfth part of a drachm ; equal to five grains. HEMIO'LION, is, according to Galen, twelve drachms; and in another sense it is the same as sesqui- altera, the Avhole of a thing and half as much more, as sesquiuncia; sescuncia an ounce and a half. HEMIONI'TIS, (from mp.iovos, a mule; because, like a mule, it is sterile). Mule's fern. Hemionitis lan- ceolata Lin. Sp. PI. 1535. It grows in Italy; resem- bles the hart's tongue in appearance and virtues. See- LlNGUA CERVINA. HEMIO'NIUM, (from the same; because it is sup- posed to make women steril, like the mule). See As- PLENIUM. HEMIOPSIA,(from"«jtt<p, a husband). The seventh class of Linnaeus's system, in- cluding plants which have seven stamina. HEPTAPHA'RMACUM, (from ««7«, seven, and pxpftetxov, a medicine or remedy). -A plaster or oint- ment, containing seven ingredients, viz. litharge, wax, colophony, fat, 8cc. HEPTAPHY'LLUM, (from «r7«, seven, and pvXXov, a leaf). See Tormentilla. - HEPTAPLEU'RON, (from «r?«, seven, and irXevpx, a rib, furnished with seven ribs). See Plantago la- tifolia. HERACA'NTHA. See Carlina. HERA'CLEA, (from Heraclea, the city near which it grew). See Marrubium aquaticum. HERACLEI'OS, orHERACLEI'US. Herculean. Names of epilepsy, mania, and loadstone; from the great strength and poAver exerted. HERACLEO'TICUM, brought from Heraclea. See Origanum. HERA'CLIUM OLEUM; supposed to be the oil of box wood. HERA'CLIUS LAPIS. See Magnes. HE'RBA, (from the Arabic term erbah, from rabah, to germinate). Herbs, or plants whose stalks die to the ground every year. Those Avhose roots continue one year are called annual; if two years, biennial; and if durable, perennial. In common language, an herb is used in opposition to a tree. By Linnaeus the herb is put for that part of a vegetable which arises from the root, is terminated by the fructification, and compre- hends the stem, leaves, fulcra, and hybernacula. Herbs are to be gathered when the leaves are at their full growth, before the flowers unfold, except those whose flowery tops are preferred. They should be quickly dried, in a room heated by a fire to a degree equal to the hottest day, from 75° to 80°. Aromatic plants should be collected from warm dry soils; fetid ones from those which are moist and rich. All herbs and leaves should be gathered in clear dry days, as soon as the morning dew is dissipated. When herbs are properly dried, they are good while their colour re- mains, both for decoctions and distillation ; those that are good when dry are preferable to the same herbs in their green state. He'rba Pa'ris, (from the Trojan youth,) this herb bearing but one seed; uva lupina, solanum quadrifo- lium, herb Paris, herb true love, or one berry. Paris quadrifolia Lin. Sp. PI. 527. It is a low plant; grows wild in shady Avoods; flowers in April and May; the berry is ripe in July. Gesner observes, that its juice is narcotic; but it is not now used. See Raii Historia. For the herba Paris alba, see Absinthium VALESIACUM. He'rba Alexandri'na. See -Hipposelinum. He'rba benedi'cta. See Caryophyllata. He'rba Britannica. See Hydrolapathum. He'rba fe'lis. See Mentha cataria. He'rba ju'lia. See Ageratum. He'rba melancholi'fuga. See Fumaria. He'rba pe'tri. See Primula veris, under Para- Ipelysis. He'rba re'gia. See Basilicum, and Artemi- HER 744 HE 11 He'rba sa'ncte Ba'rbare. See Barbarea. He'rba sa'ncti Pe'tri. See Crithmum. He'rba ste'lla. See Coronopus. He'rba trinita'tis. See Heptica nobilis. He'rba vete'ribus igno'ta. See Cardamines. He'rba vi'va. See Caaco. HERBA'TUM CANADE'NSIUM ; panaces mos- chatum; sweet scented all heal of America. Aralia racemosa Lin. Sp. PI. 393. This plant is found in Canada; but is rather alimentary than medicinal. HE'RCULEA MEDICAMENTA. Named from their supposed extraordinary powers. HE'RCULES BO'VII. The name of a once famous emetic and cathartic preparation. HERMA'NNIA. Denominated in honour of Her- man Boerhaave. The name of an African genus similar in virtue to the marsh mallows. None are used in medicine; but if any have a claim to notice, it is the hermannia althaifolia Lin. Sp. PI. 141. HERMAPHRODI'TUS,(from "Epws, Mercury, and AppofotTij, Venus). An hermaphrodite; andria; a person supposed to be of both sexes; but the clitoris of a woman being of an extraordinary size, is all the peculiarity in this supposed species of the human kind. (See Cheselden's Anatomy.) In botanical language it is applied to flowers having both anther and stigma. Hence an hermaphrodite plant is that which has only hermaphrodite floAvers. HERMETICA MEDICINA. Hermetical medi- cine, is the medical system adopted by the chemists, at present deservedly exploded and forgotten. HERMETICUM SIGILLUM, the securest means of inclosing fluids in a glass tube, viz. by melting the neck, and closing or twisting it with a pair of pincers. HERMODA'CTYLUS, (from Hermus, a river upon Avhose banks it grows, and dactylus, a date, which it resembles). Hermodactyl; colchicum illyri- cum of Forskell and Gronovius; alsurengium; asaba; Hermes dactyletus; ephemeron; is' the root of a plant brought from the east; of the shape of a heart, and of a reddish, yelloAvish, brownish colour. When white and hard it is preferred. Each root is flatted on one side, with a furrow on the other. Though knoAvn from the time of Prosper Alpinus, it is singular that its species has not been accurately ascertained. It is highly probable that it is from the plant which fur- nishes the following medicine. It hath a viscous farinaceous sweetness to the taste, but no smell. The ancients say it is cathartic; but the dried ones which we receive are perfectly inert. Prosper Alpinus in- forms us, that the Egyptian women eat them as a means of becoming fat. They are not of any known use in medicine. See LeAvis's Materia Medica. Neumann's Chemical Works. Hermoda'ctylus fo'lio quadra'ngulo, called also iris tuberosa, iris bulbosa, and snake's head iris; iris tuberosa Lin. Sp. PI. 58. The root of this plant hath a tubercle, which is both emetic and cathartic. HE'RNIA, (from *fvo?, a branch, because it pro- trudes forward). A tumour, ecrexis ramex, and a rup- ture, as occasioning a tumour. In consequence of some sudden effort, a portion of the contents of some cavity is forced through the interstices of the containing parts, usually confined to the abdominal contents forced through the interstices of the abdominal muscles, or those openings designed for the passage of nerves and blood vessels. Dr. Cullen defines it an ectopia, or dis- placing of a soft part, though still covered Avith the skin and other integuments. From the situation of these tumours, their contents, or both, they obtain their respective denominations; oc- casionally taking their name from attending circum- stances. 1. Those from the situation are the umbilical, femoral, labial, scrotal, or ventral. 2. Those from the contents are the enterocele, epiplocele, entero-epiplo- cele, pneumatocele. 3. Those from attending circum- stances are, the incarcerated hernia, Sec. True and false hernia have been distinguished; but each is a tumour of the scrotum, and the former are from the abdominal viscera, beginning from above and descending down- Avards to the groin or scrotum; while the latter begin from beloAV and ascend upAvards; as the hernia hu- moralis, hydrocele, haematocele, and sarcocele. These are diseases in the part where the tumour appears; from the Greek term xtiXvi. The inguinal is the most frequent hernia; and the next to this is the femoral. The umbilical seldom oc- curs except in elderly women, Avho have been often mothers. A hernia of any other viscus, besides the intestines, is peculiarly rare. When the intestines fall down from the cavity of the abdomen,or rather of the peritonaeum, it is evident that this latter membrane must be carried with them, unless it should be ruptured or Avounded, which is seldom the case. When independent of wound,* the gut usually falls through those apertures, originally formed for the passage of the spermatic cord; and in women of the round ligaments of the uterus, or for the femoral arteries. These apertures are imperfectly closed with fat only; for they are not muscular, and therefore do not admit of contraction. It sometimes, however, happens that the intestine is forced through the fibres of the abdo- minal muscles; and one case is recorded in which the colon was pushed through the fibres of the diaphragm ; in others, the intestines have passed by the side of the oesophagus, by the vena cava inferior, or more rarely by the aorta into the thorax; the general cause is what- ever contracts the capacity of the abdomen, or violently forces the intestine against the apertures mentioned. Violent coughing, crying, laughing, costiveness, dysury, pregnancy, or whatever produces a deep inspiration, occasions this contraction, by the united exertions of the diaphragm and abdominal muscles. Suddenly lifting a heavy weight, which produces a deep inspiration, the jumping of a rough horse, and any other violent ex- ertion, have been followed by the same consequences. Independent of these causes, in Aveak persons the weight of the intestines will produce a similar effect. It is, therefore, common in warm climates; after long fevers in old persons; those who, with poor diet, have laboured hard; and it has been said, that those who eat large quantities of oil are subject to this complaint. This, however, can scarcely happen but in the warmer regions; and increased temperature alone predisposes to it. Hernia sometimes appears to be hereditary. There are other apertures through which the intes- tines sometimes, though very rarely, pass; as betAveen If Eh 745 HER the bladder and rectum, or the uterus and rectum, Avhen the tumour appears in the perinaeum ; by the is- chiatic notch ; or by the side of the sciatic nerve, Avhen they are seated under the glutaei muscles. Mr. Cooper mentions a singular hernia, where the intestine passed into the labia pudendi, falling under the branch of the ischium along with the internal pudendal artery, but continued into the pelvis, by the side of the vagina. In one case they passed between the laminae of the peritonaeum into the mesentery ; and, in another, into a bag formed by a separation of the laminae of the meso- colon. When the formation of the muscles is defective, the intestines may even protrude at the loins. Other viscera are occasionally displaced. The brain is sometimes protruded through the skull, when the- bones of the head are deficient; the lungs will occa- sionally pass through the fibres of the intercostal mus- cles ; and the uterus or bladder has been protruded through the parietes of the abdomen. These herniae are, however, uncommon. The sac which contains the intestines is, therefore, the peritonaeum, and the contents are most" commonly the omentum and the ilium; less frequently, in suc- cession, the colon, the coecum, and the jejunum : some- times only the appendix caeci vermiformis. The pe- ritonaeum in this situation is generally thickened; though, when the Aveight has been considerable, it has been found peculiarly thin. The rupture of the peri- tonaeum, which was supposed always to happen, and which gave a name to the disease, rarely occurs. The sac, however, has occasionally burst, particularly in one instance, by a Woav ; and where the intestines escape, from defective organization of the muscles, they are seldom in a sac, for the peritonaeum also is usually de- fective in the corresponding portion. The hernia con- genita and hernia cystica are equally destitute of the peritonaeal covering; and, in one instance, the umbili- cal hernia Avas without it, a circumstance Avhich should suggest extreme caution in the operation. The size of the sac differs from different circumstances, chiefly from the duration of the disease. The symptoms, how- ever, are not in proportion to the size. We have seen the most violent ones occasioned by a rupture not equal in size to a filbert. In general there is a pain and uneasiness in the tumour; and, Avhen it has been long down, the pain is often extremely violent, felt not only.in the tumour itself, but over the whole abdomen. If the discharge of faeces is suppressed, inflammation soon comes on, the gut is thickened, the aperture through which it passed becomes too small for its return, and what is called a strangulation ensues. Herniae are consequently divided into reducible, irreducible, and strangulated. Reducible herniae are those in which the intestine on lying doAvn spontaneously returns into the abdomen, or, at least, with the assistance of very gentle pressure, and may be retained there by the bandage styled a truss. Herniae are often irreducible from their size in conse- quence of inflammation; from the intestines containing hardened faeces, or flatus, which, from some obstacle at the ring, cannot be forced back. Sometimes membran- ous bands form across the sac, preventing the free motion of its contents; or the intestine is united by adhesions to the side of the sac. In each case the hernia is irre- ducible. The reducible hernia is more subject to stran- VOL. I. gulation than the irreducible; but the latter is much exposed to accidents, which are soon fatal. The strangulated hernia is a disease of the greatest danger. When the omentum only comes doiA-n, the symptoms are those of inflammation and mortification. In this case it seldom happens that the faeces are re- tained ; yet Ave have seen inflammation communicated from the prolapsed omentum to the intestines, and produce all the symptoms of complete hernia. In general, hoAvever, the pain and tension are not so great; the hiccough is less violent and constant. When the intestine, as well as the omentum, is strangulated, a violent pain is felt in the tumour, and a stricture round the body, about the navel, or somewhat above; frequent vomiting follows, succeeded by the evacuation of fecu- lent matter. All evacuation downward is checked; the pulse is quick, and at first hard; the tumour red and painful, often cedematous; the abdomen tense and sore; hiccough soon folloAvs; great anxiety appears in the countenance; the pulse sinks; and the patient appears to be expiring. Yet these violent symptoms will diminish, though the disease remain unchanged ; and a flattering remission Avill come on, again to be succeeded by the distressing symptoms just described. These, at last, appear to yield almost suddenly: the patient is apparently easy, but the abdomen becomes more tense, the tumour of a darker colour; and death soon follows. The symptoms of the true herniae apply in a consider- able degree to prolapsed intestines in every part; and when we consider, in this detail, symptoms of pro- lapsed intestine, Ave shall scarcely fail to recognize the appearances wherever the accident happens; if, with these, we combine the injured functions of the part, and the chances of the intestines escaping into the cavity of the organ affected. See Bubonocele. This accident being unattended with any division of the containing parts, the whole of the disease must be considered as a change of situation of the parts Avithin. Were these immediately returned and kept in their place, the disorder would entirely cease; but in that preternatural situation they are pressed upon by the ten- dons through which they pass, and inflammation, with mortification, supervenes. This, hoAvever, is not owing to any change of state in the tendons, but merely to their natural elasticity, acting upon an increased and yielding subjacent bulk. The obstacle to the reduc- tion of the prolapsed contents is, therefore, the in- creased bulk which they have acquired from inflamma- tion in consequence of stricture, by which they are in- capable of returning through the same passage at which they escaped. If assistance is called in time, the return of the pro- trudecLparts must be attempted by such means as pro- duce a contraction of the vessels and diminish the bulk »of the solids: viz. cold, astringent, and stimulating ap- plications. Emollients cannot relax the tendons, but often enlarge the bulk of the hernia, and render its re- duction more difficult. Cold astringents should be im- mediately applied, and cold itself is an useful remedy. Ice, iced water, cold produced by the evaporation of vinegar and ether, are highly useful applications: at the same time these may be assisted by gentle but con- tinued compression on the part Avith the fingers, or with small bolsters of soft linen cloth. By continuing these 5 C H E H 746 H E R efforts for some time, the vessels are visibly less di- minished, the swelling grows flaccid, the stricture gives way, and the disorder is removed. When all proper attempts fail to reduce the contents of an hernia, the sooner the operation called celoto- mia is performed (see Bubonocele), the better; but when there are evident signs of the intestine being in a mortifying state; Avhen the pulse and countenance sink; and when the tumour has lost its elasticity ; Mr. Gooch recommends making an incision into the tumour, ample enough to evacuate the faeces freely, which may effectually remove the strangulation of the intestine at the abdominal ring, and then to treat the wound as a mortification, allowing nature to throw off the mortified slough. If it is doubtful in what condition the parts contained in the tumour are, the operation must be cautiously proceeded on, till we can see the state of the intestine : if that is mortified, it may be opened; and if the evacuation of the faeces do not effectually make Avay for the return of the parts, the abdominal ring must be opened by incision. But, after replacing the hernial contents, to retain them requires very often the assistance of a bandage, or a proper compress. Mr. Pott observes, " All that can be done by surgery towards the cure of the hernia is, to replace the prolapsed body or bodies in the cavity of the belly, and to prevent them from slipping out again. When Avhatever formed the tumour is replaced, the surgeon hath done his part; the rest is nature's: whe- ther the tendinous aperture will so contract as to pro- hibit a future descent or not is matter of uncertainty, and not to be known but from the event." When a rupture happens, and is unattended with any signs of stricture, or other violent symptoms, a bandage or a truss will be the most eligible means of relief. The modes of operation when the knife is necessary will be afterwards explained. He'rnia aquo'sa. See Hydrocele. He'rnia bronchia'lis. See Bronchocele. He'rnia carno'sa. See Sarcocele. He'rnia - ce'rebri. A rupture of the brain; a PROTRUSION OF THE CEREBRUM, Or CEREBELLUM, through an opening of the bones of the cranium not perfectly ossified, discoverable by a protuberance, dif- fering with respect to magnitude, figure, and place of the cranium which it occupies, covered with the common integuments, preserving their natural colour, unless a gangrene has supervened. The protuberance is soft and indolent, resisting the touch, and painful only when inflamed, usually fluctuating, surrounded at the circumference of its basis by a bony circle, which may be traced by the fingers, and discovering a defect of ossification: it is peculiar to infants, attended, at least, in the beginning, with no violent symptoms, if the tumour is small, and situated in the vertex, or sides of the head; but palsy, stupor, and convulsions come on if it be large, or if in the occiput. The disease must be carefully distinguished from a spurious aneurism, which often in infants arises from a blow, or violent pulling of the hairy scalp. Trew, and Le Dran, cured this complaint by placing thick compresses, moistened with spirit of Avine, or aqua vitae, upon the part affected, for several weeks, renewing them every twenty-four hours. See Sauvages' Nosologia, vol. i. p. 217. War- ner's Observationes Chirurgicae, xi. 59. He'rnia conge'nita, is a rupture Avhere the intes- tine and testicle are in contact. The testes are origin- ally situated in the abdomen, just beloAV the kidneys, and gradually descend near the time of birth through the sheath of the spermatic chord into the scrotum, each carrying along with it an external coat, which in each is the tunica vaginalis. This discovery was made by Dr. Hunter, in the year 1755, and demonstrated in his public lectures that year. Soon after the birth of the child, the communication between the tunica vaginalis and the abdomen is obli- terated by a stricture of the parts, and an accumulation of fat; but if the intestine falls very soon, these de- fences are not formed. In the treatment of congenital ruptures, the manage- ment is nearly the same as in the bubonocele. See Bell's Surgery, vol. i. p. 340. Dr. Wrisberg observes, that, in his dissections, he several times found a part of the omentum or intestines adhering to the testicle in the abdomen of the foetus, and in such cases a hernia congenita must take place. The same, he adds, will occur, when the peritonaeum, in its course over the seminal vessels to the mesentery, sends off a minute process to the ilium or coecum, and by means of it draws down the intestines on the right side, which is the common seat of the hernia congenita. See the London Medical Journal, vol. i. p. 376. White's Surgery, p. 332. He'rnia crura'lis. See Hernia femoralis. He'rnia cy'stica. See Hernia vesicalis. He'rnia femora'lis, crura'lis femoroce'le. This species of rupture is the same in both sexes, and formed by the falling of the omentum or intestines, or both, into the inside of the thigh, through the arch made by the os pubis and ligamentum Fallopii, where the iliac vessels and tendons of the psoas and iliacus in- ternus muscles pass from the abdomen. (See Bubono- cele.) The methods proposed for ruptures in gene- ral will often succeed ; and if the operation is necessary, it is the same as for the bubonocele, with the difference of dilating the ligament instead of the rings of the mus- cles : the dilatation must be made obliquely outwards, instead of perpendicularly upwards, to avoid dividing the spermatic vessels in the male, or the round liga- ments in the female ; but the pressure must be made directly upwards. Authors, however, are by no means clear respecting the means of avoiding the division of the spermatic vessels and round ligaments. Indeed it seems very difficult, and almost impossible. The directions of Mr. Borret in the Medical and Physical Journal are the most clear and precise. When the fascia and sac are laid bare, he observes, that Pou- part's ligament is seen binding down the sac, which must be divided; but to avoid injuring the parts men- tioned, he advises making a small incision between the fibres of the external oblique about half an inch above the ligament, and to pass a director under the ligament, and over the artery, on which the operator may safely cut. The stricture must then be divided inwards to the pubes, inclining Pott's knife rather obliquely downwards. See White's Surgery, p. 324. He'rnia flatule'nta. See Pneumatocele. He'rnia fora'minis ma'gni i'schii. In this her- nia the intestines or omentum fall through the great hole of the ischium into the internal part of the thigh, HER 747 HER between and under the two anterior heads of the triceps muscle. It is owing to a great laxity of the ligament, and the intestine must lie behind the pectineus; so that no pressure can be employed, and no operation can be successful, because the orifice cannot be dilated, on account of the vicinity of the vessels. He'rnia gu'tturis. See Bronchocele. He'rnia humora'lis; infiammatio teStium ; though often an inflammation of the tunica vaginalis only. Dr. Swediaur thinks that the testicle itself is never swelled, or in the least affected, in the beginning of this com- plaint, and that the only affected part is the epididymis. He adds, if the testicle ever swells, it is from the inflam- mation extending in consequence of bad treatment. It usually is owing to a venereal inflammation, though it may also happen from irritation, or external injuries ; and is subject to the usual termination of inflammation. This disease is often induced by a stoppage of the venereal gonorrhoea, not from the poison itself, but from the inflammation extending to the mouth of the excretory ducts of the seminal vesicles ; in which case, brisk purgatives, if they produce a return of the dis- charge, are useful, for this is the quickest method of re- lieving the complaint. Vomits, when the constitution can bear them, are useful while the tumour is in the in- flammatory state ; but are best given when the inflam- mation begins to yield. The ipecacuanha would be as useful as the hydrargyrus vitriolatus, if its activity were equal. Whatever be the cause, bleeding, according to the strength of the patient, is necessary; and an active pur- gative must follow. Goulard's saturnine water should be applied cold by means of rags folded several times, and repeated as often as they grow warm; a mixture of vinegar and brandy, or any other discutient lotion, will be nearly as effectual. (See Lotio.) If these remedies do not succeed in a few days in removing the violent pain, or diminishing the tumour, leeches must be ap- plied to the part; and in every stage opiates, in large doses, alternated with laxatives, given. The patient should lie on his back, in a large room, with little external covering; and even in this state the swollen testicle should be supported. Mercury may be employed if any induration remain, but the tumour it- self is wholly Inflammatory, and does not require this remedy. Thus, if the part is suspended properly, and if the patient can conform to lie much on his back, this tumour will be removed in a short time, without the usual violent pain, or the hardness remaining after- Avards, which is almost the constant effect of emollients. If, notwithstanding all our care, a suppuration come on, an emollient cataplasm must be applied warm, and con- tinued until the matter is discharged. The knife is usually preferred for opening the abscess, but great caution is necessary that the testicle be not wounded : the dressing may be the same as directed for abscesses in general. On abscess in the testicles, see Kirkland's Medical Surgery, vol. ii. p. 256. Dr. Swediaur proposes in cases of virulent gonorrhoea to prevent this disease, that the patient avoid exposing himself to cold, violent exercise, or venery, and that he keeps the scrotum duly suspended. If hernia humoralis occurs, he attempts, first, to allay the irritation, and then to recall the poison to its former original seat, If the pulse be quick, full, and strong, he advises bleeding immediately. If costive, a clyster should be administered, and the patient sit half an hour in a warm bath, or on a perforated chair over the steam of hot water, previously suspending his testicles. He must then go to bed; a warm dry bag truss should be immediately put on; a Avarm bread poultice applied to the penis; and a full dose of opium given by the mouth, or in a clysterwith lintseed oil. The opiate must be repeated every twenty-four hours, and the parts ex- posed two or three times a day to the steam of hot water. The design of the poultice to the penis, and the hot steams, is to reproduce the discharge; but though this be useful, it is not essentially necessary, for the disease is evidently not a translation of the poison, but of inflammation only. See Dr. SAArediaur's Observa- tions on Venereal Complaints. Aikin's Observations on the Preparations of Lead. London Medical Observa- tions and Inquiries, vol. iii. p. 152. He'rnia incarcera'ta. It is styled an incarcerated or confined hernia when the protruded intestine can-? not be returned; from its adhesion, or from the bulk of its contents. The symptoms of the disease are, a swelling in the groin, and upper part of the scrotum, very painful to the touch, and resisting the pressure of the fingers; the pain is increased by coughing, sneezing, or standing upright; frequent vomiting; and a fever, with obstinate costiveness, presently comes on, which is soon fatal. Very copious or repeated bleeding, and a proper posture, are the principal helps; the patient should be laid with his hips much higher than his shoulders, and thus by gently raising the scrotum, and a light pressure on the tumour, the intestine may return. The tobacco clyster is highly beneficial; made by infusing two drachms of dried tobacco in one pint of boiling water, for the space of ten minutes. It acts by producing nausea, and diminishing irritability. See Bubonocele. Lon- don Medical Journal, vi. p. 118, 259. Edinburgh Me- dical Commentaries, v. 270. He'rnia inguina'lis. See Bubonocele. He'rnia intestina'lis. See Hernia scrota- lis. He'rnia lachryma'lis. When the tears pass through the puncta lachrymalia, but stagnate in the sacculus lachrymalis, the tumour is styled hernia lachry- malis, with little propriety or precision. It is with equal impropriety called by Anel, a dropsy of the lachrymal sac. If the inner angle of the eye is pressed, and an aque- ous humour flows out, the disease is the Fistula la- chrymalis, q. v. Kirkland's Medical Sureery, vol ii. p. 135. He'rnia omenta'lis. See Epiplocele. He'rnia scrota'lis, he'rnia oschea'lis, and he'r- nia enteroschoce'le ; also intestinatis, ecptoma, en- terocele; by Paracelsus, crepatio, or crepatura. When the omentum, the intestine, or both, descend into the scrotum, it has these appellations; when the omentum only, it is called epiploscheocele. It is styled a perfect rupture, in contradistinction to a bubonocele, which is the same disorder; but the descent is not so great. The hernia scrotalis is distinguished into the true and false; in the former the omentum, or intestine, or both, fall into the scrotum ; in the latter, an inflamma- tion, or a fluid, causes a tumour in this part, as in hernia 5 C 2 HER 748 HER humoralis, or hydrocele. Sometimes sebaceous matter is collected in the scrotum ; and this hernia is called steatocele. He'rnia umbilica'lis ; epiploomphalon, omphalo- cele, exomphalos, omphalos; and when OAving to flatu- lence, pncumatomphalos. In this disease the omen- tum, intestine, or both, protrude at the navel, and it can, in general, only be palliated. White's Surgery, p. 323. He'rnia u'teri; hysterocele. Instances have occurred of the uterus being thrust through the rings of the muscles ; but this is scarcely to be discovered, unless in a pregnant state, when the strugglings of a child would discover the nature of the disease. In that state, however, it could scarcely ever occur. It is the ecrexis of Hippocrates. He'rnia vagina'lis. There is naturally a deep cavity between the rectum and the back part of the uterus, from the peritoneum descending pretty low, and forming a kind of sac, in which a portion of the small intestines in the unimpregnated state lies. The intestines, by pressing occasionally against the perito- neum at this depending part, deepen this cavity, and separate the back part of the vagina from the fore part of the rectum, thus forming the tumour in the vagina, called a hernia vaginalis. He'rnia in Vagi'na. See Colpocele. He'rnia varico'sa. See Cirsocele. He'rnia vento'sa. See Pneumatocele. He'rnia ventra'lis, hypogastrocele. This may happen in almost any point of the fore part of the belly, but most frequently between the recti muscles, either above or below the navel; and is only to be relieved by returning the protruded parts, and preventing the recurrence of the hernia by a proper bandage. The tumour which requires this operation is seldom bigger than aAvalnut; so when there are the symptoms of a hernia, and yet no appearance of one in the groin, the belly should be examined. In obstinate cases of ileus, also, it is proper to examine every part of the abdomen, for the most violent symptoms may arise from a very small hernia of this kind. The stricture must be relieved by dilating the part, as in other cases; but after the ope- ration a bandage must always be worn, as the cicatrix may be ruptured. White's Surgery, p. 324. He'rnia vesica'lis, seu cy'stica. In this species, the urinary bladder is the part protruded, either in the » groin or scrotum, through the opening in the external oblique muscle of the abdomen ; in the fore part of the thigh under Poupart's ligament; or in the perinaeum. Through some of the muscular interstices of that part, the bladder has been pushed into the vagina, and formed hernial tumours of no inconsiderable magnitude. The common attendant symptoms are, a tumour with fluc- tuation, either in the groin, the fore part of the thigh, or perinaeum. The tumour subsides on pressure, and occasions either a desire to make water, or an involun- tary discharge of urine.' When the swelling is large, it is necessary that the tumour should be elevated as much as possible before the urine can be discharged; but when small, and no stricture occurs, water is generally made with great ease. When this complaint is simple, and no part of the intestine has fallen down, it com- monly proceeds from a suppression of urine; so that every cause of suppression ought to be guarded against; and Avhen no adhesions take place, if the protruded portion of the bladder can be reduced, a truss, properly fitted, should be worn for a considerable time. When the bladder cannot be reduced, Avhile no symptoms occur to render the operation necessary, a suspensory bag to support the prolapsed parts, without producing severe pressure, is the only probable means of relief. When a portion of the bladder happens to protrude into the vagina, after reduction, future descents may be prevented by the use of a pessary ; and the same means will be suocessful'in preventing a falling doAvn of part of the intestinal canal into the vagina: a species of rupture which now and then occurs. But should the protruded parts be attacked Avith pain and inflammation in con- sequence of stricture, so as to render the operation ne- cessary, we must proceed, as in similar cases, to divide the parts occasioning the stricture ; but if the bladder adhere to the rupture of an intestine, great caution is required, should the operation become necessary, to avoid wounding the bladder. See Le Dran's Operations. Memoires de l'Academie Royale de Chirurgie. Sharp's Operations. Sharp's Critical Enquiry. Arnaud on Ruptures. Pott on Ruptures. Gooch on Wounds, p. 427, &c. Aikin's Observations on Preparations of Lead, p. 91, &c. Bell's Surgery, vol. i. p. 369 to 377. HERNIA'RIA, (from hernia, a rupture). Rupture- wort ; (from its supposed efficacy in curing ruptures). Polygonum minus, millegrana major, herniaria glabra Lin. Sp. PI. 317, is a small spreading plant, found in sandy ground; flowers in June and July; supposed to be diuretic and astringent. HE'RPES,velE'RPES,(from'^7ra, to spreador creep, from their quickly spreading). Tetter. Dr. Cullen places this disease in the class locales, and order dialyses; and defines it, phlyctenae, or a great number of small ulcers crowding together, creeping and difficult • to heal. These ulcers in the skin are sometimes divided into five species. The simple, which consists of single sharp- pointed pustules of a yellowish white colour, inflamed about their bases, and naturally dry. They burn, itch, and smart a day or two, and then disappear. The tetter, ring worm, or serpigo; darta; are the same in appearance, except that they accumulate in lit- tle masses; they are more permanent, for they contain more corrosive matter; they smart and itch more violent- ly, penetrate the skin, and spread considerably, without forming matter, or coming to digestion. The cure is frequently difficult; and they sometimes return at cer- tain seasons. If the disease is constitutional, slight mer- curials are necessary; and a solution of hydrargyrus muriatus in lime water, in the proportion of sixteen grains to a pint, may be used as a lotion, or the white calx of mercury, combined with common ointment, may be rubbed on the part. About two scruples may be added to an ounce. When serpigo is constitutional or scorbutic, the great water dock root may be em- ployed, either with or Avithout the mercury, in the form of a diaetetic decoction. Shingles, or zona aurea, herpes zoster, synonymous in Dr. Cullen's system with his erysipelas phlyctaenodes, as sometimes accompanied with inflammation and fever. It appears in large clusters, on the neck, breast, loins, hips, or thighs : the heads are white and watery, and suc- ceeded by a small round scab resembling a millet seed, HER 749 HER and called from thence herpes miliaris. In general the treatment is the same as in erysipelas: the chief indica- tion is to take off the irritability of the system ; and for this purpose the cortex Peruvianus and camphor are the best remedies. The prognostic of death from its sur- rounding the body is false; the malignity of the disease alone affording the only ground of fear. There is a chronic kind peculiar to old people, troublesome from the itching it excites, and sometimes dangerous. The bark internally, and externally, the lime water, occa- sionally with a small proportion of the muriated mer- cury, often succeed. These tAvo kinds were called by the ancients vermis repens; ver7nis mordica7is; formica 7niliaris. Wiseman calls them ambulativa. Herpes depascens^ noma, noli me tangere, ulcus de- pascens, esthiomenus,formix; and by Celsus ignis sacer, because, like the ulcerated erysipelas, it penetrates to the flesh, raising the skin, chiefly on the scalp, into scales of different thicknesses, and leaving a hard swelling on the part. Dr. Cullen thinks it an erythematous in- flammation. It resembles an ulcerous erysipelas of a most corrosive kind. The hydrargyrus muriatus, as directed in the lues venerea, with a decoction of the woods, or sarsa, is useful in this complaint; and the sores may be washed with a solution of hydrargyrus muriatus in aq. calcis. A dose of jalap every fourth day, with an electuary containing two parts of the bark to one of sassafras, has been successful. The mineral acids are sometimes very advantageous; and in this species the tincture of cantharides, recommended by Dr. Mead, we have found useful. Mr. Bell, in his Treatise on Ulcers, places the tinea and the herpes, as varieties of that species of ulcer, which he denominates cutaneous; adding that the cutaneous ulcer, in all its varieties, may be included in the herpes farinosus, or dry tetter; herpes pustulosus, including the crusta lactea; the tinea capitis (see Achor); herpes miliaris; formica miliaris, cencjirius, of which the ring Avorm is a variety; and the herpes exedens, including the ulcers called depascent and phagedenic. The herpes farinosus is the most simple kind. It appears on any part of the body, most frequently on the face, neck, arms, or wrists; comes, out in broad spots, consisting of very small red pimples, attended with a troublesome itching, which soon fall off in the form of a white powder resembling fine bran: they leave the skin perfectly sound, but the pustules return in the form of a red efflorescence, fall off, and are covered Avith bran as before. The herpes pustulosus occurs most frequently in children, generally in the face, and behind the ears; often on other parts of the head, but rarely on the body. It appears in the form of pustules, which are originally separate and distinct, but afterwards run to- gether. At first they seem to contain nothing but a thin Avatery serum, which afterwards turns yellow, and, exuding over the AYhole surface of the part affected, at last dries into a thick crust or scab: when this falls off, the skin below frequently appears entire, with only a slight degree of redness on its surface; but when the matter is more acrid, on the scab falling off, the skin is found slightly excoriated. See Achores. The herpes 7niliaris generally appears in clusters, though sometimes in distinct circles of very minute pimples. These are at first perfectly separate, and contain only a clear lymph, which, in the course of the disease, is excreted upon the surface, and forms small distinct scales, that fall off, and leave a considerable inflammation. From hence fresh matter exudes, with the same consequences. The itching in this ulcer is always troublesome, and the matter discharged so tough and viscid, that Avhatever is applied to the part adheres so as to be removed with difficulty. The Avhole body is subject to this disorder, but it most frequently ap- pears on the breast, perinaeum, scrotum, and loins. The herpes exedens discovers itself on any part of the body, but mostly about the loins, Avhere it sometimes spreads to such a degree as to encircle the Avaist. At first several small ulcerations appear collected into larger spots of different sizes and various figures, Avith always more or less of an erysipelatous inflammation. These ulcerations discharge a thin, sharp, serous matter, which sometimes forms into small crusts, that soon fall off; but the discharge is often so thin and acrid, as to spread, and produce similar sores around. Though these excoriations, or ulcers, do not in general proceed further than the true skin, yet the cellular membrane, and, on some occasions, the muscles themselves, are destroyed. Dr. George Fordyce describes a variety of this dis- ease under the name of herpes rapiens; and adds that it arises upon the head in small ulcers, covered Avith a browrt, moist, shining crust, similar to venereal ulcers. It is cured, he observes, by the same methods which remove venereal ulcers. In these cuticular diseases the fluids have been sup- posed vitiated, and repellents generally unsafe. This is certainly in a great measure true; and in young per- sons, as well as in robust habits, topical remedies must be employed Avith caution. In such cases the neutral salts are generally useful; and mercurials, antimonials, or both combined, are necessary at night, assisted in their operation on the skin by opium. In the more debilitated habits, bark with the warmer diaphoretics, particularly the mezereon, are proper, with the mine- ral acids, and a more generous diet. In all cases, bath- ing in the warm bath, and the utmost cleanliness in every respect, will be salutary. In the weak habits, and in old persons, external re- medies are most effectual. Simple lime water will be often useful; and about ten grains of hydrargyrus mu- riatus to a pint of distilled water, with a small propor- tion of muriated ammonia, is often a beneficial external remedy. In all cases, saturnine applications are either useless or injurious. Mercury must be sometimes con- tinued with the warmer diaphoretic alteratives for a long time; and this has given credit to Spilsbury's drops, which are only a solution of muriated mercury. When the disease recurs, which is not uncommon, a milk and vegetable diet, Avith issues, and frequent doses of neutral salts, are the best prophylactics. If the dis- ease has produced a deep foul ulcer, the preparations of zinc are the most useful applications. See Tulpius, lib. iii. Marc. Aurel. Severinus, lib. iv. de Abscessibus, cap. 9. Turner's Diseases of the Skin.' * Bell on Ulcers, article Cutaneous Ulcer, edit. iii. p. 345. White's Surgery, p. 26. He'rpes. See Purpura scorbutica. HIB 750 HIE He'rpes facie'i. In some constitutions, especially in females, the face is particularly liable to a species of herpes, peculiarly distressing to practitioners. Mer- curials, Avith decoctions of sarsa and mezereon, some- times succeed; occasionally the Dover's powder, with a small proportion of muriated mercury. Frequently all fail; but the following composition has sometimes been effectual. R. Sulphuris praecipitati 3 ij- cerussae apetatae 3 i. aq. rosarum 5 viij. m. nocte maneq. uten- dum, phiala prius agitata. See Bell on Ulcers, p. 373. He'rpes fe'rus. See Erysipelas. He'rpes serpigo. The ring worm ; a cutaneous affection common in India, in which the eruption is circular, with a cavity in the middle, apparently sur- rounded by a ring. The remedy is the cassunda vine- gar. An ounce of the fresh bark, roots, tops, or flowers, of the cassunda (cassia sophera Lin. Sp. PI. 542) are boiled in a pint of vinegar to eight ounces, and a drachm or two applied two or three times a day, previously cleaning the part with soap and water. When this does not succeed, a mild mercurial course, interposing purgatives, with a milk and vegetable diet, has removed the disease. HERPE'TON, (from epiru, to creep,) a creeping pustule or ulcer. Hippocrates. HERRING. A species of clupea, a rich, oily, and sufficiently wholesome food in strong stomachs. When dried in the smoke, they are very indigestible. The regular migration of herrings has been lately doubted, and their successive appearance on different shores ac- counted for from their coming to the shalloAver water for the purpose of depositing their spawn. HE'RVA DE A'NIL LUSITA'NIS. See Indicum. HE'SPERIS, (from etnrepx, the evening, so named because it smells most in the evening). Hesperis matro- nalis Lin. Sp. PI. 927. It is said to be diaphoretic and antiseptic; but is unknown in modern practice. He'speris a'llium. See Alliaria. HETEROGE'NEUS, (from 'elepov, alterum, and yev<&, kind). See Anomceomeres. HETERORRY'THMUS, (from elepos?another, and pv8(Ms, number). See Arythmus. HE'TICH I'NDIS, AMERICANUM, vel iETHI- OPICUM. A species of turnip in America, with leaves like those of briony: the root is as thick as two fists, and a foot and a half long. It is agreeable food, and aperitive. HEUD, or HEUDE'EN, (heud, Arabic). See Agallochum. HEXAGY'NIA, (from e£, six, and ywq, a woman). A class of plants, so named because they have six pistils, or female organs. HEXA'NDRIA, (from «|, sex, and xv^, vir). The name of the sixth class of Linnaeus's system, compre- hending those plants which have hermaphrodite flowers, with six equal stamens. HE'XIS, l|/5, (from i%e/, to have). A habit. It is a permanent habit, in opposition to diathesis, or a transient disposition, which may more easily be re- moved. See Consuetudo. HIBE'RNICUS LA'PIS, (from Hibernia, Ireland). Irish slate, tegula Gallis, ardesia Hibernica; lapis fissilis Hibernicus; argille schistense tabulaire Haiiy, iv* 447; argillite of Kirwan; is a kind of slate, or soft stone, found in Ireland and other countries, of a bluish black colour, staining the hands. When powdered it is whitish at first, but soon grows blacker; yielding in the fire sulphureous fumes, and acquiring a pale red colour. It is an argillaceous earth, with flint, lime, magnesia, and iron in a very small proportion. It is supposed to be an astringent, and was formerly given in haemorrhages, and to prevent the bad effects of bruises. It is now totally neglected. See Lewis's Materia Medica. Neumann's Chemical Works. HIBI'SCUS, (from iQis, a stork; said to chew and inject it as a clyster). See Althea and Ketmia. Hibi'scus abelmo'schus. See Abelmoschus. HIDRO'A, (from i, a stone). A calculus found in the stomach or intestines of a horse. See Calculus. HIPPO'MANES, (fromtTTos, a horse, and fixivo/uxi, to be mad,) a name of the cynocrambe, apocynum, or cynomoron, because, when eaten, it seems to produce madness in horses. It sometimes means the juice of tithymalus, and occasionally the secundines of a mare, or the fleshy substance which adheres to the forehead of a foal. HIPPOMA'RATHUM, (from ;**■•«, a horse, and (*xgx6pov, fennel. Horse fennel; and English saxifrage. See Raii Hist. Plant. Saxifraga An- glica. HI'PPONE. The name of a malagma described by .Etius. HIPPO'PHiES, HIPPOPH.E'STUM, (from its juice purging horses). Dioscorides describes it in lib. iv. cap. 162; but it is not known to modern systematics. The synonyms, according to Dale, are the cnaphos rham- nus, lappago, hippomanes; and it is probably the hip- pophae rhamnoideshin. Sp.Pl. 1452; the rhamnus salicis folio angustiorefructufiavescente of C. Bauhine. The purging thorn. It grows in the Morea, and the juice is an active purgative. Though the rhamnus H I R 752 H I R ratharticus and the tithymalus maritimus vel spinosus have also been considered as synonyms, they seem to have different properties specified under their separate titles. HIPPOSELI'NUM, (from «W«?, a horse, and treXivov, purslane; so named because it resembles a large kind of purslane). Alexanders; Smyrnium, mace- rona, herba Alexandrina, grielum,agrioselinum, Smyr- nium olusatrum Lin. Sp. PI. 376 ; an umbelliferous plant, with leaves like srnallage, but larger. It is a large kind of parsley, and was formerly blanched in gardens for culinary use. The seeds, macedonensium semina, are bitterish, aromatic, and carminative, yielding their virtue to rectified spirit of wine, but not fully to water. The roots are bitter, and recommended as resolvent, diuretic, and emmenagogue. On incision they yield a whitish juice, resembling myrrh; whence the plant hath been called, from one of the names of that gummy resin, Smyrnium. See Raii Historia Plantarum. HI'PPUS, (from 'ittttos, equus, a horse). A trem- bling and twinkling of the eyes, supposed to be usual with those Avho ride on horseback. Gorraeus thinks it is an affection contracted from the birth, owing to a convulsion in the muscle which sustains the eye. HI'RA, (from hir, the palm of the hand ; because it is usually found empty,) sometimes supposed to mean the jejunum ; at others extended to all the intestines, or even all the contents of the abdomen. HIRAPITA'NGA. BRASILIE'NSIBUS. See Brasiliensium lignum. HI'RCUS BEZOA'RTICUS,(quasih'irtus,from his shaggy hair). The goat which affords the oriental bezoar. See Bezoar orientalis. HI'RQUUS, (from Igxos, a hedge). The great angle of the eye. HIRSU'TIES, (from hirsutus, hairy). Unnatural hairiness of the body. HIRUDO,(quasiAa?/rwdo,from haurio, to draw'out). The Leech ; sanguisuga, exos ; first noticed by Themi- son. Those whose backs are striped, and bellies spotted, which are taken from clear running waters over a sandy bed, are preferable. The hirudo is a genus of aquatic vermes, characterised by an oblong body, very contractile ; having each ex- tremity capable of being expanded into a fleshy disc, by which they adhere to the body, with a kind of suction similar to that of a cupping glass; a triangular mouth situated under the anterior extremity. The body of a leech is composed of numerous rings, or rather circular muscles, by which the particular mo- tions of the animal are performed. Their skin is un- equal and tuberculous in different degrees, in the dif- ferent species, but always feels smooth to the touch, because it is covered by a slimy fluid, designed to faci- litate its motions. Their head, in a state of contraction, is more pointed than the opposite end : but each ex- tremity is equally enlarged avhen they fix. The mouth of the leech is a triangular aperture, placed at the bottom of what may be styled the anterior cupping glass, armed with three very sharp, strong teeth, which can pierce even the skins of horses and oxen. It is an instrument with three cutting edges, each of which is furnished with sixty little teeth. At the bottom of the mouth is a nipple of a firm fleshy consistence, which sucks the blood that exudes from the triangular Avound by exhausting the air. In this operation the nipple fixes on the skin, and when drawn back a vacuum en- sues. After the wound is made, the action is apparently repeated, and the poAver is so considerable as to fill the vessels around; a circumstance from which both ad- vantages and inconveniences arise. We next find the larynx, whose strong fibres contract the diameter of the canal, and carry the blood, which has been drawn, into the stomach. This A'iscus con- sists of a series of membranous sacs, furnished Avith valves, Avhich can retain the blood for many months without coagulating. In a leech of a moderate size there are about tAventy-four of these sacs. As the blood which they draAV contains no heterogeneous par- ticles, they require no aperture to carry off the excre- mentitious parts, and have consequently, it is said, no anus. M. Morand, from whose Memoir on Leeches -much of this description is drawn, thinks that the slimy- moisture on the surface, which is throAAm off in blackish filaments, found in the water they inhabit, may form the whole of the excrementitious fluids of the constitu- tion. On each side, under the belly of the leech, are tvA'o longitudinal vessels Avhich divide into branches; contract and dilate; carrying a grey fluid. In the middle is a nervous cord, composed of twenty-three ganglia; and on each side glands filled with a clear liquor. These glands have several vessels, which are lost in the body of the animal. So distant from the truth are those physiologists who deny that the Galvanic power acts on the nerves, because leeches are affected by it, supposed to have no nerves. Leeches seem to breathe by the mouth, but have no organs which correspond to lungs. Insects which breathe by lateral spiracula are killed when covered with oil. When the leech is put into oil, it lives many days, and a slough separates from it, so tenacious, when taken out, as to retain the form of the body. The greater number of leeches have eyes, and some species have so many as eight; but in others no such organ has been observed. These animals swim, like eels, by a vermicular motion ; but this is more generally in a longitudinal than in a lateral direction. When they walk they fix the fore part of the body by the mouth, and then draw the back part. They then fix the latter, and extend the former. When the greater number of the species of hirudo are cut transversely, the two parts do not immediately die, for the head liyes considerably longer than the tail. If the section is not complete, the animal raises the wounded part above the water, and keeps it in the air, till each end is cicatrised, for the parts never unite; and the fluids, usually carried downAvards, are dis- charged in abundance from the wounded part. The operation greatly weakens them, and they soon become a prey to those Avith whom they are placed, after the cure has been completed. Leeches are hermaphrodites, and generally viviparous. The organs of generation, according to Redi, resemble those of a snail. The penis lies under the oesophagus, and the aperture of the vagina immediately below it. Their young are born in the earliest part of the spring. As the animals are semitransparent, the young are seen in the body of the mother, in the form of round seeds, and seventy have been counted in a single leech. In II I R 7 their progressive state they seem to groAv not only by evolution but by augmentation, as the number of the rings seems to increase. They are found in fresh and salt water. The former prefer lakes or ponds where a great quantity of vegetables groAv. They are common in every part of Europe; but less so in the southern regions. They appear to live for many years ; but, in- dependent of the danger of the lakes being dried, or the waters putrifying, they are devoured by fish, water foAvl, by the larvae of insects, and by the insects themselves. They also devour each other; and Vauquelin found that the hungry leeches bled without mercy those which w ere full. When in Avant of blood, they suck the larvae of insects, worms, and other animals, which live or are found by accident in the water. They can live AA'ith little nourishment for many months, and pass the win- ter, often a great part of the summer, im-olved in the mud, when the lakes are dry, without eating. Sea salt, tobacco, and every salt or acrid substance, kill these animals, and this is the method of disengaging them from the body; for if torn off, the head is left in the wound, and a troublesome suppuration ensues. If cut in two, the head continues the suction, Avhile the blood is discharged from the wound, and all the conse- quences of an haemorrhage folloAV. The hirudo medicinalis Lin. is the species chiefly employed; and the hirudo sanguisuga, or black leech, is accounted poisonous. It seems, however, only to make a larger wound, and to suck with more violence. They must be collected in the spring, kept in pure Ava- ter, which must be frequently renewed, in a place not too warm. It is advised that some clots of blood should be occasionally throavii into the water, while a certain proportion should be kept hungry, for immediate use. Some years since, leeches were supposed to be useful barometers, and it was said that they lay at the bottom of the vessel when the following day Avould be clear and Avarm ; but that when rain Would come on before the noon, they mounted to the surface, and continued there till the fineweather returned. When a storm of wind ap- proached, they were said to run round their prison with considerable celerity, and to stop only when the Avind began to blow. When a tempest approached, the leech was said to rise out of the Avater, and continue above it many days, appearing restless and agitated; that it re- mained at the bottom of the bottle, contracted to a round ball, during a frost; and during snoAv and rain it fixed itself to the stopper of the bottle, remaining at rest. These phenomena maybe correctly stated, and a single leech may appear to feel the variations of the atmo- sphere ; but whoever has observed many of these ani- mals in a glass vessel, will have perceived that, in any circumstances, they have appeared sometimes still, oc- casionally restless, some at the bottom, others at the top, of the vessel, some unquiet, others at rest. They are certainly very susceptible of the effects of lightning, and often killed by it. A small species-Avas found in Egypt, not larger than a hair when not gorged with blood. They often fixed in the throat of the soldiers, and \\ ere only removed by forceps. In medicine we em- ploy only the two folloAving: 1. Hirudo 7nedicinalis, long, blackish, with lines of different colours, spotted with yellow below, and with- out eyes. 2. Hirudo sanguisuga, the horse leech, long, vol. i. 53 HIR black, of a greyish green colour below. About four teen or fifteen species are knoAvn, one of which is de- scribed in the first volume of the Linnaean Transactions, p. 188, and said to breathe by gills; but should the lat- ter be true, the animal must be referred to another ge- nus. The author, however, Mr. Menzies, is not explicit on this part of his subject: the setae he describes may not be, or may not lead to, gills. Another leech is de- scribed in the same volume by Dr. Shaw, p. 93, hirudo viridis. It is oviparous, and, like some other species, is reproduced by cutting. We have enlarged more fully on this subject because Ave have no accurate description of this useful animal in our OAvn language. We must now return to what is more strictly our object, their medical use. Leeches have lately become a fashionable remedy in every topical inflammation, in topical pains, and in the greater number of tumours, internal bruises, and ob- structions. In scirrhi and incipient cancers they are highly commended; in the Avhite SAvelling of the knee, in swellings of the periosteum, in the inflammatory state of buboes, they are supposed to be highly useful. In fact, they have been so much employed that our ponds and lakes have been, in a great measure, depopulated; and in many parts of the kingdom they are Avith difficulty procured. The mode of their operation must be after- wards considered, but the principles are sufficiently ex- plained under the article of Blisters, q. v. The pecu- liar advantages which result from their use seem to be OAvingto their exhaustion. They fill the vessels around, and not only relieve from the quantity of blood Avhich they draAV, but from that Avhich they accumulate in the subcutaneous vessels. By this effect they are often singularly useful; but from the same circumstance, the bleeding, if a bone be not subjacent, is with great diffi- culty stopped. Equal advantages may be often obtain- ed by cupping with scarifications, without the same disadvantages ; and this operation should, in many in- stances, be preferred. The leech, when full of blood, drops off; but should it not do so in time, a little salt will always induce it to quit its hold. Salt has been thrown on the animal to make it disgorge the blood which it has sucked, but the leech is generally killed in the experiment. A more easy way to discharge the blood, and save the animal, is to hold it in the hand, and gently squeeze it in a napkin from the head downward. The blood flows copiously from Avhat may appear the anus, or through the rup- tured extremity of the intestinal canal, and the worm is not essentially injured. Leeches must be kept hungry, and the part to which they are to be applied must be wetted with warm milk, blood, or syrup. If a sufficient quantity of blood is not drawn, cloths Avrung out of warm water must be ap- plied on the orifice, or the part may be put into warm Avater : in either way the bleeding may be prolonged. Leeches are sometimes applied to the anus when the haemorrhoids are suppressed, and to the gums in inflam- mations from teething. In each case they may escape into the intestine or the throat; but an injection of salt, dissolved in the infusion of tobacco, will destroy them in the former instance, and gargles or draughts of salt water in the latter. In general a healthy leech will suck about an ounce of blood; but Avarm cloths 5D H O M 754 H O M Avill continue the evacuation for some time after the animal is satiated. The curious may consult the following writers on leeches, viz. Aldrovandrus, Gesner, Swammerdam, Redi, and Stahl. Among the moderns, the Memoirs of Morand, Bosc, and Vauquelin. HIRUNDINA'RIA, (from hirundo, a swallow; so called from the resemblance of its pods to a swallow). Swallow wort. See Asclepias. HISPA'NICUM VIRIDE. See jErugo eris. HISPI'DITAS, from hispidus, rough, hairy). Hairi- ness in general; but sometimes limited to the diseases called phalangosis, or distichiasis. HISPI'DULA, (from the rough woolly surface of its stalks). See Gnaphalium montanum. HISTO'RIA, (from 'nrjopix, a case). An history. In medicine it is a medical case, or in the French idiom an observation. HOACHE. A Chinese earth resembling, it is sup- posed, steatite, or soap rock, but fusible, and more pro- bably argillaceous, with a mixture of silex. HOA'XACAN. See Guaiacum. HOCIA'MSANUM. See Agrimonia. HOITZILO'XITL. See Balsamum Peruvianum. HO'LCIMOS, (from eXxa, to draw). An epithet applied to what may be drawn out, and still preserve its continuity. It sometimes means a tumour of the liver. See Galen de Loc. Affect. HO'LCUS, (from the same). See Milium Indicum. HOLI'PPjE. Thin cakes made with flower and su- gar, poured upon a hot iron, figured, and then set on the fire. The name is now appropriated to sweet- meats ; occasionally to such as are laxative. HO'LLI. The Indian name for what the Spaniards call alii, a resinous liquor, distilling from the tree called chilli; used in dysenteries. See Raii Historia. HOLO'CYRON. See Chamepitys. HOLOPHLY'CTIDES, (from ixos, whole, and (**$,) omos; adjutorium; the shoulder, or joint which connects the arm to the body; the head of which is the olecranon. In Hippocrates it is called Brachium, q. v. HU'MILIS, Rectus musculus, (from humi, on the ground, because it turns the eye downwards). See Depressor oculi. HUMIRU'BUS. Dewberry, (from humi, on the ground, and rubus, a bramble). See Rubus ideus. HU'MOR, (ab humo,because moisture springs from the ground). Humour. A general name for any fluid; particularly applied to the fluids of the human body, and often to these in their morbid state. The term is used without any reference to disease, in speaking of the fluids of the eye ; and popularly employed as sy- nonymous with disposition; in the time of Shakspeare and Jonson greatly abused by an indiscriminate applica- tion. The ancients seem to have called the nutritious juices the radical humours. HUMORA'LIA, (from humor, a fluid). In Lin- naeus's Nosology it is an order of diseases in the class vitia ; and signifies disorders attended with vitiated or extravasated fluids. HUMORA'RIA, (from the same). A continued fever, in Sagar's system, apparently inflammatory, at- tended with a vitiation of the fluids. HU'MULUS, (from humus, the ground). See Lu- PULUS. / II YD 763 II YD HU'MUS NI'GRA PICTO'RIA. See Creta nigra. _ HUNG A'RICA A'QUA, vel 'HUNGA'RICUS SPI- RITUS. See Rosmarinus. HU'NGER. See Fames. IIU'RA, (from hura, in Spanish, a knob, from its round fruit). The sand box tree ; Jamaica aval- nuts ; warnelia and havelia, hura crepitans Lin. Sp. PI. 1431, is a native of the Spanish West Indies; the leaves of Avhich are full of a milky juice, and the seeds purge upwards and dowmvards. The shell, after the seeds are taken out, is used as a sand box. HU'SO. See Ichthyocolla. HUTZO'CHITL. See Peruvian, bals. HYACI'NTHUS, (from Uv, a violet, and xv6os, a fiower, from its colour). It is poetically said to be named from the friend of Apollo, who was turned into this flower. Hare bells. Hyacinthus non scriptus Lin. Sp. PI. 453. The roots are bulbous ; the flowers agreeably scented, and of a purple or blue colour. The plant is found in Avoods and hedges, and flowers in May. Galen thinks the roots anticteric; and they are some- times supposed to be astringent. Hyaci'nthus stellaris. See Lilio hyacin- thus. Hyaci'nthus racemo'sus moscha'tus. See Bul- bus vomitorius. HYALO'DES, (from vxXos, glass). An epithet ap- plied to urine which deposits a white, shining sediment. HYALOI'DES, (from vxXos, glass, and etfos, like- ness,) the vitreous humour of the eye; or rather its capsule. See Oculus. HYA'NCHE,(from vs, a swine, and xyxa, to stran- gle). A quinsey, accompanied with an external tu- mour on each side the throat, like the swellings on the necks of swine. HYBERNA'CULUM, (from hyberno, to winter).. That part of the plant which encloses and secures the embry o from injuries during the winter, expanding in the form of buds on the approach of summer. HYBOUCOU'HU AMERICA'NUS. The name of an American fruit, of the size of a date, but not eat- able ; whose genus is unknown. The oil expressed from it is kept in the shell of a fruit called carameno, and has sometimes the same appellation. It is chiefly used against an American disorder called torn, which seems to be the same Avith chigres, or a collection ofverysmall Avorms in the flesh. HY'BRID. A monstrous production from two dif- ferent species of plants or animals; generally barren. HYDA'RTHROS, (from v$~up, water, and xp6pov, a joint,) a clear Avater Avhich issues from wounded joints; and a name of the synovia. HYDA'RTHRUS, (from the same). A white swelling. Dr. Cullen places this genus in the class locales, and order tumores, Avhich he defines a tumour of the joints, chiefly of the knee; at first the swelling is slight, of the same colour of the skin, very painful, di- minishing the mobility of the part affected. Mr. Bell, in his Treatise on Ulcers, speaks of this disease under the name of white swellings of the joints, and distinguishes two species, viz. the rheumatic and the scrofulous: each is more frequent in the large than in the smaller joints. The first species begins with an acute pain in the joint, and frequently the tendinous aponeurotic expansions of the muscles connected with it. There are, from the beginning, an uniform SAvelling and tension of the surrounding teguments ; but, in this period of the disorder, the skin is discoloured. The pa- tient, from the beginning, suffers much pain from mo- tion ; and finding it easier in a relaxed posture, keeps it bent; which, especially in the knee, renders the flexor tendons of the limb rigid, and in time stiff. The swelling gradually often increases to thrice the natural size of the part. The cuticular veins become turgid and varicose; the limb,below the SAvelling, decays,orbecomes oedematous; the pain increases, especially if the patientis warm in bed; and abscesses form in different parts of the SAvelling. In these abscesses a fluctuation is evident on pressure; but the SAvelling is elastic, and rises when the pressure is, removed. These different collections, when they break or are laid open, discharge matter; at first of a good con- sistence, but soon degenerating into a thin fetid sanies, without apparently diminishing the size of the SAvelling. The orifices, if not kept open, soon heal, and neAV col- lections, forming in different parts, again break out and heal as before : at last the whole surrounding teguments are covered with cicatrices ; but the patient's health hath suffered considerably in the interval, first from the pain, which destroys both sleep and appetite; and secondly, from the absorption of matter, producing a quick pulse, night sweats, and diarrhoea. These changes occur independnet of any affection of the bones of the joint; but when by a continuance of the complaint the ligaments are eroded, the cartilages, and even the bones, soon suffer. Though such are the appearances" recorded, and usually confined to the first species, yet we are confident that they are peculiar to the second; and though they sometimes occur in hydarthrus from rheu- matism, yet it is only when the rheumatic inflamma- tion has produced the scrofulous. The causes of this species are strains, affecting the ligaments of the joints, so as to produce inflammation ; bruises, luxations, or rheumatic disposition. This species of white SAvelling occurs most frequently in young plethoric people : the swelling is confined to the soft parts, and is from the beginning evident. When such swellings occur in young, strong, plethoric persons, and especially those who have been subject to rheumatism, they are gene- rally of the rheumatic species. The rheumatic white swelling is ahvays inflammatory, and bleeding will be the best remedy; at first from the arm, and afterwards from the part affected. Cupping and scarifying are use- ful remedies; and at least eight or ten ounces of blood should be discharged from each side, repeated at proper intervals, according to the violence of the symptoms and strength of the patient. Cupping is preferable to leeches; but when the SAvelling of the joints is consi- derable, it is impossible to procure a sufficient quantity of blood by this operation, and leeches inustbe applied. On the anterior part of the joint, Avhere the cupping glasses or leeches have not been placed, a blister should be put; and the part be kept open, till the wounds from whence the blood was discharged are so far healed that a blister may be laid on one side of the joint; and, as soon as this is nearly healed, the other side should be also blistered. By thus alternately applying them, first to one side, and then to the other, almost a constant sti- mulus is kept up ; from which the greatest advantages are derived. Cooling laxatives are necessary at proper 5 E 2 HYD 764 II YD intervals; as well as a strict antiphlogistic course of diet. In the first stages only this or any other plan can be beneficial; and in these cures are sometimes effect- ed. When the original inflammatory disease is re- moved} the drains should be stopped, and while there are yet no appearances of the formation of matter,mercury has been sometimes recommended for a feAv Aveeks, to keep the mouth merely sore. This medicine can, how- ever, be only useful in the case just suggested, of the inflammation exciting the action of scrofula; and in- deed the mode in which it is advised shows that the friction is of as much service as the remedy; for the proportion of mercury in the ointment is so small, that two drachms of the ointment must be used three times a day; and in order to rub in this ointment with advantage, an hour should, it is said, be spent each time in rubbing. Falls of warm water on swellings of this kind are strongly recommended by Le Dran, &c. By a proper use of the several topical evacuants in the first or inflammatory state of the disease, and after- wards, previous to the formation of matter, of mercu- rials and friction in the second stage, many have been cured. When by the bent position in which the limb has long been kept the use of the joint is lost, pure olive oil may be applied warm : as much as can be easily consumed by an hour's gentle friction should be rubbed in, three times a day, extending the friction over all the muscles around. Gentle action of the parts as soon as it can be borne, as recommended by Mr. Pugh, on the Utility of Muscular Motion, is highly be- neficial. Should suppuration come on, opening the different abscesses soon after their formation may pro- bably prevent the matter from injuring the capsular li- gaments of the joints; the destruction of which renders amputation necessary. In the second species the pain is usually more acute, but more confined to a particular spot, about the middle of the joint. The swelling is at the first inconsider- able ; and little difference is seen in the size of the af- fected joint. The least motion gives great pain; so that stiffness and rigidity are equally produced by the position. As the disorder advances, the pain is more violent, the sAvelling increases, and the ends of the bones that com- pose the joint grow large. A very peculiar elastic swell- ing at last is felt; varicose veins appear over its surface, and collections of matter occur in different parts of it: these, when they burst, or are laid open, discharge considerable quantities of a glairy or purulent mat- ter, but more frequently a thin fetid sanies; and, if a probe can be passed down to the bottom of the sores, the bones are found carious, and pieces are often discharged at the openings. As the disorder con- tinues, the constitution suffers ; a diarrhoea, with night sweats, comes on, and the patient is reduced to extreme Aveakness. From every symptom, and appearance on dissection, this species seems evidently to bean affection of the ligaments, and next of the bones; the surrounding soft parts only suffer from their connection. This spe- cies sometimes appears to be the consequence of an external accident; but generally begins without the patient's being able to account for it. From the effects usually produced on the bones which it attacks, it Avould appear to be a species of the real spina ventosa, and truly scrofulous. This species of white swelling is indeed often either attended Avith other evident symp- toms of scrofula,or occurs in those descended from scro- fulous parents. When any perceptible swelling appears, the bones are found to be the parts chiefly affected, and the surrounding teguments suffer only in the progress of the disease ; and when in such patients as are evidently of scrofulous dispositions, if the disorder has begun without any, or from a very slight, external cause, avc need not doubt its being of a scrofulous nature. In the small joints, Avhen the diseased parts of the bone begin to cast off, a cure may be sometimes promoted by as- sisting the efforts of nature ; but in all the large joints, particularly in the knee and ankle, amputation will often afford the only means of relief. The remedies usually employed are those of scrofula, Avith topical stimulants to the part, to increase the action of the vessels, and to promote the absorption of the matter. We shall not anticipate the article scrofula by enlarging on its causes and the manner in which its remedies relieve, but merely remark that the applica- tions of marine plants, sea bathing, and drinking salt water, are the most effectual remedies. They act slowly, but are more successful than any other plan. The burnt sponge, which consists of alkaline or neutral sals, with animal oil, is often serviceable; and the burnt cork has had its advocates, though a remedy of inferior powers. Small doses of calomel are sometimes useful, and the bark is occasionally given, when fevers come on, or the night sweats appear to exhaust the patient. Neither of these latter remedies, however, is peculiarly adapted to the complaint. The topical applications of most service are blisters frequently repeated ; and sometimes the mercurial oint- ment, in the manner already described, has been found useful. Hemlock has been more frequently applied externally than given as a medicine; but in either way it seems of little benefit, and, when joined with the arum root, its utility is but little increased. A variety of other applications are recommended, but of inferior efficacy. Practitioners have differed respecting the opening of the tumours of the joints, and, in general, it seems to be decided that they should be left to nature. It is at least certain that the wounds are with difficulty healed, ami that the disease is sometimes removed Avithout the dis- charge of the glairy matter, which fills the place of pus. We have had occasion to doubt the propriety of this de- cision; and though Ave allow that the cavities of joints should on no occasion be exposed, Ave greatly doubt Avhether the constitution would not be spared by the early discharge of matter Avhich is never salutary, but, when retained, produces hectic, and symptoms of the greatest danger. Amputation, in cases of white SAvelling, ought never to be advised till the complaint is far advanced; it has been observed, that amputation has more frequently succeeded when the patient was previously much re- duced by diarrhoea. If this be true, Ave should never have recourse to the operation, until every probable means of saving the limb has been tried In vain. On dissection of the joint, a great thickening of the ligaments, which confounds the several parts, is observ- able, together with sinuses, formed by crude matter, through this distinguishing mass; and generally an ero- sion of the cartilages at the end of the bones. Edinburgh Medical Essays, vol. iv. p. 242 and 246. Reimarus de Fungo Articulorum. Leyd. 1757. Bell H Y IJ 765 II Y D on Ulcers, ed. 3. p. 435, &c. London Medical Trans- actions, vol. i. p. 104. White's Surgery, p. 66. HYDA'TINON, (from vfog, aqua). The name of an ancient collyrium, made of rain water. IIY'DATIS, (from the same). See Aruula. Hy'datis. A hydatid. (See Phlyctene.) Hy- datis, considered as a genus of disease, has been placed by Dr. Cullen among the local diseases in the class tumo- res. It has been found, however, to possess an inde- pendent life, and has been referred to the vermes intes- tinales, characterised as a vesicular body, at least poste- riorly; and terminated anteriorly by a head furnished with three or four antennae, with or without fangs. These lymphatic vesicles have been long known, and observed on the liver, the brain, the ovaria, and the other viscera; but it is lately discovered that they resemble in nature and almost in form the taenia. This genus differs from taenia in the membranous vesicular expansion, which appears to constitute its whole form, and in Avhich the head is generally con- cealed. It differs also in its habitation, for it is never found in the intestines, but on the surfaceof the viscera, on the membranes, and sometimes enveloped in the fat. In every other respect they are the same ; and Ave re- mark in them four suckers, and in their centre either a corona of fangs or a depression, apparently the mouth of the animal. It is not surprising that its nature has so long been overlooked, since many trials must be made to discover the head, often the only organic part of its system. Dr. Tyson first discovered hydatids in the livers of 6heep ; Bartholine observed them in the livers of goats, and Pyerus in hogs. To Pallas, hoAvever, we are in- debted for the first correct and connected account of these animals, which he has described and figured in his Miscellanea Zoologica. Since the period of his publication, Goeze, Batsch, Bloch, and others, have added to the stock of facts, though much remains to be knoAvn. Mougeot, a young physician, has collected in the form of a thesis, entitled "A Zoological and Medi- cal Essay," what has been hitherto published ; to which he has added some neAV facts, and the treatment ne- cessary in one of the species, viz. the hydatids of the uterus. This essay, unfortunately, we have not been able to obtain. Dr. Adams also has endeavoured, with some success, to sIioav that cancer is OAving to the in- troduction of an animal of this kind. But if cancer is owing to an animal, its structure forms the septa so often described in such ulcers. These are, in fact, the animal, not the residence of its formation. Hydatids are, in general, superficial; that is, some portion is enveloped in the substance of the liver, for instance, and a part rises above it. Yet this is not an universal rule; for, as they are very numerous, some must be wholly concealed. Those species which bur- row in the fat are entirely covered, and can never change their place. Their size differs according to the species, the age and temperament of the animal at whose expense they live. Pallas speaks of some as large as the fist, and others are mentioned still more bulky. Such we have ourselves seen. Their figure is infinitely varied, but very generally approaches that of a flatted sphere. Their colour is generally white, or semitransparent, sometimes of an amber colour; their substance composed of different membranes, conglu- tinated and formed of circular fibres, visible by means of a lens; but in many animals, particularly in sheep, susceptible of an evident contractile power. Internally, on the part opposite to the head, we can observe a disc, someAvhat thicker than the membrane, Avith often a number of fatty tubercles, which have been supposed eggs. They are filled, though not wholly, with lymph, usually transparent, of an oily, salt taste, which be- comes cloudy by heat. These vesicles have a motion of their OAvn, which may be styled peristaltic, and is often very lively. The head is not always at the termi- nation, but often concealed by the reduplication of its skin ; and from this part the hydatid acts on the viscus in which it lives, and sucks its lymph. The animal is best seen by separating the vesicle, and placing it be- tween tAvo panes of glass, taking care that they press very gently on the anterior part. The head, in that case, pressed forward by the lymph, projects ; and even with a lens, the suckers and fangs, if it has any, are observable. This part may be preserved dry for a con- siderable time. Hydatids, in the human race, are found chiefly in the liver, the spleen, the uterus, the ovaria, the kidneys, the placenta, the lungs, and even the muscles. Those in the accumulated fluid of dropsies are accused as the cause of the disease; and those in the head are sup- posed to occasion insanity. Hydatids exist occasionally in the human viscera, Avithout occasioning any incon- venience ; but acute pains, either continual or tem- porary, are supposed to be sometimes OAving to them. Their existence may, it is said, be suspected by Aveakness, emaciation, and oppression at the stomach ; but these symptoms are owing to many other causes, and were the existence of hydatids ascertained, there is, we fear, no remedy that Avould reach them. Hy- datids of the liver are often found in a cyst of a cartila- ginous firmness, composed of different laminae, and thicker, in some instances, than in others.' The laminae are white, and apparently lined Avith coagulable lymph. In one body, Dr. Baillie saAV the cyst divided by a pulpy substance. A cyst often contains various hydatids, some floating loosely in the fluid, and some attached to its sides ; of very different sizes, from a pin's head to that of a walnut. The largest are generally found floating in the cavity of the abdomen when distended by dropsy. In animals they are more common than in man. They are generally found in the livers of hares, especially those which have fed in marshy ground. In rats they are equally numerous ; and in sheep they occasion vertigo when in the brain, and the rot when they burrow in the liver. In the hog they produce the appearance sometimes called measles ; and they are found also in the rein-deer, the goat, and the ox. The remedy in sheep is to change the pasture from the marshes, where the disease is caught, to high gravelly soil, where it seldom appears, and to give the animal a portion of salt; for in salt marshes the hydatids are not found. An author whom we have mentioned, but Avhose work we have not seen, recommends, we are told, injections of salt water into the uterus when hydatids exist in that organ. The hydatids of hogs are found in the substance of the fat and in the muscles. They are sometimes so numerous as to be almost contiguous. The disease, HYD 766 HYD besides measles, is sometimes called lepra; and on this account it seems to have been forbidden to the JeAvs, among whom the lepra Avas an endemic disease. The hydatids of hogs are most commonly lodged under the tongue; and, from inspection of that part, the probabi- lity of their existence in the flesh may be ascertained. It has been doubted whether the hydatid of the hu- man body is really a living animal, since its head has not been observed, and no motion is perceivable in it. We, must however, reflect, that the human body is seldom dissected soon after death; and that hydatids, whose heads are not naturally observable, may, by the management already described, be compelled to exhibit them. The hydatid of man is apparently more simple than that of sheep, but its general similarity is so strik- ing that the analogy may be safely transferred ; and who shall limit the simplicity of structure consistent with animation ? The subject is yet in its infancy, and this must be our apology for the extent of the present article. There are eighteen species described, the more important of which we shall describe. 1. The globular hydatid is cylindrical, terminated by a globular, very large, vesicle, found on the liver, the spleen, and other viscera of man. It is the largest species yet discovered. 2. The visceral hydatid is globular. Its vesicle is large anteriorly, and pointed posteriorly; it is described and figured by Goeze, found in the liver, the uterus, and the hydropic sacs of the human race ; and probably a more frequent cause of dropsy than pathologists have suspected. The vesicles are often lined Avith an opaque, pulpy coat, but are more usually transparent. It is said that they are frequently contained in each other. This, however, we believe is not true ; but Ave have seen numerous hydatids contained in a sac compressed, without any containing fluid, and apparently without life. When in the ovaria, their most frequent residence, they sometimes appear to occasion a false pregnancy. Treutler has described and figured, in a separate treatise, a visceral hydatid, which, instead of a head, had a small tubercle not retractile. The author thinks, with some • reason, that many distinct species have been confounded under this title. 3. The cellular hydatid is contained in a cartilaginous vesicle, which has two appendices on its posterior part. It is described and engraved by Werner in an excellent work on the vermes intestinales. It is found in the integuments of the muscles of the human race, and has been supposed to be the same species Avith that which infests hogs. 4. The hydatic hydatid has an elongated body, large anteriorly, Avith a small vesicle, and a sessile head. It js found in the livers of rats. 5. The vervecine hydatid has a large vesicle, with a short body, rough, with an imbricated appearance, and found in the peritonaeum of sheep. 6. The cerebral hydatid is furnished Avith retractile tubercles, but has no visible vesicle. It is the animal which causes vertigo in sheep ; and, by some naturalists, has' been supposed to occasion mania in man. 7. The hydatid of the hog is conical, inclosed in a double sac, the interior of which adheres by its base. It has lately been removed to another genus, under the name of finna. Werner and his editor, Fischer, re- present little pedunculated globules in the room of the corona of fangs ; but Bosc, from frequent examination, asserts that he has always found the latter in this animal. Three species are found in the viscera of the hare ; three in those of a sheep, one in the ox, and one in the dolphin, which are not accurately distinguished. The granulated hydatid figured in Go£ze, found in the liver of a sheep, is separated by Rudolph to a different genus, echinocoqus. We must add, that Treutler has published, at Leipsic, a dissertation on many intestinal worms found in the human body, among which he has described a new species of hydatid (tenia alba punctato), found in the plexus choroides of a man who died in an idiotic state. The individuals of this species, instead of being in- closed like those of the cerebral hydatid in a common sac, are united by their base through the medium of a membrane. Their form is globular ; the largest about half an inch, the smallest ^ in diameter; then- colour grey, spotted with black, with six fangs on then- heads. The more important part of the work remains, viz. to point out the means of removing the diseases by- destroying the animal which has produced them. But this part of the task naturalists have overlooked ; and, in general, hydatids lie out of the course of the circula- tion, so that little expectation can be formed of the suc- cess of any medicine. Mougeot may have given us some information on this subject; but the only hint we can collect from those who have quoted his Avork is, the injection of a solution of common salt into the uterus, when the hydatids are known to exist in that viscus, from some being occasionally discharged. The circumstance of sheep being relieved, when placed in salt marshes, may suggest the use of common salt; but we must recollect that, in this case, the animal is gene- rally diseased from a known cause, and that in case of plants, the insects which accompany or cause the com- plaint may be removed by restoring the health and strength. If we apply this to the human body we shall discover an excess of saline nourishment itself a cause of disease; and the prudent physician, who would pursue the hint, will probably find it necessary to be cautious hoAV far in pursuit of a remedy for one disease he may produce a Avorse. There may be some reason to suspect, that, when alkalis have relieved dropsies, and more cer- tainly when mercurials have had a similar effect, they may have destroyed these animals which are, we fear, often an unsuspected cause of this disease. One other remedy we AA'ould suggest, viz. the sulphurated ammonia. We know that sulphur penetrates very minutely into every vessel of the system : we know that sulphurated hydrogenous waters are useful in cases of taenia, and it is highly probable that this may prove a valuable remedy in diseases which arise from hydatids; that it has really proved such, where the cause was unknown. What- ever may be the result, we have, at least, reason to think that medicines of this kind will not injure the constitution Avhich they are given to relieve." See Tyson, Philosophical Transactions, vol. xvii. p. 506, et ejusdem Tentamen Act, Eruditorum Lipsiae, 1692, p. 435; Schroeder de Hydatidibus; Pallas Mis- cellanea Zoologica ; Werner, Vermes Intestinales ; Goeze, der Lingeweidewiirmer Thierischer Rorper; Mougeot, Essai Zoologique et Medicale; Medical Com- HYD 767 HYD munications, vol. i. p. 101.; London Medical Journal, vol. i. p. 125 ; vol. vi. p. 139. HYDATOl'DES, (from vfotlos, the genitive case of vSup, water, and eifos, a shape.) Watery ; an epithet for wine much diluted; for limpid urine; for the aqueous humour of the eye ; and for the fluid of anasarca. HY'DEROS, (from uS'up, water). See Hydrops and Anasarca. II YDRAGO'GOS,(from v&up, water,and xyu,to bring away). Hydroticus; aquiducus. Hydragogue. Medi- cines that evacuate much water. In Hippocrates, Epidem. lib. vi. it imports a person affected Avith dropsy from drinking water. HYDRA'RGYRUM, HYDRA'RGYRUS, (from vfoop, water, and xpyvpos, silver; from its having the appearance of fluid silver.) Quicksilver. This term the college of physicians of London have adopted for the argentum vivum, in their Pharmacopoeia of 1788, and use it for the word mercurius in all the preparations of which this metal forms a part. See Argentum vivum. HYDREL-E'UM, (from vfoop, aqua, and eXxiov, oleum). A mixture of oil and water. Oribasius and P. .Egineta. HYDRENTEROCE'LE,(from vfo^p, water,ev\epov, an intestine, and xvXv, a tumour). A dropsy of the scrotum. Vogel describes this disorder as compounded of a dropsy and hernia. HYDRO'A,(from vfoop, water). See Boa andPHLYC- tis. It sometimes means a pustule called alhasef and asefi HYDROCA'RDIA, (from vfo*p, and xxpfox, the heart). Hildanus invented this word to signify a serous, sanious, or purulent tumour of the pericardium. HYDROCE'LE, (from vfoop, water, and xqXv, a tumour). This term is employed when water is con- tained in ruptures; but particularly, is applied to a dropsy in the scrotum; hydrops testis, hernia aquosa, oscheocele,andoscheophy ma. By oscheocele Vogel means a rupture which descends into the scrotum ; Dr. Cullen places this genus in the class cachexia, and order intu- mescentia, which he defines a soft, fluctuating, pellucid tumour of the scrotum, not painful. There are two kinds : in the first the water is lodged in the cells of the membrana cellularis scroti; and it is a symptom of anasarca. The second, and only proper species, is formed by water lodged within the tunica vaginalis of the testicle. The first tumour retains the impression of the finger, the second is elastic. The second, our only object at present, is a morbid accumulation of the Avater separated on the internal surface of the tunica vaginalis, to moisten or lubricate the testicle. From its first appearance it seldom disappears or diminishes, but generally continues to increase, some- times rapidly, at others more slowly. In some it grows to a painful degree of distention in a few months ; in others it continues many years, Avith little disturbance. As it enlarges it becomes more tense, and is sometimes transparent; so that if a candle is held on the opposite side, a degree of light is perceived through the whole bulk of the tumour; but the only certain distinction is the fluctuation, which is not found when the disease is a hernia of the omentum or intestines, or an inflamma- tory or a scirrhous tumour of the testicle. If the water is lodged only in the cellular membrane, scarifications may be made in the legs, as in an anasarca; but if it is a proper hydrocele, and occasioned by no other disorder, a lancet, or the trochar, may be em- ployed to discharge the fluid ; and as the testicle lies ahvays on the posterior part of the tumour, the perfora- tion must be made into the anterior and lower part of it. This is, however, only a palliative remedy. Mr. Bell proposes the use of a flat trochar in pre- ference to a lancet. The patient being seated, the operator, with his left hand, should grasp the tumour on its back part, so as to push the contained fluid into the anterior and under part of the swelling. An open- ing must then be made through the skin and cellular membrane, about half an inch long, with a lancet; the trochar introduced through the tunica vaginalis, and the stillette withdraAvn, that the Avater may be dis- charged. After this the canula may be also AvithdraAvn, and a piece of adhesive plaster should be applied to the orifice. A compress of soft linen may cover the scro- tum, and the whole may be firmly supported by a T bandage. Mr,. Pott proposes a radical cure, by exciting an arti- ficial inflammation in the tunica albuginea, and the tunica vaginalis, by means of a seton, which will produce an obliteration of the cavity, in consequence of the in- flammation. Mr. Else prefers the application of a caustic (see Causticum opiatum) to the fore and lower part of the scrotum; and Mr. Bell recommends an incision into the upper and fore part of the scrotum, to be directed dowmvards. We shall add a general account of these three methods, referring to the works of the respective authors for further particulars. Mr. Pott's method, by a seton.—The object of this is to excite the necessary degree of inflammation, if possible, without producing slough or abscess, the hazard of a gangrene, or that alarming degree of symptomatic fever Avhich sometimes attends both the caustic and the in- cision. The seton requires confinement to bed only for a feAv days, after Avhich the patient may lie upon a couch to the end, which Avill be in about a month; and during the whole time the common remedies of in- flammation are only necessary. The manner of per- forming it is as follows:—" Choose a time Avhen the vaginal coat is moderately distended; and having pierced it with a trochar of a tolerable size, draAV off the water; Avhen that is done, introduce into the canula a probe armed with a seton, consisting of ten or twelve strings or threads of silk ; pass the probe as high to the upper part of the vaginal coat as you can, and on the end of that probe make an incision of such a size as to enable you to to pull it out easily, together with a part of its an- nexed seton; then cut off the probe, and tie the silk very loosely, covering the orifices Avith pledgets. By the next day the seton will be found to have contracted such an adhesion to the tunica albuginea as would cause a great deal of pain to detach; but this it is per- fectly unnecessary to do, and it should be suffered to remain without molestation. In about forty-eight hours the scrotum and testicle begin to swell and inflame; the patient should then lose a little blood, and have a stool or tAvo, and the whole tumefied part should be II YD 768 HYD wrapped in a soft poultice and suspended in a bag truss. The disease from this time bears the appearance of a large hernia humoralis, and must be treated in the same manner, by fomentations, cataplasms, &c. The adhe- sion of the seton to the albuginea generally continues firm, and I never meddle with or move it till it be- comes perfectly loose, which it seldom does for the first fortnight, or until the inflammation is going, and the humours subsiding. By the time the seton becomes loose, the coalition of parts is universally and firmly ac- complished. I then withdraw it, and heal the orifices with a superficial pledget." Mr. Else's method, by a caustic.—" My method is this: —to lay a small caustic upon the anterior, inferior part of the scrotum, taking care to avoid the testicle: a large caustic is quite unnecessary, and every advantage may be derived from oneAvhose eschar will be no bigger than a shilling. The loose and pendulous situation of the scrotum renders the application of a bandage so very inconvenient, that we cannot easily prevent the caustic from spreading someAvhat; for this reason, I cover no more than the size of a sixpence, on a pre- sumption that it may make an eschar as broad as a shilling, though it commonly makes one of the size of a half crown. The intention is, that it shall affect, and, if possible, penetrate through the tunica vaginalis; so that the time it'is suffered to lie on is proportioned to the supposed thickness of the cyst. The caustic should never remain on less than five hours ; but if it be suffered tAventy-four hours, it can do no mischief Avhen properly guarded. On the removal of the caustic, digestives may be applied to the eschar, or the common cataplasm of white bread and milk. The scrotum must be suspended in a bag truss; and the patient had best be confined to his bed, though even this circumstance is sometimes omitted Avithout detriment. Sometimes, immediately after removing the caustic, at other times within twelve or tAventy-four hours, or even at the distance of two or three days, the patient begins to complain of a pain in the scrotum and loins, has noAv and then some colic pains, and the pulse a little quickened, and the tongue whitish. At different pe- riods of time, from the removal of the caustic, but ge- nerally within forty-eight hours, an alteration, is per- ceptible in the scrotum ; the tumour, upon grasping, feels more tense and hard than it was before, and this hardness answers to the figure of the tunica vaginalis in its whole extent; and a little attention will convince an observe*, that it is this membrane alone which gives the sensation of tension and hardness, and no other part. The colic pains and febricula seldom continue more than twenty-four or forty-eight hours; and very frequently are so inconsiderable as to require neither evacuation nor any internal medicines. If, however, the pulse be quickened a little, the pain of the back and the colic distressing to the patient, they will be speedily removed by one or two bleedings, and the injecting one or tAvo clysters. As soon as the pain of the back (ex- cept what arises from the weight of the scrotum), the febrile heat, and other symptoms are removed, for they commonly go off altogether, the patient need no longer be confined to his bed, but may be suffered to get up and Avalk about the room, provided the scrotum be suspended. In a feAV days the eschar of the scrotum Avill loosen and come aAvay, exposing to vieAV the tunica vaginalis, which bears evident marks of its having been affected by the caustic, and prepared to slough oft"; and when pressed with the finger, the undulation of the water may be felt Avithin it. As the cure proceeds, the sloughy tunica vaginalis will project more and more through the orifice of the scrotum; and when it ap- pears ready to burst, it maybe punctured with a lancet, and for this reason only, that it will relieve the patient from the weight of the tumour; for no other advantage can be derived from it. If the Avater is discharged by a puncture, the scrotum by degrees collapses, and the orifice in it is filled up with slough, which prevents the access of external air to the testicle. These sloughs continue to" come away Avith the dressings daily for about four, five, or six weeks; and in proportion to their discharge, the hard tumour of the scrotum lessens. Upon casting off the last slough, the hardness is entirely gone, the wound immediately cicatrizes; and the cica- trix being about the size of a finger's end, adheres strongly to the body of the testis, Avhich has never come in sight, nor has had any application brought in contact with it during the Avhole process." Mr. Bell's method, by incision.—" The patient being placed upon a table of a convenient height, and being properly secured by two assistants, Avith the scrotum lying nearly upon the edge of the table, the operator Avith one hand should grasp the tumour so as to hold it firm, and make it someAvhat tense on its anterior part; and with a common round edged scalpel in the other, hois is now to divide the external teguments by one con- tinual incision from the superior extremity of the tumour, all along its anterior surface, down to the most depending point of the swelling. By this means, as the divided scrotum retracts a little, the tunica vaginalis is laid perfectly bare, for the breadth of half an inch, or so, from one extremity to the other. An opening is noAv to be made with a lancet into the vaginal coat, just at its upper extremity where the first incision com-* menced. This opening should be of such a size as to receive the operator's finger, which being inserted, the probe pointed bistoury is to be conducted upon it, and by means of it the sac is to be divided to the very bottom, all along the course of the first incision. By making the first opening into the sac at the upper end of the tumour, much trouble and inconvenience are pre- vented, Avhich making the first orifice below is sure to occasion : for, as we have before remarked, when the tumour is first opened below, the water is instantly evacuated; and as that produces an immediate collapse of the tunica vaginalis, the passage through its cavity is not afterward easily discovered; whereas, by making the first opening above, as the Avater is thereby eva- cuated gradually, as the incision is extended doAvnwards, the vaginal coat continues distended to the bottom till the ineisionis completely finished. The incision being completed in the manner directed, the testicle, covered with its tunica albuginea, comes into full view. Some- times the testis protrudes from the wound altogether; in which case it must be replaced with great caution, and it ought by all means to be covered as quickly as possible from the external air; and, provided none of the tunica vaginalis is to be removed, this may be always done immediately, by finishing the dressing directly on the HYD 769 HYD sac being opened. When the sac is not too much thickened, there is no necessity for removing any part of it; but when it is discovered to be otherwise, to be thick and very hard, the removal of a portion of it on each side of the incision makes the cure of the remain- ing sore more easy and expeditious. As in this hardened state the sac generally separates Avith great ease from the surrounding teguments, any quantity of it may be easily taken away with the scalpel, without the least hazard of wounding the scrotum." As soon as the in- cision has been made, Mr. Bell inserts, between the tunica vaginalis and the body of the testis, slips of soft linen, smeared with some simple ointment, which causes much less irritation than dry lint, and is much more easily removed. Mr.Earle's method,by injection.—Professor Alexander Monro, of Edinburgh, having supplied the hint of cur- ing the hydrocele by inflammation, Dr. Monro, surgeon to lord Hume's regiment, attempted to make a radical cure by letting out the water of a large hydrocele, and injecting a little spirit of wine into the scrotum, which raised a violent and dangerous inflammation. When this was relieved by the usual remedies, he never had any return of the hydrocele. This violent inflamma- tion induced him to try a milder, remedy. Having let out the water, he injected some claret into the scrotum, by which means only a slight inflammation was raised ; but still succeeded to his wish, by completing a cure. He has. since made several radical cures by this remedy alone. See Monro on the Dropsy, p. 165, note (w), London, 1756. Mr. Earle's method is so similar to this, that it can scarcely be doubted from whence his ideas were derived. If the tumour be very large, it should, he observes, be emptied, and the water afterwards suffered to accumu- late till about six ounces are collected. The cyst is then to be tapped in the usual mode, and as much of a mixture of red port wine, with one third of water made blood warm, is to be thrown in through the canula of the trochar as will distend the tumour to its original size. It is to be allowed to remain there for four or five minutes, and then to be pressed out: should the subsequent inflammation prove considerable, a common bread poultice may be applied. Perhaps neither Dr. Munro nor Mr. Earle can claim the discovery; for the same method has been recom- mended by M. Lambert above a century ago, in his QZuvresChirurgicales,published at Marseilles. A strong solution of corrosive sublimate in lime water was the composition of which he made use; and he gave a variety of cases in which success was the consequence. See Monro, on the Tumours of the Scrotum, in the Edinburgh Medical Essays, vol. v.; Pott's Account of the Method of obtaining a radical Cure of the Hydro- cele ; Else, on the Hydrocele of the Tunica Vaginalis Testis; Bell's Surgery, vol. i. p. 403, 8cc; London Medical Journal, xi.; White's Surgery, p. 328. Hydroce'le cystata resembles the common hy- drocele ; but the tumour does not extend to the testicle, which may be felt below or behind it, while in the hy- drocele of the vaginal coat, Avhen large, the testicle cannot be discovered. In this disease also the penis is not buried in the tumour. Sometimes the fluid is contained in two distinct cells; and this is discovered by little contractions in it. It is distinguished from the VOL. I. anasarcous hydrocele by a sensible fluctuation, and the Avant of the inelastic pitting; from hernia, by its be- ginning below, from its not receding in an horizontal position, and not enlarging by coughing or sneezing. The cure is the same with that of hydrocele of the vaginal coat: in children it is often removed by spirit- uous applications. Hydroce'le funiculi. An hydrocele of the sper- matic chord is usually a symptom of ascites; but is some- times an anasarcous swelling of the surrounding cellular substance. It is owing to the usual causes of dropsy, and occasionally to the pressure of a truss. In an erect position it is oblong; in a recumbent posture flatter, and somewhat round. The swelling is generally con- fined to the groin, though it sometimes descends to the scrotum, and ehlarges it to a considerable size. When a local complaint, the Avater may be discharged by a trochar or lancet. Hydroce'le peritone'i. See Ascites. Hydroce'le spina'lis. See Spina bifida. HYDROCELO'DES ISCHU'RIA, (from vfo*?, aqua, and xijXafos, attended with tumour). A suppres- sion of urine from a rupture of the urethra opening into the scrotum. See Ischuria. HYDROCE'PHALUS, (from vfoop, water, and xeQxXtj, the head). Dropsy of the head. This dis- ease has been divided into two species, external and in- ternal. In the first, water is confined betAveen the skull and the integuments. In the second, the fluid is with- in the cranium, between it and the brain; between the membranes; or distending the ventricles. Dr. Cullen places the hydrocephalus externus, including those cases where the fluid is between the skull and the dura mater, as a genus in the class cachexia, and order intu- mescentie, which he defines a soft, inelastic, intumes- cence of the head, with the sutures of the cranium gaping. This complaint is so obvious, that it requires not any description for its discovery. In general, it is necessary to establish some drain from the head by a continued blister from the neck; free copious evacua- tions by stoohmust be procured; and Ave think the cure expedited by a grain of calomel every night. This me- dicine seems to give tone and energy to the circulation, Avhich, in this disease, is apparently deficient. With the same view, after the vessels of the head are emptied, the bark, with cold bathing, is highly useful; and even Avhen the head has been peculiarly large this plan has succeeded. See London Medical Observations, vol. v. p. 13; Medical Transactions, vol. ii. p. 18; Edinburgh Medical Essays, vol. ii. p. 22. The hydrocephalus internus is placed as a species of apoplexia hydrocephalica in Dr. Cullen's system. In a nosological work, he remarks, it is difficult to arrange accurately diseases which assume in their course dif- ferent appearances ; but he prefers placing this disease under the title apoplexy, because the tumour is not evi- dent to the senses; and because it greatly differs in its symptoms from the external hydrocephalus, Avhich is clearly perceptible. In its proximate cause, also, and at length in its symptoms, it is nearly allied to apoplexy. Dr. Fothergill names the internal hydrocephalus the dropsy of the ventricles of the brain, for the ventricles are the proper seat of the disease. Dr. Macbride names it the febris hydrocephalica; others cataphora hydrocephalica. The internal hydrocephalus arises gradually, affecting HYD 770 HYD chiefly infants of a fair light complexion from the early months to about the age often. BetAveen seven and ten the disease is rare. The first symptoms are irregu- lar fever, Avith symptoms of considerable irritation of the bowels, so as to induce a suspicion of worms. The discharges from the bowels are procured yvith difficulty; the urine is often scanty. In general an obstinate costiveness gives the first symptoms of alarm; but the complaint still proceeds so insidiously, that the most cautious observer can scarcely fix on any appearance to justify alarming the parents. Sometimes slight Avandering pains about the nape of the neck or the upper extremities precede, and are considered as febrile. When the disease appears in a more pointed form, a violent pain, deep seated in the head, seems to extend from temple to temple, and across ,the forehead; sick- ness is at times considerable; the patient occasionally doses and sighs; the breathing is interrupted; the pulse unusually slow, often irregular; at times the sleep is apparently sweet and easy, but in general dis- turbed,and interrupted occasionally by a violent scream, often a pathognomonic symptom of the disease. The pupil of the eye is dilated, and scarcely contracts, even by a strong light. The eye itself is often turned up- ward; but more commonly contracted by a spasm, Avhich occasions squinting. A little before death's ap- proach, feverishness sometimes attends, especially to- Avards evening; at last the pulse quickens, the breath- ing is very laborious and difficult; the heat excessive ; the patient is averse to the light, takes things greedily, and cannot bear any but an horizontal posture; the excrements are insensibly voided; the hands are com- monly kept about the head; the eye lids become paraly- tic, and the iris immoveable; a great heat and sweat spread all over the body; the pulse trembles, and strength soon fails, if a sudden convulsion does not bring on the catastrophe. Many of these symptoms are common to Avorms, teething, and other causes irritating by sympathy the brain, so that it is difficult to fix upon any Avhich par- ticularly characterize the disease. In general, in the early stages, the costiveness, with marks of irritation in the bowels, are the first appearances which lead to a suspicion; but the screaming, the slow pulse, and the squinting, are the only pathognomonic symptoms. The pulse sometimes sinks to forty in a minute. There is a spurious kind of hydrocephalus, similar to the spina bifida. It appears on the lower part of the occiput like a bladder of water, and underneath the bone is deficient. Opening it would be as fatal as the open- ing the tumour of the spina bifida. The disease both in its pathology and cure is still de- fective. The more obvious cause on dissection is an accumulation of water in the ventricles, generally at- tended with considerable fulness of the vessels; but the quantity of fluid is by no means in proportion to the violence of the symptoms; and in many instances where there is no considerable degree of compression from the accumulated water, the worst consequences often follow. These circumstances have led practitioners to suppose, with great reason, that the dropsy is only the effect of a previous disease of the brain; and those, who have brought this opinion into any distinct shape, have thought it to be inflammatory, or an apoplectic fulness of the vessels. The author who supposes it to be inflammatory is Dr. Rush of Philadelphia, and he thinks early and active bleeding a certain remedy. In this idea, he was preceded br Dr. Quin of Dublin, and has been followed by Dr. Garnett; though these au- thors have not been equally confident of the,success of the remedy. It is necessary therefore to examine the subject more closely. There is little doubt but that a diseased state of the brain exists previous to the accumulation of the water, and the great question is respecting the nature of this state. We have little reason to suppose ^inflammatory, for the disease does not attack strong, healthy children, those over fed, or rendered plethoric by too great care. If there are any childrerKpeculiarly subject to hydroce- phalus, it is the weak, the pale, and the debilitated. These indeed may suffer from venous plethora; but we ought to reflect that this is not a disease of their time of life. An accumulation of blood in the arteries, in a degree greater than the veins can carry off; veins, as Ave have seen, tortuous, and in Avhich the motion of the blood is peculiarly slow, may occasion increased exha- lation : but to this may be objected, that the early symptoms are not those of compression but of irrita- tion only, of irritation not in the brain, but in the bowels. If Ave pursue the series of symptoms, Ave shall find that the consequences of compression are combined with those of irritation, but that the former are by no means in proportion to the quantity of fluid found in the ventricles after death. In this argument Ave lay no stress on the effect of remedies, for we believe all re- medies equally ineffectual. It is indeed probable that symptoms of irritation and compression may be relative to the constitution of the patient; that, as in the former case, a slighter cause may in a very irritable habit produce violent symptoms, so, in a more torpid system, a little degree of compres- sion may produce insensibility or spasm. Yet these views will not lead us far, and very certainly will not assist us in the cure. The first symptoms show, as we have said, irritation in the bowels, Avhich may be readily supposed to originate from an affection of the brain: the second train are the effects of compression, Avhich may be probably accounted for from the accumulation of fluid. If, hoAvever, we apply these vieAvs to practice, Ave shall find their fallacy : the means of relieving irritation or compression are equally useless; and Ave see no means of accounting for the symptoms, but from sup- posing an original defect in the organization of some portion of the brain itself,—a cause which will be supported by its being often confined to particular families, and its often affecting the children of the same parents. What this defect is we cannot explain: but we have seen that a free communication between dif- ferent parts of this organ is peculiarly necessary; and if we suppose this communication interrupted, the usual consequences of increased action will follow. We see this deficiency of communication in the spina bifida; and children live for some time till the necessity of the free circulation of the nervous power is felt. A want cf this free circulation in the brain itself may not be so soon experienced as in the nerves which supply the voluntary muscles; and according to the part where the deficiency occurs, the disease may appear sooner op later. This idea is not supported by dissections; but, HYD 771 HYD in general, if the vessels are found peculiarly turgid, or the ventricles preternaturally filled, anatomists have been contented with the success of their researches. We rest with more complacency on this opinion, because it explains the want of success which we think has attended every plan. As authors, however, have had their favourite modes of relief, which they have some- times thought effectual, it is necessary to describe them. Bleeding, according to the idea of Dr. Rush that the disease is inflammatory, has been practised; but on this subject Dr. Rush is certainly prejudiced. Where- ever he finds bleeding useful, he sees inflammation. It has escaped us if his practice has been imitated in this country, so that its success is equivocal. Topical bleed- ing, either by the cupping glasses or by leeches, under the influence of Dr. Quin and Dr. Garnett's ideas, we have employed with scarcely even temporary advantage. Blistering either on the vertex, the nape of the neck, or behind the ears, has been more useful, but has never effectually removed the complaint. Purging, in all its forms, has only afforded a slight and temporary relief. We have been told of the effects of mercurials, and have employed them actively, so as to raise a ptyalism ; or more sloAvly to give permanent tone, or as purgatives. It has been said that they have succeeded; but Ave have unfortunately failed, though Avhen a slight ptyalism has been produced, we have found the symptoms in some degree relieved: the fatal event, however, has scarcely been retarded, or retarded only. In one case, where we suspected the source of the previous complaints, we early employed calomel as a purgative. A very slight soreness of the gums ensued, and the disease even came on during the action of the mercury. Digitalis, doronicum, and cicuta, have been men- tioned ; but, on examining the accounts of authors who have recommended these remedies, we have found little foundation for their employment, and cannot therefore speak of them from experience. The children subject to the complaint are, we have said, inactive and debili- tated ; and we should not, a priori, expect any consi- derable advantages from narcotics. As the water is usually contained in the ventricles, an operation is wholly inadmissible. When we consider the confident assertions of some authors, and compare them with the effects of the most careful trials, we shall find it highly probable that they have mistaken other diseases for hydrocephalus. We have certainly done the same, for we once thought mercurials effectual. In advanced life there are affec- tions of the head not strikingly apoplectic, though similar to apoplexy, Avhich require large doses of mer- cury, and are relieved by it. See Whytt on Hydrocephalus; Quin on the Apo- plexia Hydrocephalica; Fothergill and Watson, London Medical Observations and Enquiries, vol. iv. and vi.; Withering on the Digitalis Purpurea; London Medical Transactions, vol. ii.; Monro's Observations on the Structure of the Nerves; Edinburgh Medical Com- mentaries, ato1. v. vii. viii.; Medical Communications, vol. i. p. 404; London Medical Journal, vol. i. p. 357; Memoirs of the Medical Society of London, vol. i. p. 165 and 169. HYDROCl'STIS, (from hfoop, aqua, and kvt]is, a bladder). Encysted dropsy, or dropsy of a particu- lar part. HYDROCERATOPHY'LLON, (from ifoop, water, xe^xs, a horn, and (pvXXov, a leaf). See Ceratophyl- lum. HYDROGA'RON, (from hfoip, and yxpov, pickle). Garum diluted with water. HYDROGE'NIUM, (from vfoop, water, and yivoftxt, to become, or yewxu, to produce,) hydrogen is one of the constituent parts of water, and perhaps of muri- atic acid. (See Aer, and Chemia.) Though its gas is unfit for respiration, it is not poisonous. Its effects on the animal economy are not peculiarly striking, but it appears to affect the irritability of the muscular fibre in a considerable degree ; and animals killed by it are supposed to putrefy quickly. The latter opinion seems, however, from Chaptal's Experiments, to be founded on a mistaken observation. HYDROLA'PATHUM, (from ifoop, and XxvxSov, dock). See Lapathum aquaticum. HYDROME'LI, (from ifcp, and peXi, honey). Hy- dromel; mulsum, aqua mulsa, melicratum, braggat. Water impregnated Avith honey. After it is fermented, it is called vinous hydromel, or mead. HYDROME'LON, (from Ifoop, and ^Xov, an apple). Is made of one part honey, impregnated Avith quinces, and two parts of boiled Avater, set in the sun during the dog days. HYDROME'TRA,(from vfoop, aqua, and wlpx, ma- trix). Dropsy of the avomb. See Hydrops uteri. HYDRO'MPHALUS, (from vfo*p,water, and o^xXos, a navel). A tumour of the navel, containing Avater. See Hydrops umbilicalis. HYDRONO'SOS, (from vfoop, water, and voa-os, a disease). See Sudor Anglicus. HYDROPE'GE, (from vfoop, and snjyj;, a fountain). Spring water HYDROPEDE'SIS, (from vfoop, and zrefotu, to break out). See Ephidrosis. HYDROPHO'BIA, (from vfoop, water, and QoGea, to fear). A dread of water; aque pavor, is a symp- tom of the disease caused by the bite of a mad animal; but not peculiar to this disease, nor always attendant on it. (See Dyscapatotia.) The disorder has usually had the same appellation, and is called also canina ra- bies, cynanthropia, cynolesia. Dr. James observes, that this kind of madness properly belongs to the canine genus, viz. dogs, foxes, and Avolves, to whom only it seems innate and natural; scarcely ever appearing in other animals, except communicated from these. Dr. Heysham defines it to be an aversion and horror at li- quids, as exciting a painful convulsion of the pharynx, occurring at an indetermined period, after the canine virus has been received into the system. The hydrophobia is a nervous disorder, though at- tended with some appearances of inflammation. Dr. Cullen places it in the class 7ieuroses, and order spasmi, defines it a loathing and great dread of drinking any liquids, from their creating a painful convulsion of the pharynx, occasioned most commonly by the bite of a mad animal. This definition, however, scarcely includes the full idea of the disease; and we Avould suggest the folloAving as more complete: melancholy, a dread of 5 F 2 11 V D 772 it v n cold air, of any thing shining, and particularly of Avater, often arising from the bite of a mad animal. He dis- tinguishes tAvo species. 1. Hydrophobia rabiosa, Avhen there is a desire of biting, from being bitten by a mad animal. 2. Hydrophobia simplex, without rabies, or a desire of biting. The principal and original seat seems to be about the stomach, and parts contiguous to it. Dr. Seleg thinks that it is seated in the par vagum and intercostal nerves; for most of the symptoms happen where these nerves are interspersed. The smallest quantity of the saliva of a mad dog produces the disease. The infection may lie dormant for a period, differing according to the habit of the pa- tient, the time of the year, the degree of the disease in the animal, or the place in which the Avound is made. If the patient is not of a strong inflammatory habit, and no circumstances intervene, which otherwise affect his health, it seldom takes effect till after about forty days: if in six weeks, or two months, no sign of disorder appears, the patient is usually concluded to be safe. It has been observed, that the nearer the place bitten is to the head, the sooner the symptoms appear. If the part bitten is covered with woollen or leather, the bite is harmless. The dread of water is a symptom in some fevers, and in some particular inflammations (Edinburgh Medical Commentaries, vol. xi.p. 331); and it is highly probable, that in those cases where the poison is said to lie dormant for six or nine months, or even a year, the disease was connected with fever rather than the rabid poison. When a dog is affected with madness, he becomes dull, solitary, and endeavours to hide himself, seldom barking, but making a murmuring noise, and refusing all kinds of meat and drink. He flies at strangers; but, in this stage, he remembers and respects his master: his ears and head hang doAvn; he walks as if over- powered with sleep ; and a bite at this period, though dangerous, seldom conveys the disease. After these symptoms, the dog begins to pant; he breathes quick and heavy; hangs out his tongue to discharge a great quantity of froth from his mouth, which he keeps per- petually open; sometimes he Avalks slowly, as if half asleep, and then suddenly runs, but not always directly forward: at length he forgets his master;~ his eyes look dispirited, dull, full of tears, and red; his bark is hollow and hoarse; his tongue of a lead colour; he grows faint, thin, and weak, often falls down, again rises, at- tempts to fly at every thing, and soon grows furious: this second stage seldom continues thirty hours," death by that time putting an end to the disease, and a bite received at this time is the most dangerous. When the human species are the subjects of this dis- order, a slight pain in the Avound is first felt, sometimes attended with itching, but usually resembling a rheu- matic pain : it extends into the neighbouring parts, and the cicatrix begins to swell, inflames, and at length dis- charges an ichor; this pain is considered as the primary invariable mark of a beginning hydrophobia. There are more general pains, of a flying, convulsive kind, which are said to affect the patient in the neck, joints, and other parts; often a dull pain seizes the head, neck, breast, belly, and along the back bone: towards the conclusion of the disorder the patient complains of this pain shooting from the arm towards the breast and region of the heart. A lassitude, a dull pain in the head, and a vertigo, soon come on: the patient is me- lancholy, mutters, is forgetful, and drowsy; his mind seems disordered; his temper irritable and irregular; his slumbers disturbed, and convulsive agitations im- mediately follow his waking; a deafness is sometimes complained of; the eyes are watery; the aspect sor- rowful ; the face pale and contracted; SAveat breaks out upon the temples; an unusual discharge of saliva flows from the mouth, though the fauces are dry; the tongue becomes foul, and the breath occasionally fetid. The fetor is often only perceived by the patient; and some- times it attends the discharge from the wound, the dressings of which are said to be frequently black. Besides these, from the beginning, there are a peculiar stricture and heaviness on the breast, a struggling as it were for breath, a sighing, a nausea, and often a bilious vomiting. This oppression of the precordia is one of the constant symptoms of this disorder; it begins, in- creases, and ends with it. As the above symptoms in- crease, the second stage advances; a fever comes on, which at first is mild, and attended with momentary horrors, though there is sometimes no fever; sleep is lost, the mind is more and more disturbed, a delirium approaches, and an aversion at first to polished bodies, then to light, afterwards to fluids, is perceived. The air offends if it touches the skin, and the slightest sound is very painful. A constriction of the gullet, with diffi- culty of swallowing, first occurs; but as yet liquids are freely taken; afterwards, however, they are refused. This symptom augments so visibly, that on the sight of any liquid a horror seizes the patient; and if he strives to drink, spasms, anxiety, and loss of sense, follow. As soon as the surface of the liquid is touched, a strangu- lation in the throat is felt; the stomach is inflated; the larynx is suddenly SAvelled externally, though the swelling quickly disappears. While liquids are thus rejected, solids are swallowed Avith tolerable ease; yet this symptom may become so violent as totally to prevent solids also from being swalloAved. The patient now mourns bitterly; at times loses all knoAvledge of his intimate acquaintance; but reason returns at inter- vals, and he laments his own calamity: the thirst excites a desire of drink, but he strives in vain to sAval- low, and soon sinks into the most affecting despondency; he advises his friends to keep at a distance, and it is supposed that he feels an inclination to bite; but this is suspicion only, and it is highly improbable that, with the disease of a dog, he should adopt his manners: biting is the common method by which that animal shows his resentment. The barking like a dog is equally imaginary. A priapism and involuntary emis- sions of semen and urine sometimes attend this stage; and as the conclusion approaches, the fever and thirst increase; the eyes are bright and furious; the urine is high coloured, acrid, and in small quantities; the tongue hangs out; the mouth foams; the pulse throbs, strength fails, cold sweats come on, the tightness of the breath increases, and the patient soon expires in spasms, often losing the difficulty of swallowing liquids, for many hours; so that the dread of water is by no means a pathognomonic symptom. HYD 773 HYD On dissection, the brain, the medulla oblongata, and all the muscles, are said to be drier than usual: the membranes extenuated; the pericardium dry; the blood coagulates slowly, if at all; and putrefaction soon comes on. The fat appears completely wasted ; the gall blad- der full of greenish bile; and the stomach covered with a glary matter of a brown colour, and its villous coat livid. The liver, contiguous to the stomach, is livid, and the trachea and oesophagus inflamed. The poison of rabid animals is, like that of the small pox, secondary- in its operation. It lies concealed till, perhaps, by an assimilatory process, its quantity is in- creased, or from the heat of the body it becomes more active. It is sufficiently certain, that, if the partis extir- pated soon after the bite, the patient is safe : it is highly probable that the same operation at the first commence- ment of the inflammation would be equally advantage- ous. When absorbed, like other poisons it is carried to some excretory; and that which from chemical affi- nity or some other cause is preferred, we find to be the salivary and the mucous glands of the fauces. Previous, however, to this determination, it shows deleterious ef- fects on the nervous system by the melancholy, the in- creased sensibility, and the affection of the precordia, which precede. These are the natural and genuine effects of the poison, which prove sometimes fatal without any others following. Mead. When the poison is determined to the excretories, it shows a powerful and active stimulus. Inflammation, which is the consequence, in the mouth and fauces, seems to occasion the difficulty of swallowing. The increased sensibility, hoAvever has some influence; for if the patient does not see the fluid, or it is not given in a shining vessel, the convulsions are much less violent. The sensation of cold water to the inflamed fauces con- tributes to the effect. In all these respects, solids will be less offensive than fluids; and in general they are swalknved by a less effort. The disease in dogs is not OAving to heat, but is probably produced by their confinement in kennels. In man the disease is exclusively owing to the poison in- troduced by the wound; but its action is'said to be ac- celerated, probably increased, by fear, grief, or any of the depressing passions. The prognosis is ahvays unfavourable. If, in a disease Avhere remedies are so uncertain, Ave were to draw any prophylactic indications, they would be, first, to prevent the poison from acting, though it exists in the body; secondly, to evacuate it by the most speedy methods. This disease is peculiarly rare. Some practitioners of the most extensive experience have never seen it; and some have boldly denied its existence. In general, very few of the dogs reputed to be mad are really so; and but a small proportion of those bit by a dog, really mad, receive the infection, as the parts are usually de- fended by the clothes, and the teeth of the animal are consequently wiped clean before the wound is inflicted. This circumstance has given a delusive credit to many trifling preparations employed as prophylactics. None are to be trusted except excision ; but it is necessary to state, according to the indications laid down, Avhat has been proposed. We have already remarked, that nature is able to eva- cuate morbid poisons, if the animal power is supported, or at least no cause of debility gives the poison activity. The first indication is, therefore, answered by avoiding whatever may depress or weaken, and employing every plan to give a tone to the system. The depressing passions are consequently to be counteracted; and should the patient's mind rest on the circumstances of the bite, it should be cheered by every encouraging representa- tion. Perhaps the ridiculous specifics, as eating the liver of the dog broiled, or tying the skin of an hyaena about the arm, may have been useful by inspiring con- fidence ; and avoiding cold and excesses of every kind must be advantageous in every view. Stimulants are useful with the same design; and numerous are the remedies of this kind recommended by the ancients, though condemned by Boerhaave ; viz. Galen's theriaca; Scribonius Largus' opiate, a preparation containing opium with large quantities of aromatics; the cibi acres of Dioscorides; the wine of Celsus; the garlic and theriaca of Palmarius and Mayerne, who added occa- sionally the scordium, the snake root, and the flowers of hypericum; and the pepper of Mead; are of this kind. Tonics have been also employed, the chief of which is cold bathing. The ancients used it Avith every mode of exciting terror; and when they used the Avarm bath in this complaint, the patient on coming out of the water was plunged " in piscinam." Other tonics have not been employed, though we find the filings of tin in Mayerne's remedy ; and in some formulae, the varvain, the lesser sage, plantain, and polypody; and in others, the wormwood, mint, betony, hypericum, and lesser centaury—medicines which, if they have any power, must act as tonics. In following the second indication, we may evacuate the poison from the wound by sucking, by washing it with hot water, by cutting it out, by bleeding with cup- ping glasses, by enlarging the wound, increasing the discharge with suppurating applications, by burning it Avith gunpowder, or destroying an absorbing surface by a caustic. Each has been employed, and each has had its partisans ; but to cut out the part is the only certain remedy, and it is certain at any period previous to the inflammation. If the wound is inflicted so deep that the bitten part cannot be separated, a caustic must be applied to what remains; and though we thus lessen the chance of relief, we should reflect that, at the depth of the wound, the tooth has already lost its venom. Yet such are the horrid consequences, that even the loss of a limb would, in the event of a violent Avound from a dog certainly mad, cheaply purchase security. When our attention has been paid to the wound, Ave must look to the other excretories for the evacuation of the poison: those most "commonly preferred are the skin, the urinary organs, the salivary or intestinal glands. Mercury given in small closes, and long continued so as very slightly, if at all, to affect the mouth, may be con- sidered as a diaphoretic. Sauvages has collected a va- riety of cases in Avhich those who took mercury in this Avay escaped, while others bit by the same animal died hydrophobic. Desault, James, and others, have added their testimony to the success of the same measure; but we must add, with regret, that later experience does not support their decision. It is painful to be obliged so often to oppose positive assertions; but it would be injurious to mankind to support a delusive security. We have already observed that a dog, supposed to be HYD 774 HYD mad, seldom is so ; and that often bitten by an animal really mad, not above one or two are infected with the disease. Of the same kind is the famous Chinese re- medy, which consists of ten grains of mosch, with twice the quantity of factitious cinnabar, for the dose is ordered to be repeated, if sleep and sweat do not fol- low ; and Hillary has observed that it is useful in pro- portion as it proves diaphoretic. The warm bath has been highly commended, particularly by Lieutaud; but later experience has not confirmed its utility. The principal diuretic is cantharides, but they have been seldom employed. The chief authority we can find for their utility is Baccius de Venenis and Anti- dotis, and some cases in which they appeared to be use- ful are recorded in the first volume of the Bologna Transactions. The ashes of the river cray fish, burnt by twigs of bryony ; the sponge of the dog rose; the alyssum or mad wort; and the lichen cinereus terres- tris ; have been considered as diuretics. They may be such ; but they are useless in this disease. The cathartics employed in hydrophobia have been the rhubarb, the hiera picra, the colocynth, and helle- bore; but we have received no positive accounts of their utility, and have reason to think them of little im- portance. It has been supposed that the organs may be sheathed Avith oil, and absorption prevented, or the acrimony of the poison covered. This plan too has flattered and disappointed practitioners; and the Ormskirk medicine, which is principally an antacid, has had no better suc- cess. When the disease has come on, it has been the object of practitioners to sooth the early symptoms of irrita- tion by opium, or to assist the natural discharge by the more active exhibition of mercurials. Dr. Rush, in his reveries respecting inflammation, thought this disease also inflammatory, and proposed active bleeding. We can trace this remedy in the History of the Academy of Sciences at Paris for the year 1699, p. 58, recom- mended by Poupart; and Ave find it also mentioned in the Medical Essays of Edinburgh, vol. v. part ii. § 51. This also has failed. Later authors have called hydro- phobia a putrid fever, and given bark in large quanti- ties, but with the same success. Opium seems to rest on more rational principles, and two grains, or even a larger dose, given every three hours, seem to have relieved the symptoms, but have done no more. A ptyalism, rapidly excited, and steadily continued, has scarcely succeeded better; and the vine- gar, of which four ounces have been directed three times a day, has equally failed. In short, full, effectual, and complete excision of the wounded part is the only certain means of relief; and this is certain. See jEtius, Coelius Aurelianus, Lommius, Sauvages sur la Rage, Desault; James on Canine Madness; Mead on the Bite of a Mad Dog; Seleg, Nugent, and Hamilton on the Hydrophobia; Medicai Museum, vol. ii. p. 97, Sec ; London Medical Transactions, vol. ii. and London Medical Observations and Inquiries, vol. iii.; Edinburgh Medical Commentaries, vol. v. p. 42 ; Vaughan's Two Cases of the Hydrophobia; Cullen's First Lines, vol. iv.; White's Surgery, p. 102; Me- moirs of Medical Society of London, vol. i. p. 243; Memoirs of the Royal Society of Medicine in Paris, Supplement to vol. iv, The second species arises without any contagion, in some fevers from topical inflammations of the thorax or neighbouring parts; from the accession of an epi- lepsy ; from the bite of an epileptic patient; the bite, it is said, of persons in violent fits of passion : an infe- rior degree of it will be observable in some hysteric cases, when, from the difficulty of swallowing, patients are fearful of taking liquids, and sometimes cannot be prevailed upon to make the attempt. In all these cases, musk and opium appear to be chiefly efficacious. HYDROPHTHA'LMIA, (from vfoop, water, and otptoxXfios, the eye). See Proptosis. HYDROPHTHA'LMION, (from the same). It is the part under the eye which swells in cachectic and hydropic cases. HYDROPHYSOCE'LE, (from vfovp, water, fy°s, a cartilage). The hypochondria are those viscera on each side, which lie under the spurious ribs, extending to the ilia, and comprehending not only the muscles, but the internal parts; because they are subjacent to cartilages. Celsus, from several places in Hippocrates, renders the word praecordia. Coelius Aurelianus does the same. The state of tension in the hypochondria should be examined in every fever. Affections of the hypochondria, according to Hippo- crates, are, hypochondrion anespasme7ion, a retraction of the hypochondrium inwards, without any proper dis- order of the part; hypochondria diaborborizonta, a rum- bling of the hypochondria; hypochondrii entasis, a soft- jsh tension of the hypochondria; hypochondria catexer- as7nena, the hypochondria dried up and contracted in- wardly ; hypocho7idria meteora, raised by flatulencies ; hypochondria xyntasis, a distention of the hypochondria from inflammation; hypochondria scolitoes, an inequality of the hypochondria; hypochondrium chronium, an hy- pochondrium affected with an obstinate disorder : and HYPOCHONDRI'ACUS MO'RBUS, (from wn- Xovfyiov, the hypochondrium). The hypochondriac disease; affectio hypochondria,passiohypochondriaca, hypochondriasis, vapours, spleen, &c. Hoffman, with great propriety, contends, that hypo- chondriasis is not the same disease as hysteria. He ob- serves, that a strangulation of the fauces, a quick and difficult respiration, endangering suffocation, loss of speech and motion, are the proper and essential symp- toms of the hysteria: that the hypochondriasis is inve- terate, and rarely so effectually relieved as not to be again easily excited; that though many of their symptoms are the same, yet tbey each have such as is essential to it. Many others comprehend these two disorders under the general title nervous; and think that they only differ as affecting different sexes, or by the flatulence of the stomach, which distinguishes hysteria. Dr. Cullen places hypochondriasis in the class neuroses, and order adynamia ; and defines it indigestion, with langour, sad- ness, and fear, from uncertain causes, in a melancholic temperament. One idiopathic species is only known. The state of mind peculiar to hypochondriacs is thus described by Dr. Cullen. " A languor, listlessness, or want of resolution and activity, Avith respect to all undertakings; a disposition to seriousness, sadness,find timidity; as to all future events, an apprehension of the worst or most unhappy state of them ; and, therefore, often upon slight grounds an apprehension of great evil. Such persons are particularly attentive to the state of their own health, to every the smallest change of feeling in their bodies; and from any unusual sensation, perhaps of the slightest kind, they apprehend great danger, and even death itself. In respect to these feelings and fears, there is commonly the most obsti- nate belief and persuasion." He adds, that it is only when the state of mind just described is joined with indigestion, in either sex, somewhat advanced in years, of a melancholic temperament, and a firm and rigid habit, that the disease takes the name of hypocho7idriac. The seat of the hypochondriac passion is in the sto- mach and bowels; for, first, these parts are disordered, then the others suffer from the connection. In this Hoffman agrees, by saying the peristaltic motion in the bowels is retarded by spasms. The causes are, sorrow, fear, or excess of any of the passions; too long continued watching; irregular diet. Those habitually disposed to it—and these causes have little effect in other constitutions—have generally a sal- Ioav or brown complexion, and a downcast look, a ri- gidity of the solids, and torpor of the nervous system. Whatever may occasion nervous disorders, in general, may be the cause of this in particular. The signs of this complaint are so various, that to de- scribe them is to describe almost every other disease ; but in general there is an insurmountable indolence, dejected spirits, dread of death, costiveness, a slow and somewhat difficult inspiration, flatulencies in the primae viae, and various spasmodic affection. It is seldom fatal; but if neglected, or improperly treated, may bring on melancholy, jaundice, madness, or vertigo, palsy, and apoplexy. The hypochondriac disease is very difficult to cure : it rarely occurs early in life, generally- in more advanced years only; and Avhen once it has taken place, it in- creases as life advances. Indigestion, accompanied with vapours, distinguishes the disease Avhen the tem- perament is of this peculiar kind. If the disease admits of a cure, it is by means slow and steady in their operation ; for the Avhole constitu- tion must be corrected before any expectation of relief can be obtained. In these cases the mind must be cheered by every pleasing prospect; by assurances of a cure; by change of place and objects; by engaging it in any employment which will interest without fatigu- ing. For these purposes the fashionable mineral waters may be drunk on the spot, and they should be of the HYP 782 HYP mildly cathartic kind, as those of Cheltenham, Seltzer, or Tunbridge; but the cathartic waters arc, on the whole, preferable to those which contain steel among their impregnations, though this medicine is not parti- cularly injurious. If these plants cannot be admitted, an active emetic should be given, and repeated every three or four days; a small blister applied to the neck ; and the bowels kept freely loose by the pillulae ex aloe cum myrrha, or the tinctura aloes. Dr. Cullen observes, that in the hy- pochondriasis there is a want of activity, not a loss of tone, in the fibres, but, on the contrary, a rigidity in them; and he recommends warm bathing; drinking tea and coffee; exercise, not merely to excite the activity of the stomach, but to divert the mind from its despondency. Astringents are generally improper. As there is usually an acid in the stomach, bitters may be given with the alkaline salts and rhubarb: but chalybeates are of more uncertain efficacy; and bark, in general, is injurious; though, when attended with flatulence, aro- matics may be sometimes allowed. In managing the minds of hypochondriacs, any inti- mation that their complaints are imaginary, must be avoided, and neither raillery nor reasoning in addressing them employed. Their attention should be engaged with any object but their own feelings; diverted with any employment not attended with emotion, anxiety, or fatigue. Diversion, in which some skill is required; exercise in the air, which requires some dexterity, are both to be admitted : riding is better than either walk- ing, sailing, or travelling in a carriage; and a distant journey is the best. The study of botany, which com- bines exercise with employment, has been highly salu- tary. If pain and flatulence, accompanied with an head- ach, attend, a slight anodyne may be admitted; and if spasmodic symptoms are considerable, tending to con- vulsions, relief may be obtained by means of opiates, joined with fetid gums, or with musk. Warm bathing in pure Avater,.heated sufficiently to raise Fahrenheit's thermometer to ninety or ninety-two, should be continued until some relief is obtained, and then gradually the cold bath may be substituted. Cheerful company conduces much to relief; but boisterous mirth, or any exercise carried so far as to fatigue, are injurious. A dry warm air is almost uni- versally proper. See Nervous diseases ; Hoffman on the Morbus Hypochondriacus; Cullen's First Lines, vol. iii. edit. 4. HYPOCHONDRIASIS. See Hypochondriacus MORBUS. HYPOCHY'MA, and HYPOCHY'SIS, (from vro, and xvui t0 pour; because the ancients thought that the opacity proceeded from something running under the crystalline humour). See Cataracta. HYPOCI'STIS, (from vro, under, and xiPi) sanies; a bloody, thin, but acrid fluid, which distils from wounds. I'CHTHYA, (from i%lvs, a fish). The name of a hook for extracting the fcetus; from its likeness to a fish hook; or raspings, according to Erotion. ICHTH YE'MATA, (from <#<>«*, the scale of a fish). ICH The scales of fishes, and the raspings of the bark of trees. ICHTHYOCO'LLA, (from tx6vs, fish, and xoxxx, glue). Isinglass ; colla piscium; alcanna; and huso; fish glue, is a solid glutinous substance, prepared in Muscovy from the sturgeon. The skins and fins are boiled in water; the decoction is inspissated to a due con- sistence, and poured out so as to form very thin cakes, which are either dried in that form, or cut while soft into slices, and rolled up into spiral and other shapes. A finer kind is, it is said, prepared by rolling up the air bladders of the accipenser struthio. That which is clear, thin, and almost transparent, is the best. See Philosophical Transactions, vol. lxiii. It is one of the finest of the animal glues, without smell or taste. When beat into shreds, it readily dis- solves in water or milk, forming a mild, nutritious, restorative aliment; as well as a remedy in the fluor albus, continued diarrhoeas, and other evacuations from debility. Its solution in water or spirit, if nicely spread upon silk, is an elegant plaster for slight injuries to the skin; and, joined with some resins, it is called court plaster. (See Empl. adhesivum nigrum.) It is said to agree with the gum tragacanth in medicinal' vir- tues; but, like all other animal mucilages, it soon runs into a state of putrefaction, and becomes more irritating than the vegetable mucilages. Hollow cylinders of isinglass are employed to support the sides of a divided intestine, when united by a suture. A passage is thus left for the contents, which by a solution of the isinglass is gradually enlarged till the wound is healed. Sec Lewis's Materia Medica; Neumann's Chemical Works; Cullen's Materia Medica. ICHTHYOSIS, (from ix*vx, the scale of a fish, which it resembles). A harsh, dry, scaly, and almost horny texture of the skin, differing from leprosy by its not falling off in branny scales. Above and below the elbow and knee, Dr. Willan observes, that the scales arc small, rounded, and papillary, of a black colour : the 5 H 2 ICT 788 IC T papillae have short narroAv necks, with broad irregular tops. On the rest of the body they are large and imbri- cated, sometimes divided by Avhitish furrows. The soles of the feet are dry and rough; the palms of the hands thickened and brittle, with large painful fissures, and the face is covered with bran rather than, scales. The inner part of the wrists and hams, the inside of the elboAv, and the furroAV along each side of the spine, the inner and upper part of the thigh, are usually free. Some perspiration is necessary; and this seems occa- sionally to produce inflamed'pustules. The disease ap- pears to be constitutional, not hereditary. Two cases of a horny ichthyosis impeding the motion of the mus- cles are described in the 68th volume of the Philoso- phical Transactions. I'CICA, and ICICA'RIBA. Gum elemi. See Elemi. I'CON. A figure : the abbreviation of icones plan- tarum, botanical plates. ICOSA'NDRIA, (from etxoo-i, twinty, and xvnp, a husband). The names of the twelfth class of the Lin- naean system, comprehending those plants Avhich have hermaphrodite flowers, with tAventy or more stamina, growing on the inside of the calyx, not on the recep- tacle. The situation, and not the number, of stamina is chiefly to be attended to. The calyx is also monophyl- lous and concave in this class; and the claws of the pe- tals are fixed into the inside of the calyx. ICTERO'DES, (from ixlepos, the jaundice). The BILIOUS ARDENT FEVER. See BiLIOSA FEBRIS. ICTERITI.E, (from icterus, the jaundice). Disco- lorations, or diseases which occasion an unusual colour of the whole skin without acute fever. FCTERUS, (from ixlepos, the golden thrush, from the complexion of the patient resembling in colour the plumage of that bird. Pliny ridiculously observes, that if the jaundiced person looks on this thrush, the bird dies, and the patient recovers ;) the jaundice, morbus arquatus, aurigo, morbus regius, cachexia ecterica, or icteritia; by Paracelsus, leseoli 7norbus. It is OAving to an obstruction of the discharge of the bile into the bow- els, and its return into the blood by the absorbents. Dr. Cullen places this disease in the class cachexia and or- der impetigines; defining it a yellowness of the skin and eyes; white faeces; the urine of a deep red, tinging a Avhite rag of a yelloAV colour Avhen dipped into it. The species are: 1. I'cterus calculo'sus, Avhen there is acute pain in the hypogastric region, which increases after eating, and when bilious concretions pass through the intestines. 2. I'cterus spasmo'dicus, without pain, and the yel- lowness of the skin happening after spasmodic diseases or affections of the mind. 3. I'cterus hepaticus, without pain, following a dis- ease of the liver. 4. I'cterus gravidarum, arises during pregnancy, and disappears after delivery. 5. I'cterus infa'ntum, happens soon after their birth. A yellowness of the skin sometimes arises from a de- ficiency of the red particles of the blood, or the effusion of the serum. The appearance deceives common ob- servers, but may soon be distinguished by an experi- rienced eye. The yelloAV tinge of the urine will at once decide any doubt. Infants have a yelloAvness of- ten independent of bile from the red effusion under the skin, assuming a yellow colour, after being partly absorbed. The true jaundice of infants proba- bly arises from the hardened meconium obstructing the duct. The genuine jaundice arises from an obstruction of the duct, by gall stones, or viscid bile. Sydenham speaks of a symptomatic jaundice produced by hysteric symptoms ; but this complaint is probably the icterus spasmodicus. The yellowness from the bite of a viper is not a species of jaundice.' Women are generally more subject to this disease than men, either from a slower action of the intestines or from a more sedentary life. The cause of the true jaundice is the bile mixing with the blood in consequence of its obstruction from gall stones, spasms, scirrhus, and sometimes even from flatulence or a gravid uterus. A scirrhous liver is the cause of the most fatal kind; and a jaundice is often a mark of a constitution wholly decayed : in such cases the liver is often scirrhous In a late publication Dr. Gottlieb Richter thinks it probable, that " the most common cause of jaundice is a stimulus or irrita- tion acting upon the hepatic system, which prevents the afflux, secretion, and excretion of the bilious fluids; or, rather so deranges the circulation in the hepatic system, that the several parts do not reach their destined places, according to the laAvs of health, but are again mixed with the general mass." In proof of Avhich he recites a case of a high degree of jaundice, where no gall blad- der was found; but, in its place, only a skinny substance of a very small size, without any cavity. " The whole liver was full of white concretions, apparently of the nature of calcareous earth, of different sizes, from that of a pea to that of a cherry, and which floated in water." In this case, however, though the bile formed was not collected, it was evidently obstructed, and of course absorbed. He confirms his opinion by the authority of Chaux, who, in the seventy-fourth volume of the Journal de Medecine, endeavours to show that the jaundice can be cured by sedatives alone; by that of Selle, who, in his Medicina Clinica, p. 292, imputes the jaundice to a stimulus; and of Vogel, who, in his Treatise on Jaundice, published at Wetzlar in 1791, has, he thinks, proved in a very convincing manner that the jaundice is occasioned by a state of irritation in the liver. See Richter's Medical and Sur- gical Observations. These opinions were formerly common, but have long since been rejected; and jaundice is now very ge- nerally attributed to obstruction of the bile from the causes which distinguish the species. However, when the jaundice affects the habit, the skin and whites of the eyes are usually yellow, the excrements most fre- quently white, and the urine deposits a copious dark sediment. Besides these, an inactivity, anxiety, sick- ness, indigestion, uneasiness, or acute pain, at the pit of the stomach, itching in the skin, and other symptoms, occasionally attend. In general every function is dis- ordered, for the bile mixes in part with every secreted fluid, except, perhaps,.the milk; but the principal in- conveniences arise from its obstruction, which prevents its action on the stomach and intestines. When a scirrhus of the liver, or the gall duct, is the cause, a cure can scarcely be expected; and a haemorr- hage, which shows that the blood is both acrid and thin, is highly dangerous. In adults this disorder often I C T 789 IC T mav continue many months without any considerable danger; but, in general, its duration for a long time shows that the obstructing cause is firmly impacted ; and the injury Avhich the bile, Avhen again deposited, does to the digestive organs often occasions an incurable dys- pepsia, or a chronic debility, Avith a general dissolution of the fluids. After a fit of jaundice has disappeared, another slight one will often folloAV, which yields with little difficulty, and the disease is not peculiarly liable again to recur. During the whole of this disorder the patient should use frequent exercise, but without much fatigue ; a warm bath and cheerful company greatly assist the cure : the diet should be attenuating and aperient. Medicines in this complaint are of doubtful efficacy, and the disease often yields rather to the relaxation of the duct, Avhen the continuance of the stimulus renders it habitual. Stimulating the mouths of the ducts by the most soluble laxative, as soap and the neutrals; compressing the duct by the joint action of the stomach, diaphragm, and abdominal, muscles, as in the operation of vomiting; and alternating, with the emetics and cathartics, opiates, often in the most active doses, is the best plan. The operation of vomits has been sup- posed likely to induce inflammation ; this consequence, however, Ave have never yet found; but should it oc- cur, a large bleeding, with a blister externally, and cooling laxatives, are the best remedies. The castor oil has been preferred in those cases as a laxative, but it seems to possess no peculiar advantage. Mercurials have been lately given in jaundice and in hepatitis, it is said, with success. Calomel is undoubtedly often an useful purgative. The best exercise is riding on horse- back. If a viscid bile occasion this disorder, Avhich is known by the absence of an acute pain at the pit of the stomach, shooting out from thence to the back, after bleeding, and an emetic, aloetic and mercurial purges are preferable ; after these, the kali acetatum is the best remedy, for it hath all the advantages of soap Avithout its disagreeable taste, and is at the same time an useful febrifuge. It may be given to a drachm, or a drachm and a half three times a day. A redundancy of bile never produces jaundice, for the stools are highly coloured Avith the bile. In this case, the proper remedies are active purges,particularly the rhubarbxand calomel, in doses adapted to the consti- tution of the patient. Acids and demulcents also con- tribute to the relief. When the haemorrhage is a troublesome symptom, acids and demulcents, the ol. ricini, made into an emulsion, or a decoction of hemp-seed in milk, are the best remedies; and if fever require it,Avhich is scarcely in any instance the case, a little blood may be taken from the arm. In case of a scirrhus, the extractum cicutae may be given as an anodyne or palliative, but will do little real service. As an attenuant, the rubia tinctorum is said to be useful, perhaps because it is yellow ; and the Avaters of Bath and Harrowgate are highly esteemed. Bitters, and even the bile of animals, have been given to supply the place of bile ; forgetting that much inconvenience arises from the bile secreted in the stomach when accu- mulated in the blood. After the disease is removed they may be useful to restore the strength of the stomach. See Calculus biliaris. From the idea of jaundice arising from irritation, or spasmodic affections, in the hepatic system, small doses of ipecacuanha, tartarized antimony and valerian, asafoetida, cataplasms of cicuta and hyoscyamus, with linseed tea for common drink, blisters, locally applied, in case of pain, with opiates, have been severally admi- nistered, it is said, with success. See F. Hoffman ; Saunders on Bilious Diseases; White on Diseases of the Bile ; Huxham de Aere et Morbis Epidemicis, p. 143, &c. ; Sydenham; Heberden's Observations in the London Medical Transactions, vol. ii. p. 123 ; Medical Museum, vol. i.; Cullen's First Lines, vol. iv. ; Coe on Biliary Concretions ; Maclurg on the Bile. I'cterus a'lbus. See Chlorosis. ICTHYOSIS, (from /%0f$, a fish). A species of lepra, in which the eruption appears like the scales of fish. See Lepra. I'CTUS, (from ico, to strike). A stroke or bloav. It signifies also the pulsation of an artery, and the sting of a bee or any other insect. I'ctus sola'ris. A stroke of the sun ; insolatio; and by the French coup de soleil. A disease arising from too violent an influence of the sun's heat, particularly on the head. The diagnostics are a violent head ach, a hot dry skin, a redness and heaviness of the eyes, sometimes a continual involuntary motion of the eye lids, a loss of sleep, drowsiness,occasionally with delirium on aAvaken- ing, a violent fever, faintness, loathing, and thirst. Persons not accustomed to labour in the sun are sometimes struck by its heat while on journeys, and die on the spot; others fall into a lethargy, or die in a feAv hours Avith symptoms of raving madness. If a pa- tient escapes, he is frequently attacked afterwards with violent head achs, which in some instances affect the eye lids greatly. In others a delirium without a fever, gutta serena, 8cc. are brought on. In infants this disorder manifests itself by a heavy, deep drowsiness, which continues several days; fre- quent delirium; by convulsive twitchings, periodical head achs, and frequent vomiting. The effects of too great a culinary fire are the same with that of the sun'; sleeping with the head near the fire hath produced apoplexy during sleep. The method of cure Avhich has been pursued is the same with that of sanguineous inflammation ; bleeding as freely as the strength will admit. The legs, or, if .the disorder is violent, the Avhole body, has then been put into a tepid bath ; emollient clysters frequently in- jected, almond emulsion, lemonade, and similar de- mulcent cooling fluids, freely drunk: linen cloths wrung out of vinegar and water are also applied on the face and scalp. Such are the directions usually given. We have, however, great reason to think the nature of the dis- ease has been misunderstood; at least as it occurs in this climate. The affection of the brain appears to us similar to that after concussion, viz. a state of atony from excess of excitement; and the increased action to be of short duration, and inconsiderable in degree. We have seen no instance in which bleeding has been IGN 790 IGN requisite; and if the slight increased action rendered leeches or blisters necessary, the period in which they Avere applicable Avas soon at an end. The vital functions then appeared to be greatly weakened, and tonics of every kind, with the most perfect rest of mind and body, were indispensable. The shock has not been soon recovered, and, for many months, the mind could not be readily exercised, or a close room borne Avithout gid- diness and confusion. After some time the cold bath has appeared highly useful; and, during the whole time, the state of the bowels and the diet should be cautiously attended to. See Tissot's Advice. , IDtE'US DA'CTYLUS,(from Mount Ida, its native place). See Peonia. ID^E'A. See Ophtoscordon. IDEA'LES, (from ifox, an idea). A class of diseases consisting in a faulty judgment or alienation of mind. IDIOPATHEI'A, (from ifo<&>, peculiar, and *rx6<&>, affection). A primary affection of any part; as of the head in lethargy, and the lungs in pleurisy; but when these parts suffer by consent, or from disorders of other parts, they are then said to be affected by sympathy. IDIOSYNCRA'SIA,(from ift©-,peculiar, o-w, with, and xpxo-is). Idiosyncrasy ; sometimes also idio- cracy, idiotropia. Every individual hath a state of health peculiar to himself; and different bodies vary from each other, though each may be in a healthy state. This peculiarity of constitution is called idiosyncracy. Idiosyncracy sometimes depends on the original organ- ization ; and diseases from this cause are often incur- able. But when they arise frrm the state of the nervous power, it either respects its mobility or tone, and is shoAvn by some peculiarity in the functions. It may then be readily corrected, if not wholly removed. See IIygieia. IDIOTRO'PIA, (from ifo<&, peculiar, and rperu, to nourish). See Idiosyncrasia." I'DOU MOU'LLI. The name of a tall plum tree growing in the East Indies, whose fruit is cooling, and bark useful in many chronical diseases. Its place in the botanic systems is unknown. IGA'SUR. See Nux Vomica. IGBUCAI'NI BRASILIANO'RUM. A tree in Brasil, whose fruit resembles apples, and its kernels are a remedy in dysentery ; unknown to modern botanists. IGNA'ME. SeeCARA. I'GNIS, (from the Hebrew term aesh). Fire. Bacon, Boyle, Newton, and their folloAvers, consicter fire not as an element but as an adventitious property, resulting from the intestine motion of the smaller par- ticles of matter; and this opinion has been lately re- vived by Count Rumford and Mr. Davy. On the other hand, Homberg, Boerhaave, Lemery, Lavoisier, and Black, consider fire as a material principle or element. The motion of friction or percussion undoubtedly gene- rates or elicits heat; and, if the supposition of the mere vibration of parts could adequately account for the effects, it Avould be more simple than to suppose a ma- terial substance endued with peculiar properties; for it is still an hypothesis, since Ave cannot show the existence of fire without 6ombination, and all reasoning by ana- logy promises very little elucidation of a subject which can only be prosecuted by experimental research. So far as experiment has extended, the result is in favour of the existence of fire as a distinct body. The reality of fire seems evident, by the power we possess of in- creasing or diminishing it. In the living human body, whatever increases the quantity of crassamentum in the blood, increases the degree of heat also; as an animal diet, aromatics, sometimes iron, and the mineral acids; but nitre, crude sal ammoniac, carbonic acid gas, seem to diminish it, or at least prevent its evolution. In physics, fire is understood to be that subtile invisible cause by which bodies are expanded or 'enlarged in bulk, and become hot to the touch; fluids rarefied or converted into vapour; solid bodies fluid, and either dissipated, melted into glass, or scorified. It seems, likewise, to be the chief agent in nature on which animal and vegetable life depend ; and without which it does not appear that nature could itself subsist for a single moment. See Caloric It has been doubted whether light is a modification of heat or a distinct principle. The greater number of facts show it to be distinct, and it has been lately sup- posed from induction, that they are antagonising prin- ciples repelling each other. See Lumen. Many distempers have been named ignis, or fire, but principally the causus, or burning fever, which Hippo- crates often calls vvg, fire. I'gnis ca'lidus. A hot fire. A violent inflam- mation hath been called a gangrene when about to de- generate into it; and has hence received the name of ignis calidus. I'gnis fri'gidus. A cold fire. A sphacelus; because the parts affected become cold as the surround- ing air. I'gnis pe'rsicus. I'gnis sa'cer. I'gnis sa'ncti A.nto'nii. See Erysipelas and Herpes exedens. I'gnis sylva'ticus. See Impetigines. Ignis is also a name of several medicines, as argen- tum vivum; the essential oil that swims on the top of distilled waters, 8cc. The chemists use fire in different modes in perform- ing their operations ; whence their I'gnis sapie'ntium, or heat of horse dung. I'gnis reverberato'rius. A reverberatory fire is made in a furnace covered with a dome, that the heat or the flame maybe reverberated on the vessels imme- diately exposed to it. Ignis ro'te, or fire for fusion. Red hot coals, surrounding the vessel in which the matter is con- tained. The chemists formerly regulated their fire by dif- ferent degrees: the first was scarcely to be perceived ; the second was Avhen the heat was manifest, but not sufficient to give pain ; the third, Avhen the heat was painful; the fourth, when sufficient to destroy the body ; and fifth, when the heat would cause gold to evaporate in fumes. Boerhaave was the first who regu- lated the heat of fires by means of a thermometer; and when the degrees of heat are mentioned in his writings, they are to be understood according to Fahrenheit's scale. We have since learnt to regulate the higher degrees of heat, by means of Mr. Wedgewood's thermometer, which enables us to ascertain degrees of temperature so high as 32277° of Fahrenheit, could his scale be I LI 791 [LI extended so far; but, in electrical and galvanic experi- ments, Ave seem to experience a greater degree, since Ave can produce greater effects than can be attained by any fire ; but perhaps some of the power must be at- tributed to the momentum. On the contrary side, at 1500° of Fahrenheit, it is supposed no heat exists ; but this is necessarily hypo- thetical, for it cannot be ascertained by experiment. I'gnis at'vens. See Circulatum. I'gnis volv'ticus. See Impetigines. IGNI'TIO, (from ignis, fire). Calcining. I'GNYE, I'GNYS, (from ixveopxt, to supplicate; be- cause bent in supplication). See Poples. IKAN, a root apparently of the orchis tribe, brought from China in pieces someAvhat oval and compressed ; but we knoAV nothing of the plant which produces it, and little of its nature, which is said to be nutritious. I'LAPHIS. See Bardana. I'LECH, and I'LEI'DOS. A first principle, or ele- mentary air. Paracelsus. I'LEUM INTESTI'NUM," (from eiXeu, to turn about; on account of its many convolutions,) eilion; ilion; one of the small intestines, immediately follow- ing the jejunum. Its convolutions surround those of the jejunum, on the two lateral and inferior sides, and it winds about from the left side by the hypogastrium to the right side, Avhere it terminates in a transverse manner at the fleshy brim of the pelvis, and forms the first of the great intestines, called cecum. Winslow observes, that the ileum is of a paler red than the jeju- num. Through the whole length of this intestine it is wide and easily dilatable; but where it enters the colon narrow, and its sides more firm and solid. In the course of this intestine, the valvulae conniventes gradually decrease in size and number. When it ap- proaches the coecum they become longitudinal. In this intestine also, as well as in the jejunum, there are single solitary glands or lacunae ; sometimes clusters of glands called reticulated, increasing in number near its extre- mity, and flatter than in the jejunum. The ileum is more closely tied down than the jejunum, and conse- quently less capable of dilating. The appendices digi- tales are denominated from their resembling the finger of a glove, and are little processes sometimes sent off from the jejunum and ilium: they sometimes form hernia. I'leum crue'ntum ; described by Hippocrates in his work De Internis Affectionibus. In this disease, as well as in the scurvy, the breath is fetid, the gums recede from the teeth, haemorrhages of the nose and ulcers in the legs occur; but the patient's general health is not greatly inj-ared. I'LEUS, (from ileum,) (see Iliaca passio,) is an ancient name for the colic. (See Colica.) The chief varieties are of colica spasmodica. FLEX, (from the Hebrew alah, or alon). A tree of the oak kind, of Avhich two species are occasionally no- ticed, viz. aquifolium Lin. Sp. PI. 181, (see Aqltfoli- uM,)and quercus ilex Lin. Sp. PI. 1420. The scarlet oak. Its berries are.the Chermes, q. v. I'LIA. The plural of He, (from eiXeu, to turn). The flanks ; the space between-the loAvest of the false ribs and the upper edge of the os ilium on each side; the two divisions of the regio umbilicalis. ILIAC \ PA'SSIO, (from ilia, the small guts). The iliac passion, ileus, convolvulus, contorsio, cileos, chordapsus,volvulus, tormentum; a disease of the small intestines, generally from spasm : Dr. Cullen considers it synonymous with colica. Considerable confusion has prevailed in describing the symptoms and cure of iliac passion, from inflam- mation being often attended with spasm, in consequence of increased sensibility and irritability; as Avell as from spasm producing inflammation. We shall, in consider- ing this complaint, distinguish it Avholly as a spasmodic disease, referring the inflammatory ileus to its proper head, under Inflammation. The disease is characterised by a violent pain in the abdomen, with an inversion of the peristaltic motion of the bowels, so that their contents are thrown up by vomiting. It is usually an acute disorder, but not essentially inflammatory. We know only of three species. The first consists of spasm from causes of debility. These are, gout, repelled eruptions, narcotic passions, particularly of lead, and the vegetable narco- tics. In this case the disease is nearly in cause and cure the same with Colica pictonum, q. v. The second species is produced by an introsuscep- tion of the intestine, where a portion of the intestine falls doAvn into the part below, generally doubling the intestine for the space of an inch or more, and thus constricting it. This is occasioned often by spasm, which contracting the diameter of a part of the gut admits of its introduction into that beloAV. To this species the term of the true iliac passion is sometimes confined. Dr. Hunter takes notice of a disease to which children are more particularly subject, because their mesentery, having scarce any fat upon it, easily slips with the gut; and this he calls the volvulus, or volvulus, of which he observes there are two kinds : the first is when a part of a gut is received into the part next above it; the other is when a part of the gut is received into that below it. The last is, hoAvever, by far the most frequent. The third species is a spasm of the intestines, excited by a mechanical body irritating or obstructing the in- testines. A plumb stone or a calculus is of this kind; but the intestinal calculus is very rare in the human species. It will be obvious, however, that the first and third of these species properly belong to colica; nor indeed is it easy to separate these diseases. Much con- fusion would be avoided by abolishing the term altoge- ther, or by confining it wholly to colic from introsuscep- tion. The latter, however, is seldom knoAvn till after death, and cannot properly form a distinct disease. A costiveness usually precedes this disorder for some days, and pain is chiefly felt about the navel. With the pains, the belly is gradually inflated, and a hard tumour is felt in the umbilical region, surrounding the belly like a cord : not the least flatulence can for a time pass either upward or doAvnwards. Inflammation, with its Avorst consequences, rapidly comes on. The iliac passion should be distinguished from rheu- matic pains in the muscles of the abdomen, and from inflammation of the peritoneum. In the first the ex- ternal soreness is considerable, and the pain in moving the body much greater than in colic, even when inflam- mation has come on. The same circumstances distin- guish peritonitis, and in both free motions do not pro- cure considerable relief. 1LI 792 ILY The cure of iliac passion differs in no respect from that of colic. If it arises from introsusception, we have said that it is seldom knoAvn. Practical authors have remarked, that if the gut has fallen into the in- testine below, laxatives are injurious, and the cure must be attempted by clysters. The contrary practice is preferred in opposite circumstances. This is, hoAV- ever, a refinement Avhich we cannot apply, as the exist- ence of either is unknoAvn. Clysters of the fumes of tobacco will, in this species of disease, be particularly useful; and the Avarm bath is frequently salutary. A blister also to the abdomen, a remedy particularly adapted to Inflam- matio intestinorum, q. v. is often useful in this disease. The prognostics are favourable while inflammation is absent; while clysters can be throAvn up, and returned by stool; Avhile the pains shift, and the pain and vomit- ing occur only at intervals : it is still more promising, if a laxative, taken by the mouth, passes by the anus; but if little or no relief is obtained by stool for some days there is scarcely room for hope—indeed none, un- less true faeculcnt matter is copiously discharged. An entire suppression of urine is a dangerous symptom, though some degree of suppression generally attends. See Hippocrates de Morbis ; Aretaeus ; Coelius Au- relianus ; Celsus; F. Hoffman; Sydenham; London Medical Observations and Inquiries, vol. i. p. 223, &c.; Edinburgh Medical Commentaries, vol. ix. p. 266, 278. Ili'aca mi'nor, arte'ria, is the most posterior branch of the hypogastric artery; sometimes the branch of the glutae. Ili'aca va'sa. The Iliace arterie and vene, Avhich see. ILI'ACiE ARTE'RIA; belonging to the ilia. The iliac arteries are formed by the bifurcation of the aorta, at about the fourth vertebra of the loins. They descend nearly three fingers breadth from their origin ; and when they arrive at the psoas muscle, on each side, or are upon it, each divides into two, an external and an internal: the external hath no particular name; the internal is called hypogastrica. See Hypogastrice ARTERIE. The external iliac, on each side, runs down to the ligamentum Fallopii, under Avhich it goes out of the abdomen. In this course, it gives off a feAv small ar- teries to the peritonaeum, and parts near it; but, as it passes out of the belly, under the ligament, it detaches two considerable branches, one internal, the other ex- ternal : the inner is called Epigastrica, q. v.; the ex- ternal, Innominata, q. v. The external iliaca also gives off a small branch internally, under the ligament, Avhich runs to the vagina or the spermatic chord, and some- times another from the outside of the os ilium. For the internal iliac artery, see Hypogastrice ARTERIE. Ili'ace ve'ne, (from the same). Iliac veins, titillares vena, are formed by the bifurcation of the vena cava, about the last vertebra of the loins. After their leaving the vena cava, each divides into two principal branches ; the iliaca externa, or anterior; and the iliaca interna, or posterior: the external, which seems the true continuation of the trunk, is sometimes simply named iliaca; the internal hypogastrica: each folloAvs the course of the respective arteries. The external iliac veins lie a little on the inside of the arteries, and, before they leave the abdomen, they accompany their corresponding arteries, both in their course and in their divisions into branches. ILI'ACUS EXTE'RNUS, MUSCULUS, (from the same). See Pyriformis. Ili'acus inte'rnus, musculus, lies upon the con- cave part of the ilium, arising likewise from the an- terior edge of the bone, and runs down before the psoas muscle: it then runs over the head of the bone, and passes iinvards, to be inserted into the little trochanter ; lifting, in its action, the thigh upwards. ILI'ADUM. The three principles of Paracelsus. Sometimes, according to the same author, a mineral spirit, supposed to be contained in every element, and the cause of diseases. ILIA'STER. The occult virtue of nature, Avhence all things increase. Paracelsus. ILI'NGOS, (from iXiy\, a vortex). See Vertigo. I'LION. See Ileum intestinum. I'LIOS. See Passio iliaca. ILI'SCUS. Madness occasioned by love. Avicenna. I'LIUM, OS ; os i7inominatum, but strictly its upper part. Its name is given from its supporting the ilia. The ilium forms the upper and posterior portion of the pelvis, extending to the transverse section of one third of the acetabulum. The external side is convex, called its dorsum; the internal part is its costa; the superior semicircular edge, the spine. The Avhole cavity is called cholas, or cholago. BetAveen the os sacrum and the ilium is the sciatic notch, Avhere the sciatic nerve and posterior crural vessels pass without being subject to compression. ILLECE'BRA, (from eiXeu, to turn; because its leaves resemble worms,) vermicularis, piper 7nurale, se- du7n minus. Wall pepper and stone crop. Sedum acre Lin. Sp. PI. 619 ; is a very acrid plant, proving vio- lently emetic and cathartic, so that the best authors have thought it unsafe. It has been employed, how- ever, boiled in milk, as an antiscorbutic, and has been occasionally used in epilepsies. When employed in scurvy, a handful is boiled in eight pints of milk to four. Macquer recommends it in scrofulous and can-. cerous ulcers. ILLEGI'TIMUS, (from in, and legitimus, lawful). Illegitimate ; an epithet for the false ribs, and for some anomalous fevers. ILLI'XCTUS, (from illingo, tolic k k^). See Linctus. ILLI'SIO, (from illidor, to dash against). See Enthlasis. ILLISIO'NES AQUA'RUM. See Cataclysmus. I'LLOS, (from eiXeu, to turn ro7ind). See Oculus. ILLOSIS, (from the same). See Strabismus. ILEUMIXA BILIS LA'PIS, (from illumino, to shine). See Bononiensis lapis. ILLUTA'TIO, (from in, upon, and lutum, mud). Illutation; besmearing any part of the body with mud, and reneAving it as it groAvs dry, with the vague or ridiculous view of heating, drying, and discussing. The mud found at the bottom of mineral springs is chiefly employed. I LEYS, (from etXeu, to turn round). A person af- fected Avith strabismus. I'LYS, (from tXvs, 7nud). The feces of wini ; IMP 793 IMP and an epithet for the sediment in stools and urine, Avhich resembles them. IMAGINA'RII, (from imagino, to conceive). Dis- eases in which the imagination is principally affected. IMAGINA'TIO, (from the same). Imagination. To the poAver of the mother's" imagination many pecu- liarities in the foetus have been ascribed. See Fcetus. Philosophical Transactions Abridged, vol. ii. p. 222. Medical Museum, vol. iii. p. 273, 8cc. IMBECI'LLITAS, (from imbecillis, feeble,) acratia and arrhostia, generally means a debilitated state of the habit, and the latter word sometimes implies mental imbecility. Imbect'llitas oculo'rum. See Amblyopia. Nyc- talops. IMBE'RBIS, (from in, not, and barba, a beard). Beardless ; botanically it is applied to the corolla. IMBIBI'TIO, (from imbibo, to receive into,) a kind of cohobation, when the liquor ascends and descends upon a solid substance, until combined with it. Some- times it signifies cohobation, and any kind of impreg- nation. IMBRICA'TUS, (from imbrex, a tile). The leaves or scales of plants, disposed so as to lie one on the edge of the other, like tiles on a house. The term is applied to leaves, and their serratures in the bud: to the stem, when covered with scales; tectus utnudus non appareat; to the calyx, as in the hieracium, sonchus, and other syn- genesia; to the spike, when the flowers are so close as to press over each other. IMME'RSIO, (from immergo, to plunge in). Che- mical immersion is a species of calcination, when a body is immersed in any fluid, to be corroded. When any substance is plunged into a fluid in order to deprive it of a bad quality, or to communicate a good one, the same term is employed. IMME'RSUS, (from the same). See Infrascapu- LARIS MUSCULUS. IMPASTA'TIO, (from in, and pasta, paste). Im- pastation. The making dry poAvders into paste by means of some fluid. See Incorporatio. IMPA'TIENS HE'RBA, (from in, and potior, to suffer, because its leaves recede from the hand with a crackling noise). See Momordica and Persicaria sii.iquosa. iMPERATO'RIA, (from impero, to command, be- cause its leaves extend, and overwhelm the lesser plants which grow near it). Masterwort. Astrantia, magistrantia, ostritium, imperatoria major, astritium, struthium, smyrniom; imperatoria ostruthium Lin. Sp. PI. 371. It is an umbelliferous plant, with large winged leaves, divided into three indented segments, producing thick, oblong, striated seeds, surrounded with a narrow leafy margin: the roots are oblong, thick, knobby, jointed Avith several lateral fibres, brown on the outside, and whitish within ; perennial, a native of the Alps and Pyrenees; found in several places on the banks of the Clyde, in Scotland, by Mr. Lightfoot. The root is warm, grateful, and aromatic, nearly of the nature of angelica; yielding to water, or spirit of Avine, its smell, warmth, pungency, and bitterness. On inspissating the spirituous tincture, very little of its fla- A'our exhales; but nearly the whole is carried off in dis- tillation with water. If the root is held in the mouth it VOL. I. provokes saliva; if SAvallowed, purges; and is some times called the countryman's purge: an infusion of it in water, SAveetened with honey, is said to be an expec- torant. The roots should be taken up in the middle of the winter of the second year. It was considered as an alexipharmic and sudorific; and in some diseases em- ployed with so much success as to be called divinum remedium; but, at present, it ranks only among the in- ferior aromatics. A name also for angelica. Imperato'ria ni'gra. Black masterwort, astran- tia nigra, sanicula femina; astrantia major Lin. Sp. PI. 339, is kept in the gardens of the curious, and floAvers in July. Its black and fibrous roots only are used. See Raii Historia Plantarum; Lewis's Materia Me- dica ; Neumann's Chemical Works. IMPERIA'LIS A'QUA. See Fluor albus. IMPETI'GINES, (from impeto, to infest). Diseases which occasion blemishes on the skin; terna, derbia, ignis sylvaticus, volagrius, or volaticus, and serpigo. See Lepra, Pruritus, Herpes, and Mentagra. In Dr. Cullen's system the impetigines are an order of the cachexia, defined disorders from a general bad habit, manifesting themselves principally by disfiguring the skin and other external parts of the body. The itch, though affecting the skin, is placed in the class locales, since it is unconnected Avith the general habit. IMPETI'GO of Celsus, (from the same,) lepra Gra- corum, Blanchard. In Celsus it is described as consist- ing of hard dry prurient spots in the face and neck, sometimes over the whole body, disappearing in branny scales. Impeti'go Pli'nii and a'rabum ; the lichen of Blanchard. IMPLU'VIUM, a shower bath, (from i7npluo, to shower upon). See Embrocatio. IMPOTEN'TIA, (from in, not, and potens, able). Impotence in men is the same in its effect as sterility in women, that is, an inability to propagate their spe- cies; but in the causes and the circumstances these states greatly differ. In each case there is a failure of propagation; but, in each, there is by no means an unfitness for the venereal act. Sterility in women, indeed, often arises, like im- potence in men, from a coldness of constitution, which admits not of due excitement; but it is also owing to the causes Avhich separate the fcetus almost as soon as formed. From men Avho are impotent no impregnation takes place. The great causes of impotence in men are organic defects and debility. We have shown, that in genera- tion the semen must be carried to the uterus, and probably to the Fallopian tube; but in this ultimate destination it is apparently assisted by the action of the womb itself. To carry it to this organ requires a free passage through the urethra, no inconsiderable activity in the ejaculatory muscles, and the full distention of the corpora cavernosa. The free passage is sometimes pre- vented by strictures in the urethra, and sometimes, as in a case recorded by Petit, by a faulty direction of the orifices through which the semen passes. A natural phymosis has been found also an obstruction to the free discharge of the seminal fluid. A severe priapism seems occasionally to constrict the cavity of the urethra, or of the entrance of the vasa deferentia ; for in this disease there is no emission, and the feelings are those of 51 IMP 794 IMP violent pain rather than of pleasure. Intoxication, in some men, will produce this violent spasm, and unfit them for the completion of the venereal act. See Priapismus. Debility, hoAvever, from too frequent or unnatural indulgences, is the most common cause, shown by an imperfect erection of the penis, or too weak a discharge of the semen: the latter is often a consequence of the former. In some Aveak habits the discharge immedi- ately follows the slightest irritation, either of the parts or of the mind. Dreams so imperfect as scarcely to be remembered will occasion it, and this arises from the increase of irritability, in consequence of debility. From its remote cause, tonics, and the most stimulant nutri- ments, are employed; but the only remedies are those which lessen irritability, viz. camphor, opium, and hen- bane, or hemlock. Washing the penis and scrotum, morning and evening, with cold water, and dashing the water against these parts from a bidet, are often useful'; but it is necessary to remove every alluring or enticing object; to guard against every lascivious thought. When impotence arises from so great a debility as to admit of the discharge of semen by the efforts to relieve the belly, the strongest tonics and astringents are required. It has been supposed by some authors, that, in such cases, the semen Avants its usual stimulating properties, as it is observed to be unusually fluid; but of this there is no evidence; and, as the discharge is so readily excited, Ave think it more probable that its fluidity depends on its not being allowed to stagnate. Mr. Hunter has, Ave think, refined unnecessarily on this subject, by stating one cause of impotence to be a Avant of correspondence in the successive actions of se- cretion and discharge. If the first is too rapid for that erected state of the penis which renders the ejaculation effectual, it constitutes this disease as certainly asAvhen the action of the muscles of the latter is too quick for the former. Debility, and its consequent state of irrita- bility, are sufficient to explain all the circumstances of the case Avithout such recondite researches. In general, Avhere there arc corresponding actions of two connected parts, it is very unusual to find them separated. Each may be Aveakened; but from habit each will partake of the disease, and will act together as before, but with diminished poAver. A singular cause of impotency is recorded in the Me- dical Essays of Edinburgh, where each attempt Avas fol- lowed by an epileptic paroxysm. From Avhat has been said on that disease, it will not be surprising, that, in a mobile habit, disposed to convulsions, a stimulus so violent should bring on a paroxysm. The reasoning and the cure were equally ridiculous; nor is this a single specimen where physicians have succeeded by accident, and have really taken a readier road for the' relief of the diseased than they themselves suspected. The state of the mind, it is observed, has a considerable influence on the poAvers of the body, particularly in the venereal act. The body, Mr. Hunter remarks, should not only be in a state of health, but the mind free from appre- hensions, anxiety, and distress. The mere anxiety of ex- celling in this act has been no uncommon cause of dis- appointment. A state of hope, a consciousness of crime, a recollection of former failures, equally enervate the body. Such causes of impotence are to be clearly distinguished from real defects, since an alteration in circumstances, by which anxiety, distress, Sec. arc re- moved, Avill relieve the complaint. Greater confidence, from having once succeeded, will alone break the charm, and all will be Avell. The mind is more intimately connected Avith the genital system, chiefly in men, though in a certain de- gree in the other sex, than has been imagined. The apprehension of weakness, in this most important of functions, really produces it. The imagination broods , over fancied ills, till the Avhole system is really disor- dered. In this state every wall offers a certain remedy, and the Solar Tincture, the Restorative Drops, are ea- gerly bought. It is remarkable, that these diseases are distinguished by capitals to lure the unwary; but the medicines are sometimes truly restorative, for they re- store confidence, and thus contribute to remove the disease. In general, however, each quack is tried in succession, till tired nature decays into a hectic, is over- whelmed in a dropsy, or the mind, sinking in imbecility,. or mania, offers a melancholy spectacle of Avhat degra- dation human nature can suffer. All this distressmight be removed if the patient had the resolution to tell his grief to a friend, or a physician of character and judg- ment. A Avell regulated plan of medicine and diet would contribute to relieve the bodily complaint, while the mind, consoled with prospects of returning health, would assist in realizing the prediction. Many such instances we have known Avhere the disease has been radically removed, and the desponding patient become a happy husband, and the delighted father of a nume- rous and healthy offspring. We have so mixed the medical directions with the descriptions of the disease, that we have little to add on this part of the subject.- We may, hoAvever, again re- peat, that, except in impotence from great relaxation, tonics and astringents are of little avail. Where it arises from too great irritability, a coojing diet, abstain- ing from lascivious thoughts or objects, with sedatives, are the best remedies. In that case, which arose from epileptic paroxysms, the cure was effected by rendering the object of desire more familiar before the act was again repeated, and, of course, lessening the too violent stimulus. There is no opinion more inconvenient in its effects than that which dictates a full, nutritious, and stimulant diet. We have often had occasion to repeat, that no cause of weakness is so frequent and obstinate as that which arises from fulness of the circulating system, and no plan of medicine more injurious than constringing over distended vessels by tonics. It has been supposed that some medicines have a peculiar ef- fect on the genital system; and the balsams have been given, as they are directed to the bladder, and, of course, may communicate a stimulus to the neighbouring parts. We have not found them particularly advan- tageous; and even the balsam of Peru, which unites a tonic with its stimulant power, has not produced any very salutary effect. If, as we have been informed, Geneva is not favourable to the active energy of these organs, we can hardly expect great advantage from medicines so nearly resembling this spirit. In every case, except where the fulness is considerable, cold bathing, both general and topical, is highly useful. To abstain from, or to indulge, venereal pleasures, is equally injurious. A moderate use is salutary; and marriage, if the disease be not too far advanced, is to INC 795 INC be advised. It has often succeeded; and when the confidence that the power is not wholly lost be once established, the power itself is soon regained. IMPRjEGNA'TIO, (from impragnor, to conceive). Impregnation. Ingravidatio. The state immedi- ately after conception, continuing till delivery. A wo- man usually perceives the child to move at different pe- riods ; the soonest at the end of forty days, the latest at the end of five months. But some women, without being pregnant, perceive amotion like that of a child. La Motte thinks that a large child and a small quantity of water may prevent a pregnant woman from perceiv- ing the motion of the child. (See Generatio and Con- ceptio.) For the impregnation of plants, see Farina fcecundans. IMPRE'SSIO,(from imprimo, to press upon). See Depressio. I'MUS VE'1$TER,(the lower belly). See Abdomen and Hypogastrium. INA'IA GUACU'IBA. See Palma coccifera. INCANTAME'NTA, (from incanto, to charm). See Amuleta. INCA'NUS,(from in, and canus, white, hoary). The leaf of a plant covered Avith whitish down. INCARNA'NTIA, (from incarno, to bring flesh upon). Medicines which assist the filling up wounds or ulcers with flesh. See Anaplerotica. INCE'NDIUM, and INCE'NSIO, (from incendo, to burn). A burning fever ; burning heat; sometimes a hot inflammatory tumour. INCERA'TIO, (from in, and cera, wax). Incera- tion ; the reduction of any dry substance to the con- sistence of wax, by the gradual admixture of oil. lNCERNI'CULUM, (from incerno, to sift) A strainer or sieve. In anatomy it means the pelvis of the kidney. INCIDE'NTIA, (from incido, to cut). Medicines which divide the particles of fluids, supposed to cohere preternaturally, and induce disease. INCINERA'TIO, (from incinero, to reduce to ashes). Incineration ; astaphara. Reducingany body to ashes by fire. See Calcinatio. INCI'SIO, (from incido, to cut). Incision. The opening of abscesses by means of a lancet or scalpel. For the best modes of opening them, or extracting mat- ter Avith the most ease and security, see Bell on Ulcers, edit. 4. p. 76, &c. INCISO'RES DE'NTES, cutters, (from incidere, to cut). A name of the four anterior'teeth in each jaw from their use in cutting, Ctenes, dentes lactei, risorii, dichasteres. The edges of the incisores, by use and friction, are blunt and thicker ; though, from the form of the jaw, and direction of the teeth, they sometimes seem to sharpen each other, and become thinner. These teeth are convex externally, and concave internally; so that when they are Avorn, the internal concave surface of the upper ones, and the external convex surface of the lower ones, are wasted. See Dens. INCISO'RII DU'CTUS; two canals from the bot- tom of the internal nares, across the arch of the palate, which open behind the first and largest of the dentes incisorii; their lower orifices are in the foramen pala- iinum anterius, called nasopalatini ductus. Inciso'rii inferio'res Cowpe'ri, musculi, arise from the alveoli of the lateral incisores of the lower jaw, and are inserted into the middle of the semi-orbicularis of the lower lip. Inciso'rii latera'les, musculi. Canini minores. A biceps muscle, which unites at the other extremity. It arises from the os maxillare, below the middle ten- don of the orbicularis palpebrarum, and below the edge of the orbit in the os maxillare, near the union of this bone Avith the os malae; the heads from each side unite about the lateral dentes incisorii. Inciso'rii med'ii, musculi ; incisorii minores Cow- peri, or incisores, 7ninores, superiores; are two small short muscles situated near each other beloAV the septum narium: they rise from the os maxillare, on the alveoli of the first incisores, and are inserted into the middle and upper part of the upper lip. INCISO'RIUM, (from incido, to cut). A table Avhereon a patient is laid in order to have an incision made on any part; or a body to be dissected. Inciso'rium fora'men,lies behind thedentes incisores of the upper jaAV, Avhich divides into tAvo, as it opens into the nose on each side of the septum nasi. * INCI'SUS, (from incido, to cut). A leaf \A-hose edge is notched. INCITABI'LITAS,(from incito, to stir up to action?) incitability. In a practical view it has appeared necessary to make a distinction betAveen this term and irritability; because, though it is alloAved that to those two powers the existence of a machine in a living state, and the action of its moving solids with respect to their continuance, are entirely OAving; yet they do in some degree certainly exist independent of each other. By this knowledge, therefore, it is sup- posed that we shall sometimes be able to explain the different appearances of diseases, and the means of re- lieving them by medicines directed to either. By in- citability is meant that power in the brain and nervous system, which may be excited to action by mental af- fections, as well as local irritation, and which produces those affections we call sympathy ; by irritability, that poAver which may be put into action by material stimu- lus, locally exerted, yet is obedient to the influence of the nerves in general, and cannot in the living machine exist for any considerable time without this union. More strictly, incitability is confined to the nervous, and irritability to the moving, fibres. See Wallis on Health and Disease ; Irritabilitas and Sensibilitas. INCLINA'TUS, (from inclino, to bend down,) an epithet applied to a root of a plant which runs obliquely. INCLU'DENS, (from includo, to shut up). The calyx of a flower Avhich shuts up and conceals the co- rolla. INCLU'SUS, (from the same). The stamen of a flower when shut up in the corolla. INCONTINENTIA, (from in, not, and conthieo, to contain). Incontinence. An inability in any of the organs of the human body to retain their contents, Avhich are usually discharged by the exertion of vo- lition. INCORPORA'TIO, (from incorporo, to blend to- gether). Incorporation. The union of oily or tere- binthinate substances with water into one uniform fluid, by the mediation of a third substance. INCRASSA'NTIA, (from incrasso, to make thick^ 5 I 2 INC 796 IND pyinotica. Incrassating medicines; such as reduce the blood and secreted fluids to a proper consistence when supposed to be too fluid. INCRASSATUS,(from the same). The epithet of a stalk which increases in thickness as it approaches the flower. INCRUSTA'TIO, (from incrusto, to harden). In- crustation ; forming a crust or eschar upon any wound. I'NCUBUS. The night-mare; (from incubo, to lie on ; ephialtes, from etyxXXopLXi, to leap upon ; epibole, from en^xXXa, to press on; because the patient imagines that something leaps or presses upon him; and babuzicarius, from pxQx^u, to speak inarticulately, because, in his distress, he mutters indistinctly). There is also a species called succubus. The Incubus is sy- nonymous with oneirodynia in Dr. Cullen's system. This complaint always happens during sleep: the patient suddenly feels a sense of weight, a dread of suf- focation, an oppression as from somebody falling upon him, with an intent to deprive him of life, not suffering him to cry out; hence it is usual with these patients to start up and exclaim with a confused inarticulate voice : they move with difficulty, but, on the first mo- tion, the distressing feelings vanish.* This disorder hath been supposed to proceed from a stagnation of blood in the brain and lungs; but it is a nervous affection, chiefly from indigestion: and those Avhose nerves are weak, who lead sedentary lives, feed heartily, and sup late, are the most subject to it. Wind is a frequent cause : deep thought, anxiety, or any op- pression of mind, equally produces it. It is said that none are attacked Avith the ephialtes but when laid on tfeeir backs. A sense of suffocation, rousing the patient from sleep, has been styled an ephialtic symptom, dis- tinguishing hydrothorax; but, in this case, there is no sense of a heavy Aveight on the praecordia. If the patient hath a sanguine plethora, bleeding, a spare diet, aloetic purges, relieve the complaint. Dr. Whytt says that he generally found a glass of brandy, if taken at bed time, would prevent the attack. A slight supper, cheerfulness before bed time, due ex- ercise during the day, are the best remedies; but if these fail, the fetid gums, Avith camphor joined to opium, at bed time, will succeed. See Coelius Aurelianus de Morbis Chronicis, lib. i. cap. 3. Lommii Observationes Medicinales, iii. P. Egineta, lib. iii. c. 15. Soranus's Aitiologoumena. INCU'MBENS, (from incumbo, to lean against,) a term in botany. INCURVA'TUS, (from incurvo, to bend). Bent, a term applied to a gibbous spine, and in botany to the stalk. I'NCUS, (from incudo, to strike upon). The anvil. The name of one of the bones in the ear; named from its resemblance to an anvil. It is broader than it is thick; articulated with the malleus, behind the manubrium, from whence a short thick process projects backwards, and a long one downwards, which runs down parallel to the long process of the malleus, but rather more backward. The short process is thick at its beginning, but ends in a point, which is turned backAvards, and joined to the edge of the opening of the cellulae mastoideae. The long process at its extremity is rather bent inwards, by Avhich we may distinguish the incus of one ear from that of the other; for, turning the short process backAvards, and the long process doAvnwards, if the bending in of the long leg be to- wards the left hand, it belongs to the right ear, and vice versa. See Auris. I'NDEX,(from indico, to point out). See Digitus. INDI.E ORIENTA'LIS RADIX GENUINA. See Gensing. INDIA'NA RA'DIX, from the West Indies, its na- tive place. See Ipecacuanha. INDICA'TIO, (from endico, to show, or point out). Indication} delatio, endeixis. The diagnostics of a dis- ease, and its pathognomonic signs, are collections of particulars that occur to observation. Indications are conclusions that arise from reasoning on these par- ticulars, called signs. The indication of cure, in all diseases, is to remove the proximate or immediate cause; but this is seldom knoAvn. INDICA'TOR, (from the same). See Extensor indicis. I'NDICON. See Myrtidanon. I'NDICUM, (from the Arabic term hindi, India). The indigo blue plant; also called indigo, anil, nil, isatis, and coronilla Indica, emerus Americanus, glastum Indicum, Ameri, coaachira Indorum, colutea hidica, herbacea, enger,gali,herva de anilLusitanis,hin-awaru; Indigofera tinctoria Lin. Sp. PI. 1061, is a native of South Carolina, but was knoAvn to the ancients. It seems to have been indigenous in Malta, and Avas cer- tainly produced in large quantities in Egypt; and the name anil (al-nil) seems to show that it was knoAvn to the Arabians. It requires a tropical temperature, but is found within forty degrees on each side of the equator. We are now supplied from the continent and islands of America, though some indigo is prepared in France. This substance is a faecula, or starch, sepa- rated from the plant by the powerful action of fennen- tation. It is not agreed Iioav far this process should proceed. It certainly goes beyond the spirituous, since ammoniacal salts are found in indigo, but, by complete putrefaction, it is spoiled. Some oil is used in the preparation, though with no very decided object. We suspect its chief advantage to arise from its power of moderating the too violent fermentation, or preventing the escape of the carbonic acid gas. Various species of this plant, and various processes for separating the faecula, are employed, which it is not our object to detail. It is brought to us in flat cakes of a moderate thickness, moderately hard, of a deep violet colour: the best kind swims on water, and Avhen broken hath no Avhite spots in it. That which is reddish, on being ' rubbed with the nail, and hath dust and broken pieces in it, is far inferior. Such Avhite spots are found in the common indigo of the shops, which is an adulteration of the genuine kind by the mixture of flour. The plant is said to be detergent, of some use when applied to ulcers, or to kill lice. There is another plant which is called anil, used by way of decoction in nephritic colics, and suppressions of urine; but we have not been able to determine the species. See Raii Historia Plantarum. Neumann's Chem. Works. INE 797 INF I'ndicum ba'lsamum. See Peruvianum balsamum. I'ndicum li'gnum montanum. See Campechense lignum. I'NDICUS. See Costus. I'NDIGA SPU'RIA. See Colinil. IXDIGE'NI, Indigenous; natives of the country in which they are found. The term is applied to plants and animals. INDIGES'TIO. See Digestio, Apepsia, and Dys- pepsia. INDIGNATO'RIUS MU'SCULUS, (from indig- nor, to scorn; because this muscle assists in producing a scornful look). See Abductor oculi. 1'NDIGO. See Indicum. lN'DU'SlUM, (from induo, to put on). A shirt or shift. Clean linen promotes perspiration, and it may be renewed as often as the patient pleases, whether the isorder be of the acute or the chronical kind; except during a crisis in fevers, Avhile the patient is in a sweat. Yet, even in this state, with proper precautions, the linen may be sometimes safely changed. See Amnion. INEBRIA'NTIA. We have anticipated the more important observations on this class of medicines in our article Anodyna, q. v. and we shall now only point out the more common inebriants, with some remarks on their action, for which our readers were not at that time prepared. The most common inebriant is Opium. It is employed among the eastern nations, very gene- rally, to procure, not sleep, but serenity and cheerful- ness ; and its use, in this respect, may be traced to the earliest ages, for it was probably the nepenthe of Homer. Tea is equally general in the west, and in its native country, China, but it is mild in its effects, and, if not drunk unusually strong, or in too copious draughts, it is not injurious. There is some reason to suspect that the additions, which give it the flavour, are most hurt- ful; for the finest teas produce the worst effects. The Bangue of the east, prepared from the leaves of the canabis indica, and not from those of the hibiscus abel- moschus, as has been asserted, is in general use (vide in verbo) in India, as an inebriant; but the Betle, q. v. is rather a stimulant than a narcotic. The Assyrian rue, peganum harmala of Linnaeus, was formerly used, as Bellonius informs us, for this purpose; but its very offensive and disagreeable smell prevents it from being any longer a luxury. The seeds of different species of datura have been also used to inebriate, as Avell as the roots of the black henbane, and the hyoscyamus, physa- loides Lin. The Delecarlians employ the leaves of the millefolium to increase the intoxicating power of the beer; and the porter brewers of this country are said to use the canabis indicus and the cocculus indicus; but this has lately been denied on oath in the King's Bench. Tobacco; the darnel; the clary; thevanilloes; the hem- lock ; the spawn of the barbel; and the agaricus musca- rius, have been all employed for this purpose. Fer- mented liquors and spirits are sufficiently known. See Linnaei Amaenitates Academicae Inebriantia, vol. vi. All these medicines are sedative, and their effects on the nervous system are to produce an unequal excite- ment. We have explained, in a variety of articles (see Insomnia), that the regular discharge of the mental functions depends on a free, uninterrupted communi- cation between the different portions of the brain. When from any cause this is prevented, delirium, in different degrees, takes place. If unequally excited, the delirium is of the violent kind : if unequally de- pressed, of the Ioav, and often of the pleasing kind. Whether pleasing or otherwise, the effect is nearly si- milar, since the same medicine, in different constitu- tions, will excite the most soothing and the most horri- ble images. See Materia medica. INE'RMIS, (from in, non, and arma, arms). Harm- less ; applied to soft thorns, as those of the thistle. INE'RTIJE VIS, (from iners, sluggish). The poAver of inactivity. By this, apparently contradictory term, sir Isaac Newton means that passive principle in matter, by which bodies resist any change or alteration of their state, whatever it be, of rest, motion, or its di- rection ; and this resistance, always equal in the same body, is, in different bodies, proportional to the quantity of matter they contain. Hence, in medicine, it means when the powers of the constitution are torpid or inert, and make no effort in the recovery of health. 1'NFANS, (a non fando, from its inability to talk). An infant or child. Fred. Hoffman limits the period of infancy to the time when children begin to talk, and that of childhood to the age of puberty. During infancy the parts are disproportioned, and the organs, from Aveakness, incapable of those functions which, in future life, they are designed to perform. The head, the liver, and pancreas, are much larger, in pro- portion, than in advanced periods; and their secretions more copious. The bile is very inert; the heart is stronger and larger than in future life; the arteries fuller and more active; the quantity of blood sent through the heart of an infant, in a given time, is also more in.proportion than that in adults. Though these circumstances are not without utility and subservient to the growing state, yet the imperfection attending them subjects this period of life to many injuries and dangers, from which a more perfect state is exempted. Infants are more acutely sensible and more irritable than adults ; and the diognostics of diseases are conse- quently more uncertain. HoAvever, no very great em- barrassment arises from these circumstances; for the disorders of infants are usually acute, less complicated than those of adults, and are more easily discovered than is generally apprehended. The vigour of children's constitutions depends greatly on that of their mothers. Healthy women, Avho accus- tom themselves to exercise and air, and whose diet is firm and invigorating, alone bring forth children per- fectly healthy. As soon as a child is born, the mucus with which its body is covered is best washed off with soap and water. But the anxiety to render the infant perfectly clean pro- duces inflammation, and considerable uneasiness; mo- derate cleanliness is at the first sufficient: and the next dressing will easily and safely complete the whole. After examining the new born infants with a view to discover any accidental injury, or natural imperfec- tion, Avrap the navel string in a rag, sufficiently fold- ed, to prevent its coldness from producing inconve- nience. The heads of infants should be dressed loosely, and their future formation left to nature. It was usual after dressing to give oil of almonds, with syrup of violets; sugar Avith butter, or other I N F 798 INF slight laxatives, to discharge the meconium. These are at least useless. A little gruel Avith milk will alone bring it off; and the first milk of the mother will com- plete the necessary discharges. For this purpose the child is put early to the breast, usually within twelve hours, which solicits the secretion, and prevents its too violent current. The general management of the infant state is di- rected too frequently by fashion, or rather by caprice. Modes and medicines used for centuries, handed down in successive generations, cannot always be combated by reason, but are sometimes wholly exploded by a fashionable physician, who aims at distinction by total overthrow of what has been long held sacred- Com- mon sense must at last decide, and without engaging in controversy, Ave shall pursue its dictates. The little being, when first introduced to this world, is brought from a temperature of at least 96°, and should therefore be cautiously guarded against sudden exposure to the air. His clothing should be light and easy ; and, at first, warm. The tender skin would be chafed Avith flannel, and therefore old linen is preferred. Calico aaouIcI be still better; but the whole must be co- vered with flannel, and fastened as much as possible by strings. For a long time cold excites uneasy sensations, and he is properly placed close to the mother; by her side, or that of a healthy nurse, he should lie till at least he has lived twelve months; but modern refinement, or modern apprehensions, place him alone in a crib by the side of the bed. On this subject we can only observe, that Ave have knoAvn infants, thus separated from the warm bosom, cry nearly a whole night; and, in general, they increase slowly, are Aveak and delicate, while those with a nurse, if not the mother, have appeared thriving and happy. But, though the child should be kept Avarm, the air around should circulate freely. A curtain against its head may prevent the current passing over him, but no other curtain should be drawn, and the 'room should be high, large, and airy. On the food of children we cannot add to Avhat we have said in the article Ablactatio ; but may here remark, in opposition to a common and most ridiculous practice, that a child should not be accustomed to take its food at distant intervals. Digestion in children is rapid; and, if food is delayed, the child is uneasy; and, when brought, takes it greedily and too copiously. A healthy child scarcely ever cries. This position will, we know, be disputed; and a child is said to be peevish, fretful, and uneasy, Avhen the nurse is careless and inattentive. Dispositions undoubtedly differ; but the parent, who finds a child constantly crying, should suspect her nurse, and even herself. One cause of this fretfulness is the opinion that the nurse knows when the child should sleep, or eat, better than itself. It is forced to feed when not hungiy, and to sleep when eager for play or amusement. We have often cured this disease, by correcting the attendant. It in- deed happens that some children will not sleep by night, but even this may be conquered by management; for the healthy child may be amused during the day, and his amusements may be gradually protracted till night approaches. Disposition and fancies show themselves very early to the attentive observer; and, when reason has not yet attained its poAver, to correct them Avith violence, irritates without amending. Even at an early age, children may be soothed into regularity and obe- dience : they cannot be forced. If a child screams sud- denly, he is undoubtedly ill, and should be carefully at- tended to. A healthy infant is fond of exercise. He should be moved gently up and down, but without any shocks. On this account the modern cot is preferable to the cradle, for the child may be shook by the latter into a stupor, which a nurse will take care to do, as it saves her the trouble of attending to the infant's play. In dandling the child, great inconveniences arise from compressing the breast. The child sits on the left hand, and, to prevent accidents, leans forward against the right placed on its breast. If the nurse is timid, or if the child starts, the only security is to clasp the breast, by which the ribs are often compressed.. If, hoAvever, the right hand is placed under the arm, with the thumb over the shoulder, an active child may even start from the other hand without danger. The right hand will support it, or convey it gently to the ground. SAvinging seems to give children an uneasy feeling, and even being carried quickly doAvn stairs will make them shrink to the nurse's breast. This is almost the only instinctive feeling that, after much observation of children, has occurred to us. Gentle friction is an ex- cellent addition to exercise, and peculiarly grateful to infants. The pathology of the infant state is slight and sim- ple. From the disproportioned size of the head, ac- cumulations in this organ are frequent, and almost every fever is attended with a considerable load in the brain. The only peculiar disease of the head is hydrocephalus, though apoplexy and palsy have, at times, attended the infant state. A great difficulty arises in distin- guishing the accumulation of water from fever. This is not, indeed, easy, but often unnecessary, since the treatment does not greatly differ; free evacuations from the bowels being equally indispensable in both. Accu- mulations in the stomach and intestines are the great source of children's complaints. A considerable quan- tity of mucus is a.part almost of their constitution, and it is this accumulation Avhich occasions Avorms, diarr- hoeas, and convulsions. Emetics and cathartics are, therefore, the chief remedies, and the most active dras- tics are borne Avith ease, and even advantage. A child may more safely take five grains of calomel than an adult; and often two or three grains of gutta gamba Avill not produce a considerable discharge. Suffocation, considered as the disease of children, is, we fear, al- ways the creature of art, the effect of indulgence arising from too great warmth, and more frequently from fulness. The prophylactic management of children is not a very abstruse subject. Early hours, moderate warmth, exercise in the open air, to as great a degree as their strength admits, Avith a proper attention to their diet (see Di.eta), and the due regulation of the alvine dis- charges, comprise the Avhole. The medicines for chil- dren should be feAv and simple. Their stomachs abound Avith acids, Avhich change the bile to a green colour, and thus tinges the stools with the same hue. The anxious parent, on this appearance, flies to absorbents; but, Avhile the child continues lively and cheerful, and the stools are neither too copious nor too feAv, no remedy is necessary. In early infancy a child has generally i N F 799 I X F from three to five motions in tAventy-four hours. This number lessens; and, at the age of two years, there are seldom more than two daily. Constitutions differ in this respect, and Ave have known an infant continue in perfect health with one motion only in twenty-four hours. See Percival's Essays, Medical and Experimental, cd. 2. p. 363—367; Armstrong on the Management and Diseases of Children. Cadogan's Essay on the Management of Children. Harris on the Diseases of Children, translated by Martin. Clark's Directions for the Management of Children. Moss on Nursing. INFE'CTIO, (from inficio, to infect). See Con- tagio. INFE'LIX LIGNUM. See Sambucus. INFERNA'LIS LA'PIS, (from its burning and de- structive property). Caustic made by evaporating strong soap leys almost to dryness. See Causticum com- mune fortius. It is sometimes used instead of the causticum lunare, and often is distinguished by the same name. See Argentum. INFE'RUS, (from infra, beneath). Situated beneath another part. IXFIBULA'TIO,(fromfny?d«/o, to button together). Infibulation. This operation is the reverse of cir- cumcision ; for it confines the prepuce over the glans penis, to prevent its being drawn back. That part of the prepuce Avhich extends beyond the glans is per- forated by a needle armed with a waxed thread, which is moved backAvard and forward every day until a cica- trix is formed. After this the fibula is fixed. The ancient Romans thus used to prevent in their singing boys premature venery, to preserve their voices. See Celsus, lib. vii. cap. xxv. The fibula seems to have been a kind of ring. INFLAMMA'TIO,(from infiammo,to burn,) Phleg- mone; Phlogosis; inflammation. Phlegma, Hippo- crates ; oxy phlegmasia; a topical pain, with an injury of the functions of an internal organ, attended Avith in- flammatory fever, and the appearance of a buffy coat on the blood. External inflammation is characterised by a redness, heat, and a painful tension of the affected part. The most obvious idea which the symptoms of in- flammation suggest, is that of an accumulation of blood in the vessels, and its confinement in a given part. The 'conclusion, hoAvever, is too general; forthe veins of the part are often swollen, and the secretions from the neighbouring glands sometimes increased in quantity. The accumulation has, however, suggested the idea of its arising from a stimulus, and the confinement of the fluids in the part the idea of obstruction. It is ob- vious, that a stimulus will produce inflammation; but when this is removed, the inflammation ceases. Ob- struction then has been the leading principle in every theory of inflammation, especially when pathologists had remarked, that obstruction alone excites the action" of the vascular system. The source of this obstruction has differed according to the fancy of the enquirer. It Avas first supposed to be too great viscidity of the blood, and we were trium- phantly shown the dense buffy coat on its surface, when drawn; but we noAv knoAV, that the whole mass of the crassamentum is not preternaturally dense or viscid, for that the basis of the clot is loose in proportion to the density of the surface. Another opinion Avas, that, as there appeared to be a series of vessels of decreasing diameters, and evidently some into Avhich the red glo- bules Avere unable to enter from their size, inflamma- tion might consist in these globules being impelled into vessels not adapted for them, where they were confined, occasioning, from their obstruction, inflammations. This is the famous error loci of Boerhaave, and there is no doubt of this " error" taking place ; but we shall find it to be an effect, not a cause. Dr. Cullen con- siders the obstruction as owing to spasm. " That a spasm of the extreme vessels takes place in inflam- mation is presumed, he observes, from what is at the same time the state of the Avhole arterial system. In all considerable inflammations, though arising in one part only, an affection is communicated to the whole system; in consequence of Avhich, an inflammation is readily produced in other parts besides that first affected. This general affection is well known to physicians under the name of diathesis phlogistica. It most commonly ap- pears in persons of the most rigid fibres; is often ma- nifestly induced by the tonic or astringent power of cold; increased by all tonic and stimulant powers ap- plied to the body; always attended by a hardness of the pulse; and most effectually taken off by the relaxing poAver of blood letting. From these circumstances it is probable, that the diathesis phlogistica consists in an in- creased tone, or contractility, and perhaps contraction, of the muscular fibres of the Avhole arterial system." Thus rested the state of opinions for many years, when a new opinion arose in the school of Edinburgh; an opinion, hoAvever, of private teachers rather than of the professors, that inflammation Avas owing to a debility of the vessels of the part affected, admitting of considerable distention; or, at least, to a disturb- ance of the balance betAveen the action of the larger vessels and that of the capillaries, in which inflamma- tion is seated. This opinion has been published by Dr. Wilson, in his third volume on Febrile Diseases, and attributed to Dr. Lubbock, or a Mr. Allen, Avho, we believe, gave a course of lectures on physiology in that university. We had, many years since, formed a similar opinion, when digesting the observations already offered on fevers, which attributes the phaenomena of these to a change in the equilibrium of the circulation. We mention this circumstance neither to detract from these authors' credit, nor to add to our own; but, as some confirmation of the claim, we may suggest the consistency of this doctrine, Avith the vieAv we have given of fever in general. In our explanation of fever, Ave attempted to prove that debility was the first change Avhichtook place; and, in all the varieties and changes of appearances, debility, we remarked, was always the leading feature. With a view to inflammation, Ave observed, that, Avhile there was a quiescence of the capillaries, probably a spasm, since debility is its general and principal cause, the ac- tion of the sanguiferous system was excited, but that the excitement was partial. If, then, from any cause, this action is excited in a peculiar degree, and if any debility in a given part concurs, inflammation will be the consequence. These are not hypothetical positions. Inflammations chiefly occur in the young, the robust, and sanguine, whose habit, or diathesis, is inflammatory, and from hence called phlogistic, a term derived, like INF 800 INF inflammation, from fire, before phlogiston had an ex- istence in chemistry. The phlogistic diathesis consists in a strong action of the arterial system, and increas- ed tone and vigour of the active powers of the circula- tion, which are evident from *the strong, hard pulse, and the general firmness of the whole habit. If any of fever happens, it will be evident that the action of the arterial system will be, in such constitutions, inordinate. The partial debility is also equally con- spicuous. No more certain cause of rheumatism exists than topical cold, after the part has been unusu- ally heated; of peripneumony, than previously having breathed warm air; and of any inflammation, than from the same part having been formerly affected with the same disease. All these circumstances point out previous topical debility, quiescence which admits of accumulation, in which inflammation seems to consist. This forms, hoAvever, the extreme case : various are the intermediate ones, in which, though the balance is disturbed, the vis a tergo is more or less violent in pro- portion to the debility, or the debility more or less con- siderable in proportion to the former force. When in a healthy state a part is rubbed or irritated, a redness comes on, Avhich on the cessation of the cause again re- cedes. This can scarcely be called inflammation, for it isnot a disease. In fact, the balance of the circulation is not disturbed; but if the motion of the fluids is in- terrupted, and their return by the veins impeded, the usual consequences of obstruction follow; the vis a tergo Is increased, the vessels distended and weakened. If, on the contrary, a part is weakened, as by cold, the fluids accumulate without any increase of the vis a tergo, become red and livid, but by the gradual approach of warmth again recover their usual appearance. This again is not disease; but if the cold is farther continued, so that the power of the arteries behind cannot propel the fluids, chilblains and gangrene ensue. The great subject of debate has been, whether ob- struction really exists in inflammation. Dr. Wilson, from microscopical observations, is convinced that this is the case. We have said that the conclusion is -too general. It seems to fulfil all the idea of inflammation, if, from a disturbed balance in the circulation, the blood is accumulated in a part faster than it is conveyed away by the veins or exhalants. Obstruction is not necessary to explain the phenomena; and in some instances, as we have said, the veins SAvell, and the discharge from the neighbouring exhalants is increased. Yet we are willing to admit, that in every violent inflammation ob- struction does take place; but it is unnecessary to distin- guish the circumstances with accuracy, as the explana- tion of the symptoms or the cure will not be affected by the decision. The view of inflammation thus given will suffi- ciently explain almost all the varieties, and give a con- sistency to the method of cure. Theonly kind, whose pathology is less obviously derived from the foregoing remark, is erysipelatous inflammation. The only dif- ficulty however arises from the inaccuracy of language. We are accustomed to call those internal inflammations erysipelatous, in Avhich the action of the arteries, so far from being increased, is weakened, and which hastens to gangrene rather than suppuration. There is not, however, the slightest evidence that the state of inflam- mation internally resembles the external appearance usually denominated an erysipelatous eruption, for this is properly an exanthematous disease, except when in the fauces, where a similar appearance attends the gan- grenous throat; but in this case the eruption is a symp- tom only, and the inactive inflammation hastening to gangrene, the real disease. All the additional explan- ation Avill appear from the ratio symptomatum, to which we proceed. The leading symptom of inflammation is redness, Avhich has been usually explained from the entrance of the red globules into vessels not adapted to their dia- meters. This error loci we believe really takes place; but, independent of this cause, the redness proceeds in part from slight extravasations in consequence of rup- ture, but chiefly depends on the greater quantity of the red globules from dilatation and accumulation. It ap- peared from the microscopical observations of Dr. Wil- son, that slight irritation, instead of producing redness, occasioned paleness, in consequence of the more rapid circulation, and that the redness did not appear until the appearances of the blood's motion had ceased. It must be remarked, hoAvever, that these experiments are, in part, fallacious. The circulation cannot be observed but in transparent organs; and when vessels are distend- ed so as to admit of considerable accumulation of blood, they are no longer transparent. Increased heat is another symptom equally character- istic of inflammation, and this was easily explained by the pathologist from the increased circulation, and con- sequently increased friction. We know, however, that the change in the blood's capacity for heat, which takes place during the circulation, is equally going on during its stagnation, and Avhen a larger quantity is ac- cumulated in a part, the heat given out in consequence of this change must be necessarily greater. On the ap- proach of gangrene the parts are cold ; but this change never takes place till the blood has already assumed a livid hue, and of course has yielded all the heat which could be separated in consequence of this change of capacity. The pain is more easily explained from the distention, and the spasm which also must take place in conse- quence of the distention. It will be obvious also, that where the vessels are closely confined in membranes, they admit of distention with difficulty, and the pain is proportionally increased. The pain is also in proportion to the sensibility of the organ and the diathesis phlo- gistica, Avhere the disease in a great degree arises from the violent action of the vis a tergo. On both these accounts, the inflammation of the eye is attended with the most excruciating pain. Ligaments and tendons when inflamed are also acutely sensible, though their sensibility is inconsiderable in the sound state. The source of the only other symptom, the swelling, is suffi- ciently obvious. The remote causes of inflammation are either general or topical. The general causes are those of fever, de- termined in their seat by some accidental cause, gene- rally some debility of the part. Inflammations of this kind are usually inflammatory, arising from excess of action in the larger arteries; but in different states of .the atmosphere, or rather in different epidemic consti- tutions, either a less degree of phlogistic diathesis will produce the accumulation, or the balance is destroy- ed by the loss of tone in the affected part; often not- INF 801 INF Avithout suspicion of a morbid poison determined to the part, particularly in the putrid sore throat, which seems rather an exanthema than a phlegmasia. Of the topical causes but a few only are direct stimuli. A thorn in the flesh is one of the most familiar in- stances of this kind; chemical acrids produce the same effects; but a more frequent cause in the human body is any extraneous body, or any portion of the body de- prived of life which acts as such. These continued irritations seem to produce those inflammations, in Avhich, as we have said, there is no decisive evidence of obstruction. The other topical causes are those of indirect debility, as burning, overstretching, concussions, 8cc. Avhich we have already shown, with a view to this subject, act by producing atony. The coup de soleil, at least in this country, appears to have a similar effect. See Ictus SOLARIS. The terminations of inflammation are said to be by resolution, by abscess, by gangrene, and scirrhus; but this offers a very fallacious view of the subject. In fact, the salutary terminations of inflammation are by effusion and abscess; the fatal ones most commonly by haemorrhage and gangrene. Scirrhus is usually a pre- vious disease, and excited to cancer by inflammation. When an inflammation either by the operations of nature or the influence of remedies yields, an action is first perceived in the vessel, the dark colour assumes a brighter hue, the tumour lessens, and an effusion takes place from "the adjoining exhalants. The effusion some- times proceeds and relieves the over distended vessel, but there is scarcely an instance of resolution of inflam- mation, without some effusion, which occasions the adhesion of contiguous membranes. It consists of the serum of the blood, with its proportion of fibrin. This is commonly the termination of the febrile inflamma- tions. In those which depend on the loss of tone, the effusion is of a different kind; and in these, though it relieves the original disease, yet it leaves one scarcely less dangerous. We allude to the effusion of a watery fluid which sometimes follows inflammation of the lungs, producing hydrothorax. When cedematous swell- ings follow gout or rheumatism, the danger is less. When nature or art fails in relieving the inflammation by effusion, the texture of the part is destroyed by the continued pressure of the accumulated fluids, and the whole is melted down into one uniform, opaque, white, mild fluid, called pus; and an abscess is said to be form- ed. The appearance of an abscess is prognosticated by the cessation of the pain and the distention. But to these symptoms, which occur also on effusion taking place, must be added a throhbing pain, synchronous with the dilatation of the arteries, and irregular shiver- ings. After a short time a weight is felt in the part, the pain disappears, and, if on the surface, the tumour is soft, and an evident fluctuation is perceived by the touch. The skin gradually becomes thinner, and a little conical apex appears, generally about the centre of the tumour, which is called its pointing; though frequently the skin only becomes thinner, and the tumour softer in one particular part, above, below, or on either side, indis- criminately, and seemingly from accident. The nature of purulent matter, as well as its source, has been disputed. We have called it a mild fluid, and undoubtedly to all the senses it is so; yet it seems to VOL. I. dissolve the cellular substance around, and to form for itself a cavity greater in proportion to the resistance it finds in its way to the surface, where it generally tends. When not the salutary termination of inflammation, it is sometimes highly acrid, as in venereal or scorbutic sores; but its reputed acrimony in other cases arises often from its pressure, which destroys the life of the part, and subjects it to the action of the absorbent ves- sels. An aneurism, in which there is not the slightest suspicion of acrimony, will do the same. The source of the purulent matter is said to be the serum of the blood, changed to this form by the process of fermentation. This was the opinion of Gaber and Pringle; but De Haen and some modern authors con- tend, that it is a morbid secretion from the exhalant arteries. On this subject we find it difficult to form an opinion. Were we to offer any, we should say that it consists of the substance of the vessels and of the cellular membrane dissolved in the serum ; but this is an opinion we are not prepared to defend. It is cer- tainly an albuminous fluid, which has, however, a ten- dency to the putrid fermentation. To produce this fluid a certain degree of excitement of the vessels is requisite. When too considerable, it is sometimes bloody; when the excitement is in too small a degree. it is thin, acrid, and glairy; when in a still less, ichor- ous. In the latter cases we must apply stimulants and astringents respectively, for only Avhen the pus is of a proper nature and consistence, in the language of sur- geons laudable, does it contribute to healing the wound. There is another fluid which certainly is not laud- able, viz. that which is found in scrofulous glands, and which is discharged in consumptive cases. This is of a ragged cheesy kind, surrounded generally with streaks of proper pus, apparently from the inflammation of the coats of the containing cyst. It seems to consist of the gluten of the blood so hardened and condensed that it will not admit of solution. The distinction between pus and mucus is not easy to the inexperienced practi- tioner. In general, mucus is in rounded masses; pus flows more readily: the latter is softer and whiter, with little globules swimming through it, and, when mixed with a saturated solution of potash, a transparent tena- cious jelly is separated, while the same solution pro- duces no such change in mucus. The fatal terminations are hamorrhage and gangrene. We might have mentioned haemorrhage among the salutary terminations, but they rarely prove so in this climate; yet occasionally a slight bleeding from the neighbouring glands, as a bloody tinge of the sputum in pneumonia, we have thought useful. In general, however, the salutary haemorrhages are copious ones, generally from a neighbouring organ, as from the nose in phrenitis; but these are uncommon in this climate. The fatal haemorrhages occur in the lungs, in the bowels, and bladder, but are not very common terminations. Gangrene is a fatal termination in the very active inflammations, where the fever runs Avith peculiar rapid- ity ; or in the very low ones, Avhere want of tone re^d.ly admits of considerable dilatation, and consequently compression. In gangrenes the life of the part is destroyed, the redness assumes a livid hue, vesications appear on the surface, and the inflammation is external; pain is no longer felt, a peculiar serenity comes on, with a sinking of the features, which gives a ghastly INF 802 INF appearance to the countenance, and the patient dies with every feeling and every expectation of recovery. When a putrid acrimony occurs in the fluids, gangrene is more to be dreaded in inflammations of every kind : it is particularly common in those diseases which occur in jails and crowded hospitals. There is a kind of gan- grene which follows considerable irritation and violent pain, independent of great inflammation. In this case the violence of the excitement seems at once to destroy the tone of the part, and it is in this kind that Mr. Pott has found opium so eminently useful. Some authors have supposed gangrene to be occasionally owing to blood effused; but we have no evidence that blood, if preserved from the access of air, is peculiarly disposed to putrefaction. See Erysipelas, Abscessus, and Mortificatio. It may appear that, in this disquisition, Ave have omitted the inflammations of the mucous membranes. These, however, make no part of the present subject; for they arise very generally from a morbid poison, car- ried to the glands, and the inflammation excited in these organs is attended with an increased or a vitiated dis- charge. If it were necessary to reduce them to this head, they would be found to resemble the inflamma- tions excited by mechanical or chemical acrids Avithout obstruction. The prognostics in inflammations are more or less favourable in proportion to the importance of the part affected, the constitution of the patient, the violence of the symptoms, and the coincidence of other diseases. Inflammations of the glands, of the ligaments, and the tendons, are tedious in their progress, and the tAvo last leave a disposition for the future attack of a similar disease. The cure of inflammation will, we think, be greatly elucidated by the former enquiries; and, for this purpose, inflammations must be divided into those at- tended with a phlogistic diathesis, and those in Avhich distention and dilatation arise in a greater degree from atony than an increased vis a tergo. This distinction cannot be made with accuracy, for the two kinds pass into each other by almost undistinguishable shades. Yet the difference is real, and it will be only necessary to modify the treatment of each when it approaches the confines of the other. The chief remedy of the active inflammations is bleeding, and Hood must be often taken in large quan- tities from a large orifice, since the relaxation Avhich it produces is in proportion to the quantity lost in a given time. If we peruse the Avritings of physicians in the early part of the last century, we shall perceive that they bled freely and repeatedly where we find a single evacuation only admissible. Constitutions are greatly changed in this respect; luxury has enervated our ha- bits, and the changes in diet have greatly lessened that active constitutional power Avhich forms the essence of the inflammations now before us. In the robust la- bourer, in a cold season, where the disease has arisen from cold to which the body when heated has been exposed, a large bleeding may be repeated; but in a crowded city, with a person whose constitution has been enervated by a sedentary occupation, or by luxury, whatever the appearances may be, bleeding must be cautiously employed. After a general bleeding, mo- dern refinement, adapting the remedy to the change of constitution, has employed topical bleedings either by means of leeches or cupping glasses, Avhich relieve the distended vessels, without too far debilitating the system. The inflammations to Avhich copious and ac- tive bleeding are chiefly adapted seem to be phrenitis, carditis, pneumonia, rheumatism, and perhaps thepsoaa inflammation, when it is certainly known to exist. Emetics we have seen producing relaxation through the whole system; and though they may appear to be con- traindicated, when we recollect that a partial debility favours the inflammatory distention, yet any inconve- nience which this may occasion is compensated by the freedom which they restore to the circulation in gene- ral. In conformation of this idea, Ave find, that, in the other class of inflammations, where the circulation is more languid, they are injurious; and if given in the ulcerated throat, it is rather Avith a vieAV of emulging the glands of that part, an effect which renders them so useful in pneumonia, than of counteracting an inflam- matory state. The nauseating doses of antimonials are peculiarly useful in such active inflammations; nor in diseases of short duration, in constitutions peculiarly strong, have we any thing to apprehend from their de- bilitating effects. In all inflammations of this kind, it must be remembered that the increased inordinate action of the arterial system is the chief disease. Cathartics are not generally indicated in these com- plaints ; yet, as they draAV the fluids powerfully from the head, and from the chylopoietic viscera, they are useful in inflammations of these parts, as they act Avithout in- creasing the phlogistic diathesis in general. They are most advantageous in the earlier stages; nor need we Avait till the increased action of the arterial system is taken off by bleeding. As cathartics are peculiarly useful in phrenitis and enteritis, so are they injurious in pneumonia. As evacuants they are perhaps singularly advantageous in rheumatism; though the inconve- nience of moving renders them less eligible to the pa- tient than other remedies. Diaphoretics are apparently Avell adapted to active inflammation, from the effects which we have already had occasion to explain. In general, however, theip stimulant power renders them less advantageous in those cases where the vis a tergo is very actively in- creased. To this there is only one exception, viz. where the evacuation is from the neighbourhood of the organs affected, as in rheumatism; for it compensates for any disadvantage that would otherwise arise from the increase of the circulation. In general, however, the relaxing diaphoretics, as the nauseating doses of emetics, and the combinations of opium, with either the ipecacuanha in Dover's, the white hellebore in Ward's powder, or with the warmer preparations of guaiacum, are most effectual. Opium, which we have styled the most certain and powerful diaphoretic, is not always admissible, it is said, from its stimulus, but this is generally inconsider- able, and sometimes unobserved. The chief disadvan- tage of opium arises from its checking the secretions, so essentially necessary in many of the active inflamma- tions, particularly in pneumonia, hepatitis, and enteritis. When this inconvenience is obviated, as Ave shall find in speaking of each disease, opium is an useful remedy, and it is occasionally employed, in each, with advantage. Blisters are of the highest importance in inflamma- INF 803 INF tions of every kind; but when the inflammatory diathesis is considerable, they fail of relieving; and it will be obvious, that, Avhile the disease continues in conse- quence of the force of the arterial system, the advan- tages derived from topical depletion cannot be consider- able. In the most active inflammations we have some- times found it necessary to bleed previous to each ap- plication of a blister, particularly in rheumatisms, where blisters must be often repeated. Sedatives of every kind are essentially necessary. A class of medicines, Avhich we have styled inirritants, Avhich we shall soon notice, and which consists of those diluents and demulcents Avhich sooth and sheath the irritations of the nervous system, or inflamed mem- branes, are highly useful in these active inflammations. The other sedatives employed with advantage in such cases are nitre and camphor. The utility of the former is generally acknowledged, except in inflammations of the bladder, where large doses are supposed to produce some additional irritation. The latter is not so generally employed, as it is thought to prove occasionally stimu- lant, and by some practitioners to be useless. In small doses, however, we have repeatedly found it an ad- vantageous medicine, particularly in those cases where nitre seems to produce too great an irritation. Some of the narcotics promise to be useful in such cases, par- ticularly the hemlock, and the digitalis ; but they have net been often employed and of their advantages we cannot speak from experience. Cold, as a privation of heat, has been considered as an active remedy of inflammation, and employed very freely of late, in one species, the gout. (See Arthritis.) In general, however, it is a doubtful and uncertain re- medy. When temporarily employed, it is followed by increased action, and will of course exasperate the disease; when continued it occasions torpor, and may produce or hasten gangrene. In external phlegmons it is of use in the early periods, and will sometimes con- tribute to their resolution ; but in internal phlegmasiae it is generally a dangerous remedy. It may be questioned, however, whether, when Ave avoid cold, we should freely indulge a higher tempera- ture. The reason for employing heat has been to pro- mote perspiration, and consequently to relieve internal accumulations; but we have found reason to doubt whether the discharge from the skin, brought on by high temperatures, is truly salutary. In general it appears otherwise; and the warm diaphoretics, of which Avarm air and Avarm fluids are the principal, appear to injure more by increasing the circulation, than they relieve by the discharge they produce from the surface. When then Ave would avoid cold, we would not indulge heat. The temperature of the room should be moderate, and scarcely exceed 62°; the drinks tepid, somewhat about the heat of new milk, a degree peculiarly soothing to the irritated nerves. See Inirritantia. As cold applications are admitted in phlegmons, it may be considered that they would be equally beneficial where the cold air is applied to the part, as in pneumo- nia and sore throat. In the latter, cold applications are sometimes useful; and nitre or sal prunellae held in the mouth has been said to relieve the inflammatory angina. The lungs are, hoAvever, more irritable; and though great heat is injurious, extreme cold is equally so ; nor can Ave sink the temperature of the room or of the drinks far below the degrees stated, though per- haps they may be somewhat diminished with advantage. Of this, however, the feelings of the patient are the proper criteria. Phrenitis and pneumonia are perhaps the only in- flammations which form an exception to the general rule, respecting the utility of a recumbent posture. In the former the erect position is highly advantageous, and it has been supposed equally useful in the latter ; but the subject will be resumed when we speak sepa- rately of each. Inflammations, as the habit is less inflammatory, and the circulation less actively excited, require these re- medies in a less degree and diminished power. When we approach that low state in which inflammation pro- ceeds from atony, with a very slight, if any, increased circulation, we must be cautious in all the evacuations. Great inconvenience has arisen from a want of caution in professors and lecturers, who generally remark, in every inflammation, that, should the patient be young and plethoric, some blood may be taken. Many epide- mic pneumonias and cynanches occur in Avhich this eva- cuation would be fatal in forty-eight hours. In the Breslaw epidemic, though attended Avith topical inflam- mation from atony, so debilitating was the cause as at once to take off rheumatic pains. The practitioner must consequently attend with care to the reigning epi- demic ; to the state of the pulse ; to the countenance, and all the circumstances which indicate "debility; and he must be particularly cautious not to mistake- a pulse throbbing from irritation for a hard inflammatory one. The countenance often furnishes a very certain index: if the features are sunk, the eyes staring, the expression lost, whatever are the other symptoms, bleeding must be avoided. The warmer diaphoretics must be preferred also to the nauseating or relaxing ones; and cathartics,particularly the purgatives, care- fully avoided. In the more asthenic inflammations of this kind, we must soon have recourse to bark, and the warmest cordials ; nor will blisters, as Ave have had oc- casion to remark, be always safe. Many modifications of these directions will occur under the separate dis- eases. External inflammation is more within the reach of the sight and touch; and to this the former directions are only applicable, when attended with general fever. If not in the vicinity of any large vessel, or in a situation peculiarly inconvenient, we are seldom anxious about its resolution, but suffer it to proceed to suppuration. If it arises from wounds or bruises, the remedies styled dis- cutient are useful: these are Avarm and astringent appli- tions, capable of exciting the torpid action of the vessels, and restoring the tone destroyed by the blow. If these do not succeed, and the accumulation is followed by in- creased action from behind, the vessels are depleted by topical bleeding, and our discutients applied with increas- ed poAver, or more frequently repeated. In all such cases, practice gives the firmest support to theory, for emolli- ents are constantly forbidden Avhere resolution is attempt- ed. The use of the preparations of lead rests on some un- certainty. This metal is an apparent exception to the general tonic powers of metallic substances : it seems to render the nerves torpid, and the muscular fibres less 5 K 2 INF 804 INF irritable. It is not, therefore, always proper in inflam- mations where the action of the vessels is inconsider- able ; but, in watery solutions, a valuable remedy where the circulation is pushed on with increased energy. When we aim at producing suppuration, gentle and continued Avarmth, sometimes with a slight stimulus, favours the dilatation of the arteries, and lessens the resistance of the skin. (See Furunculus.) In indo- lent tumours, the stimulant applications are most use- ful ; in highly inflammatory states, the emollients, with anodynes. Dr. Cullen has inserted, among the species of phlo- gosis (external inflammation), erysipelas; but apparent- ly without due consideration, as its nature and symp- toms differ essentially from phlogosis. When attended with fever, it is an exanthema; and, Avhen without it, a cutaneous disease. When inflammation attacks the glands independent of fever, the lymphatic glands chiefly suffer, and the treatment of these is not very different from that of phlogosis. In general, resolution is attempted by topical evacuations, by sedatives, or occasionally by those re- medies Avhich excite the action of the minuter vessels. We shall, however, enlarge on this subject, under the diseases where they chiefly occur, viz. Syphilis and Scrofula, q. v". It might be expected that we should distinguish the inflammations, attended to the active energy of the whole arterial system, from those which are rather ow- ing to atony; but in general these form varieties only, as the putrid peripneumonia, the ulcered throat, &c. Were Ave to make any approach to such distinction, Ave should arrange them in the following order, from the system of Dr. Cullen : .1. Inflammations peculiarly active. Phrenitis. Ophthalmia epidemica(Egyptian Ophthalmy). Cynanche. Trachealis and Pharyngea. Pneumonia. Rheumatismus. II. Inflammations less active. Phlogosis. Ophthalmia. Membranarum and Tarsi. Cynanche. Trachealis. Carditis. Peritonitis. Gastritis. Phlegmonodea. Enteritis. Hepatitis. Splenitis. Nephritis. Cystitis. Hysteritis. Odontalgia. Podagra. III. Atonic Inflammations. Anthrax. Cynanche. Maligna. Pneumonia. Putrida. Gastritis and Enteritis. Erysipelatosa. Arthropuosis. Podagra. Aberrans. Bell on Ulcers, edit. 3, p. 17—36, 47—53 ; Cullen's First Lines, edit. 4, vol. i. p. 211; Kirkland's Medical Surgery, vol. i. p. 235; Pearson's Principles of Sur- gery, vol. i.; White's Surgery, vol. i.; Wilson on Febrile Diseases. 1. Inflammation in a joint. See Rheumatismus and Hydrarthus. 2. Inflammation of the heart, carditis. Dr. Cullen has placed the inflammatio pulmonis Lom7nii, and pericarditis, as synonyms, under this genus, included in the class pyrexia, and order febres, defining it to be fever, with pain in the region of the heart, anxiety, difficulty of breathing, cough, unequal pulse, palpita- tion, and fainting: in this case also the pulse is small, irregular, and intermittent; the patient frequently faints, and if not speedily relieved the disorder soon becomes fatal. The method of cure is not peculiar, but resem- bles that of other internal inflammations of the chest. Though the pulse is soft, bleeding, it is said, must be carried to a greater extent than in pneumonia or pleuri- tis ; but in other respects the cure does not greatly differ from that of pneumonia. Where we have suspected carditis we have thought the camphor peculiarly use- ful. It often seems to succeed pneumonia, or rather the inflammation appears to be communicated from the lungs to the heart or pericardium. See Senac sur le Coeur; Lieutaud's Historia Anatomico Medica; and Inflammatio pericardii, No. 15. 3. Inflammation of the fauces. See Angina. 4. Inflammation of the thigh. Inflammation sometimes takes place under fascia lata femoris, fol- lowed by very unkindly suppurations. The usual re- medies of active inflammation must be employed ; but whenever matter is formed it should be discharged as soon as it is discovered. The remedies of active inflammation do not always appear to be indicated by the violence of pain, or de- gree of fever, and the disease sometimes approaches in the insidious form of the psoas inflammation. It is dis- tinguished, however, from the latter, by want of pain on bending the body. The diagnosis is, indeed, of less importance; as free bleeding and a sudorific regimen, with the relaxing diaphoretics, are useful in both. The inflammation of the thigh terminates more safely than that of the psoas muscle, though, as the matter falls down, the abscess does not soon appear, and then points at a very distant part. The sinus is, therefore, gene- rally extensive, and requires a steady, though not a vio- lent, pressure. 5. Inflammation of the liver. See Hepati- tis. 6. Inflammation of the intestines ; enteritis. Dr. Cullen places this disease in the elasspyrexia, and order phlegmasia ; defining it a typhus, attended with pun- gent, tensive, pain of the abdomen, chiefly felt round the umbilicus; a vomiting and obstinate constipation. He distinguishes two species. INF 805 INF 1. Enteritis phlegmonodea, inflammation of the bowels, with acute pain, strong febrile affection, vomit- ing, and costiveness. 2. Enteritis erysipelatosa, inflammation of the bowels, with pain and fever, more mild than the for- mer, without vomiting, but Avith an attendant diarr- hoea. The disease consists in an inflammation of the exter- nal coat of the intestines, and differs greatly from an inflammation of the villous coat, or mucous membrane, usually attended with aphthae or a dysentery. (See Dysentery.) According to the different parts of the intestine in which the inflammation is seated, different names have been assigned; but the treatment is the same in all. If a sharp pain, with a fever and nausea, is felt above the navel, and below the stomach, the colon under the stomach is the probable seat of the inflammation : if in the right hypochondrium, under the spurious ribs, then that part of the colon which joins the ilium may be af- fected : if in the middle of the belly about the navel, the small intestines. The different parts affected need hot, however, be accurately discriminated, since, as we have observed, the method of cure is the same. The causes are either those of fever in general, ob- structions of any kind in the intestines, intususceptio, or wounds. The usual causes, however, are those of fever. The symptoms are, a shivering, with an uneasiness in the bowels soon increasing to a violent pain, occa- sionally, at first, remitting, but soon becoming continual. Generally the whole abdomen is affected at the same time with spasmodic pains, which extend to the loins, apparently owing to flatulency. The pulse is small, fre- quent, generally soft, but sometimes hard, and at last irregular and intermittent. The extremities are cold; the strength sinks rapidly. Costiveness, which has sometimes preceded, becomes unconquerable, or slight mucous discharges are brought off with great straining. After a short time the flatulency increases to vomiting, and every thing is rejected. The tongue is dry, thirst great, the urine often obstructed, or high coloured, and discharged with heat and difficulty. The breathing is quick. The patient bends forwards, because the abdo- minal muscles are spasmodically contracted; great ten- sion and soreness are felt externally; the vomiting in- creases to violent and incessant retchings, in which at last the faeces are returned, and after this scene of dis- tress has continued, without relief from stools, the whole commotion ceases; the pain goes off, and the patient appears to be relieved; but his face grows.pale, the un- der eye lid becomes livid; the pulse continues soft, more regular, though small and Aveak; the extremities are cold; delirium and convulsions come on; and the patient expires, often discharging very fetid stools in the moment of death. This disorder seldom terminates in an abscess. When this is the case, the pain abates, and is converted rather into a sense of distention, and irregular cold fits, Avith other symptoms of internal suppuration; the pain, the great frequency of the pulse, and other symptoms, go off. When this abscess bursts, the patient swoons, and seems relieved from a sense of Aveight in the part where it was, but soon expires in cold sweats. Inflammation in the external membrane of the intes- tines is distinguished from the stone in the kidneys or in the ureters, from the pain in the latter cases shooting down the thigh, from spasmodic pains of the belly, from colic, and from other obstructions there in which no inflammation attends, by the external soreness and fever. The disease, however, with Avhich it is most easily confounded, is the inflammation of the peritonaeum, in which there is equal external soreness, and often an equally obstinate constipation. But in the latter the pain is more pungent, the difficulty of raising the body greater, and when stools are procured the re- lief is inconsiderable. The passage of a gall stone sometimes puts on the appearance of enteritis; but in this case the pulse is seldom affected; the pain is confined to the pit of the stomach, and at last shoots through the body to the back, in a manner that cannot easily be mistaken. If the pain shifts, the vomiting returns only at inter- vals, and clysters procure a truly feculent discharge, there is room to hope. If the pain abates suddenly, with chillness and shivering, a suppuration is forming. When every thing is rejected, the patient very weak, the pulse fluttering, the countenance pale, the breath offensive, danger is imminent. Clammy sweats, a small intermitting pulse, fetid or black stools, a total abatement of pain, are signs of mortification, and death soon follows. In the treatment of enteritis there is much doubt. We are ordered to bleed freely, though the pulse is small, and to repeat it till the pulse rises. When the patient is a laborious countryman, and the disease in- duced by drinking cold fluids in a heated state, this ad- vice may be useful; but it is not generally so. Perhaps bleeding is more seldom necessary in this disease than in any other inflammation, for it rapidly tends to mor- tification ; and, should it not at once relieve, it soon proves fatal. The salutary termination is by a discharge of faeces. If this can be obtained, the patient is safe; but, unless free, copious, and truly feculent stools are procured, the most promising appearances in every other respect will"deceive. These are procured by laxatives; but the operation of laxatives is assisted by clysters, blisters, and the warm bath. Emetics in this case are inadmissible; for vomiting soon comes on, and prevents the action of the only certain remedy. The cathartics, first used, are the milder kind, as castor oil, salts Avith infusion of senna and manna; but these are seldom sufficiently powerful, and are soon rejected. We must then have recourse to the more acrid purga- tives, and the colocynth pill with calomel is substituted. This medicine is often given in considerable doses Avithout effect; and the end is at last obtained by the former medicine, salts and senna. In this period the operation of cathartics is greatly assisted by the frequent injection of clysters. These, to be effectual should be of the most active kind; and the decoction of colocynth with salts, the infusion of tobacco, and the vinum antimoniale, have been em- ployed in this Avay, often without apparent advantage; but the frequent solicitations downward seem to assist the operation of medicines given by the mouth. In this course we are almost constantly interrupted by the vomiting, and it has been usual to add opium to the laxatives, to check that irritability of the stomach INF 806 INF which discharges them. The disadvantage of this plan is, that it delays the cathartic effect of the medicine, till, by the pOAversof the stomach, its nature is changed. We have, therefore, preferred omitting for a time the laxatives, and giving the opiates freely. If pain is checked and the inflammatory state relieved by a blis- ter, we have found no inconvenience if the stools are delayed for a day or two. It is said, indeed, that the disease is fatal in three days: but this is owing proba- bly-to the bleeding: where this is omitted, the disease has continued for six or eight days, and at last termi- nated favourably. If then the usual laxatives, assisted by clysters, do not procure motions, and violent vomiting comes on, a grain of opium may be given in a single pill. If this is rejected, a tea spoonful of the tinctura opii camphorata may be taken alone, and repeated every hour till the stomach is quieter. This quantity is lost about the fauces, and its anodyne effect communicated to the sto- mach. We may, in the mean time, inject clysters; but should give nothing by the mouth, except a very small quantity of toast and Avater, or a very little pep- permint tea. After about eight or ten hours the co- locynth pill with calomel, or the infusion of senna Avith salts, may be cautiously tried, in small quantities, at short intervals; and stools are often in this way success- fully procured. At any part of this period, if the soreness and ten- sion are considerable, a blister may be applied to the ab- domen, or the patient put in the warm bath. Each re- medy contributes to relieve the pain; but we have sus- pected that the warm bath hastens mortification. At least we have not been so successful, where it has been employed, as in those cases in which it has been omitted. Dashing cold water against the legs and thighs, a remedy sometimes employed in the iliac passion, has been recommended in enteritis; but we suspect that it is not a safe remedy when inflammation has taken place. Bathing the abdomen with warm water, rendered more stimulant by camomile flowers and worniAvood, gene- rally precedes the application of blisters. Tartarised antimony, given in doses of a quarter or an eighth of a grain, and repeated every quarter of an hour, sometimes produces motions, when every other remedy has failed. It often happens, that, in the momeqt of approaching mortification, a sudden resolution takes place, and stools are evacuated. The extremities have perhaps already begun to grow cold, and languor to come on. In such cases, wine, with warm generous cordials, will prevent the approaching death, if the stools are freely kept up; but, either in this case, or Avhen the relief is obtained at an earlier period, the evacuations from the bowels mus* be copious, free, and unremitted, while the stools are dark. It is too common to fear the debilitating ef- fects of purging, and, after a few motions, to interpose opiates; but the debility must be indeed great to justify this conduct, for a relapse frequently follows. See Colica and Abscessus intestinorum. The-cry thematic inflammation of the intestines may be treated as that of the stomach. See Inflammatio ventriculi ; Cullen's "First Lines, vol. i. p. 372, edit. 4.; Edinburgh Medical Commentaries, vol. iii. p. 722. 1. Inflammation of the mammae, mastodynia. Dr. Cullen places this as a variety of the phlogosis phleg- mone; and though it may happen at any time, it usually attacks those who give suck. A shivering most fre- quently precedes, and the inflammation with more or less fever; a quick pulse, thirst, head ach, and difficult respiration, follow. As the usual methods to prevent the afflux of milk in the breast are uncertain, to guard against inflamma- tion, the mother should consent to suckle her child, at least during the first month. After this time, by gra- dually discontinuing the sucking, keeping the bowels lax, and the breasts as empty as possible, by means of glasses, inflammation may be usually prevented. But if it should actually take place, bleeding, a thin spare diet, laxatives, and applying a sedative or discutient em- brocation by means of linen rags, which should be moistened with it as often as they dry, will be generally successful. The lotio ammoniae muriatae of Mr. Justa- mond is prepared in the following manner: R. am- moniae muriatae 5 i. sps. rorismarini lb L In pulverem redige ammoniam, et in spiritu solvatur. In the early stage of this disease, the lotio ammoniae acetatae is re- commended. 5o. aquae ammoniae acetatae, sps. vin. rectif. aq. distillatae aa. ^ iv. m. Some prefer the aqua ammoniae acetatae alone; or, a fomentation made of a decoction of poppy heads, in a pint of which an ounce of crude sal ammoniac is dissolved, will often succeed. To each of the lotions above mentioned the tinctura opii may be occasionally added. If the inflammation does not yield to this management, the best method is to en- courage a suppuration without delay. See Abscessus pectoris, and Mammje; Bell's Surgery, vol. v. p. 396. 8. Inflammation of the mediastinum, mediastina. The cause and cure are the same with those of pleurisy, and the symptoms are often similar. The pain, how- ever, is more confined to the sternum, and shoots across to the back. There is a difficulty of breathing, with cough, but not always, attended with spitting. These symptoms are not so violent as in a pleurisy, nor is the pain on inspiration so much increased, or the inflam- matory diathesis so great. Suppuration is with diffi- culty avoided, and generally fatal. 9. Inflammation in the mesentery. See Peri- tonitis. In this disease there is a languid slow fever, without thirst or other violent symptom; a loss of appetite, a sense of tension, and weight below the stomach, with- out much hardness, and only discoverable by pressing on it. This tension is without much pain, because the mesentery hath but a small degree of sensibility. The stools are often chylous, and succeeded by a discharge of thin ichor, without any sense of pain; sometimes pure and unmixed, and sometimes mixed with the faeces. These symptoms are mild and gentle, if the mesentery only is inflamed; but if the liver, spleen, or any of the intestines, are also affected, they are more violent, and distinguished by the appropriate symptoms of each dis- ease. These inflammations generally terminate in abscesses; and the purulent matter is sometimes translated to other parts. The disorder, therefore, is often found to recur, and in this case sometimes the fever returns, or is occasionally changed into a colic. Inflammation of the mesentery is, however, very seldom an idiopathic INF 807 INF disease. It chiefly occurs when the glands are obstruct- ed, and any cause of topical irritation combined. When the presence of this inflammation can be dis- covered, the method of cure will be jthe same as that of an inflamed liver or spleen. Bleeding is, however, scarcely admissible. Inflammation of the muscles of the belly, myocoilitis of Vogel. When these muscles are inflamed, the skin is greatly distended; and if they are swelled, the figure of each is often preserved, and fever generally attends. Pain is considerably augmented in sneezing, straining at stool, breathing, or any exertion, and is often felt at the origin or insertion of the muscles, Avhich distinguishes this in- flammation from any internal one. The rheumatism sometimes attacks these muscles ; and they suffer from pressure, when patients from a stone in their bladder seek for relief, by resting their weight upon some hard body in a prostrate position. This complaint is easily distinguished from a colic, an inflammation in the liver, or any of the subjacent viscera, by the considerable distention, the very early soreness, and the circumstance just mentioned, viz. the pain shooting to the false ribs and the spine of the ileum. The myocolitis scarcely in any instance terminates in mortification or abscess. It is very commonly of the rheumatic kind, and yields to general and topical remedies, the latter of which may approach very near the seat of the disease. Fomentations are particularly use- ful ; but the disease is rare. If the hardness is considerable, and a throbbing pain perceived, an abscess is forming, and should be encou- raged by emollients, that the discharge may be exter- nal. Heurnius observes, that these muscles are covered with so dense a membrane, that abscesses require the knife; and, if the opening is neglected, they sometimes become scirrhous. Hildanus thinks that these tumours should be opened more early than is usual in other in- stances, to secure an external discharge; for the matter is apt to pass betwixt the muscles, and form sinuous ulcers, as bandages cannot easily be applied. The cold air is particularly offensive, and the air in the room should be moderately warm, when the abscess is open- ed, or the wound dressed. Bleeding, with purging, and such other means as are used in inflammations of the external parts, should be employed, and steadily pursued. 11. Inflammation of the eye. See Ophthal- mia. 12. Inflammation of the cesophagus some- times attends Angina, q. v.; but is occasionally an idiopathic disease. We have mentioned it under the title of angina pharyngea, described by Eller de Cog- noscendis, et curandis morbis, p. 172. It is the angina sine tumore of the ancients, and is relieved by cooling subacid drinks. Eller recommends external cataplasms to draAV any matter that may be formed outwardly, but no danger of this kind seems to impend. We have seen it occasionally as the effect of swallowing acri- monious fluids, and once from a pill of calomel sticking in the pharynx; but in each case the inflammation was followed by no disagreeable consequences ; nor was the disease obstinate. 13. Inflamma'tio omenta'lis. See Perito- nitis. 14. Inflammation of the bones. The blood vessels from the periosteum to the bones run between their laminae, whilstothers pass through particular per- forations to the diploe of the cranium, and the marroAV in the bones; from these arise the separation of the corrupted parts, and the restitution of such as are lost. Inflammation may, therefore, be seated in the bones, and is attended with obstinate and violent pains, seeming to the patient to be deep seated. Hence also arises a spina ventosa, &c. See Inflammatio pe- riostei, N° 16. 15. Inflammation of the pericardium, peri- carditis, which Dr. Cullen considers as synonymous with carditis, or inflammation of the heart; adding, that " the pericardium has been known often to be inflamed, without any other symptoms attendant, except those of a peripneumony." The pain, however, seems to be deeper seated, and is not so much increased upon in- spiration. The cure is the same with that of pleurisy or peripneumony. 16. Inflammation of the periosteum. Be- sides the other usual causes of inflammation in other parts, the venereal disease and the scurvy induce it in this. The venereal poison is a frequent cause, when the periosteum within the bone is the seat of the dis- order. When the external periosteum is inflamed, a deep seated pain, heat, and sometimes a pulsation are felt; and, when the part is not thickly covered, the pain will be augmented by pressure; muscular motion, however, always increases it. That the membrane which lines the bone internally is the seat of the inflammation appears probable, from the want of pain on pressure, or motion; by the absence of pulsation; by receiving no relief from any position of the pained part; and particularly by a sensation of the bone outwardly, splitting from within. Inflammations in both membranes of the bone pro- ceed from the same causes, produce the same effects on the part of the bone to which they adhere, and termi- nate either in an abscess or a gangrene; but when the inner membrane is affected with gangrene, the marrow and bone are both destroyed. If inflammations of these kinds are not speedily re- moved, the periosteum will be destroyed; and cannot be renewed until the bone exfoliates, and is restored. In this period the incumbent parts will be irritated by an acrid sanies, and malignant ulcers produced, espe- cially if a large portion of flesh covers the bone, and hinders a decisive incision on the part. The cure is as that of all other inflammations ; but the matter must be directed outwards by fomentations and incisions, if the inflammation cannot be discussed by bleeding, purgatives, &c. For this purpose, after these general remedies, softening fomentations and poul- tices may be applied; but if these fail, it remains only to cut down through the flesh to the bone, if the part ad- mits. Amputation is often, however, at last necessary. When an abscess begins to form, it is known and treated as described in the article Abscessus peri- ostei. 17. Inflammation of the rectum is rarely so acute as that of the small intestines, nor so apt to INF 808 INF affect the pulse or the stomach; nor is there such a stric- ture as to render the intestines impervious. The cure is the same as inflammation in any of the other intes- tines ; purgatives are equally necessary, and ought al- ways to be employed. Clysters, from the soreness, are inadmissible, and sitting over warm water useful. 18. Inflamma'tio re'num. See Nephritis. 19. Inflammation, of the spleen, splenitis, and pleuritis splenica. Dr. Cullen places it among the phleg- masia ; defining it febrile affection, attended with ten- sion, heat, tumour of the left hypochondrium, and pain increased on pressure, without signs of a nephritis. Lommius observes, that this disorder is rare; that it is attended with a hard and a throbbing tumour, a pain in the left hypochondrium, a continual violent fever, extreme heat, unquenchable thirst, a blackish tongue, a total loss of appetite, with a difficult, and, as it were, imperfect respiration, like that of children when they sob through anger. Aretaeus adds, that the pain at- tending inflammation in the spleen is not considerable. If the distemper continues, not accompanied by an ulcer, the patients have an aversion to food, are swollen, have a bad habit, a disagreeable aspect, with many round, livid, hollow, foul, and incurable ulcers over the whole body, and die cachectic; but such as have only a small, hard, and scirrhous tumour feel little or no pain, and consequently live longer. A dropsy, a consumption, or a colliquation of the whole body, are its frequent consequences. The cure is that of other violent internal inflamma- tions; but the India punctures and scarifications are employed by the native practitioners. 20. Inflamma'tio te'stium. See Hernia humora- lis. 21. Inflamma'tio u'teri, hysteritis, and. metritis. Dr. Cullen defines this disease a febrile affection, at- tended with heat of the hypogastric region, tension, tu- mour, and pain; the os uteri painful on being touched, Avith vomiting. Women, after child-birth, when the lochia are im- peded, are sometimes subject to this complaint: but it does not often occur, except as in idiopathic inflamma- tion ; for bruises, external stimuli, obstructed menstrua, or obstructed lochia, in very few instances produce real permanent inflammation. The imprudent use of instru- ments, or violence in delivery, is not a very uncommon cause. When it occurs from any of the former causes, the symptoms are chiefly those of irritation rather than inflammation. The pain at the bottom of the belly is nei- ther throbbing nor constantly acute; the pulse is, as usual after child birth, frequent, often small, sometimes irre- gular ; in strong habits, and after early abortions, hard. Subsultus tendinum, and the other symptoms of irri- tation, come on ; the womb mortifies, and the patient sinks. In the unimpregnated state the pain is more constant, circumscribed, and throbbing; the pulse hard, full, and strong, with other symptoms of general in- flammation ; or, if the disease rises to a greater height, the pulse is small and frequent, and suppuration is more frequently the consequence. In both, as different parts of the womb are affected, there is a strangury, or a suppression of urine, and the urine discharged is fetid and hot; or a tenesmus at- tends, with a pain in going to stool; there is pain in moving the lower extremities, or swelling, Avith heat, to be felt at the os tincae, Avhich is usually shut. The belly is tense; a soreness is felt on pressure; a red stain sometimes extends up to the navel, and turns black when fatal: if it occurs in an impregnated uterus, an abortion follows. It often happens that the woman can only lie on her back ; and on turning on either side, she feels a painful heavy mass fall to that side ; with an excessive pain in the loins, kidneys, and groin, of the opposite side. The pain sometimes extends to the thighs. This disorder may be removed by a spontaneous eruption of the menses, or of the lochia; or, after an abortion, or child-birth, by the patient's falling into a constant, equable, gentle, long continued sweat. If it terminate in an abscess, or a mortification, both are fa- tal ; but a metastasis may be a means of relief. Bleeding is useful at the first attack, and if the dis- charge is then copious, it is found to be salutary ; but, if at a later period, it sinks the patient with marks of de- bility, or hastens gangrene. In abortions and labours, where the patient is not greatly debilitated, if the pulse is hard, and not very fre- quent, the loss of blood by the arm is borne with ad- vantage ; but it cannot be repeated; and the general method of cure will ahvays depend on mild diaphoretics, as the pulvis antimonialis and haustus salinus, carefully avoiding irritating purgatives. To these may be added anodyne and antispasmodic fomentations. In delicate or feeble constitutions, after child-birth, and where there is no hardness, but great frequency of the pulse, this disorder too often proves fatal. All that can be done is to keep the patient moderately warm, ex- citing, if possible, a gentle perspiration by farinaceous decoctions, in small quantities, frequently repeated, and applying fomentations and poultices, supporting the strength by the moderate use of wine, and occasionally the bark. All extraordinary evacuations are dangerous. Even the perspiration must be the gentle diapnoe for- merly described. Every irritation, as external pressure, urine in the bladder, or from faeces in the rectum, must be avoided. Urine, if necessary, may be drawn off with the catheter, and the bowels may be emptied by repeated clysters, which are useful also as internal fomentations, and these are particularly necessary when the irritation is commu- nicated to the rectum. Blisters are dangerous reme- dies, as their irritation may be conveyed to the neck of the bladder. Opiates, however, may be freely given, and, indeed, to a considerable extent, if costiveness is avoided by mild laxatives. If suppuration comes on, we are told to direct it to the perinaeum. We may do so, but our success will be inconsiderable. Abscesses in the uterus are rare, but they are very generally fatal. See Fernelius; For- dyce's Elements of the Practice of Physic, part the se- cond; and Hamilton's Outlines. 22. Inflamma'tio vagi'n^ may occur from any cause which produces inflammation in other parts, and must be cured by the same means; but emollient, saturnine, and anodyne injections are particularly useful. When it happens after delivery, it is occasioned by the head of the child being long retained in the pelvis. If the swelling and inflammation be not very great, IXF 809 I \ F they are generally removed by the discharge of the lo- chia; but if the internal membrane of the vagina is inflamed, emollient injections must be thrown up from time to time, and a piece of prepared sponge should be introduced, to prevent the effects of the adhesive in- flammation. Soak a piece of sponge, of a proper size, to keep the vagina open, when expanded, in Avarm wa- ter; then bind it tight Avith a string, cutting off any ir- regularities or lumps. When dry, take off the string, and the sponge will remain in the same form ; anoint it with lard, and introduce it into the vagina, the mois- ture of which will expand it. If the pressure was so long continued as to obstruct the circulation, a mortification will ensue, which if par- tial only, the mortified parts will slough off. This is probably the case, if the woman complains of great pain after delivery, a fetid smell, and a discharge of sharp ichor, or of pus and matter from the vagina. Emollient fomentations may be thrown up in such cir- cumstances ; dossils of lint, dipped in any warm balsam, may be applied; and when the sloughs are separated, great care should be taken to prevent the vagina from coalescing, either by introducing dossils of lint or pieces of sponge. Inflammation and sloughing of the vagina occasionally happens from violence of any kind. 23. Inflamma'tio ventri'culi, gastritis, cardialgia inflammatoria. Dr. Cullen places this, as usual, in the orderphlegmasie, defining it a typhoidal pyrexia, attend- ed with anxiety; heat and pain in the epigastric region, increased on taking any thing into the stomach ; a pro- pensity to vomit, and immediately throAving up what is taken, with a hiccough. He distinguishes two spe- cies :—1st, Phlegmonodea, when from internal causes, in which the pain is acute, and the febrile affection vio- lent. 2d, Erythematica, when from external causes, and the pain with the febrile affection is of a milder nature, with an erysipelatous inflammation appearing in the fauces. He is certain, he adds, from many obser- vations, that of the gastritis, as well as the enteritis, there are tAvo species, of which one is phlegmonous, and the other erysipelatous; and, therefore, he has dis- tinguished them : though he confesses that the symp- toms of the erysipelatous inflammation of the stomach, and more so those of a similar affection of the intestines, are often obscure and uncertain ; but of these he has spoken, that posterity may investigate the subject more diligently. It is produced from nearly the same causes as the inflammation of the intestines, except introsusception and hardened faeces, and it is more liable to be excited by acrid substances. It rarely occurs from external causes, though we have seen three instances in Avhich it has arisen from external cold. When the stomach is inflamed, there is soreness ex- ternally; a pungent, fixed, burning pain, with a distention and tumour, sometimes a pulsation in it: the mildest drinks increase the pain, bring on sickness, vomiting, purging, or hiccough. A continual uneasiness is felt about the praecordia, a difficulty of breathing and swallow- ing, Avith a pain in sneezing: the pulse is small, quick, hard, and intermitting; the extremities cold, Avith clam- my sAveats and faintings: sometimes a temporary mania, and, in one case, a hydrophobia. When from a Avound in the stomach there is frequently little or no pain; but the patient sinks with all the symptoms of irritation. VOL. I, Inflammation in the stomach must be distinguished from a cardialgia, a circumstance by no means difficult, as neither vomiting nor fever attend ; and from an in- flammation in the convex part of the liver; which, Iioav- ever seldom occurs without some inflammation of the stomach. This disorder is seldom so dangerous as is represent- ed. Indeed it seldom occurs in its acutest form; but mild nutritious drinks, in very small quantities, nour- ishing clysters, with a blister externally, has generally relieved. Bleeding, we are told, must be freely used : it may be so, but we have never found it necessary. All stimulants are undoubtedly injurious. When highly acute, a metastasis takes place to the head, and violent phrenitis supervenes : in other circumstances it quickly terminates in gangrene, a change known by a cessation of pain, a coldness about the praecordia, a languid or an intermitting pulse, with a calm serenity, without hic- cough. The drink should neither be cold nor hot, but gently warmed. Demulcents and emollients are best adapted for the common drink, with small portions of nitre, or of the rob of currants. A solution of gum arabic, or spermaceti made Into draughts, in each of which may be gr. v. of nitre, and about a drachm of the syrupus e meconia, may be repeat- ed as often as seems necessary for moderating the pain ; and checking the vomiting. If acrid poison, or an excess of eating, is the cause, an active emetic may be given ; but on all other occa- sions avoided. The emetic preferred is SAveet oil ; but one that acts Avith effect and quickly is more effectual : of this kind is the vitriolated zinc. If an abscess bursts, a milk diet, Avith the mildest food, in small quantities at once, is only necessary. The erythematic inflammation of the stomach comes on insidiously ; but sometimes it is evident by the inflammation appearing in the pharynx, as well as on the whole internal surface of the mouth. When, therefore, an inflammation of this kind affects the mouth and fauces, Avith a frequent vomiting, and an unusual sensibility in the stomach, we may suspect that the same affection extends doAvnward. Even when no inflammation appears in the fauces, yet if a pain be felt in the stomach, with a want of appetite, anxiety, fre- quent vomiting, an unusual sensibility to acrids, some thirst, and frequency of pulse, Ave may suspect the ex- istence of this disease in the stomach. The inflamma- tion often extends farther, occasioning diarrhoea and mucous discharges from the rectum. The treatment will vary according to the causes, &c. When from an acrid matter taken in by the mouth, it must be evacuated by a quick emetic; by large draughts of Avarm mild liquids ; or by the proper antidote, if the nature of the poison is knoAvn. If symptoms of inflamma- tion are manifest, bleeding, blisters, fomentations, and frequent emollient laxative clysters may be used. But as the affection often arises in putrid diseases, all that can be done in such circumstances is to avoid irritation, and to throAv into the stomacli as much of mild and of aces- cent aliments as it can bear. When the disease is a little alleviated, a light infusion of bark, Avith a few drops of any mineral acid, is borne Avith ease, and is highly beneficial. Sec Cullen's First Lines, vol. i. p. 356, &c. ed. 4. INF 810 IN F 24. Inflamma'tio ve'sica:, cystitis, and cystiphlo- - gia. This disease is also placed by Dr. Cullen in the order phlegmasie, and defined a febrile affection, at- tended with pain and tumour of the hypogastric region; frequent and painful micturition, or ischury and tenes- mus. He distinguishes two species. 1. Cystitis from internal ; and, 2. from external causes. It is produced by the usual causes of internal inflam- mation, or from topical irritation ; as acrid diuretics, or a calculus. A pressing and burning pain, with external soreness, is perceived in the region of the bladder above the pubes, and in the perinaeum, soon after a febrile attack. If the neck of the bladder be inflamed, the urine is re- tained, Avith frequent stimulus to its evacuation ;—if the fundus, there is a continual discharge, with great efforts to throw out a larger quantity, which the patient con- ceives to be contained in a bladder. Frequent attempts to expel the faeces, with Avhich the rectum appears to the patient to be always loaded, increase the pain very much, particularly Avhen any hard faeces are contained in it. The pulse is frequent, but seldom hard ; the ex- tremities cold, with restlessness, sickness, vomiting ; sometimes delirium, and other symptoms of irritation. This disorder, if very violent, usually terminates soon, either in a recovery or death; frequently the latter, gene- rally from a gangrene. So violent an inflammation of the bladder seldom, however, occurs. We have often seen it without considerable danger, chiefly from topi- cal irritation, and once only from catching cold. This disorder is sometimes relieved by an increased secretion of mucus from the internal membrane, resem- bling, in appearance, pus, but much lighter, and more uniform ; or by a metastasis. When suppuration fol- Ioavs, pus is discharged with the urine, passes externally through the perinaeum, or into the cavity of the abdo- men, where it proves fatal. The ulcer in the bladder and perinaeum are difficult of cure. Inflammation in the external coat of the bladder should be distinguished from that of the internal ; and inflammation in any part of the bladder should be dis- tinguished from inflammation in the adjacent parts, as Avell as from that retention of urine which proceeds from other causes. The distinction is, however, by no means difficult, as, when the external membrane is affected, the pulse is hard, and the external soreness considerable ; nor is the great irritation to make water so painful or frequent. In the cure, bleeding is seldom necessary to any con- siderable extent; but the bowels should be kept freely open by such laxatives as do not irritate the rectum. Relaxing medicines, such as the pulvis antimonials and haustus salinus, should be given early, and repeated frequently. Fomentations to the pubes and perinaeum are highly useful ; and mild clysters, which act as such, should be frequently injected. If the urine is retained, decoctions of mucilaginous herbs may be taken ; but we should always reflect, that, though we abate the acrimony of the urine in this way, ■we increase the disease. Such decoctions should not be drunk in too large quantities, and gum arabic kept in the mouth will sheath the inflamed parts without adding to the quantity of urine. If necessary, the ca- theter must be introduced; though much care is requir- ed in the attempt, ijhich often fails. If, notAvithstanding due evacuations, spasmodic con traction with much pain continues, opiates in consider- able doses, such as tinct. opii. gt. xx. every three or four hours may be given, taking care that no accu- mulations take place in the bowels. The patient may be placed in the warm bath two or three times in the day. Blisters are sometimes applied to the perinaeum, and Avith advantage ; the plaster should, hoAvever, be covered with thin gauze, and re- moved as soon as a vesication has taken place. In this Avay Ave have often applied them with success. The rubefacients promise greater utility Avith less in- convenience, but we know not that they have beer tried. If by irregular shivers, and the diminution of pain, a suppuration is suspected, we must wait its progress, and the disease will then become an ulcer of the uri- nary passages, which must be treated accordingly. 25. Inflammato'ria fe'bris. Dr. Cullen places i' in the class pyrexie, and order febres ; and as a syno- nym of synocha ; defining it heat, greatly increased; a frequent, strong, and hard pulse ; high coloured urine ; the functions of the sensorium somewhat disturbed. This fever is the continua non putris of Boerhaave ; and the feb7-is acuta sanguinea of Hoffman. When fever is attended with an inflammatory dia- thesis, or when actual inflammation affects any part during the existence of fever, the patient is said to la- bour under one of an inflammatory kind; but, accord- ing to the different parts in which the inflammation is seated, different denominations are given to the disor- der, as we have seen in the preceding articles. In strong constitutions it is produced by any of the causes of fever ; but it has been doubted whether in- flammatory fever exists, independent of topical inflam- mation. There is little doubt but that it is most com- monly attendant on topical inflammation, though it cer- tainly exists alone. When we consider the distinctions of fever, we shall find that they have been too curiously subdivided ; and that fever is a more simple disorder than pathologists have represented it. At present we shall only remark, that this disease is distinguished by a hard pulse and more considerable heat than usual, generally owing to the strength and tone of the habits it attacks. The horror and rigor of the attack are violent, but short in their duration, and are followed by a violent hot fit, in which all the symptoms indicating increased action of the arterial system are very conspicuous. The fever is often terminated by topical inflammation, or a haemorrhage, and is alone fatal, though it may become rapidly so, when the inflammation falls on the brainr lungs, or intestines. If none of these consequences happen in the second week, the strength diminishes, and the fever goes off with a perfect crisis, or changes to a typhus. When attended with local inflammation, and this is removed, the same change sometimes takes place, and the typhus is rendered more dangerous, by the weakness induced from the necessary evacuations. This has been the reason of nosologists introducing the genus synochus ; but synochus, the real disease, is very generally a typhus,_ and the previous inflammatory symptoms are accidental only. The cause of symptoms so dissimilar is not easily assigned. In some cases the infectious miasmata are only excited to action by the INF 311 I>,j previous inflammatory fever, and in others the irregu- lar action subsequent to the spasm is directed to a par- ticular organ, and the irritation excited by its inflam- mation increases the force of the circulation, so as to produce the symptoms described. See Febris and Inflammatio. The causes of inflammatory fever are chiefly cold when the body is heated; but it may also arise from accumu- lations in the stomach, or topical irritations. The sto- mach and bowels are the chief sources of this disease in children; and, indeed, the most common causes, Avhen it appears independent of topical affections. The other sources of irritation are obscure. Bleeding, the common remedy with indiscriminating practitioners, must be employed with caution. If an inflammatory fever attacks a young, strong, robust la- bourer, it may be employed with freedom; but Ave should ahvays recollect that though pneumonia, phrenitis, or any active inflammation, may come on, a typhus may be also at the bottom. The pulse may direct; but, as Ave have often observed, it requires pe- culiar judgment to distinguish between a strong and an irritated pulse, as Avell as betAveen an apparently low and a labouring one. We have found the countenance a good criterion; and if the features are sunk, with any apparent anxiety in the countenance, whatever are the other symptoms, bleeding must be avoided. On the contrary, strong rigor, soon succeeded by violent heat, flushed face, a sparkling and a full eye, Avill require-a free and active evacuation from the arm, which may be repeated according to circumstances. Emetics are remedies of the utmost importance, and in children, where a foulness of the stomach is the principal cause, they will often carry off the fever. In general, the headach and fulness of the vessels appear to contraindicate this remedy; but we have already observed, that the increased fulness is temporary, the advantages permanent. Yet where the determination to the head is very violent, and the vessels have not been depleted by venesection, emetics should be avoided. Cathartics are still more necessary than emetics, and less dangerous. They not only relieve the head, but they prevent determinations to the lungs and liver, and lessen the violence of typhus, should its fomes be latent. The saline purgatives, with senna, are, in this case, preferable. The cooling sedatives and inirritants must be freely employed. The antimonials, nitre, with all the other neutrals, are valuable remedies ; and, vvhere the head is affected, camphor, united to vinegar, has been em- ployed Avith advantage. (See Phrenitis.) Opiates are often necessary when violent irritation and.restless- ness prevent sleep. They should be given with cam- phor and the antimonial poAvder. When local pains come on, they are occasioned by topical inflammation, and must be treated according to their nature. See Inflammatio. The diet should be chiefly gruel, or barley water, sub- acid fruits, Water acidulated with lemon, the jelly of currants, or similar sharp fruits. It may be drunk warm or cold, as is most agreeable to the patient. Half a drachm of nitre may be dissolved in every pint of liquor in Avhich no acid juice is mixed. The room should be high, large, and airy. The patient may sit up a little each day, according to his strength; for this will lesser the fever, headach, and delirium : but when a salutary perspiration comes on, it should be indulged in bed. The sheets may be changed every two or three days. and all putrid matters should be removed. See Fordyce's Elements of Physic, part ii. Fordyce'^ Inquiry into the Causes, &c. of Putrid and Inflammatory Fevers. INFLA'TIO, (from infio, to puff up). See Emphy- sema. INFLA'TUS, (from the same,) is applied botanically to the perianthium, when blown up like a bladder. INFLO'RESCENTIA, (from in, and fioreo, to blos- som,) the mode in which flowers are joined to the plant by the foot stalk. INFLUE'NZA. Influence. (Spanish.) See Catarrhus epidemicus. The same principle Avhich induced Hippocrates to attribute epidemics to the it Oeiov, gave this general epidemic catarrh the name ol influenza. From Sydenham, upwards to Hippocrates. it was knoA\-n by the name ofcatarrhalis febris epidemical but Sydenham chiefly calls it tussis epidemica: it hath been since variously named, but is now styled influenza. In Dr. Cullen's system it is a variety of catarrhus ii contagio. In the year 1673 Sydenham treated of the nature and cure of the putrid fever, which he called variolous fever ; he found that this fever returned every summer afterwards, and was succeeded by the cholera morbus and bilious fever (by him called the new fever). In 1675 these fevers Avere attended by a new symptom, viz. an uncommon degree of stupor, which frequently ended in a coma, and Avas for that reason by Sydenham called the comatous fever. In the beginning of No- vember of the "same year, this fever Avas complicated , Avith a cough, and was described by Sydenham nearly as follows: " The fever proceeded in this manner during the autumn, sometimes seizing the head, at others the bowels, every where raging under the appearance of symptoms peculiar to those parts till the end of Octo- ber; when the weather, which till now had continued in a manner as warm as summer, changed suddenly to cold and moist; whence catarrhs and coughs became more frequent than I remember to have known them in any other season. But it is of most moment to ob- serve, that the stationary fever of this constitution usu- ally succeeded these coughs, and hence became more epidemic, and likewise varied some of its symptoms. For whereas, some little time before, it attacked the head and bowels, now it chiefly seized the lungs and pleura, whence arose peripneumonic and pleuritic symp- toms ; though it was still precisely the same fever that began in July 1673, and continued without any altera- tion of its symptoms till the rise of these catarrhs. * " These catarrhs and coughs continued to the end of November, after which they abated, but the fever still remained the same as it was before the catarrhs appear- ed : though it was neither quite so epidemic, nor ac- companied with quite the same symptoms, these de- pending accidentally upon the catarrhs. " 1675, the season having continued unusually Avarm, like summer, till towards the end of October, and being suddenly succeeded by cold and moist wea- ther, a cough became more frequent than I remember 5 L 2 INF 812 INF to have knoAvn it at any other time; for it scarce suf- fered any one to escape, of whatever age or constitution he were, and seized Avhole families at once; nor was it remarkable only for the numbers it attacked (for every winter abundance of persons are afflicted Avith a cough), but also on account of the danger that attended it; for as the constitution, both noAv and during the preceding autumn, eminently tended to produce the epidemic fe- ver above described, and as there Avas now no other epi- demic existing, Avhich by its opposition might in some measure lessen its violence, the cough made way for, and readily changed into, the fever. In the mean while, as the cough assisted the constitution in produc- ing the fever, so the fever on this account attacked the lungs and pleura, just as it had affected the head even the week preceding this cough; which sudden altera- tion of the symptoms occasioned some, for want of sufficient attention, to esteem this fever an essential pleurisy or peripneumony, though it remained the same as it had been during this constitution, i. e. since July 1673. " For it began now, as it always did, Avith a pain in the head, back, and some of the limbs ; which were the symptoms of every fever of this constitution, except only that the febrile matter, Avhen it Avas copiously de- posited in the lungs and pleura, through the violence of the cough, occasioned such symptoms as belong to those parts. But, nevertheless, as far as 1 could observe, the fever was the very same with that which prevailed to the day when this cough first appeared: and this like- Avise the remedies, to which it readily yielded, plainly showed. And though the pungent pain of the side, the difficulty of breathing, the colour of the blood that Avas taken away, and the rest of the symptoms that are usual in a pleurisy, seemed to intimate that it Avas an essential pleurisy; yet this disease required no other method of cure than that which agreed with the fever of this constitution, and did no ways admit of that which was proper in the true pleurisy, as will hereafter appear. Add to this, that when a pleurisy is the ori- ginal disease, it usually arises betwixt spring and sum- mer ; whereas the distemper we now treat of began at a very different season, and is only to be reckoned a symptom of the fever which was peculiar to the cur- rent year, and the effect of the accidental cough. " Now, in order to proceed in a proper manner to the particular method of cure, which experience shows to be requisite both in this cough and in those which happen in other years, provided they proceed from the same causes, it is to be observed that the effluvia which used to be expelled the mass of blood by insensible perspira- tion are struck in, and thrown upon the lungs, from the sudden stoppage of the pores by cold ; these by irritating the lungs immediately raise a cough; and the hot and excrementitious vapours of the blood being hereby pre- vented from passing off by perspiration, a fever is easi- ly raised in the mass ; namely, when either the vapours are so copious that the lungs are unable to expel them, or the inflammation is increased by the adventitious heat arising from the use Of overheating remedies, or too hot a regimen, so as suddenly to cause a fever in a person who Avas already too much disposed to one. But of whatever kind the stationary fever be, which prevails the same vc-.r, and at the same time, this new fever soon assumes its name, becomes of the same kind, and in most particulars resembles it; though it may still retain some symptoms belonging to the cough, whence it arose. In every cough, therefore, proceeding from this cause, it is sufficiently manifest that regard must be had not only to the cough, but likewise to the fever that so readily succeeds it. " Relying on this foundation, I endeavoured to re- lieve such as required my assistance by the folloAving method: if the cough had not yet caused a fever, and other symptoms, which, as we said, usually accompany it, I judged it sufficient to forbid the use of flesh meats, and all kinds of spirituous liquors, and advised moderate exercise, going into the air, and a draught of cooling pectoral ptisan to be taken between whiles. These few things sufficed to relieve the cough; and prevent the fever, and other symptoms usually attending it. For as by abstaining from flesh and spirituous liquors, along with the use of cooling medicines, the blood was so cooled as not easily to admit of a febrile impression, so by the use of exercise those hot effluvia of the blood, which strike in, and occasion a cough as often as the pores are stopped by sudden cold, are commodiously exhaled in the natural and true way, to the relief of the patient. " With respect to quieting the cough, it is to be ob- served that opiates, spirituous liquors, and heating me- dicines used for this purpose, are equally unsafe; for, the matter of the cough being entangled and stiffened thereby, those vapours Avhich should pass off from the blood, in a gentle and gradual manner, by coughing, are retained in the mass, and raise a fever: and this fre- quently proves very fatal to abundance of the common people, who, whilst they unadvisedly endeavour to check the cough, by taking burnt brandy, and other hot liquors, occasion pleuritic or peripneumonic disorders ; and by this irrational procedure render this disease dan- gerous, and often mortal, which of its own nature is slight, and easily curable. Neither do they err less, though they seem to act more reasonably, who endea- vour to remove the cause of the disease by raising sweat; for though we do not deny that spontaneous sweats frequently prove more effectual than all other helps in expelling the morbific cause, yet it is apparent - that whilst we attempt to force SAveat we inflame the blood, and may possibly destroy the patient, whom Ave desire to cure. " But it happens sometimes, not only when the dis- ease has been unskilfully treated, in the manner above described, but also spontaneously, at the beginning of the illness, or in a day or two afterwards, especially in tender and weakly persons, that the cough is succeeded by alternate intervals of heat and cold, a pain in the head, back, and limbs, and sometimes a tendency to sweat, especially in the night; all which symptoms generally followed the fever of this constitution, as it were, of the lungs, which occasioned a difficulty of breathing, stop- ped the cough, and increased the fever. " According to the best observation I could make, the fever and its most dangerous symptoms were best re- lieved by bleeding in the arm, applying a blister to the neck, and giving a clyster every day. In the mean time, I advised the patient to sit up some hours every day, to forbear flesh meats, and sometimes to drink small beer, sometimes milk.and water, and sometimes a cooling and lenient ptisan. If the pain of the side abated not in two or three days, but continued very violent, INF 813 INF I bled a second time, and advised the continuance of the clysters. But with respect to clysters, it must be carefully observed, either in this or other fevers, that they arc not to be long and frequently used Avhen the disease is in its decline; especially in hysteric Avomen, and in men that are subject to the hypochondriac dis- ease; for the blood and juices of such persons are easily changed, and soon agitated and heated; whence the animal economy is disturbed, and the febrile symptoms continued beyond the usual time. " But to return to our subject: Avhilst by these means Ave allowed time, that the blood might gradually free itself from those hot particles that were lodged in the pleura and lungs, all the symptoms usually went off in a gentle manner; Avhereas, when the disease was treated in a rough Avay, by giving abundance of remedies, it either destroyed the patient, or rendered it necessary to repeat bleeding oftener than the disease required, or would safely bear, in order to save life. For though repeated bleeding answers every purpose in the true pleurisy, and is alone sufficient for the cure thereof, provided there be no hindrance from a hot regimen and heating medicines; yet, here, 6n the contrary, it suf- ficed to bleed once, or at most twice, in case the patient refrained from bed, and drank cooling liquors. And I never found it necessary to bleed more frequently, un- less the symptoms relating to the pleura and lungs were much increased by some adventitious heat, and even in this case the practice was not wholly A'oid of danger. " Upon this occasion, I shall briefly deliver my senti- ments Avith respect to a very trite and common opinion, viz. that a pleurisy is found to be of so malignant a na- ture in some years that it will not then bear bleeding, at least not so often as this distemper ordinarily demands. Now, though I conceive that a true and essential pleu- risy, which, as shall hereafter be observed, happens in- differently in all constitutions, does in all years equally indicate repeated bleeding ; yet it sometimes happens that the peculiar epidemic fever of the year, from sud- den alteration of the manifest qualities of the air, readily throws off the morbid matter upon the pleura and lungs, Avhile the fever notwithstanding continues exactly the same. Wherefore, in this case, though bleeding may be used to abate this symptom when it is very violent, yet generally speaking, little more blood ought to be taken away than is required by the fever whereon this symp- tom depends; for, if the fever be of a kind that will bear frequent bleeding, it may likeAvise be repealed in the pleurisy, Avhich is a symptom thereof: but if the fever will not bear repeated bleeding, it will be prejudicial in the pleurisy, which will go off with, or last as long as the fever does. And in my judgment this was the case in the symptomatic pleurisy that accompanied the fever which prevailed here at the time the cough began, namely, in Avinter, 1675 ; and therefore I must observe, that whoever, in the cure of,fevers, hath not always in view the constitution of the year, inasmuch as it tends to produce some particular epidemic disease, and like- Avise to reduce all the contemporary diseases to its form and likeness, proceeds in an uncertain and fallacious way. " In the month of November of the above-mentioned year I attended the eldest son of sir Francis Wyndham in this fever. He complained of a pain in his side, and the other symptoms that attended those who had this disease. I bled him but once, applied a blister to his neck, injected clysters every day, gave him cooling ptisans and emulsions, and sometimes milk and water, or small beer, to drink; and advised his sitting up a feAv hours every day; and by this method he recovered in a feAv days, and a purge completed the cure. " But it must be remarked, that' though these Avere the symptoms which succeeded the cough, during this winter, yet the cough, unattended with these symptoms, Avas more prevalent at the same time. But this re- quired neither bleeding nor clysters, provided a fever was not occasioned by a hot regimen or heating medi- cines ; it sufficed to alloAV the benefit of the open air, and to forbid the use of flesh, wine, and such spirituous liquors which are apt to cause a fever." Wallis's Sy- denham. In the month of July, 1775, the putrid fever came on; Avas succeeded by the cholera morbus in August, and the bilious fever in September, as usual; this bili- ous fever, hoAvever, was attended with a degree of stu- por, which went off Avith the other symptoms Avhen pro- perly treated ; but was easily turned into a coma, Avhen improperly treated at any period of the disease. See Dr. Grant's Account of the Epidemic Cough and Fever, 1776, from Sydenham. This subject hath engaged the attention of many since the year 1775; and in 1782, Dr. J. C. Smyth gave his observations of this disorder, in the first volume of Me- dical Communications, p. 71, &c. the substance of Avhich is as folloAvs : " The late influenza was very generally accompanied not only with the usual catarrhal symptoms, but with others no less distressing to the patient, and which were still more alarming to the physician; such as great lan- guor, lowness, and oppression at the praecordia; anxiety, with frequent sighing, sickness, and violent headach. The pulse was uncommonly quick and irregular, and the sick Avere frequently delirious, especially in the night. The heat of the body Avas seldom considerable, particu- larly Avhen compared Avith the violence of the other symptoms; the skin Avas moist, with a tendency to pro- fuse sweating; the tongue Avhite or yellowish, but moist. • Some persons complained of severe muscular pains either general or local, others had erysipelatous patches or efflorescences on different parts of the body, which in one instance terminated in gangrene and death. I observed petechiae but once, and then only two days be- fore death. Those attacked with the influenza were in general taken suddenly ill, and the symptoms in the beginning, or for the first twenty-four or forty-eight hours, were extremely violent, bearing no proportion either to the danger or duration of the distemper. Children and old people either escaped entirely, or were affected in a slighter manner. Women with child, when seized with the disease, were apt to mis- carry ; or, if far advanced in their pregnancy, to be de- livered before their time; in either case, the haemorr- hage was considerable, and several died. Patients subject to pulmonic complaints suffered much from th cough, difficult breathing, and other peripneumonic symptoms, and to them also the disease proved danger- ous or fatal. " The headach Avhich accompanied the influenza may be distinguished into three kinds. " 1st. The uneasy weight, soreness, and distention, of the forehead, usual in common colds. 1 ?s F 814 I N F •' ~dly. The violent sick headach, arising from the affection of the stomach, and relieved by vomiting. " 3dly. -The headach, during Avhich the patients com- plained of a sensation as if their head Avas splitting, with a severe shooting pain at the vertex ; this last head- ach was most usual in peripneumonic cases, and seemed chiefly occasioned by the violence of the cough. " The fever began with irregular chilliness, had con- siderable exacerbations and remissions, and was always greatly increased toAvards night; but even then the heat of the body and thirst were seldom so great as might have been expected, and the accessions of fever Avere chiefly marked by the increased quickness of pulse and delirium. The frequency of the pulse was greater than is common in fevers ; (it Avas often 120, even in the re- missions of fever, in the accessions 140, and sometimes ■ so frequent that it Avas impossible to reckon it: in many instances it was irregular and intermitting;) nor do I remember to have felt so frequent, and at the same time so irregular, a pulse (the irregularity of the pulse is in a great measure characteristic of malignant conta- gious fevers), in any fever attended Avith so little danger, and of so speedy and easy a termination; the violence of this being commonly over in twenty-four or forty- eight hours. Many, from the beginning, were deliri- ous in the night time and during the exacerbation of fever, who were perfectly recollected and distinct in the day and during the remissions.; but even where the de- lirium continued, it was not a constant one, as the sick kneAV those who spoke to them, would answer some questions distinctly, and a feAv minutes afterwards talk incoherently; a fixed stare of the eyes at the time, and a kind of wildness in the countenance, Avere also very expressive of this state or condition. The delirium which we have just now described, though unnoticed (so far as I knoAv) by any practical writer, is not un- usual in the putrid fever, and differs as materially from the low delirium incident to the last stage of that dis- ease, as it does from the phrenetic delirium of the fe- bris ardens, or of any inflammatory fever. During the whole of the influenza, I met only one instance of true phrenetic delirium; and it may not be foreign to the purpose to remark, that it happened to a patient who had been three times bled, had sAvalloAved no heating cordials, and who was taken every day out of bed, con- formable to the judicious practice of Sydenham (vid. De Febre Comatosa), expressly with the intention of preventing this termination of the disease. Respecting the danger of the influenza, physicians, I find, have en- tertained someAvhat opposite opinions; possibly OAving to the difference of place and situation. In London, al- though the distemper doubtless proved fatal to many, yet it could hardly be accounted a dangerous one, if the number who died be compared with the prodigious number of those who recovered. " The late influenza might very properly have been named the sweating sickness, as sweating was the natu- ral and spontaneous solution of it, and rest, abstinence, and warm diluents, were, in most instances, all that were necessary for the cure; yet, amidst such an amaz- ing number and variety of cases, many occurred which required some further medical assistance, and when that •became necessary, it was of the utmost importance that it should be procured early; for the disease when ne- glected or improperly managed in the beginning, some- times ended in a malignant fever of difficult treatment and of very doubtful termination. And although the tendency to profuse SAveating often continued, it nov only weakened the patient, and a critical or salutary so lution of the disease, in consequence of this evacuation. was no longer to be expected ; nor do I recollect a sin- gle example of profuse sweating being attended with any advantage after the first forty-eight hours. " The medicines which I found most serviceable in abating or carrying off the fever were small doses of an antimonial powder, composed chiefly of tartar, emet. the julep e camphora, with about a fourth part of the spt. Mindereri; the common saline draught, with ten or fifteen grains of the pulv. contrayerv. c. or, what I commonly preferred, from twenty to forty drops of the liquor anod. min. Hoffmanni, adding occasionally a small quantity of the paregoric elixir. " In cases of great lowness, besides the drinks and nourishment usual in fevers, I alloAved the sick white Avine whey, Avine and Avater; and Aveak veal broth. " For removing the oppression at the praecordia,-sick ness, and headach, no means Avere so certain as vomit ing Avith tart. emet. giving it in small doses, largely di- luted, and repeated every ten or fifteen minutes, until {■ produces the desired operation. This medicine, admi- nistered in this manner, had also a very remarkable effect in bringing on a remission of the febrile symp- toms, and in accelerating the termination of the disease. It likeAvise commonly opened the body; when that Avas not the case some gentle laxative was given. " The cough required not only plentiful warm dilu- tion, but opiates and blisters were also very necessary; and where the sick were attacked with stitches, or acute pains about the chest, with difficult or laborious breath- ing, and other peripneumonic symptoms, the propriety of bleeding was, in my opinion, clearly and evidently pointed out; nor can I think any physician justifiable in neglecting the use of the lancet under such circum- stances. At the same time, I am ready to acknow- ledge, that bleeding, though necessary to obviate the fatal consequence of a particular symptom, Avas by no means conducive to the general cure of the disease; that, on the contrary, the loAvness and dejection were often increased by it; that the blood taken aAvay had not always an inflammatory appearance, but was some- times florid, and the crassamentum tender; that the re- lief afforded by bleeding was neither so considerable nor so certain as in other similar cases of peripneumony, and that in the course of the disease there frequently appeared unequivocal signs of a putrid tendency. But admitting the whole of these facts, and granting that they ought to make a physician cautious of taking away blood so freely, perhaps, as he otherwise would do, and as the urgency of the symptoms might seem to justify, yet they surely do not lead to an entire prohibition of the use of the lancet, at least in those cases where there was evidently no alternative, and where, although the effects of bleeding might be doubtful, the consequence of omitting it was certain. Upon such occasions, the advice of Celsus is the voice of reason, " Saitus est enim anceps auxilium experiri quam nullum." Besides bleeding, blisters applied as near as possible to the parts affected were here, as in similar cases, of very essen- tial service in removing the stitches in the side, and in relieving the difficulty of breathing; so that we may INF 815 INF lustly apply to them Avhatan eminent author said of the Peruvian bark, that he found it most serviceable where it Avas most wanted; for in cases purely inflammatory, Avhero bleeding of itself will commonly do every thing, blisters are less necessary; but in those of a mixed na- ture, where the assistance of blisters is more immedi- ately required, the relief afforded by them is in general more certain. " Some may think it strange, that amongst the reme- dies employed in the treatment of this disease I have made no mention of oily medicines, such as emulsions, linctuses, See. nor of the Peruvian bark. In regard to oily medicines, I have often observed that the advantage derived from them in cases of catarrh, attended with heat and fever, was extremely equivocal; and that wherever there Avere nausea, oppression, and uneasiness at the stomach, with a bitter taste in the mouth, and ni- dorous eructations, they did more harm than good : as these symptoms so frequently occurred in the influenza, I thought it safest to omit their use entirely. " As to the bark, I shall only remark, that in the in- fluenza, the cough, affection of the breathing, and op- pression at the praecordia, Avhere they occurred, were to me sufficient reasons for not employing it; and that even Avhere these symptoms Avere not present, and in cases Avhere the great lowness, and apparent putrid ten- dency, seemed not only to justify but even to demand the use of the bark, I never Avas so fortunate as to see one single instance where it produced any sensible good effect, either in moderating the fever, supporting the strength, checking the disposition to gangrene, or in preventing the fatal catastrophe that ensued. " When'the fever, and other immediately alarming symptoms of the influenza had ceased, there frequently remained a teasing cough; and convalescents in general complained of languor, want of appetite, and that their sleep was interrupted and unrefreshing. For removing these complaints, and completing the recovery of the patients, change of air, and riding on horseback, were the most effectual remedies; and to some they were absolutely necessary. A milk diet Avas recommended Avhere the cough was obstinate; but I did not find it either necessary or of advantage to enjoin so strict an antiphlogistic regimen as is usually done in similar com- plaints. Neither do I know of any instance where the cough terminated in a phthisis pulmonalis, and I am much inclined to believe that this fatal termination was much less frequent after the influenza than after a com- mon cold. For the lowness and Avant of appetite, cha- lybeate Avaters, especially when drunk at the spring, were of singular service. I also frequently prescribed, und I think with advantage, the elix. vitr. cum liquor. inod. Hoffmanni, taken to the quantity of thirty or forty drops in a bitter infusion, or in a decoction of the bark. " In this short account of the late influenza, I have offered no conjecture with regard to the original cause of the distemper, or the manner in which it was propa- gated. I apprehend, from the present state of our knoAvledge, that we can hardly venture to say even what it is not; still less to affirm, with any probability, what it is." Having thus inserted the best accounts, both ancient and modern, Ave shall Tefer for our own opinions and ex- perience to the article Catarrhus epidemicus. See also Observations on the Influenza by A. Brough- ton, M. D.; a Description of the Influenza, by R. Hamilton, M., D.; Fothergill's Works, by Lettsom, 4to. p. 615; Medical Observations and Inquiries, vol. vi. p. 340, &c.; Medical Transactions, vol. iii. p. 54, 6cc; Medical Communications, vol. i. p. 1, &c.; Edin- burgh Medical Commentaries, vol. ix. p. 393; Me- moirs of the Medical Society, vol. i. to vi. INFRASCAPULA'RIS MUSCULUS, (from infra, below, and scapula, the shoulder blade,) infraspinatus, superscapularis inferior, subscapularis, or immersus, rises from the whole inner surface of the scapula, passes under the coracoid process, runs over the capsular liga- ment, and is inserted into the outer tuberosity of thcos humeri, carrying the arm round, and partly raising it, being the reverse of the supraspinatus. INFRASPINATUS, (from infra, and spina). See Infrascapularis. INFUNDI'BULUM, (from its shape,) choana, pel- vis, chone. Between the basis of the anterior pillars of the fornix, and the anterior part of the union of the optic thalami, lies this funnel-like cavity. It runs down towards the basis of the cerebrum, contracting gradually, terminating in the glandula pituitaria, and communicating with the lateral ventricles. (See Ce- rebrum.) The name also of the pelvis of the kid- neys (see Renes,) and of the pharynx. INFU'SIO, (from infundo, to pour in). Infusion. It signifies either the action of the fluid, or the medi- cine prepared by it. By infusion in Avater, the gummy, the extractive, and the saline parts of vegetables, are separated: and by the intervention of the gum, the resin and oil are in part taken up by the same menstruum, so that in many instances the whole virtue of a plant is obtained. In general, Avater takes up more by infusion from dry herbs than from fresh ones, particularly the neAvly dried ones. From animal substances, Avater extracts the ge- latinous and nutritious parts; and by this means glues, jellies, and broths, are prepared; and along Avith these it sometimes takes up principals of more activity. Wa- ter also generally suspends some portion of calcareous and aluminous earth; the quantity it dissolves of either is truly inconsiderable. In making infusions, Avhether in cold or hot Avater, the ingredients are only steeped in it, without boiling. It is the same, whether proof spirit, rectified spirit, or any other menstruum, is employed, though these prepa- rations have a different title. This form is preferred where the medicinal portion is soluble and easily sepa- rated ; when it is volatile, and Avould fly off by boiling; or where it Avould be lost or destroyed by long maceration. In nervous disorders, infusions are best made in a Vinous, a spirituous, or an alkaline menstruum. Sto- machic infusions should be moderately spirituous. Ca- thartic ones, whether saline or resinous, if for extem- poraneous use, are best made with hotAvater. Infusions should not,-if possible, be so fully impreg-. nated with the ingredients as to make the medicine un- palatable : though the infusions of many of the fetid plants must be necessarily unpleasing. Many infusions are most agreeable Avhen made with cold Avater, though probably Aveaker than Avhen heat is employed. The cold infusion of camomile flowers and the carduus benedictus are pleasant, and will not excite vomiting. INJ 816 INF Infu'sio. See Transfusio. INFU'SUM. An infusion. Sometimes styled di- lutum; at others it means a clyster or an injection. INGE'STA, (from i7igero, to throw in). The con- tents of the stomach; generally alimentary, sometimes medicinal. INGRAVIDA'TIO, (from ingravidor, to be great with child). See Impregnatio. IN'GUEN, (from eyxva, to bring forth). The groin. The tAvo groins are the lateral divisions of the hypogastric region. INGUINA'LIS, (from inguen, the groin; so called from its supposed efficacy in diseases of the groin). See Eryngium. INHALA'TIO. • See Fumigatio. INHA'LER. An instrument recommended by Dr. Mudge for the cure of catarrhs, but now disused, though it may be in many cases probably advantageous. I'NHAMjE ORIENTA'LES, See Batatas His- PANICA. I'NHAME. See Cara Brasiliensibus. INIIUM A'TIO,(from mAw/wo, to bury in the ground). A method of digesting, by burying in horse dung the vessel Avhich contains the chemical ingredients to be digested. INIMBOI'A. See Bonduch Indorum. I'NION, (the place whence ives, the nerves, origi- nate). See Occiput. INJACULA'TIO, (from injaculor, to shoot into). A violent spasmodic pain in the stomach, feeling as if darts Avere shot into it, with an immobility of the body. Van Helmont. INJE'CTIO, (from injicio, to throw into). An in- jection, called also eisbole. Fluids used for injec- tion should be used lukewarm; and may be applied either by a syringe or clyster pipe. When used in gleets or gonorrhoeas, Dr. SAvediar ad- vises that the syringe should have a short but wide pipe, so large that its orifice may enter the urethra, and the piston be close to its sides. If the Avhole pipe of the syringe be much smaller than the orifice of the urethra, it may wound the inside of the canal, and admit the poison by absorption, or the liquid run out sideways, instead of passing into the urethra. If the piston itself does not apply closely to the sides of the syringe, even if the pipe is sufficiently large, so that it perfectly closes the orifice of the urethra, the liquor will still regurgi- tate between the piston and the syringe, and very little of the fluid Avill pass. The syringe being properly made, should be applied closely and exactly to the ori- fice of the urethra; so that, by the conic form of its pipe, all passage may be denied to the liquid betwixt it and the sides of the urethra. If the disorder lies in the usual original seat of gonorrhoeas, viz. just under the fraenum, the patient should, with one hand, compress the ure- thra at the first curvature of the penis, where the scro- tum begins, while he holds and manages the syringe with the fingers of the other. The piston, which should always go close and easy, ought then tobe pressed softly and sloAvly, till he feels the urethra gently dilated, and thus keep the liquid injected for a minute or two in the passage, repeating the same operation three or four times. By a rash or longer continued pressure of the piston, the irritation often does considerable injury. By attending to these directions, the liquid is properly applied to the part affected, and no danger is incurred of carrying some of the venereal poison farther into the urethra Avith the injected liquid. This precaution is, however, not very necessary, as the dilution will pre- vent any injury. The liquid should ahvays, in cases of virulent gonorrhcea, be lukeAvarm; but in gleets, cold. In gonorrhoeas, if the liquid is too cold or too Avarm, it is supposed likely to hurt the patient, either by the rctropulsion of the matter, or increasing the inflamma- tion. In all cases, before an injection is applied, the patient should attempt to make water. There are a va- riety of injections made use of in this complaint; among the most efficacious are the following : Injection of acetated ammonia. To three ounces of distilled water add one ounce of acetated am- monia.—Of acetated litharge. To four ounces of rose Avater add eight drops of acetated litharge.— Muriated injection. To four ounces of distilled Avater add eight drops of muriatic acid.—Oily injec- tion. To four ounces of oil of almonds add eight drops of acetated litharge.—Opiate injection. To four ounces of distilled water add forty or sixty drops of tincture of opium.---Injection of green tea. Infuse half an ounce of green tea in four ounces of boiling water, and let it stand till cold.—Compound INJECTION OF CERUSSA, See PLUMBUM.--INJECTION OF MURIATED QUICKSILVER. To foul" - OUllCCS of distilled Avater add two drops of the liquor of mu- riated quicksilver. This must be weakened if the in- flammation in gonorrhoea is great: or, should there not be any, it may be strengthened. Any of these may be used in the inflammatory stage of a gonorrhoea; but the muriated is considered as the most eligible, Avhere the scalding of urine is very troublesome.—Injections of vitriol of zinc. Dissolve ten grains of vitriol of zinc in five ounces of water.—Compound injec- tions of vitriol of zinc. Add to the above ten drops of acetum lythargyri, or half a drachm of white vitriol, with as much acetated lead, a drachm of camphor, and two scruples of opium, are dissolved in sixteen ounces of boiling water, and strained.—Mercurial injections. Mucilaginis gum arab. 5 iv. calomelanos 3 ss. or hydrargyri purificati 3 i. mucilaginis 1 iss. aq. § iss. As astringent injections the following are re- commended : injection of alum. Dissolve four grains of alum in four ounces of rose Avater.—Of copaiba. Mix two drachms of balsam of copaiba with six ounces of rose water, by means of the yolk of an egg; or, with four ounces of lime water, by means of the mucilage of gum arabic ; of acetated copper ; of AMMONIATED COPPER ; of VITRIOLATED COPPER ; COMPOUND INJECTION OF VITRIOLATED COPPER. (See Cuprum.) These are beneficial in the last stage of gonorrhoea; gleets; fluor albus ; and, perhaps, with small portions of their active ingredients may be em- ployed in the inflammatory stage as sedatives. Injec- tion of galls. See Gall.*. Patients who labour under gleets, after having used injections with some advantage, grow careless in the application, and even sometimes neglect them for a day or two. The consequence of this has been that the dis- charge has increased, as if it had been a fresh disease; and the relapse being more obstinate thari the original complaint, the patients have been obliged to continue the injections for more weeks than it might have required IN J 817 IN J days had their use not been interrupted. In general, to prevent all danger of a relapse, it is proper to employ the injections three, four, or, according to circumstances, six times a day during the disease, and to continue the same regularly for ten or twelve days after the Funning has entirely ceased. In anatomy great improvement hath been made by means of injections. Ruysch first employed thern Avith success; and it is said that the Czar Peter, seeing an in- jected boy, whose appearance nearly resembled life, ran and kissed it. Injections, which unite Avith water, and consequently Avith-the animal fluids, consist of isinglass and common glue. These succeed Avith the finer vessels, in mem- branes ; but, if employed to fill the larger, they take too long time in coagulating. If coagulated by alcohol, they become brittle; and, when the water is carried off by evaporation, the vessels are not properly filled. It has been attempted to remove these inconveniences, by first injecting the solution of glue; and, Avhen the capillary vessels are filled, a coarser wax injection; but the wax either hardens too soon, mixes irregularly Avith glue, or the parts separate where the two fluids are in contact. Alcohol mixes both with water and oil, and conse- quently has been employed to fill the capillary vessels, but it coagulates the animal fluids it meets, and often blocks up the canal. It will not suspend durably colour- ed powders, and, at last, evaporates, leaving little more than the colours of those to which it had. been united. Melted tallow, with a little mixture of oil, is often use- ful; but it sometimes stops too soon, where it meets with animal fluids, and becomes, by time, very brittle. Oil of turpentine, recommended by Dr. .Monro, is ge- nerally employed to fill the finer vessels. It suspends the colouring matter; and, when the more volatile parts are evaporated, enough of the grosser particles remain, to retain the powder, and keep the vessels sufficiently full. After this is injected, it is confined by filling the larger vessels with a coarser injection, with Avhich it unites very accurately. Anatomists have preferred for the colour of their in- jections such pigments as most nearly imitate the na- tural contents of the vessels; the red for the arteries, and the blue for the veins. The vegetable colours are apt to concrete, and are destroyed by insects. The mineral are therefore preferred. The red is generally vermilion, a substance which in a small proportion gives a very considerable body of colour; and the green consists of distilled verdigris, which is brighter than the common sort, and dissolves in oil; the blue of verditer or smalt; the yellow of king's yellow; the black of lamp black or burnt ivory are used. The properties required in the injecting matter are fluidity; and they must likewise grow stiff, but tough and flexible when cold; for were they too hard the smaller vessels would be frequently broken. The fol- lowing possess these properties: Fine injection. By Dr. JVicholls.—Take hard white Spanish varnish, and hard brown Spanish varnish, of each equal parts; turpentine varnish and vermilion, of each a sufficient quantity. Mix them. Coarse injection. By Dr. JVicholls.—Take of yellow resin two pounds ; of yellow wax one pound ; of turpentine varnish a sufficient quantity. VOL- i. These injections may be coloured with vermilion or Avith verdigris. Whatever colouring matter is used,it must be ground extremely fine. Dr. Monro recommends for the fine injection a pound of oil of turpentine, gradually poured on the co- louring matter finely poAvdered. To procure the ver- milion or verdigris very fine, it may be agitated Avith the oil, and, after standing at rest a little time, poured off; the coarser parts will by thatmeans be separated, as they Avill have subsided. Dr. Monro's coarser injection consists of tallow one pound, Avhite wax five ounces, common oil three ounces, melted over a lamp, adding Venice turpentine two ounces. When this is dissolved, the whole must be strained through a warm linen cloth; and, if design- ed to run far, some oil of turpentine must be added when it is used. The fine injections, it is said, should be thrown in as warm as the finger can well bear ; the coarser nearly at the boiling point. In general, how- ever, these directions are erroneous; for, by such heats, the colour will be changed, and the coats of the vessels injured. It will be safer to give them only so great a degree of heat as is sufficient to render them perfectly fluid. Quicksilver is frequently used for injections, and it is excellently adapted for this purpose, from its admitting of the minutest division. Were it possible to render it' solid, and to impart to it any given colour, its advantages would be very considerable. May it not be possible to oxidate it within the vessels ? Its great fluidity is, hoAV- ever, inconvenient, as the slightest puncture empties all the vessels filled with it; and its Aveight renders the preparation so heavy, that it is liable to strike against the glass, and to rupture the distended vessels. In in- jecting with quicksilver no impulse of a piston is ne- cessary, for its own weight is sufficient; but the opera- tor must recollect, that the momentum is in proportion to the perpendicular height of the column, not its dia- meter. Quicksilver is chiefly used in injecting the lacteals and lymphatics, the vessels of the parotid glands, of the testis, and of the mammae, sometimes the ar- teries and veins of the hand. In general, the younger the animal is the injection will go farther, and the same will happen Avhen the fluids have been exhausted by disease. In the first case, the small vessels are larger; in the second, they are more empty. The less solid the part is, more ves- sels will be filled; and the more membranous, the brighter and more beautiful the preparation will appear. The great object in injections, therefore, is, to empty the vessels, to relax the solids, and prevent the too ra- pid coagulation of the injected fluids. Water is, there- fore, first injected, till it returns colourless by the veins; the Avater is propelled by injecting air, and the air is afterwards squeezed out. But the water cannot be wholly separated, and the particles of this fluid interposed between those of the injection occasion its breaking. It is, therefore, more common to trust to maceration for some time in the water, and squeezing the vessels, so as to evacuate the fluids by the divided end. It is not easy to detail with advantage, in this place, the minuter regulations of this operation. It must be learnt from the works of practical anatomists, and from experience. The arterial system, after death, is usually empty; and the injection runs freely through it. To 5 M INI 818 INI inject the veins from the trunks the valves must be forced, Avhich is difficult, and generally impossible; for the coats Avill yield rather than the valves, so that one of the smallest branches which will admit the pipe must be opened. It must be recollected, however, that the veins of the abdominal viscera have no valves, so that they may be injected in any direction. The subjects to be injected, after having their vessels cleared of their contents, should be wanned in Avater. A fcetus may be injected by the umbilicus; a child - by the aorta ascendens from the left ventricle; an adult in the same manner as a child. Injection by the aorta fills only the arteries ; but by the umbilicus of a foetus both arteries and veins are injected. When the arteries in the cornea are filled, the injection should not be pushed farther. When finished, the subject should be cooled suddenly in cold water. If the body is macerated a day or two in cold, before it is put into Avarm, water, the blood will be more effectually dissolved, and the vessels more effectually emptied than by any other method. When put into warm water it may continue thirty-six or forty-eight hours, the water being kept as hot as one can bear a hand in it. A preparation is best dried by a current of free air, avoiding dust; when dry, it must be varnished. The shining varnish maybe laid on it with a brush. While drying, if animalcules appear, the part may be Avetted with a solution of hydrargyrus muriatus dissolved in rectified spirit of wine. Muriatic or nitrous acid diluted is proper for de- stroying the soft parts of injected preparations. The rectified spirit of malt is the best for preserving these or any other anatomical preparations. INIRRITA'NTIA. This is a class of medicines not hitherto introduced into the systems of therapeutics, though described, we apprehend, by Dr. G. Pearson, in his course of the Materia Medica, under the appellation of acentropoctics, from «, a privative, and xevrpov, stimulus, a term we might have adopted, had it occurred to us in an earlier stage of the work. The great doubt which remains is, whether this be not properly a subdivision of sedatives. We think that strictly it is so; and we noticed these medicines in the article Anodynes, q. v., but thought it would be useful to the younger student -tobringthe whole subjectinto one view, as its application is extensive, and utility considerable. The sources of irritation in the human body, are nu- merous. Of this kind are external stimuli; acrimony in the first passages, or the secreted fluids; inflamma- tory stimulus, particularly of the mucous membranes; scirrhi, or other indurations; extraneous substances lodged in the cellular membrane, or among the fibres of the muscles; worms, ossifications, or extravasated blood. The remedies of these irritations occur under their proper heads; and it is rather the object of this ar- ticle to speak of the nervous irritations more generally, whose source is less obvious. Nervous excitement often arises from a particular State of the nervous power, or, as we may be allowed to Style it, the nervous fluid. Whatever be the state which causes animation, the increase'of that energy is irritation. This irritation, according to its different cir- cumstances, is allayed by cold, by heat, by exhausting the nervous power, or, more directly, destroying its activity ; by diluting, and thus diminishing the activity of its cause; by sheathing the nerves from its action, or discharging it. Cold we have already spoken of; and the sedative power of this remedy, either by its continued effect or its repetition, has been already explained. It properly belongs to a subsequent head, but it is distinguished in this place in consequence of its application. It is par- ticularly adapted to the increased excitements which produce a more active circulation, either in general or in particular organs; in general, chiefly in haemorr- hages, and locally, in those inflammations which rapid- ly destroy the texture of the part, or produce atony, from excess of stimulus. It is thus one of the most ready and poAverful inirritants that Ave employ. • Heat. The regulation of temperature, in a different way, is often effectual in lessening irritation, viz. by the continuation of a degree somewhat lower than that of the body, and much .loAver than that of the affected part. Thus water of the heat of 92° to 95° gradually sooths the irritated nerve, and lessens its excitement. Air acts more slowly, and, of course, less effectually; for the application even of the water must be long con- tinued before it produces any effect. To their warmth a variety of demulcent remedies owe their efficacy, but often to their other qualities, Avhich we shall soon notice. • -, Exhausting the nervous power, by stimulants, some- what below in their effects those of the irritating cause, is often effectual. By this our object is to continue the excitement, not in a morbid degree, but by diminishing its power to exhaust safely the irritability of the nerve. Thus volatile alkali and eau de luce succeed in lessening the fatal effects of the viper's poison; alcohol and tur- pentine relieve burns; mercury sometimes lessens the irritation of the hydrophobic poison, and perhaps partly in this way of the lues venerea. We were long since taught to prevent the trismus expected to arise from the puncture of a nerve, by applying ethereal spirit of turpentine. Many similar remedies are em- ployed, and this is one of the most successful refinements of modern practice. In a similar way we destroy the activity of the nervous power by sedatives; by tonics, which lessen irritability; and by narcotics. We lessen irritation by opium and by vinegar; by bark and other vegetable astringents ; by lead, copper, zinc, and silver. The narcotics we employ are tobacco, belladonna, hemlock, and digitalis. Each is useful in this way. We sometimes lessen irritation by diluting the stimu- lus, and this is necessary when acrid poisons are carried to the excretories, as cantharides to the bladder, or when saline acrimony abounds in the blood- Dilution is, however, most often necessary when acrimony abounds in the primae viae ; a more frequent occurrence than any other of this kind. The diminution of irritation by sheathing the parts, and thus defending them from acrimony, includes the class of demulcents. This class is of considerable ex- tent, and the medicines we shortly enumerated in that article. They are the oils and fats in all their variety, including spermaceti and bees wax; the pure mucilages, including the gums and althaea; the farinaceous muci- lages, as the lint and hempseed, the quince and foenu- greek seeds ; the fecula of wheat, and some miscella- INS 819 INS neous vegetables, as the branca ursina, the melilot, the white lily, he. We can easily conceive that these can sheath the fauces, the epiglottis, the stomach, and intes- tines; but it is more difficult to suppose that they can be carried into the blood, and again act on the excretory vessels. This is, however, undoubtedly true, and we see it certainly in the urinary organs, probably in the lungs. These demulcents, like warm water externally, seem to sooth irritation beyond the part to which they are applied; for such is the consent of the small vessels on every portion of the surface with each other, that changes produced in one part are, by sympathy, com- municated to the whole. The medicines Avhich discharge the acrid matter can scarcely be enumerated among these; for puncturing a furunculus cannot be styled an inirritant. It was mentioned, however, to connect the whole, and to suggest that a source of irritation in distant parts is often productive of great inconvenience. When vio- lent symptoms of irritation, therefore, appear, of which the immediate cause is not perceived, it will be neces- sary to extend our views to every part of the body; and we may thus be able to discover and discharge sub- stances Avhich have been unnoticed, and produced, without suspicion of the cause, the greatest incon- veniences. We have confined, in this view, the action of inirri- tants to cases of excitement; yet we shall find other sources of irritation from privations. Thus, hunger produces symptoms of irritation ; the want of the usual distention in any of the cavities, and fatigue, have a si- milar effect. The only remedy in common to both these causes of irritation is Avarmth, or particularly warm Ava- ter: but it is unnecessary to enlarge at present on this subject; since to add the remedies of this kind Avould render the class less natural, and we should anticipate what will occur under another article. See Irrita- tion. INNOMINA'TA ARTE'RIA, (from in, non, and nomen, a na7ne). This word is applied to any part that has no specific denomination. It is the external branch of the external iliac artery at its division, near Poupart's ligament, ascends outwardly to the inside of the spine of the ilium; is lost in the muscle of the belly, and sends branches to the ileus internus. INNOMINA'TI NE'RVI. A name of the fifth pair. See Trigemini nervi, INNOMINA'TUM OS. Coxe ossa, os ilii, or cox- endix. The principal bone of the pelvis. INNUTRI'TIO, (from in, not, and nutrio, to nou- rish). See Atrophia. INOCULA'TIO, (from inoculo, to engraft). See Variola and Vaccina. INOSCULA'TIO, (from in, and osculum, a little orifice). See Anastomosis. INPINGUE'DO PORCI. See Costus. INSA'NIA, (from in, not, and sanus, sound). De- lirium, or madness. See Mania. INSE'CTA, (from in, into, and seco, to cut). An insect. These animals are thus named from their being almost Avholly divided in the middle. We deferred considering this class of animals in a physical or a medicinal view when we treated of the Animal kingdom, q. v., because we had not received the last labours of Cuvier and La Treille. Insects Averemost strictly distinguished by Lyonnet, Avho sty led them animals without any vertebrae, with articulated paws or limbs. The flesh is soft, but the skin hard, scaly, or crustaceous, to which the muscles are attached; though the true crustaceous animals should be sepa- rated from insects, as having a muscular heart, and breathing by means of gills. See Crustacea. Another distinctionof insects is their colourless blood. If some insects are bruised, a red fluid is discharged; but this has, in general, no relation to blood, except when blood has been previously SAvalloAved; and in some insects it is a secreted fluid under the eyes. Yet, from the late observations of Cuvier, red blood seems to occur in some animals of this class. The arrangement of insects is scarcely the object of this work. We may, however, remark, that they have been considered for this purpose in all their varied relations. SAvammerdam has preferred, as the basis of his classification, their metamorphoses; Linnaeus the organs of motion; Fabricius those of nutrition. The system of Linnaeus is certainly the best and most natu- ral ; yet later observators have found some inaccura* cies in his characters, and less exact distinction in his apterous insects. De Geer and Olivier have lessened these inconveniences by stricter discriminations, and forming a new order, the orthoptere, taken from the hemiptere. Indeed, we consider Olivier's arrangement as the best and most natural; more simple than La- treilles, more correct than that of Fabricius. Insects may be considered in a work like the pre- sent as articles of food, as medicinal bodies, as either useful or detrimental to mankind. If Ave except the Crustacea, we shall find few species used at any time as aliment. The locust (gryllus cristatus Linnaei) is used in the east as food. It is said to taste like a pigeon, but more insipid, and is seldom eaten but Avhen other food is scarce. Its price is high only in times of famine. The wings and feet, sometimes the intes- tines, are separated. The Bedouins of Egypt eat them roasted alive; the Arabians roast and eat them with butter; or, when they Avish for a dish of peculiar deli- cacy, they parboil, and then fry them in butter. The inhabitants of Morocco dry them, and those of Barbary pickle them. Forskal, however, tells us that they have very little flavour, and that they are far from nu- tritious, and occasion melancholy, or cutaneous affec- tions. In different parts of India and America the larvae of coleopterous insects, bred in the internal parts of trees, as the weevil, a species of lucanus, the passalus of Fabricius, the prionus cervicornis, 8cc.; but these can only be procured with much trouble, and can never form an article of food. We have heard of the worms of filberts being eaten as a delicacy, and said to be rich, like marrow, with the taste of the nut, and that the maggots of every fruit have its peculiar flavour. The Romans used to eat the larva of an insect Avhich they styled cossus, supposed to be the same which is found under the bark of the wHIoav or the ash; but this larva, which is a true caterpillar, has an insupportable smell and probably a disagreeable taste; so that it is cer- tainly not the same. In Africa the inhabitants eat the white ants. The galls formed by a cynips on a species of sage in the isle of Crete, and on the glechoma hede- racea Linnaei, are accounted by children a peculiar de- licacy. The honey of the bee is too Avell known as a 5 M 2 I N S 820 I X * nutritious substance, and a medicine to be particularly noticed. The honey of some districts in America is, however, poisonous (see American Transactions); and new honey will often disagree with the bowels, when these are peculiarly tender and irritable. If, with much trouble, we have collected a scanty catalogue of nutritious insects, we shall not find the materia medica greatly enriched from these minute ani- mals. The cantharides are, however, of considerable importance in medicine (vide in verbo); and the ants are said, by infusion, to furnish a pleasant and salutary acid drink in fevers. (See Formica.) The galls of the oak and the bedaguar of the rose tree, though the effects of insects, derive all their virtues apparently from juices of the tree and vegetable. The carabus, chryso- cephalus, two species of the sphaex of Linnaeus, two of the chrysomela and coccinella, three of the curculio, have been recommended in tooth ach. The insects are to be bruised between the fingers, and the tooth and gums rubbed with the same fingers. The meloe majalis and proscarabaeus are of the nature of can- tharides, but less powerful. The oniscus asellus (millepes) was formerly much employed as a stimulat- ing expectorant in dropsy, in obstructions of the liver, in asthma, and cynanche. Its nauseous acrimony points it out as a medicine of importance; but its disgusting appearance has occasioned its neglect. The coccus of the cactus coccinelliferus (cochineal) is said to be„sti- mulant and diuretic; the same insect of the ficus Indica, and quercus ilicis, the lac, and kermes, to be astringent; but modern practice neglects both. We have said that the more refined naturalists had separated the spiders from the insects; but we may mention here, without an apology, the use of the spider's webs in external hae- morrhages, which act in assisting the concretion of the blood. We mention it also to add, that an ant found in Cayenne, the formica fungosa of Fabricius, com- poses its bed of a down so fine, that it generally suc- ceeds in stopping arterial haemorrhages on the same principle. The ancients used the horns of the cervus volans as~an absorbent; and Linnaeus tells us, that in Sweden a- species of gryllus is irritated so as to bite warts, and that the fluid from its mouth destroys them. The trivial name is assigned from this property. Among the advantages derived to mankind from in- sects, we need not name the silk, and the scarlet dye from the cochineal. Many insects, besides that of the mulberry, spin a silken pod ; and from many of the eocci, a brilliant colour, though inferior to that of the cochineal, may be obtained. From the silk worm's pod, the Chinese, it is said, prepare a brilliant and du- rable varnish. This worm affords also the Bengal root, styled in England Indian grass, so useful to the fisher- man. We need not add Reaumur's attempt to make silk from spider's webs, in which it has been supposed he would have succeeded, could he have induced them to live peaceably Avith each other. The gum lac and bees wax are well known, and some naturalists have „attri- buted amber to these animals. Among the advantages of insects to mankind, we may also reckon their fur- nishing birds Avith a copious supply of nourishment, and their destruction of putrid matter and of each other. The chief disadvantages are derived from their de- structive ravages on books and furniture, and, above all, from the diseases which they occasion. (See Ani- malcula.) The very troublesome itching produced by many species of acarus is well known. The louse, the flea, the bug, and the mosquito, are the common enemies of our repose; and in Warm climates are far more numerous and fatal. The locusts, which destroy our harvest, the insects so fatal to vegetables of every kind, are scarcely objects of our attention at this time. They must be Avatchedin their state of larvae, when they may be at once extirpated. The most destructive flies escape our attention by their harmless or pleasing appearance in this state of disguise. INSERTIO. The union of parts so close that one seems to penetrate the substance of the other, as the in- sertion of muscles into a bone. It sometimes means the insertion of any instrument into a cavity of the body. INSE'SSIO, incessus, (from insideo, to sit upon). Sitting over relaxing vapours. I'NSIDENS, (from the same,) applied in botany to that which rests upon another part. INSIDE'NTIA, (from the same). See Epistaxis. INSI'DIANS,(from insidior, to deceive). Insidious, latent ; an epithet of diseases which betray no evi- dent symptom, but are ready on any exciting cause to appear; or which, on their first attack, do not shoAv their peculiar or dangerous nature. INSI'PIDUS, (from in, non, and sapidus, savoury). Tasteless. See Ap^eum. ' INSITIO. Engrafting. INSIPIE'NTIA, (from in, priv. and sapientia, wis- do7n). Childishness; a low degree of delirium. INSOLA'TIO, (from in, upon, and sol, the sun). Insolation ; exposing any thing to the sun. See Ictus Solaris, of which this word is a synonym. INSO'MNIUM. A dream. Quod in somno vi- detur. Dreaming is a subject of considerable import- ance, not only in a physiological vieAV, but as often af- fording useful prognostics, particularly in fevers; and it has been considered with great attention both by phy- siologists and metaphysicians; but whether the culture has been erroneous, or the soil stubborn, it is at least certain that the harvest has failed of producing that satis- faction which, from the labour and care, might have been expected. It remains to be determined whether we shall be more successful. A dream is a series of images either sensible or in- tellectual, presented to the mind during sleep, more or less vivid, and sometimes so lively as to impress the mind with the fullest conviction of their real existence. They are evidently distinct from the mind, since fear and joy, despair and admiration, are excited by them; since the immaterial principle can decide on the pro- priety of the actions they may suggest, or can excite volition in consequence of their being presented. The images, however, thus passing before the mental eye are often incongruous, disjointed, and absurd; but whatever forms they may assume, we believe it to be a well established fact, that every part is derived from sensible ideas formerly received. The physiologist who has not particularly attended to this subject may start at so positive an assertion; but after the examina- tion of our own dreams during a series of many years, after the most extensive inquiries, we have never, in a single instance, been able to trace any image, or any INS 821 INS portion of a neAv combination, which was not previously conveyed to the mind by the senses. So extensive, however, is the power Avhich suggests these sleeping scenes, that their objects are as various as our ideas; »nd the Quicquid agunt homines votum, ti7nor ira voluptas Gaudia discursvs form the farrago of this drama of the fancy. Our pas- sions are excited as by reality ; our reasoning, however, is weak and imperfect. In dreams we seem to reason, to argue, to compose ; and in all these circumstances, during sleep, we are highly gratified, and think that we excel. If, however, Ave remember our dreams, our reasoning we find to be Aveak, our arguments inconclusive, and our composi- tions trifling or absurd. Some metaphysicians have supposed that from age and reflection our dreams be- come more consistent and philosophical, and have even supposed that the mind can, during sleep, retain its wonted powers. We are willing to believe that, from age, our minds wander less in this state of repose; but we suspect that it arises from the sleep being less per- fect, and not from any experience in the " art of dream- ing." We certainly fancy in our dreams that a given image is new; but if we can retain it when awake, we find that this opinion arose from our imperfect recogni- tion, and we shall then be able to recollect its proto- type. We seem to think, also, some place, which in fancy is seen in our sleep, to be more beautiful and glorious than any which has before occurred. Yet on awaking we shall find this splendour a thing of shreds and patch work, made up of heterogeneous and dis- jointed vestiges before offered to the senses. It has been supposed that the fancy pursues the images of the foregoing day, and that Queen Mab sports " on lovers' lips, who straight on kisses dream." This general opinion we dare not deny, especially Avhen sanctioned by the magic of Shakspeare's poetry. Yet our experience does not support it; and when the mind has been exhausted by joy or sorrow, Ave have often -found the sleep sound and refreshing. When less ex- hausted, the fancy seems to play with various images, not always connected with the previous state of mind. We have even thought that when the mind has been very deeply impressed with any peculiar images, that such have less seldom occurred in dreams than their opposites. That dreams ever offer any foreboding of future ills or. benefits ; that we ever, in this state, re- ceive information from preternatural sources; are opi- nions which we leave to the childishness of the nursery, or the wandering fancies of superstition and dotage. The aegri somnia have been proverbial, as descrip- tive of disjointed incongruous images; and what may be considered as the pathoWgy of dreams, will perhaps more fully illustrate their nature. In fevers the dreams are often highly distressing; from indigestion they are equally so, but of a different kind. In the former, the mind is hurried from one object to another with inconceivable rapidity; in the latter, chained down and oppressed Avith a heavy weight. Should it happen that the patient is relieved of his foad during his dream, the complexion of these airy nothings im- mediately varies. Aversion is changed to liking, dis- gust to complacency, oppression to freedom. If the heat of fever is relieved by a salutary perspiration, the patient is no longer hurried through the trackless air, but reposes in a verdant meadow, or more often drinks of the cool stream, for the thirst vanishes. In general, very deep sleep is oppressive; light sleep salutary and refreshing. The senses no longer convey the usual impressions, but images are excited, which, though not wholly sirlkilar to the usual ones, are not very dif- ferent. Thus violent heat will suggest a dream of scorching fire ; throwing off the clothes in winter, of walking through a river. The effects of opium on our dreams are singular. In those with whom it agrees it excites the most pleasant images ; when it disagrees, the most frightful: in all it greatly influences the ideas of the duration of time- A man of genius and an art- ist under the ipfluence of opium, fancied Holbein's Dance of Death realized, and that each figure assumed a real form, and was presented to him in all its horrors. He suffered, in his opinion, from this exhibition, for many hours ; and, at last, awaking in terror, heard the clock strike twelve, when he recollected that he did not sleep till after eleven. The author of this article, in whom opium excites the most agreeable images, has experienced the; same change in his ideas of time. We have sometimes thought the nature of dreams influ- enced, in a certain degree, by the temper and disposi- tion of the dreamer. Thus the sanguine cheerful tem- per finds, in all his distresses, a means of escape ; where the more gloomy melancholic disposition perceives no resource till he awakes in horror. But in this we may be styled dreamers. The other facts recorded in this article have been verified by repeated observation. The cause of dreams has excited various speculations. This waking sleep, or sleeping activity, appeared to Baxter so inconsistent, that he supposed immaterial spirits Avere amused, or engaged in suggesting these plays of fancy, and sometimes, perhaps, conveying im- portant information. We cannot deny the existence or employment of these spiritual agents ; but can scarcely conceive, in the whole circle of creation, beings so use- less. They are, however, wholly unnecessary ; for, in the pathology of dreaming, we have seen that the cause is purely corporeal; and, indeed, Baxter's opinion is, we believe, consigned to the same oblivion with that which looks to dreams as foretelling future events. Wolfius supposed a previous excitement of some part necessary to suggest to the fancies during sleep ; and, in fact, delivers the fictions of Shakspeare in the garb of sober sound philosophy. This opinion, is, however, inconsistent with the phenomena of dreaming; and Ave have no modern idea on this subject which need detain us, except the opinion we are about to explain, originally derived from Dr. Cullen. In sleep, Dr. Cullen observes, that there is a partial collapse of the brain, at least so far as respects the ani- mal functions ; and this partial diminution of excite- ment is shown by the delirium which occurs in the in- terval between the sleeping and waking state. To dif- ferent degrees of the collapse, dreams, more or less vivid, appear to be owing. Dreams, indeed, are of the na- ture of delirium. Similar heterogeneous or disjointed ideas constitute both; and the whole must be resolved into that unequal balance of the nervous power in the brain arising from diminished energy. The proof of this is the aa ant of the usual associations; another, the INS 822 INT deficiency of judgment; a function, when perfect, which arises, as Ave have seen, from a free communication be- tAveen the different parts of that organ. The defect of judgment is seen from a high opinion we form of what we suppose we have Avritten or said in our dreams, which is often ridiculous, and strangely heterogeneous. Yet, it may be asked, are no ideas suggested in our dreams which deserve the attention of*our awakened judgment ? We have heard of some such suggestions, and suspected that we have experienced them ; but they consist only of a happy recollection, or a new combina- tion, which we are sufficiently awake to be pleased with, and rouse ourselves to recollect. We remember dreaming of being asked for a motto for an air balloon, and immediately suggested the following : Tentanda via est qua me quoque possu7n Tollere humo victorque virum volitare per ova. Every instance of peculiar genius or supernatural in- formation in dreams may be referred to one of the sources just mentioned. Though this partial collapse explains, in some degree, the heterogeneous combinations of dreams, it does not shoAv us hOAV the images are excited. It will be at once obvious that this question includes one to which no an- swer can probably be given, viz. in Avhat manner do sensible impressions act on the mind to produce ideas, or how, in turn, does the mind act on the brain, by means of volition, to excite action ? We may hazard a feAV speculative remarks, which, if ill founded, will detain the reader but a short time. We have seen that the power which resides in the brain and nerves is probably a subtile fluid, capable of vibrations, and that its action consists in these vibrations. If, then, such have been excited by sensible impressions, we know that they may be renewed by poAvers more inconsiderable ; and it is not impossible even that the motion of the blood, in those parts of the brain where the mobility of the fluid is con- siderable, may excite vibrations, and these be attended with the same ideas Avhich originally followed them. In constitutions where the nervous fluid is particularly mobile, or in cases where the circulation is hurried, dreams will be more frequent, more vivid, and often more troublesome. Dreams, Ave have said, are useful in affording prog- nostics in various diseases. When the dreams are hurried and violent, Ave have often reason to expect de- lirium : when the mind in fevers is gloomy and dis- tressed, and the dreams frightful, the fever soon be- comes dangerous; but when in sleep, the fancy is soothed by pleasing images, the disease is seldom alarming. In these cases, the consequences are pro- bably those of terror on one side, and complacency on the other; and the peculiar states of fever may not be the causes of the dreams. Yet, when we recollect that, in other instances, diseases of the body excite dreams of distress and horror, we must think that the more violent corporeal affections are really the causes of the terrific visions. In either case they are often use- ful prognostics. If any part of the brain, is more easily excited to action by having been previously impressed, the mind, on the contrary, becomes more insensible. Thus, the person used to distress is comparatively calm in witnessing the most painful scenes : the mind, once harrowed Avith horror, will bear common trouble Avith- out emotion. This will account for the fancy not al- ways pursuing, in sleep, the painful scenes of the day, or rather for their not being folloAved by pungent dis- tress, so that they escape the recollection when we are awake. Is it a fact that the dreams of children are more ter- rific than those of adults ? Infants certainly dream, and seldom awake in terror; in fact they know not the tendency of objects, and are not capable of appreciating their effects so as to be terrified. When they are farther advanced, the tales of the nursery often inspire horrible images,Avhich may again return in their dreams; or their systems, more mobile and irritable than those of adults, may be more susceptible of violent impres- sions. We could wish, however, that the fact were more decidedly ascertained. Animals dream,- particularly dogs ; but in these vi- sions they are more often pleased than terrified, though sometimes angry. Their bark is different, and the voice of those Avho talk in their sleep is usually altered. We have no evidence of the feathered race being sub- ject to these nocturnal visitors; and perhaps they are connected, like associations of ideas, with the propor- tional bulk of the brain. See Baxter on the Immateriality of the Soul; Lord Monboddo's Works; Hartley on Man ; Wolfius's Onto- logy ; Cullen's Physiology ; and Lommius. INSPIRA'TIO, (from in, and spiro, to breathe). In- spiration ; eisp7ioe, epipasmos. The action of the chest and diaphragm, by which the air is draAvn into the lungs. See Respiratio. INSTILLA'TIO, (from instillo,to drop upon,) often synonymous with embrocatio. I'NSTITA, (from incisto, to stay). A fillet; and a TAENIA. INSUFFLA'TIO,(from insufflo,to blow into). Blow- ing into any cavity, to convey any remedy to a part affected. - INSU'LTUS, (from insulto, to attack). The first invasion or ace'ess of a paroxysm. INTEGA'STRUM. The decussation of the optic nerves. Paracelsus. INTEGUME'NTA, (from intcgo, to cover). In- teguments ; the cuticle, rete mucosum, cutis, and membrana cellularis; sometimes applied to particular investing membranes, as the coats of the eye. INTEMPERA'NTIA, (from in, non, and tempera^ to moderate).. Intemperance. Besides its usual signi- fication, it sometimes is synonymous with dyscinesia. INTEMPE'RIES, (from in, non, and tempero, to mingle.) See Dyscinesia. INTE'NTIO, (from intendo, to stretch out). In- tention. It is either extension or indication. Heal- ing a wound " by the first intention," means when di- vided parts are placed in contact, and unite without any suppuration. INTERCE'PTIO, (from intercipio, to stop). See Apolepsis. INTERCOSTA'LIS, (from inter, between, and cos- ta, the ribs,) any part situated between the ribs; viz. Intercosta'les arte'ria, which arise in pairs from the aorta, and run on the lower parts of each rib. They are eight, nine, or ten in number, of which. the upper come from the subclavian. The INT 823 INT intcrcostales of the tme ribs anastomose with the internal mammary ; those of the superior go to the muscles of the belly. Intercosta'les mu'sculi ; mesopleurioi ; inter- costal muscles are eleven in number on each side externally, and as many internally; in all forty-four. The external ones pass dowmvards and forwards; rising from the edge of the superior, and inserted into that of the inferior, rib: their fibres run nearly parallel; but near the sternum disappear. Their use is to elevate the ribs. The internal ones are the reverse of the ex- ternal ; rising from the edges of the inferior, and in- serted into those of the superior, ribs; consequently they decussate each other. These depress the ribs; so that, by the alternate action of the two sets of muscles, the thorax is expanded in inspiration, and diminished in capacity during expiration. The levatores costarum longiores and breviores of Albinus are those portions of the external intercostals Avhich arise from the the transverse processes of the ver- tebrae, where the ribs are fixed to them, and other por- tions which pass over one rib and terminate in the next below it. Similar portions of the internal are called by Douglass costarum drpreasores proprii Cowperi. Intercosta'les ne'rvi ; intercostal nerves, sym- pathetici nervi majores, are formed of all the spinal nerves, and of branches from the fifth and sixth pairs from the brain. They run on the other side of the ribs. This is a very important part of the nervous system ; but it has already claimed a large share of our attention. See Cerebrum. Intercosta'les ve'n^e, dextrje, superiores, .et inferiores. See Azygos. INTERCU'RRENS FE'BRIS, (from inter, between, and curro, to pass). An intercurrent fever. Some fevers are epidemical in certain seasons only; others happen in all years, and are only occasionally epidemic. The former are called stationary; the latter, by Syden- ham, intercurrents. See Sydenham's Works. Intercu'rrens vel interci'dens pulsus. When between tAvo strokes at proper distances a third quickly intervenes. I'NTERCUS, (from inter, between, and cutem, the skin). See Anasarca. INTERDE'NTIUM, (from z'flfer, between,anddentes, teeth). The intervals between teeth of the same order. INTERDI'GITUM,(from inter,between,and digitus, toe or finger). A corn between the toes. INTERFEMl'NEUM, (from inter, between, and femur, the thigh). See Perineum. INTERFOLIA'CEUS, (from inter, between, and folium, a leaf). Proceeding from between opposite leaves. INTERLU'NIUS MO'RBUS, (from inter, between, and luna, the 7noon ; because it was supposed to affect chiefly those born in the wane of the moon). See Epilepsia. INTERMISSIO, (from intermitto, to discontinue). The intervals betwixt two fits of any distemper. INTERMITTENS FE'BRIS, (from the same). An intermittent fever, is a febrile disease consisting of distinct attacks, with perfect freedom from fever in the intervals. Different names are given to this fever according to the periods of its return; if after twenty- four hours, a quotidian; if after forty-eight hours, a tertian; if after seventy-tAvo hours, a quartan; after ninety-six hours, a quintan, or a pemptaus. Such inter- mittents are, hoAvever, rare; and those Avith longer in- tervals have been styled erratic. Those are called autumnal Avhich begin in August, and those vernal which begin in February. Dr. Cullen places intermittent in the class pyrexia, order febres; defining it fever arising from marsh miasma, consisting of many paroxysms; a total free- dom from fever, at least an evident remission; re- turning Avith a marked exacerbation, and generally with shivering; having one paroxysm only in a day. He adds, " whoever will weigh Avhat will be delivered concerning remittent fevers, and their distinction from continued fevers, strictly so called, will readily see why I have thought it necessary to change the character formerly given of intermittents as Avell as continued fevers." The latter he defines fevers having no inter- mission, nor arising from marsh miasma, but continuing only Avith slight remissions and exacerbations; having two exacerbations each day. " He thinks that the no- sologists, Sauvages, Linnaeus, and Sagar, have not acted judiciously in instituting a separate order of remittents, as if they were altogether different from perfect inter- mittents ; for those fevers called remittents arise from the same cause, viz. marsh miasma, as intermittents ; each appears as an epidemic, in the same place, and at the same time of the year; each is cured exactly by the same remedies; and very often in the same subject, the same disease sometimes exhibits the intermittent, some- times the remittent, type; diseases, therefore, so ex- tremely alike Avith respect to their causes, mode of cure, and type, ought neither to be placed under a dif- ferent order, or in different section." The patient, though free from fever, is slightly indis- posed the following day with chilliness and languor : he hath a weak and slow pulse, his urine is pale, and either deposits a sediment, or contains a small cloud suspended in it; the sediment is of a reddish colour, exactly re- sembling brick dust; the surface frothy, or covered with a pellicle. The beginning of autumnal intermit- tents is sometimes not very different from that of con- tinual fevers. When weakly persons are the subjects, the intermissions are proportionally less distinct. Obstinate intermittents often end in dropsies, or hectics from obstructed viscera. Vernal intermittents often require no assistance, and very rarely prove fatal. Intermittents are distinguished by the very regular appearance of each stage of fever formerly described (see Febris}; and the continuation of the paroxysm sometimes extends to twenty-two hours, the patient having scarcely two hours interval; but this chiefly happens Avhen two diseases of this kind have attacked the patient at once, so that the fit of one comes closely on the conclusion of the former paroxysm. A single quotidian will, however, sometimes last eighteen or twenty hours. In general it will be found that the longest paroxysms have the shortest intermissions; and the contrary ; but the time of the paroxysms is occasionally anticipated or retarded. An increase of the interval, or rather a retarded paroxysm, shows the disease to be declining; while an anticipated attack is rather a sign that the disease is becoming a remittent or continued fever. It is singular that intermittents rarely attack in the INT 824 INT night. When the paroxysm anticipates, so as to come before eight, its next step is usually to the febrile period of the evening, previous to the usual day of its attack; and when it is retarded beyond eight or ten in the evening, the following attack is usually at eight in the morning following its accustomed day. Continued fevers are said to attack in the night, but we have generally found that the patient has complained in the evening, and that the fever has then formed, though the rigor has only taken place during the night, or rather about four in the morning. The attack of intennittents is sometimes attended with the most alarming symptoms, such as syncope, apoplexy, a great load on the chest, Avith threatening suffocation, epileptic paroxysms or violent spasms, or a coldness, which increases till the patient sinks into torpor, soon folloAved by death. These are circum- stances ofpeculiar danger, and require the most minute attention. The hot fit is also sometimes so violent as to be attended with delirium, and occasionally with rup- ture of the vessels, from the violence, in the language of Dr. Cullen, of the reaction. These circumstances require particular attention in the conduct of the cure. Intermittents are sometimes complicated; that is, there may be two tertians, or two quartans, existing at the same time. The double tertian of authors, the duplicana of Linnaeus, consists of two tertians, return- ing each at their regular times, and thus attacking every day. The real disease is distinguished from a quotidian by the time of the attack, which in a tertian is about noon, by the shorter paroxysms; and by the fits of fever which occur on the alternate days resembling each other : while, if that on the succeeding is com- pared with the fit of the former day, some difference is observable. Another form of the double tertian is with two paroxysms in one day ; and this kind is distinguish- ed by the appellation of tertana duplicata. A triple tertian has also been observed, consisting of two paroxysms on each alternate day, and one only in the interval. This is the semitertiana of authors, the ter- tiana triplex of Sauvages. Tertians differ also in the degree of remission, when complicated in the manner already mentioned. Thus a double tertian, which re- turns daily, will have often the remission between the unequal and equal day; between the third and the fourth, for instance, more strongly marked; between the equal and unequal day less strongly. Quartans vary as much; but, indeed, in this country quartans are uncommon, except in the marshy coun- tries on the east of this island. The quartana duplicata of Sauvages consists of two paroxysms every fourth day, and on the other days none. The quartana triplicata consists of three paroxysms every fourth day, with three days of intermission. The quartana duplex has only an intermission of the third day, and the paroxysms of every fourth day are alike. The triple quartan attacks every day; and the paroxysms of every fourth day re- semble each other. This disease, like the double ter- tian, is distinguished by the period of the attack and the shortness of the paroxysms. The author of this article, in thirty-five years practice, has seen but one quartan, which was imported from a distant county.- Quotidians vary but little, except in their causes and their partial attacks. Many of these are symptomatic only; but the partial quotidians attended Avith violent pains are peculiarly distressing, and with great difficulty removed. The quintana and septimana are described by authors very vaguely, and seem, in general, to be symptomatic. Intermittents are not always dangerous, and the ver- nal agues generally-disappear on the approach of sum- mer. The autumnal ones are more frequently attended with infarctions of the liver, and the more obstinate ■kinds of these, the quartans, leave often this organ in a scirrhous state. Dropsies and hectics are the conse- quence. It has been, on the other hand, contended, that vernal tertians are salutary, and clear the constitu- tion of other diseases, as indigestion, flatulency, and acidity of the stomach; habitual rheumatisms and other inflammations; cutaneous and nervous complaints. For this opinion we offer the very respectable authority of Dr. G. Fordyce, for having seen but few cases of in- termittents, we will not add, as an ojection, that such salutary effects have not occurred to us. 'We have found every intermittent, which we have seen, to be a disease which we have been anxious to cure as speedily as was consistent with the safety of the patient. The cause of intermittents is exclusively the miasma from marshes, and the remote causes those of fever in general. We have already observed, that no satis- factory reason has been assigned for the recurrence of the paroxysm. Dr. Cullen attributes the duration of fevers to the violence of the spasm or the weakness of the reaction; and though in each paroxysm of inter- mittent the spasm may be conquered, yet its cause, the atony, remains to be combated by a new series of symptoms. It is evident that in intermittents the cause remains, for they leave a languor, in part the effect of the exertions; but, in part also, of the remain- ing debility. While we have modified, in some mea- sure, the doctrine of Dr. Cullen, yet this explanation, with a change of the language, may appear probable; and it is supported by a fact already stated, that the concluding paroxysm is the most violent. We know not, however, the duration of an intermittent in conse- quence of the debility remaining unsubdued; for we shall find, that it is often continued from habit, and that raising any violent emotion, fixing the attention, or exciting a different train of motions, in any way, will prevent its recurrence; and, when once prevented, the fit seldom returns. It may be then questioned, Avhether, even in the early stages, it may not be the creature of habit. When an intermittent first attacks, its paroxysms are seldom regular. When they become so, they soon establish a habit which we knoAv is with difficulty removed; but this habit seldom takes place but in weak, mobile constitutions. In the cure of intermittents, our first object is to prevent the recurrence of the fit; our second to conduct the paroxysm, so as to obtain a complete solu- tion of the disease; the third to increase the general tone of the system, in the intervals, that the disease shall not again return. Our first object, for it is not strictly an indication, is limited to those remedies whose immediate action may prevent the attack. These are means of increasing the tone of the system, or supporting the action of the ex: treme vessels, so as to prevent their quiescence, per- haps their spasm. The tone of the system is increased by stimulants and tonics. Wifn this view aromatics. INT 825 INT the strongest acids, and ardent spirits, in almost every imaginable variety of form, are administered Avhen the fit is expected. Very large doses of bark are also given, so as to accumulate from one ounce to two in the stomach, at the time of the usual return. The former of these plans is highly injurious Avhen a phlogistic diathesis prevails in the system; for it converts the in- termittent often into a continued fever, Avith topical inflammation. The latter is equally injurious, Avhen the stomach and boAvels have not been previously cleared; aud occasions those infarctions styled ague cakes, which have been so often attributed to the bark. In different circumstances each has succeeded. The action of the extreme vessels is supported by emetics and sudorifics. An emetic is given previous to the return, Avhile the perspiration is supported by Avarm negus, the volatile alkali, or the sudorific poAvder-of Dover. Opium, with warm teas, will equally succeed; but, in general, for the reasons formerly assigned, great external heat should be avoided. Opium is not the only medicine which acts peculiarly on the vessels of the skin, though it is the most powerful. Guaiacum has a similar effect; and the ammoniated tincture, when joined with opium, is often a valuable remedy used with these views. Musk, empyreumatic oil, and ether, are said to have had a similar effect, without producing sweating; but in such cases, they probably, if success- ful, Avhich has been doubted, act as simple stimuli. To the same source may be attributed the effects of bracelets of mustard seed and garlic to the wrists and ancles; bruised spiders and tobacco, applied to the Avrists ; yarrow, 8cc. to the feet. These excite so great a degree of inflammation as to increase the heat as well as the circulation, and have often undoubtedly suc- ceeded. We must add, that whenever we attempt to prevent the paroxysm of an intermittent by sweating, this mode of relief must be continued till the period of the paroxysm is at an end, or at least till the time when the SAveating stage would have otherwise commenced. Those means which excite terror, surprise, and hor- ror, or, as we have said, raise a train of new emotions, Avill prevent the return of paroxysms. A man has been pushed into the water; fire has been cried; the most distressing tidings invented and communicated. A patient, labouring under an ague, has been ordered to SAvallow half a pint of his own urine; to hold a toad in his hand till it dies; to eat common spiders in a raisin, or cobAvebs in crumb of bread. All these re- medies fill the mind with such dread as to counteract the impression of the cause; but in general they are dangerous, and Avhen we wish to prevent the fit, we depend rather on the tonics, the stimulants, and the sudorifics. These are often highly necessary; for when the fever attacks Avith apoplexy, epilepsy, or other symptoms which threaten the life; or Avhen the patient is so far debilitated that another fit would be probably fatal; we must take the most decisive steps to pre- vent it. We remember to have seen three cases of this >tind, in which by the sudorific plan, detailed above, we succeeded. To conduct the paroxysm so that its solution shall finally remove the disease, is often beyond our power. An emetic, given at the first approach of coldness, will often lessen both it and the next stage; and Ave must repeat, what Dr. Fordyce tells us, that he has remarked vol- i. the superior efficacy of the antimonial preparations to the ipecacuanha. When the hot fit comes on it must be mitigated by cold, and by the cooling diaphoretics. Opium, at this period, is said by Dr. Lind to lessen the heat, and hasten the SAveat; and Avhen the last stage has fully come on, the exhibition of the bark is said to render the sweating more effectual. Such are the ob- servations of authors, which we can neither confute nor confirm. From what we have, hoAvever, read and seen, we suspect that these measures lessen the inconveniences of the paroxysm, but seldom put a stop to the disease. In the intervals our chief exertions must take place; and we have been lately accustomed to trust almost ex- clusively to the Peruvian bark. We have seen (see Cortex Peruvianus) that Ave can derive little informa- tion from the sensible qualities of this medicine, or from its analysis, either in the milder or more forcible sepa- ration of its component parts, and we must rest con- tented with the fact, that the bark will usually cure in- termittents. We say " usually," for was it so certain a remedy as the language of authors would lead us to suppose, they would not fly from the common to the red and yellow kinds, to combinations of bitters and aroma- tics, to copper and to arsenic. As it is, hoAvever, the common remedy, Ave must direct its exhibition. We have already spoken of the bark, given immedi- ately preceding the fit, and in the SAveating stage. We now speak of it as a remedy in the intervals. In ge- neral, then, it must not be given Avhile there are any- considerable infarctions of the viscera. We have al- ready shown (see Febris), that fever almost consists in, or is constantly attended Avith, a disturbed balance of the circulation, and that the biliary system and the; brain, from their structure and constitution, receive a large proportion of blood, which is confined to the larger vessels. Fever cannot, therefore, continue long Avith out infarctions of the liver at least, if not excessive ful- ness of the cerebral system; and in this state the bark is certainly injurious. Physicians may colour this objection in a variety of ways, but they cannot elude it. Inter- mittents then, which continue usually some time Avith- out decisively showing their true nature, must be attend- ed with at least fulness in each viscus, and this should be previously removed. We have already shoAvn that emetics and cathartics are the chief remedies for this purpose; and hinted, that it was not without reason that physicians formerly condemned the cortex as the cause of these swellings; but, in reality, they should have blamed its injudicious use. These opinions are confirmed by another caution, universally laid down, that the bark is only admissible during a remission. In fact, at the time of the fit the fulness is most consider- able: after its solution, that degree of fulness only re- mains Avhich is OAving to the dilatation of the vessels. Dr. Fordyce is so confident of its injury during the paroxysm, that he directs it to be omitted during the time that the paroxysm would have come on. In other Avords, if the fit is expected on a given day, which usually lasted from ten to four, or six, and if the bark, taken previously, has prevented the accession, the re- medy must still be omitted during this period, though no accession really takes place. We find also that, in remittents, unless the remission is considerable, the bark is not ahvays admissible; in continued fevers it is very rarely so. I N T 826 1 N 1 Though the bark be confined to the interval, it is not necessary that it should be exhibited with equal free- dom in every period of that interval. In a quartan, tor instance, though given in the first day of intermission, its doses need not, during that day, be considerable, or often repeated. On the next, the medicine should be given in as large doses as the stomach will bear. In a tertian, the dose of the remedy should be greatly in- creased during the last six hours of the interval. What the dose should be must be determined by the judg- ment of the practitioner, and the constitution of his pa- tient. Not less than an ounce of the powder will ef- fectually stop a tertian; and a much larger quantity must be taken in the interval of a quartan. As the in- terval of the fits of a quotidian is short, we must be more active; but the disease should be lessened by emetics and cathartics before the bark is employed. It is common and highly proper to recommend the removal of a diathesis phlogistica previous to the exhi- bition of the bark; but it is equally necessary to guard against its purging or its constipating effects. The former is most successfully opposed by combining a laxative, as rhubarb with the bark, and the latter by opium; but as the rhubarb adds to the bulk, and to the nauseous taste of a medicine, already sufficiently dis- agreeable, we may choose the period of the accession for the action of any quick purgative, as the castor oil with senna; the senna or jalap with cream of tartar, or the jalap with calomel. Should opium disagree, the bark may be taken in a strong decoction of logwood. When we have been most successful, we should not too soon abandon our remedy, as intermittents, except when continued from habit, are very liable to a relapse. The bark, with every precaution, will not sometimes remain on the stomach, though joined with aromatics, with opium, or followed by an effervescing draught. In this case, we have been directed to quilt it in a calico waistcoat, to be worn next the skin; to bind it round the wrists; to inject it in a clyster; or to bathe the patient in its decoction. Each method is said to suc- ceed; but what will not appear to succeed in the eye of its inventor ? If the bark is really useful in these Avays, we should expect that it will not be employed in any other; but when we reflect on the quantity requir- ed to cure an intermittent in the stomach, an organ which so quickly sympathises with the extreme vessels, the brain, and the sensorial power, we can scarcely ex- pect lesser quantities, applied less advantageously, to succeed. The advocates of this practice have quoted Dr. Alexander's experiments with some triumph, to show that bark applied to the skin is absorbed; but when large quantities have been given to check an in- termittent at once, and vomiting has succeeded, the Avhole is apparently evacuated though the fit be stopped. If it be contended that the bark in this Avay is really applied to the extreme vessels themselves, the advocates for the practice must show how it passes the cuticle, ex- cept by the absorbents; and prove, what may be still more difficult, how in this way it can obviate the cause, viz. the atony of the sensorial power. The prejudices against the bark, on its first introduc- tion, led to a variety of substitutes for it in these dis- eases; and all the bitters and astringents were occa- sionally employed, joined sometimes with alkaline and neutral salts, at others with aromatics, more simple stimulants, or antispasmodics; the abrotanum,the vari- ous species of wormwood, the carduus, the centaury, the camomile floAvers, the columbo root, orange and lemon peel, gentian, quassia, tansey, rue, St. E^auus' bean, with almost every medicine Avhich contains a bitter juice. It is a doubt Avhether the bitter is the same in all. When the bitters are pure, as in the gen- tian and camomile flowers, the principle is apparently the same; but the wormwood, for instance, contains an essential oil totally different from its bitter juice; the orange peel not only an essential oil, but an astrin- gent principle. This may have perhaps occasioned the preference of the latter, since the bark also contains an astringent portion ; and Avhatever aversion physicians had to the bark, in their substitutes they came as near it as possible. The action of bitters and astringents wc have already noticed. See Amara and Astringentia. Tne astringents employed have been the alum, the galls, the tormentil, and the oak bark: each, it is said, has been successful; but their success has not been so decided as to lead to their general employment instead of bark. The additions to the bitters and astringents, though chiefly to the former, have been, we have said, alkalis, neutral salts, stimulants, or antispasmodics. Boerhaave was fond of the bitters with alkalis, as producing a sa- ponaceous medicine, in his opinion a powerful deob- struent; though he sometimes preferred the neutrals. These are undoubtedly of great utility as antifebrile medicines, though seldom sufficiently powerful to stop the paroxysms of an intermittent. The aromatics usually added are nutmeg and ginger; the antispas- modics, the animal oil of Dippel, or, sometimes, the less elegant form of candle snuffings. The latter, with nut- meg, is said to have often effected a cure. Similar ad- ditions sometimes render the bark more effectual. The other substitutes have been the metallic tonics, copper, arsenic, and iron. We know not that copper has been employed in the pure intermittents, though used with success in the intermittentes larvatae, which we shall notice in the following article. Arsenic was employed many years since in this disease, and lately has been in general use, from the success of Edwards's ague tincture (see Arsenicum). It is undoubtedly a very active and powerful medicine; nor have we found any disadvantages from its use. It has succeeded, when the bark in every form, and Avith every addition, has failed. Fowler's arsenical solution is made in the following manner: take arsenic very finely powdered, and fixed alkaline salt, of each sixty-four grains (some ordered half the quantity); distilled water, half a pint; these are to be put into a Florence flask, and placed in a sand heat: the Avater is then to boil slowly till the arsenic is perfectly dissolved: when the solution is cold, half an ounce of compound tincture of lavender is to be added, and of distilled water, another half pint, more or less, so that the whole of the solution shall yield by measure a pint, or rather weigh fifteen ounces and a half. Patients from two to four years of age may take from two to four drops; from five to seven years, from five to seven drops; from eight to twelve years, from seven to ten drops; from thirteen to eighteen and upAvards, twelve drops at a dose, in any proper vehicle, two or three times a day. Iron is sometimes added to the bark and bitters to increase their virtue; but it has, we believe, been INT 827 INT seldom trusted alone. All these medicines seem to act by increasing the general tone of the system, and thus counteracting the debility in which the dis- ease apparently consists. The mineral acids, though powerful tonics, have not been used, we believe, in this disease. The general management of patients, who labour under intermittents will not detain us long. It is in the first place necessary to remove them from the in- fected air; but the activity of modern husbandry has lessened the number of marshes, and the disease is comparatively rare. In parishes where the number of intermittents Avas not annually less than two hundred respectively, the disease is not found, or only in a few instances in its disguised state. The diet should be light, easy, and digestible. The ancients seldom ad- mitted of food in the first days of fever; and in the early periods of intermittents, when the disease has seldom any regular interval, the less nourishment that is taken, the sooner will the fever assume its proper type. In general, when the fits are more distinct, ani- mal food should be avoided unless there is sufficient time to complete the digestive process before the ex- pected return. This precaution must be continued after the fits have disappeared. The intermittentes comitata and perniciosa of Torti are more nearly allied to the remittents, and are indeed often of the remittent kind. They Avill therefore be considered with advantage under that article. See Remittentes. See Torti Therapeutice Specialis, Sydenham's Works; Cleghorn on the Diseases of Minorca; Hunter on the Diseases of the Army; Senac de Recondita Febrium Natura; Fordyce on Fevers, second Dissertation. Intermittentes larvat^e. A fever of a truly in- termittent nature is often disguised under the appear- ance of a very different complaint, or seems to the in- experienced practitioner a fever of a different kind. In the first, the real disease may generally be suspected from the appearance of regular paroxysms, or more cer- tainly by perfect intermissions, since these more often occur in such disguised intermittents than a regular recurrence of the disease. Intermitting pains of every kind, where the paroxysm is completely terminated, are of this kind; and the most common and most trou- blesome instance is the hamierania. The distinction of the complaint is not easy, for pains in the head, from whatever cause, are not constant t even the noi.nrc iaciei crucians, q- v. the tic doloureux, has its re- missions (see Cephalalgia). Haemicrania, therefore, }s distinguished from its situation, occupying often with such minute precision one half of the head, that the patient can place the point of a pin between the part pained and that unaffected; frequently from its regular attack, at least a regular continuance; in many instances from its being ushered in by rigor, followed by feverish heat; almost always from soreness in the bones of the cheek of the side affected during the pa- roxysm only. It is a disease of the most distressing kind, for its obstinacy is equalled only by the violent degree of the pain. The intermitting nature of this complaint is known rom its occurring in the Ioav, damp, marshy situations, from its regular recurrence, and from the remedies which relieve it. But among these we cannot reckon the Peruvian bark alone ; for, though large doses have sometimes appeared to cure, they are often ineffectual, so that Ave are rather inclined to attribute the relief, sometimes experienced, to the spontaneous cessation of the disease. The remedy which most frequently suc- ceeds is that recommended by Dr. Grant, consisting of an ounce of valerian, half an ounce of bark, two drachms of the Philonium Londinense, one drachm of kali, with a scruple of rhubarb, made into an electuary with simple syrup. He remarks, what we have found to be true, that if this quantity is SAvallowed betAveen two paroxysms, the last Avill be greatly mitigated; and if the same quantity is swalloAved between the two next, the complaint will be so far cured as to be scarcely troublesome. The effects of this plan, however, are rendered more certain by giving an emetic before the expected attack, Avith a blister behind the ear of the side affected ; and as it is necessary to keep the bowels free, which the propor- tion of rhubarb is unequal to, the period of the acces- sion may be employed for this purpose. The duration of the pain is amply sufficient for the operation of salts, of the oleum ricini, or jalap. The quantity to be taken, according to this plan, may be sometimes inconvenient; but the pain is so excruciating that we have scarcely found any one whose resolution has not been equal to the alternative. It sometimes, however, though rarely, has happened, that the stomach will not retain it: the resolution has occa- sionally failed; and even the medicine has not succeed- ed, for the disease in our practice has been frequent. In such circumstances the copper has sometimes re- lieved ; and, in more than one instance, a secret me- dicine, which is pretty certainly a solution of arsenic. If the period of the fever is not required for the action of a laxative, the pain may be mitigated by opium, Avith which camphor or musk has been combined ; but of these additions wre cannot speak from our OAvn ex- perience. Other periodical pains and nervous complaints, as the hooping cough, hiccough, nausea, colic, and palpita- tions, regularly recurring, are very frequently removed by the same means (Senac). It has been usual to give the bark in every periodical complaint; but it seldom succeeds, except in doses much more inconvenient than those of Dr. Grant's medicine ; and, when it seems to relieve, it leaves the patient more subject to relapse. There are, however, symptoms periodically recur- ring, not always of this kind ; but we have only been able to trace them when belonging to one disease, viz. lues venerea. We have seen a periodic ophthalmia, a haemicrania, and an haemorrhage from the nose, re- curring at regular intervals in this disease. Each has been cured by a mercurial course. It may be said, that mercury, like copper and arsenic, will remove it; and it may be true, but each laboured under syphilis. The patients are at this moment alive, and the author, by a personal application, has refreshed his memory on the different subjects. We must add, however, that Senac, an author of the highest credit, mentions intermitting haemorrhages, ophthalmy, ear and toothach, cephal- algia, pains under the scapula, nephritic affections, pain of either leg or arm, and of the stomach, often without any other appearance of fever. Those inter- mittents also which Ave have mentioned as attacking with syncope, apoplexy, asthma, and convulsions may INT 828 I N T be properly styled larvate. The nature of these cannot be at once knoAvn; but some opinion may be formed from the prevailing epidemic, from the damp marshy situation in Avhich the patient lives, from the bilious vo- miting', the lateritious sediment in the urine, from the recurrence; but, above all, as we have said, from the very perfect intermission. The third paroxysm is po- pularly supposed to be fatal; indeed it often is so. The varieties of intermittents which we have noticed, in which the cold obstinately continues; Avhere the hot fit becomes phrenitis, or Avhere the subsequent debility is attended with marks of putrefaction, and the worst symptoms of malignant fevers, have been reckoned among the disguised intermittents by Morton and Torti. But these authors were preceded in this opinion by Salius Diversus, by Valesius, Mercatus, &c. Indeed were a descriptive (raisonne) Medical Biography, a work much Avanted, ever published, numerous reputed discoveries might be carried far beyond the ages of the supposed authors. We have already mentioned the manner in which in- termittents pass into remittents, and into continued fevers of the worst kind; but Ave have referred the con- sideration of these subjects to the Remittents, q. v. Avhich afford examples of the most destructive exacer- bating fevers. See Morton de Febribur, Senac de Re- condita Februm Natura, lib. 2. INTERNO'DIUM, (from inter, between, and nodus, a joint,) that part of the stalks of plants which are be- tAveen two joints or knots; in anatomy the knuckles, and the space between the joints of each finger. INTERNU'NCII DI'ES, (from internuncio, to go between; as standing between the increase and decrease of the disease). See Critici dies. INTERO'SSEA ARTE'RIA, (from inter, between, and osa, bones). The cubical artery, in its course between the heads of the radius and ulna near the interosseous ligament, gives off these arteries, the in- ternal and external. The internal runs close to the ligament, till it reaches below the prunator teres, where it perforates the liga- ment, and passes to the convex side of the carpus, and back to the hand, Avhere it communicates with the ex- ternal interosseus, the radical and the cubical arteries. The external pierces the ligament about three fingers' breadth below the articulation, and sends off a branch towards the external condile of the os humeri, under the ulnaris externus and anconaeus minimus, to Avhich, and to the supinator brevis, it is distributed. The in- terosseous artery then runs downwards on the outside of the ligament, giving branches to the ulnaris, exter- nus, extensor digitorum communis, the extensores pol- licis indicis, and minimi digiti. Having reached the lower extremity of the ulna, it unites with a branch of the internal interosseous artery, which at this place runs from Avithin outwards, and is distributed with it on the convex side of the carpus and back of the hand, communicating with the radial artery and with a branch of the cubital. By these communications this artery forms an irregular arch, from whence branches are sent to the external interosseous muscles, and to the exter- nal lateral parts of the fingers. Intero'ssea ligame'nta. The interosseous liga- ments in the fore-arm are fixed by one edge along the sharp angle of each ulna, and by the other along that of the radius. They principally consist of two very strong planes of fibres, Avhich cross each other at obliqur- angles, and leave holes at different distances for the passages of blood vessels. The ligament ties the two bones closely together, and the two planes serve for the insertion of several muscles. In the supination of the hand it is very tight, but in the pronation it is folded a little lengthwavs. INTERO'SSEI MU'SCULI, are found both in the hands and feet. There are three in the upper part of the hand, and as many on the inferior. Their name de- scribes their origin, and they are blended Avith the lum- bricales, performing the same office, of moving the fingers sideways. The first of the interossei interni is called by Albinus posterior indicis; the second and third are the prior annularis, and interosseus auricularis. These three muscles draw the fingers, into Avhich the v are inserted, towards the thumb. There are four inte rossei externi, for a small muscle, which supports the forefinger, the semi interosseus indicis of WinsloAv, the prior indicis of Albinis, is included. This muscle then may be styled the first; the second is the prior; and the third the posterior niedii. The fourth is the posterior annularis. It is useless to be more minute in these un- important muscles. They may be cut through with little danger, and will unite with as little trouble. In the feet several small muscles fill up the four in- terstices between the metatarsal bones, after the same manner as in the hand. Like the interossei of the handr there are three internal and four external. Their use is also similar. INTERPELLA'TUS MO'RBUS,(from interpello, to interrupt). A disease attended Avith irregular or un- certain paroxysms. Paracelsus. INTERPOLA'TUS DI'ES, (from interpolo, to re- new). Days interpolated between two paroxysms. Paracelsus. INTERSCA'PULUM, (from inter, between, and scapula, the shoulder blade). See Scapula, INTERSE'PTUM, (from inter, between, and sep- tum, an inclosure). See Uvula, and Septum narium. INTERSPINA'LES CO'LLI, (from inter, between, and spina, the spine). Winslow calls these muscles spinales colli minores. Dr. Hunter calls them intras- pinal, adding, that they lie between the spinal processes of the neck and loins, serving to erect the body, by bringing the spinal processes nearer to each other. The interspinal™, dnrsi, and lumborum are tendinous, and connect the spinal with the transverse processes. INTERTRANSVERSA'LES MU'SCULI, (from inter, between, and transversales, the transverse pro- cesses). They lie between the transverse processes of the cervical and lumbar vertebrae, serving to bend the neck and body to one side. Winslow calls them trans- versales minores. To the first of these muscles the name concutiens has been given. INTERTRI'GO, (from inter, between, and tero, to rub). Attrita, attritio. A galling, or erosion of the cuticle, or of the skin. Children are apt to have exco- riations behind their ears, in the neck, and thighs: the last often arise from neglect. The excoriated parts should be bathed frequently with warm water; and powdered chalk, or cerusse sprinkled on them through a bit of fine muslin when quite dry. Dr. Cullen con- siders it as avariety of erythematous inflammation. I N T °29 I N \ INTERVERTEBRALS MU'SCULI, (from iw/er, between, and vertebra). They arise from the body of one vertebra laterally, and are inserted, after an oblique progress, into the back part of the other vertebra, imme- diately above it. They draAV the vertebrae nearer to one another, and a little to one side. INTESTFNA TE'RR^E. See Lumbricus ter- restris. INTESTINA, (from intus, within). The intes- tines, chorda, and pantices. From the pylorus to the anus, is one continued canal, divided into the small and great intestines, covered by the mesentery and mesoco- lon ; and, as they are longer than these membranes, they are contracted in folds to the length of the latter. The whole length of the intestines is between seven and eight times the length of the body ; the small ones are about five of these parts. The small intestines called dertron, and cholades, because they contain bile, are named Duodenum, Jejunum, and Ileum, q. v.: the large intestines are, the Ccecum, the Colon, and Rectum, q. v. The first coat of the intestines, the external, is from the peritoneum, called cellulosa tunica Ruyschii; tunica exter7ia vel me7nbranosa; the second is the muscular coat formed of two planes of muscular fibres, the one thin and longitudinal; the other thicker, in a cylindri- cal direction: the third is styled the nervous, but con- sists of cellular substance; the fourth the villous, peri- stoma. The villi are of different shapes and lengths in different parts of the intestines, more thick in the small, more long and thin in the large ones; they are thought to be secreting and absorbing organs, as there the arteries seem to terminate, and the veins to begin. The glands of the intestines, enteradenes, are supposed to be lodged in the nervous coat, next the villous, and are divided into glandula solitaria and aggregata; but their existence is not clearly established. In the great intestines we may observe little holes, Avhich, when inflated, lead to cells analogous to the fol- licles of Malpighi; and by analogy we may suppose glands to exist in the great intestines near the anus, to separate a lubricating mucus, for facilitating the pas- sage of the faeces. The arteries and veins run together on the intestines. In the intestines the first digestion is completed; from them the chyle is absorbed, and through their cavity the faeces ultimately carried off. These actions are performed by theirperistaltic or vermicular motion,which apparently moving their contents backward or forward, in effect propel them ; as the Avaves of an increasing tide some- times fall short of, and at others gain on those which preceded them, but on the whole advance. This motion is caused by the successive contraction and relaxation of the circular fibres of the muscular coat; and the prin- cipal stimulus to this motion is the distention of" the canal. The action of the lungs on the diaphragm and of the abdominal muscles assist the progress of the contents of the stomach and intestines. Thus the clara lectio, read- ing aloud, is said by Celsus to assist digestion. INTESTINA'LIS, (from intestina, intestines). Be- longing to or proceeding from the bowels. Ixtestina'lis arte'ria. SeeDuoDENALis arteria, and Gastrica dextra arteria. Intestina'lis ve'na. See Duodenalis vena. INTESTINO'RUM SOLA'MEN. ThesemenamV:, according to Hoffman; and the oleum anisi, according to Van Helmont. Intestino'rum tu'nica exte'rna, and membranosa. See Intestina. INTOXICA'TIO, (from to^ixov, poison,venom). It is properly the same as infectio, but generally synony- mous with inebriation. See Inebriantia. INTRAFOLIA'CEUS, (from intra, and folium, a leaf). GroAving within the side of the leaf. INTT$ASPlNA'LIS,(fr6mintra,andspina, the spine). See Interspinales. INTRATRANSVERSA'LIS. See Intertrans VERSALES INTRICA'TUS, MUSCULUS, (from its intricate folds). See Abductor auris. INTRI'NSECI, (from intra, and secus, towards). Painful disorders of the internal parts. INTRI'TUM,(frominteror,to berubbed,) entrimi/la; a culinary term for minced meats, or rather such as are prepared by pounding, as potted beef, See. INTROCE'SSIO, (from introcedo, to go in). See Depressio. INTROSUSCE'PTIO, (from intra, within,and sus- cipio, to receive). Slight degrees of introsusceptio seem to occur frequently, and are soon restored; but even when in a considerable degree, the functions of the in- testines are often not disturbed. Unless inflamed, or adhesions are formed between the external part, and that " received within," no disease seemingly follows. It occurs often so low in the rectum, that it may be reached by the-finger, or the received intestine may, be even protruded. Monro, Edinburgh Medical Essays. See Iliaca passio. I'NTSIA. Mi7nosa intsia Lin. Sp. PI. 1508. A large evergreen tree in Malabar, called also acacia Ma- labarica globosa. The juice of the leaves, and bark is used to relieve pains in the bowels. See Raii Historia. INTUMESCE'NTLE, (from intumesco, to swell,) tumidosi. Disorders attended with a SAvelling of the body, or a considerable part of it; the second order of the cachexia. INTUSSUSCE'PTIO, the same as Introsusceptioj q. v. See Iliaca passio. I'NTYBUS, (from in, and tuba, a hollow instrument, from the holloAvness of its stalk). A name for the ci- choreum latifolium sive endivia vulgaris. I'NULA. See Enula. INU'NCTIO, (from inungo, to anoint). Inunction. The action of anointing, or the materials which are employed. INVA'SIO, (from invado, to attack,) accessio. INVERECU'NDUM OS, (from in, not, and vere- cundus, modest; because the os frontis is regarded as the seat of impudence). See Frontis, os. INVE'RSIO U'TERI, (from inverto, to turn in- wards). See Procidentia uteri. INVI'DIA, (from in, and video, to look upon, animis intuendo fortunam alterius). Envy ; a depressing pas- sion arising from a consciousness of the superior ad- vantages of another. It induces debility, indigestion, and hectic. INVO'LUCRA, (from involvo, tofoldin; from com- ing next after the child). Secundines,hystera, lncmbrane. I P E 830 I P E They form an universal covering for the fcetus, and the water in which it floats during pregnancy. They con- sist of the membranes called Chorion, and Amnion ;_ the Placenta, and part of the Funus umbilicalis, vide in verbis. If in labour the membranes do not break immediately upon their being pushed into the vagina, they should be allowed to protrude still further in order to dilate the os externum.—If they suddenly burst, and dis- charge much water, and the pains soon slacken, the la- bour becomes tedious. While the head of the child is yet covered with the unbroken membrane, it is smooth, soft, and slippery to the touch. Sometimes when the head presents the fontanel feels puffy, and deceives us, as it is mistaken for the membranes; but this should be carefully distinguished. If during labour the waters push the membranes down in an oblong form, the birth will be tedious. A short broad, or round form is the best. INVOLU'CRUM, (from the same,) the calyx of an umbelliferous plant. See also Pericardium. TON, (from Ionia, its native place). See Viola. IO'NIA. See Chamjepitys. IONTHLA'SPI, lunaria. Itisclypeolaionthlaspihin. Sp. PI. 910 ; found in France, Italy, and Spain, said to be detersive, aperitive, Sec. but not at present used. IO'NTHOS, (from ion, the violet). The Grecian ap- pellation of those hard pimples in the face of a violet colour, Avhich the Latins call by the name of varas, and gutta rosacea. IOSA'CCHARUM, (from ion, the violet, and sac- charum, sugar). Sugar of violets. lOTACI'SMUS, (from iu\x, the Greek letter /). A defect in the tongue or organs of speech, which renders a person incapable of pronouncing his letters; or where the letter i is frequently and rapidly pronounced. IO'UI. A restorative alimentary liquid prepared in Japan. It is made from the gravy of half roasted beef, but the other ingredients kept a secret. IPECACUA'NHA, (Indian). Brasiliensis radix, herba paris Br asiliana, poly cocos, poaio do matto, caa- apir; cipo; Indianaradix,periclymenumparvum,iVECA- cuan, or Brasilian root. Many of these names have been assigned, from the opinion of naturalists, respecting the plant which produces this valuable re- medy. It hasbeen supposed to be the root of a viola,of a periclymenivm, and of a species of psycotria. Indeed the evidences in favour of the latter are so strong, that we have much reason to believe that its roots are at least emetic, though not the real ipecacuanha. In fact, if we can trust Decandolle's description in the Bulletin des Sciences, the white ipecacuanha is derived from the viola, and this medicine is afforded by three species, the v. calceolaria of the species plantarum, a native of Gui- ana and the American islands ; the v. parvifiora of the supplementum plantarum ; and the v. ipecacuanha of the mantissa. These roots may be found among those of the true ipecacuanha, but they are a fraudulent addition, as, though emetic, they do not possess the valuable pro- perties of the true or grey kind. They are distinguished by the size of the woody part, which, in the true kind, is a fibre only; in the white it is as thick as the bark. The roots of different species of aselepias, dorstenia, and other genera, are sold as ipecacuanha, but with the dis- tinction of " false." In 1780 Mutis sent to the younger Linnaeus, from South America, a full description of a plant, Avhich he was assured was the true ipecacuanha; an account con- firmed by a medical resident, who has been stigmatised with the name of an empiric. This naturalist referred it to the genus psycotria with the trivial name of emetica, doubting, however, whether it was the same Avith the ipecacuanha of Piso and Margraave, though the figures of these authors greatly resembled it. Dr. Wood- ville, in 1793, published an engraving of a specimen preserved in spirits, sent from the Brasils. The root was entire, and ascertained it to be the real plant; but the flower was wanting, so that the truth of Mutis's narrative and the credit of his informant could neither be established nor invalidated. In this state of uncer- tainty, we received in 1802 the description of the true plant from Felix Avellar Brotero, in the sixth volume of the Linnaean Transactions, p. 137. The author is professor of botany in Coimbra, and professes to have drawn his description from numerous dried specimens, corrected by the observations of his friend Bernard Gomes, a diligent medical botanist, who has often ex- amined the living plants. They grow in Parnambuqui, Bahia, 8cc. and other provinces of Brazil, flower in November, December, and January, and again in Feb- ruary and March. The berries ripen in May. It is scarcely the object of this work to transcribe the minute description of Brotero, which would be unin- teresting to the medical reader ; and we shall prefer making a few remarks on the minute difference be- tween the callicocca ipecacuanha, the title he gives it, and the psycotia emetica of the younger Linnaeus. This genus callicocca belongs to the rubiacea of Jussieu, and the species are all perennial. The description of Brotero greatly resembles that of Mutis. In the latter, the bracteae Avhich separate the florets are said to be so small as to be scarcely discerni- ble; but Brotero describes the bracteae, involucri and flosculorum longitudine; but we have long since learnt that plus vel minus non mutat speciem. The stipulae, according to Mutis, are awl shaped, and horizontal; in Brotero appressae sessiles sublineares partito fimbriatae, lacinulis subulatis. In Mutis the flowers are said to be axillary ; in Brotero terminal. In Brotero's figure, how- ever, there is but a single flower which, though placed terminally, is apparently axillary. The stipulae in Sir Jo- seph Banks' plant seem to resemble those described by Mutis. There appears, if these circumstances only are consi- dered, little doubt but that the plant of the younger Lin- naeus is a variety of that described by Brotero; but in Mu- tis' plant there is no involucrum: in that of Brotero a large and strongly marked one, so that in reality, they must be two distinct species, though they certainly belong to the same genus. The involucrum is, indeed a part of the essential character in Schreber, and in the cephaelis of Wildenow (the same genus); yet many of the species have naked heads. It has, in conformity with the same views, been proposed to add as a species of callicocca the e. mutisii (psycotria emetica Lin. Filii Supplementum Plant, p. 144). Head naked peduncled ; few flowered; leaves lanceolate,smooth; stipules entire, awl shaped; corolla five, cleft; chaffy bractes, very small. It is brought from the Spanish Westlndies. Foursorts are mentioned, viz. the grey, brown, white, and yellow. The grey is generally esteemed the most valuable, but IPE 831 IPE Neumann assures that the brown is equally good. The Avhite sort is much weaker than the other, and the yel- Ioav does not act in the least as an emetic, being merely purgative. The Peruvian sort is called bexuguillo. The roots of the grey sort are about the thickness of a small quill, very unequal and knotty; variously bent and contorted, full of Avrinkles and deep circular fissures, which reach down to a small whitish Avoody fibre that runs in the middle of each piece: the cortical part is compact, brittle, looks smooth, and re- sinous on breaking. They have little or no smell, the taste is bitterish and subacrid, covering the tongue as it Avere with a kind of mucilage. The roots of the brown kind are small, somewhat more wrinkled, of a dark co- lour without, and white within. The white is woody, has no wrinkles, and, to the taste, no perceptible bitter- ness. The ash coloured or grey ipecacuanha is general- ly preferred: the broAvn has been observed even in a small dose to produce violent effects; but the white has scarce any effect, whatever the dose may be. The root contains a gummy and resinous matter, though the gum is in the greatest proportion, and the most ac- tive part: the bark is more powerful than the wood; and the whole root manifests an antiseptic and astrin- gent power. The emetic quality is said by Dr. Irvine to be counteracted by the acetous acid ; for thirty grains, taken in two ounces of vinegar, produced only some loose stools. For this reason it has probably become fashionable to add the ammonia, which is supposed to increase the emetic power of the ipecacuanha. This medicine is the most certain, the mildest, and safest emetic with which Ave are acquainted; for it readily passes off by stool, if it does not operate by vo- mit ; but perhaps less certainly by urine or perspiration than the antimonials. The larger compact roots that have a resinous appear- ance are preferred. The slender, blackish, brown ones, full of fibres, are the worst. Mr. Henry, of Paris, has lately ascertained, by experiment, the fact first men- tioned by Lassone, that the ligneous part is equally powerful Avith the cortical. The roots of the caapia, commonly sold under the name of white ipecacuanha, are yellowish, or of a yel- lowish white colour. The apocynum is another impo- sition which we have mentioned; but the colour of its medullary fibre is of a deep reddish yelloAV colour, whereas that of the ipecacuanha is whitish, or of a pale gray. Helvetius first brought this root into repute as an antidysenteric, though it Avas brought to Europe about the middle of the seventeenth century. Since his time it has been used in diarrhoea, menorrhagia, leucorrhcea, in long continued obstructions, and in spasmodic asthma. In violent paroxysms'of the latter it has procured re- lief; and Avhere habitual, from three to five grains may be given every morning, or from five to ten every other morning, and continued for four or six weeks. Small doses of one to two grains have been of use in catarrhal, some consumptive cases, and various states of fever. It has also been employed in the cure of agues as an eme- tic, given at the time of accession, or at the close of the cold fit. Very small doses, as one third or one half of a grain, have been recommended every four hours, in menorrhagia, cough, pleurisy, and haemoptoe ; and in larger doses, to counteract the effects of opium. Of all its preparations, the powder is the best; six or eight grains of which will produce two or three discharges by vomit; and in diarrhoeas and dysenteries, after this operation, it excites perspiration, if the patient is kept Avarm. It chiefly operates as an emetic in proper doses ; in smaller doses, as a nauseating and aperient medicine, upon which its antidysenteric power seems to depend. It is said to succeed equally well in small as in large doses; but the quality of the root we now obtain is not the same, or it has lost this power. It is so certain an emetic, that we cannot venture to give it where vomiting would be injurious. Geoffroy supposed that the resinous part only was emetic, and that the virtue of the ipecacu- anha in dysenteries depended on its gum, which acted as a demulcent; but this is highly improbable, as other emetics or similar medicines in nauseating doses are perhaps equally effectual. Dr. Irvine found the gum more actively emetic than the resin., and the bark than the wood, though the latter possessed this power in an inconsiderable degree. Water distilled from it Avas not emetic, but the remaining decoction violently so, though its peculiar properties were destroyed by long boiling. See Cullen's Materia Medica. The best menstruum for extracting the Avhole virtue of the root is one part pure spirit, and two or three of water ; of wines the Canary or mountain best extracts its virtue ; but the London College directs the follow- ing v'inum iPECACuA'NHiE. Take of the roots of ipe- cacuanha in powder, two ounces ; of Spanish white wine, two pints; digest ten days, and strain. Ph. Lond. 1788. Its dose, as an emetic, is from 3 ij. to § i. ss.— as a diaphoretic, from twenty to forty drops, adding about ten drops of tinctura opii. Dr. Alston thinks that the virtue of this root resides not in its oil, gum, or resin, but in its peculiar spirit. Later chemists, however, particularly Mr. Lassone and Mr. Henry, of Paris, have shown that ipecacuanha con- tains a free acid of a vegetable nature decomposed by fire, and different salts Avith a calcareous basis. It also contains a small proportion of an elastic gum. The most active part is the resin, though the extractive is by no means without power, in about a double dose. If three grains of powdered ipecacuanha are added to fif- teen grains of jalap, it more certainly aud efficaciously purges; but it also often deceives by producing vomit- ing. - To deceive children 9 i. or 3 ss. of powdered ipeca- cuanha may be infused in half a pint of boiling Avater, adding a little milk and sugar. A tea cup full may be given every ten or fifteen minutes, till it operates; and it will then need nothing to work it off. It might per- haps be better infused with weak coffee, or to this a tea spoonful of ipecacuanha wine may be added. The college also orders the following p'ulvis ipecacua'nh^; compo'situs. Dover's powder. Take of ipecacuanha, hard purified opium, of each, rubbed into powder, one drachm; of vitriolated kali in powder, an ounce. Pharm. Lond. 1788. The dose is from ten to thirty grains ; the former dose containing a -grain of opium. This is very nearly the same as the powder of Dr. Do- ver, and is considered as one of the most certain sudo- rifics in rheumatism, gout, and other diseases where sweating is necessary. 1111 832 IR1 :ce LcAvis's Materia Medica; London Medical Ob- servations and Inquiries, vol. i.; Neumann's Chemical Works ; Woodville's Medical Botany. I'PHION. See Asphodelus luteus. IQUETA'IA. See Scrophularia aquatica. I'RA, (from the Hebrew term chirah). Anger quickens the pulse, and hurries respiration, and for a time increases the tone of the whole system. The sto- mach and boAvels are greatly affected ; and a stricture on the gall ducts is sometimes produced, so that a jaun- dice is the consequence ; though more frequently the gall is determined more copiously to the duodenum, producing disagreeable complaints in the boAvels. An- ger also produces haemorrhages from the nose, the lungs, the vessels of the brain occasioning apoplexy, and the haernorrhoidal vessels, particularly in those who are disposed to these evacuations. During the fit of anger, or its immediate effects, it is said that vomits and purges should be avoided, though few take them in a passion; nor can we see what inju- ry would be produced if they Avere given. Anger, called justly " a short madness," will gradu- ally cool; and should any bad effects be left, they must be treated according to their nature. IRACU'NDUS MU'SCULUS, (from ira, anger). See Abductor oculi. IRI'NGUS, Eryngo. See Eryngium. I'RIS, (from eipu, to show). A rainboav. The forepart of the choroides of the eye, named from the variety of its colours. It lies floating and loose; is convex on the anterior, and concave on the posterior part; the perforation in its middle forms the pupil. The iris, by contracting or dilating, excludes or admits of light in such proportions as the variety of circum- stances may require. Two orders of muscular fibres are found between the laminae of the iris ; one circular, the other radiated, which produce these actions. See Uvea, Choroides, and Circulus arteriosus. The operation of cutting the iris is required when a cataract adheres to it; and when, from the contraction of its muscular fibres, the pupil is closed up, a disease called xynizesis, or caligo pupille, is produced. Mr. Sharp, in his Operations, chap. xxix. directs the operator to pro- ceed as folloAvs : Place the patient as for couching; open and fix the eye Avith the speculum oculi; then in- troduce the knife in the saixve part of the conjunctiva that is Avounded in couching ; insinuate it Avith its blade held horizontally, and the back of it towards you, be- tween the ligamentum ciliare and circumference of the iris, into the anterior chamber of the eye; and, after it is advanced to the further side, make your incision quite through the membrane; and, if the operation succeeds, it will, upon wounding, fly open, and appear a large orifice, though not so wide as it becomes afterwards. Mr. Sharp further observes, that when the pupil is con- tracted from a paralytic disorder, this operation cannot be encouraged. I'ris. A species of rash, included by Dr. Willan in his third order of exanthemata; but we have not yet received his description and explanation. We may find an opportunity of resuming this subject, if the number appears in time. See Cutanei morbi. I'ris, (from the resemblance of its flower to the rainbow). It is a perennial plant, with, long, narrow, sAvord like leaves standing edgCAvisc to the stalk, and large naked floAvers divided deeply into six segments, of Avhich alternately one is erect, and another arched dowmvard, Avith three smaller productions in the mid- dle, inclosing the stamina and pistil: the roots are tu- berous, irregular, and full of joints. (See Erysimum.) It is a name likeAvise of the hedge mustard, hermodac- tylus; a kind of ginger; a species of xyphium, and of a pastil, consisting of alum, saffron, myrrh. I'ris florentina. Florentine orris ; iris Illyrica, and white flower-de-luce, iris florentina Lin. Sp. PI. 55. It is supposed to be only a variety of the com- mon iris ; but its roots are brought from Italy, as supe- rior to our own. They are in oblong, flattish pieces, freed from the fibres, and brownish externally, but Avith broAvnish specks internally, and easily reduced to a fa- rinaceous powder. The root, in its recent state, is nauseous, acrid, and purgative, but loses these qualities by drying. The dry root is unctuous, bitterish, and pungent; the taste not strong, but durable; with a light, agreeable smell, which resembles violets, or rather raspberries; and communicates a similar flavour to spirits and to Avines. As a medicine, the fresh root is a poAverful cathartic; and its juice has been employed in the dose of 3 i. in dropsies : when dry it is a demulcent, and an expecto- rant, attenuating viscid phlegm, and promoting its dis- charge ; but Dr. Cullen considers it as insignificant in this state. When cut in the form of peas it is used for promoting the discharge in issues. In distillation it yields all its flavour to water; its bitter remaining in the extract. Rectified spirit brings over a part, and the extract is bitter and pungent in the mouth. See LeAvis's Materia Medica; Neumann's Chemical Works. I'ris tubero'sa, vel bulbosa. See Hermodactylus FOLIO QUADRANGULO, &C. I'ris fce'tida, spatula felida, xyris, gladiolus feti- dus, SPRUGE WORT, STINKING GLADDON, Or GLADWYN J iris fetidissima Lin. Sp. PI. 57; a wild species of iris, distinguished by a strong smell, found in hedges, &c.: its root is thick, and spreading in the earth, with many fibres, from which spring numerous leaves, longer, narroAver, and sharper pointed than the common iris. The root is diuretic, but seldom noticed. I'ris palu'stris, acorus adulterinus gladiolus luteus, pseudo acorus, pseudo iris, butomus, butomon, yellow water flag; iris pseudacorus Lin. Sp. PI. 56. It is common by the sides of rivulets and marshes; the roots are reddish; several flowers, of a yellow colour, stand on a stalk ; the middle ribs of the leaves are pro- minent. The roots of this species, when fresh, are more acrid, and strongly cathartic, than the former. Eighty drops of the expressed juice, repeated every two hours, have purged, Avhen jalap, gamboge, and mercurials have failed. The root is without smell, but has an acrid styptic taste; its juice in the nose and mouth creates a burning heat, accompanied with a copious discharge,' and is consequently considered as an errhine and sialo- gogue : from its astringency, it has been used in diarr-. hoea; forj making ink, and dying black. To serpigin-; pus eruptions, and scrofulous tumours, the expressed. juice is said to be ah advantageous application. Bergius IRIt 833 IRR observes, that, when fresh, it is ahydragogue; when dried, an astringent: but like the other species, it is too variable in its strength to be received into general use. I'ris latifo'lia tubero'sa. See Zingiber. I'ris vulgaris; iris hortensis nostj-as; iris Ger- manica Lin. Sp. PI. 55; iris purpurea, the common purple iris. Several blue or purple flowers stand on one stalk; their arched segments bearded with a yel- loAvish matter. The plant is a native of the mountain- ous parts of Germany, common in our gardens, and floAvers in June. The roots, when fresh, smell dis- agreeably, have an acrid nauseous taste, and are a strong irritating cathartic. The expressed juice has been given in a dropsy, from two to four drachms di- luted Avith Avater. By gently inspissating the juice it is less active; but, if inspissated to dryness, it loses its purging quality. The dried root resembles in smell and taste the Florentine species. IRRADIA'TIO, (from irradio, to shine upon). See Actinobolysmus. IRREGULA'RIS, (from in, and regularis, regular). A disease anomalous in its paroxysms. IRRITABI'LITAS, (from irrito, to provoke). Ir- ritability ; the vis insita of Haller, vis vitalis of Gorter, oscillation of Boerhaave, tonic power of Stahl, and the inherent power of Cullen. It means that sus- ceptibility to contraction which is peculiar to muscular fibres. We chiefly speak of it when morbidly increas- ed, and in this state it may exist without or with inflam- mation. In the former state it is called spasm; in the latter, it is considered as a symptom only. Parts scarcely sensible or irritable in a natural state, become highly so in consequence of inflammation. Irritability, according to Haller, differs greatly from sensibility; for many irritable parts are not sensible; and organs which are both irritable and sensible have by no means these qualities in the same or any propor- tional degree. The intestines, he remarks, are less sen- sible than the stomach, though more irritable; and the heart is an organ peculiarly irritable, though by no means sensible. In the language of this physiologist, cellular is often considered as synonymous with nervous, and, both in the French and German authors, the cel- lular substance is spoken of as an important organ, of- ten as an irritable one. We have already offered our opinion, that it is merely an insensible connecting me- dium; nor have we been ever able to ascertain that it has any other office, or any appropriate function. The cellular, or rather the membranous parts, he considers as irritable, particularly the ligaments, the periosteum, the dura and pia mater, and the other membranes. The tendons possess, he thinks, no irritability; and, though the smaller arteries may possess this quality, he did not discover it in the aorta- The veins, the excretory ducts, the gall bladder and its ducts, the urethra, and ureters, he found only irritable in an inconsiderable degree; but the glands, the mucous sinuses, the uterus, the genitals, the oesophagus, the stomach, the intestines, the muscles, and particularly the diaphragm, are highly irritable. This principle he supposes to be owing to the mucous matter interspersed among the muscular fibres, and to be Avholly independent of volition. Other authors have attributed irritability to a particular set of nerves not under the influence of the mind. It is VOL. I. certain that it may be destroyed by drying; by coagu lating the ©ily fluids of our system; by opium, bella donna, tobacco, &C. The high reputation of Haller has induced us to en large on his opinions much farther than their real merii Avould require. His experiments were made on ani- mals, often cold blooded ones, and in a state of health He seems never to have looked at the human body in i state of disease, as the source of his observations; but had he done so, he would have found numerous facts in the most decided contradiction to his experiments. N'"< part, not the eye itself, is more sensible than, for in- stance, the membranes when inflamed; no part shoAVs greater irritability, either from passions or the stimulus of a gall stone, than the biliary ducts. The idea, thai irritability is owing to the mucus in the interstices of the muscular fibres, is gratuitous and imaginary. Irrita- bility is a property of life; but by Avhat means does thi> mucus acquire life, and by what function, except this fancied one, does it shoAv any vital poAver? The existence of different sets of nerves giving irritability i> Avholly imaginary, Avithout the slightest support from anatomy. Irritability, as inseparable from life, must be con- nected with the nervous power; but the nerves, Ave know, are not irritable. It must then owe its existence to the nen-ous influence, or the muscular fibre must differ from the nervous by some peculiar organization on Avhich this property depends. There is little doubt of the muscular power depending on organization; for the muscle differs only from the tendon in structure. The fibres pass on, and may be traced from one to the other. Organs, at first in a great degree muscular, be- come, by age, more tendinous; so that, in the latter, the fibres are apparently more compacted, in fact, of an organization essentially different. Is then the mus- cle Avholly nervous, or an organ only excited to action by nerves? Dr. Cullen thinks it wholly nervous, and calls muscles the 7noving extre7nities,in opposition to the sentient extremities of nerves; and the Aveight of evi- dence is strongly in favour of this opinion. We have said that we know of animal matter but in two forms, fibrous and cellular substance, more or less condensed. The fibrous seems exclusively nervous, and the nerves are closely compacted as in membranes, or more loosely organized in muscles. It is equally difficult to under- stand the construction of muscles, whether we supposed them nervous, or animal matter of any other kind. Though Ave cannot ascertain the structure of the or- gans possessing irritability, we may shortly mention the laAvs by which it is regulated; and we shall find them so analogous to those of sensibility, that there will be little difficulty in recognizing the source to be similar. Irritability, like sensibility, is exhausted by exercise, and recruited by sleep; but, unlike sensibility, its ex- ertions are alternated by relaxation. It is probable that the nerves in the muscular organs are in a higher state of excitement than in the sentient; for muscular organs are constantly, in a certain degree, exerted in order to counteract the antagonizing muscles, but unless the action is occasionally remitted, it is spon- taneously relaxed. This constant state of tension is called the tonic power, and is in proportion to the ge- neral excitement. It presupposes irritability, in con- sequence of organization, which has been called the 5 O IRR 834 ISC inherent power, and is probably the same Avith the ner- vous power of physiologists: it must be so if muscles are only the " moving extremities of nerves." Irrita- bility, as a morbid affection, however, implies a very different state, and has been styled mobility, a suscepti- bility of action from slight and otherwise ins. fficient stimuli; and this susceptibility, connected generally Avith debility, is more readily alternated with relaxation producing convulsions. Irritability, as we have just remarked, is exhausted by exercise, and it may be suddenly destroyed, so as to kill; for a flash of lightning will at once extinguish it in every organ. It is, howeArer, recruited by rest, and, as modern physiologists, with some reason, have sup- posed, accumulated so as to occasion increased action. Many of the facts adduced may, however, be resolved into the effects of custom-; for, when given actions are excited by a weak stimulus, a common power becomes, in comparison, inordinate. Thus the iris, accustomed to contract in the gloom of a dungeon, feels the com- mon daylight as painful as the glare of a noon day sun would be to a person who has never been confined. This leads us to remark, that the irritability of each organ has specific stimulus, by Avhich only it is ex- cited. Ipecacuanha does not irritate the eye; and the acrid urine or bile excite only pleasing and healthy sen- sations in their appropriate organs; but in the brain produce phrenitis, or in the stomach, vomiting, Avith faintness, cold sweats, See. In general, muscles which act more slowly and regularly, preserve their irritability longer than those Avhich act with violence; for in these the irritability is apparently supplied as fast as it is ex- pended. A certain degree of action, we have remarked, must be kept up in all muscles, to preserve their irrita- bility, or rather the tonic power. Beyond, irritability is exhausted; beloAV the due point, it is lost; and this point differs in alniost all the different organs. Each has its appropriate action, which it can bear without injury, or even with advantage; and the irritability of each is exhausted "more rapidly, in proportion to the continued action which it exerts. The voluntary muscles can bear a very considerable increase of action, because it is temporary: the involuntary ones, Avhose action must continue, soon lose their irritability after a short in- crease. See Nerat; Musculi; Irritatio, and Ce- rebrum. Haller on Sensibility and Irritability; Whytt's An- sAver to Haller; the Difficulties in the Modern System of Physic, Avith Regard to the Sensibility and Irrita- bility of the Parts of the Human Body, by De Haen; Kirkland on the Brain and Nerves; on the Sympathy of the Nerves, and of different Kinds of Irritability; Cullen's Introduction to the Materia Medica. IRRITA'TIO, (ab irritare). Irritation is a term to which different meanings have been affixed, and this has occasioned some confusion among pathologists. The most obvious idea of irritation is the action of a mechanical or a chemical acrid, as a thorn under the skin, or the effluvium of ammonia in the nose. Similar irri- tation is the effect of poison in the habit, as of cantha- rides; of altered secretion, as in gonorrhoea; of unnatu- ral contents in the stomach, as in heartburn. Irritation, however, is discovered by its effects, when not obvious to the sense, as in cases of scirrhi, Avorms, ossifica- tions, or extravasated blood; and, independent of these, a peculiar state of the excitement of the nervous poAver occasions the most common impressions to become the source of pain and uneasiness. This state of excite- ment is sometimes OAving to inflammation, which acts in a manner Ave shall aftenvards explain (see Nervus and Tonus); sometimes to latent sources of irritation in the brain, sometimes perhaps to a change in the slate of the nervous power itself. We can no otherwise explain the effects of an east wind on some hypochondriacs, or a particular state of electricity of the air on persons peculiarly susceptible of its effects. We have already had occasion to remark, that priva- tions sometimes occasion what are called symptoms of irritation. Thus hunger produces restlessness and anxie- ty; the want of the degree of tension, either from exter- nal pressure or internal fulness, from the sudden empty- ing of any cavity, will occasion uneasiness, which has been styled a symptom of irritation. Internal feelings of this kind are sometimes opposed to pain; and the pe- culiar sinking in atonic inflammations, has been styled also a symptom of'irritation, not, perhaps, with perfect propriety,but with sufficient distinctness when explained. The effects of irritation are generally increased ac- tion; and, in the animal-system, privations are, by an unaccountable solecism, considered as positive causes of increased action. This loose, illogical language arises from a want of distinction between increased and irregular action; for in spasms produced by causes de-, structive of life, in convulsions closing the last scene of mortal existence, it would be absurd to say that action, Avhich ahvays implies energy, is increased. We have already shown that in all these instances the power is diminished, and the action, in consequence, irregular. See Convulsions and Inirritantia. IS, (is, a fibre,) its plural is ives. Hippocrates, and other writers, have used this term for both a fibre and a nerve. I'SAROS. See Arum. I'SATIS, (from io-x^u, to make even, from its poAver in reducing tumours). Sativa latifolia; tinctoria. Woad. See Glastum. I'satis I'ndica. See Indicum. ISATO'DES, (from isatis, and eifos, likeness). Of the colour of woad. I'SCA, (ir%x). A fungous excrescence of the oak, or of the hazel. The ancients used it as the mpxa. See Moxa. ISCHuE'MON, (from <«•#*>, to restrain, and xipx, blood). A name for any medicine which restrains or stops bleeding. IsCHiE'MON SATl'vUM. MANNA GRASS. See GrA- MEN. I'SCHIAS , (from. isx'-ov, the hip). A name of a rheumatic affection of the hip joint, called the sciatica or ischiadicus 7norbus, and of tAvo crural veins, one of which is called the greater, the other the less. See Cruralis vena. ISCHIA'DICUS DO'LOUR, (from the same). See Arthritis. ISCHIA'DICUS MO'RBUS, (from the same,) also called ischias,sciatica, coxe dolores. Aretaeus ranks this disorder as a species of gout, " which comes," he ob serves, " on the hind part of the thigh, the ham, or the tibia; at other times attacking the acetabulum of the os femoris, and then the buttock and loins, seeming to be ISC 835 ISC any thing rather than a sciatica." Dr. Cullen ranks it as a synonym with rheumatismus. The sciatica is sometimes seated in the tendinous ex- pansion which covers the muscles of the thigh, occa- sionally, it is supposed,in the coat of the sciatic nerve. In the last case the pain is more acute and violent, attend- ed with a numbness ; a symptom easily accounted for. Its most common seat, however, is in the muscles, or in the capsular ligament; and it is then either rheuma- tic or gouty. The two former species cannot be distinguished ; nor do they admit of any peculiar treatment. In general, the disease must be treated as a rheumatism of the chronic kind, to which we refer. (See Rheumatis- mus.) There are, however, some modes of relief sup- posed to be peculiarly useful in sciatica, which we must mention in this place. That recommended by Fo- thergill, consists in giving a grain of calomel every night, washed down with a draught containing twenty-five drops of tincture of opium, and thirty of antimonial Avine. If not relieved after ten doses, the quantity of calomel is to be increased to two grains every alternate night. Other authors have recommended the ethereal spirit of turpentine, which is a very efficacious medi- cine, if united with honey, by gently melting over a slow fire ; and in this way the dose may be increased to thirty or forty drops. We have found the combination of mercury and antimony, in the form of Plum- mer's pill, with the Lisbon diet drink, frequently suc- ceed Avhen every other medicine has failed; but these remedies we shall again mention when speaking of rheumatism. The ischias nervosa of Cotunnio is supposed by this author to be owing to a fluid distending the sheaths of the nerves, and irritating the nervous fibres. The pecu- liar treatment suggested by this opinion is the applica- tion of a blister immediately under the knee joint, on the inside of the leg, as Avell as to the hip ; as near the knee the blister affects more particularly the nerve in the neighbourhood of that part. There is little doubt •of the existence of a sciatica not attended Avith any striking inflammatory symptoms ; but of the peculiar cause assigned by Cotunnio we can find little support from observation or dissection. See Culleni Nosologia Methodica. Richter speaks of some cases of the ischias ner- vosa being successfully treated by blisters often repeat- ed, and sudorifics. In one instance, the blisters were ap- plied on different parts where any pains were felt in succession: the sudorifics were first crude antimony, the stipites dulcamarae in pills, and the warm bath for six days; on the seventh, a powder composed of camphor, ipecacuanha, and opium, was given, preceded by a tepid bath ; the bath was continued till the foot became cede- matous, and then left off; the other remedies were still pursued, which, in about six weeks, completed the cure. The symptoms were, pains in his arms, shoulders, and back, which settled about the hip joint, continued fixed, and increasing till the patient could not Avalk; the whole limb became shorter; the pains extended from the hip joint down to the foot; he felt as if ants were running about in the foot; and was totally unable to move the limb to cither side, which, in other respects, was Avarm, and properly nourished. A lady and a young man were cured by the application of burning cones and blisters ; on which he remarks, that from this method nothing is to be expected unless in such kinds of lameness as pro- ceed from the metastasis of any stimulating matter. where the lameness is accompanied with pains in tlu- suffering limb, and chiefly the hip joint; and this mor- bific matter he thinks rheumatic or gouty; though, in some cases, he had reason to believe it Avas scrofulous. See his Medical and Surgical Observations, p. 169. These cases,hoAvever,by no means support Cotunnio\s idea of the cause. They are instances only of chronic rheumatism, though pains in the hip joint are, as he re- marks, sometimes scrofulous, and occasionally,Ave think, of a cancerous nature. I'SCHIAS EX ABSCE'SSU, (from io-xiov, the hip). See Arthropuosis. I'schias sparGano'si. See Lymphaductus. ISCHIATOCE'LE, (from <*£/*t<»?, the genitive of io-X'xs, and xvXti, rupture). Intestinal rupture through the sacro-sciatic ligaments. ISCHIOCE'LE. A rupture betAveen the os sacrum and the tuberosity of the os ischium. I'SCHIO-COCCYGjE'US. See Coccygeus ante- rior. I'SCHION. The ligament which retains the head of the thigh bone in the acetabulum coxendicis. I'SCHIUM, os, (because it lies near i^x's, the loin). Coxendix cochone; the hip bone. The extent of this bone may be marked by a horizontal line drawn through near the middle of the acetabulum coxendicis ; for the body of this bone forms the inferior portion of the acetabulum. The great tuberosity on which Ave sit, as it advances fonvards, becomes smaller, and gives origin to the corpora cavernosa, and the erectores penis or clitoridis ; then the bone mounts upwards Avith a considerable curve, and is stretched out into its small leg. It forms the lower part of the pelvis. The tubero- sity is large and irregular, covered apparently Avith a cartilage, which is in reality the tendinous fibres of the muscles inserted into it. Between the spine and the tu- berosity is a cavity on which the obturator muscle plays, as on a pulley, defended by cartilage. The ramus of this bone, Avhich passes fonvards and upwards, makes, with the ramus of the os pubis, the foramen magnum ischii. ISCHNOPHO'NIA, (from itxvos, slender, and s, slender). Leanness. ISCHURE'TICA, (from ivxvpix, a suppression of urine). Medicines that remove a suppression of urine. ISCHU'RIA, (from i. Rob bacc. juniperi ^ ij. dilue in aq. juniperi simplicis Jfe ij. spiritus juniperi ^ ij. et ad sitim sedan- dam, sps. aetheris nitrosi z ss.: m. dosis cochl. ij vel iv. tenia hora. The infusion of the berries, either alone, or mixed with a little gin, is in dropsies a very useful drink. In uterine obstructions, scorbutic affections, and cutaneous diseases, the juniper is said to have been useful; but in the two last complaints the wood and tops have been preferred. The essential oil is an ac- tive stimulant, a warm carminative, an useful diuretic, and a deobstruent. Doses from ten drops to thirty. The Avood of the juniper tree is sudorific, and of simi- lar qualities with that of guaiacum and sassafras, but inferior to either. Juni'peri gu'mmi. The resin obtained in warmer climes, particularly in Africa, is semipellucid, and of a pale yelloAvish colour; it is in small masses, resembling mastich, but larger; the sandaracha of the Arabians and the gum juniper of the shops. From its use it has been called vernix, and the poAvder is employed to pre- vent ink running on paper, under the name of pounce. This resin hath a light agreeable smell, and not much taste. It dissolves in rectified spirits, if violently shak- en in them; and in oils both expressed and distilled, but is insoluble in water. See Lewis's and Cullen's Materia Medica. Juni'perus. A name of several species of cedar See Cedrus folio Cypri, and Cedrus Phcenicia. Juni'perus Ly'cia. See Olibanum. Juni'perus Sabi'na. See Sabina. JUPICA'NGA. See China occidentalis. JUPITER. See Stannum. JUS, (because in families it was distributed in just proportions). Broth; brodium. Broths made of the lean parts of beef or mutton are very nourishing; in weak worn out constitutions strong broths cannot be digested, and their strength should always be propor- tioned to the digestive powers. JUSTI'CIA. See Adhatoda. JUVA'NTIA, ADJUVA'NTIA, (from juvo, and adjuvo, to assist). Medicines or aliments that assist, op- posed to ladentia, such as injure. When the nature of a distemper was doubtful or unknown, the ancients prescribed some innocent medicines which they were well acquainted with, and according as they were ser- viceable or otherwise, though in a small degree, they formed some judgment of the future method of pro- ceeding. These approximations were technically styled juvantia and ladentia. JUVE'NTUS, (from juvo, to help, because at this period of life persons began to be useful). See .Etas. JUXTANGl'NA, (from juxta, near, and angina, a quinsy). A species of quinsy. See Paracynanche. 845 K AL .IjLAA'TH. (See Terra Japonica). Even in a very late work, the Dictionary of Natural History, it is said to be the inspissated juice of the barleria hystrix, probably the b.prionitis Lin. Sp. PI. 887, brought to a greater consistence with farina and saw dust. KABOLO'SSA. See China occidentalis. KA'DAL. This shrub groAvs in the East Indies, and is probably the melastoma malabathrica Lin. Sp. PI. 559, though greatly resembling in habit the osbeckia chinensis. The fruit, Avhen ripe, is eaten, and calicoes, are dyed with the juice. KADA'NAKU. See Aloes hepatica. KiEKU'RIA. See Elemi. K./EMPFE'RIA ROTUNDA. See Zedoaria." KA'HA. See Curcuma. Kara mou'llon, kaha mullu. An East Indian siliquose tree. The bark is boiled in milk, and is said to cure a diabetes and gonorrhcea. Raii Historia. Kara nia'ra. An East Indian tree, the leaves of Avhich destroy worms. See Raii Historia. Kaka-to'ddali. Paulina Asiatica Lin. Sp. PI. 524. A small shrub growing in Malabar, used in va- rious disorders, from a redundancy of serum. Raii Historia. KALENZI-KANSJA'VA. See Bangue. KA'LI, (Arabic,) salsola, salicornia, alga marina, SALT WORT, and SNAIL SEEDED GLASS AVORT. Salsola kali Lin. Sp. PI. 322, a plant with spreading, reddish, pretty thick branches; oblong, narroAv, pointed, fleshy leaves, like those of horseleek; flowers imperfect in the bosoms of the leaves, followed each by one seed spirally curled, and inclosed in the cup. It is annual, grows wild on the sea coasts in the southern parts of Eu- rope, particularly of the Mediterranean. The herb is juicy, bitterish, and remarkably saline. The expressed juice, and infusions, or decoctions of the leaves, are said to be poAverfully aperient and diuretic, and been much recommended in dropsies; but the kali is principally regarded on account of its yielding copi- ously the fixed alkaline salt, called soda; and it is culti- vated about Montpelier: for this purpose it is perparcd at Alicant, in Spain, from a different species of kali. Different marine plants contain this salt, and Avhat is made in Scotland and Ireland is called kelp. See Wood- ville's Medical Botany, p. 387,388. K AL From the quercus marina, or fucus vesiculosus, fucus maritimus, alga marina, sea oak, sea wrack, or sea tang, much alkaline salt is obtained by incineration : the juice of its vesicles, left to putrefy, yields on evapo- ration a portion of acrid pungent salt. The plant is a soft slippery one, common on rocks that are left dry at the ebb tide ; the leaves resemble those of the oak tree in shape, the stalks running along the middle of the leaves, and terminating by Avatery bladders, containing either air or a mucilaginous matter. The vesicles begin to fill in March, burst about the end of July, and discharge a viscid matter. If the putrid juice is applied to the skin, it sinks into it immediately, excites a slight sense of pungency, and deterges like a solution of soap. One of the best appli- cations at the decline of glandular swellings, for per- fectly discussing them, is a mixture of the juicy vesicles on the leaves of this plant, gathered in July, with an equal quantity of sea water : they should be kept in a glass vessel for ten or fifteen days, until the liquor be- comes of the consistence of thin honey. The parts af- fected are to be rubbed with the strained liquor two or three times a day, and afterwards washed clean with water. A cataplasm of the quercus marina, made by bruising a quantity of this plant, is applied externally in cases of scrofula, Avhite swellings, and other glandular tu- mours. Sea-Avater and oat meal formed into a poultice sometimes supply its place. The salt here described is, in strict language, the soda or natron, the mineral alkali; but, in general, every al- kaline salt has the same title, and the chemical, as well as the medical properties, are the same. Their affini- ties also differ very little; but as an external application in glandular swellings, the salt from the sea plants is pre- ferred. See Alcali and Cineres clavellati. Ka'li arsenica'tum. Arsenicated kali. Let equal quantities of arsenic and purified nitre be pow- dered and well mixed together, put into a retort, and placed in a sand bath, the heat of which is "to be In- creased gradually, until the vapours cease to issue from the mouth of the vessel. The mass must then be dis- solved in four pounds of distilled water, a proper quan- tity of which must be evaporated, and the residuum set aside to crystallize. Dose, one fifth of a grain three times a dav. This is used for the same purpose as the K All 846 KIN &olutio arsenici. See Intermittens febris, and Cancer. Ka'li, vice Sal absi'nthii. See Alcali, and Ci- neres CLAVELLATI. Ka'li aceta'tum. See Sal Diureticus. Ka'li PRiEPARA'TUM. See Alcali. Ka'li tartariza'tum. See Tartarum. Ka'li pu'rum, or fixed vegetable caustic alkali, is prepared by evaporating a gallon of the water of pure kali to dryness, and afterwards melting it by fire. Ph. Lond. 1788. This salt is deliquescent, which renders the application very inconvenient, unless joined with quick lime. See Causticum commune fortius. Ka'li sulphura'tum. Hepar sulphuris. Take flowers of sulphur one ounce, kali five ounces; mix the salt Avith the sulphur melted by a slow fire, by constant stirring, till they perfectly unite. Ph. Lond. 1788. The dose is from five grains to a scruple. In tetters and other cutaneous affections this salt has been recom- mended. It has been employed, dissolved in water, as a bath for the psora : and in cases of tinea capitis it has often been used by way of lotion, and has been strongly recommended to prevent the effects of mineral poisons. For the alkaline neutrals see Chemia. Ka'li a'qua is the kali which has deliquesced in a moist place ; and it does not differ from the kali prae- paratum. Ka'li pu'ri a'qua. Take of kali four pounds; quick lime six pounds ; distilled water four gallons ; add to the lime four quarts of water, and let them stand for an hour; then add the kali, and remaining part of the water; boil them for a quarter of an hour; let the liquor cool, and strain it: a pint of this fluid ought to weigh sixteen ounces. If the liquor raises an effer- vescence by the addition of any acid, more lime must be added. An earthen or glass vessel should be used, and the liquor strained through linen. Pharm. Lond. 1788. KA'MSIN. The hot winds blowing over the burn- ing sands of the desert, and reaching Egypt about the period of the equinox. The fatal effects of this wind are in part owing to its containing a considerable pro- portion of inflammable air, probably from the decom- posed water, and in part from its great heat and dry- ness. The effects of the Samiel of the Desert, a wind nearly resembling the kamsin, is described with great pathos and eloquence by Bruce. See Volney's and Bruce's Travels. KANE'LLI. A name of two East Indian evergreen trees, the flowers of which are used in diarrhoeas; but they are not found in the systems of the botanists. See Raii Historia. KANNAGHO'RAKA. See Carcapuli linco- TANI. KAOLIN. One of the ingredients of the Chinese porcelain, probably a growan clay, or a decomposed granite. KA'PA MA'TA. See Acajaiba. KA'RATAS. The penguin, or wild ananas; common in the West Indies, as an acid in punch, but too austere to be swallowed alone. The karatas of Plumier is,hoAvever, a different species from thepinguen of Dillenius. Each, however, is a species of bromalia, and each an American plant See Lin. Sp. PI. 408. KARE'MYLE. See Orobus. KA'RFE, (karfeh, Arab). See Cinnamomum. KARIN-TA'GERA. An evergreen tree in Mala bar; it resembles an hazel. The oil from the root pre vents the hair from falling off. Raii Historia. KARI-VE'TTI. A tree in Malabar; the juice of it- leaves is emetic. Raii Historia. KA'RVA, (karvah, Arab). See Cassia lignea. KA'TKIN. See Amentacei flores. KATO-COL'LIA. The abdomen. See Ccelia. KELP. Mineral alkali. See Kali, Alkali, and Chemistry. KE'NNA. See Ligustrum Indicum. KERATOPHY'TON, (from xepxs, a horn, and cf>v7ov, a plant ;beeause it is pellucid). Lithophyton. The name of a submarine plant, transparent, of a viscid con- sistence, and often covered with a cretaceous crust,some- times of elegant and various, colours. The only species which possesses any medical virtue is the corallium nigrum, q. v. and these are very inconsiderable. KE'RMES, (Arabic term chermah). See Chermes. Ke'rmes mineralis. See Antimonium. KE'RVA, OL. (kervah, Arabic). , See Cataputia. KE'TMIA. The leaves and flowers resemble those of mallows; the fruit is divided into many partitions, the top of which opens when ripe, and discloses many- seeds. All the species, except those Avhich taste like sorrel, agree in virtues Avith mallows. The genus called ketmia by Tournefort, is the hibiscus of Linnaeus. It is of little importance to ascertain any species, as none ex- cept theABELMoscHus, q. v. has any medicinal quality. KE'TRAN. See Cedria. KEYSE'RI PI'LULjE. Keyser's pills, (from the inventor's name). According to an account in the Edinburgh Medical Commentaries, they consist of pure quicksilver, reduced to a red calx by a proper degree of heat, which, being dissolved in eight parts of vinegar, is to be mixed with manna, of which two pounds will be required to each pint Of the solution. This com- position being dried gently by the fire, is rolled into pills, and recommended as the most effectual remedy of all the mercurial preparations against the venereal dis- ease. See Argentum vivum. Mr. Keyser adds a singular remark; if to the solution of a pound of the red calx, in eight pints of vinegar, two pounds of mercury, in the metallic state, be added, a substance will arise, by agitation, to the surface, in the form of cream. If this be taken off, more will rise on every successive agitation. This cream, united with manna, he supposes to be highly useful in recent vene- real complaints. KIBES. An obsolete name for the heel, and conse- quently for chilblains, which usually affect the heel. See Pernio. KI'K/or KI'KI, (from kike, Arabic). See Cata- putia. KIKEKUNEMALO. A gum resin, whose source Ave are not acquainted with. It has a subacrid resinous taste, and has been supposed an useful resolvent, as well as beneficial in nervous diseases. KILBURN WATERS. A bitter purging water. See Aqu.e minerales. KI'NA-KI'NA, (from the countess of Cinchon). See Cortex Peruvianus. KOL 847 K YN Ki na-ki'na aroma'tica. See Thuris Cortex. KI'NKINA EUROPjE'A. See Gentiana. KI'NO, (Indian). See Gummi rubrum astrin- gens. KIPPAKELE'NGU. See Battatas Hispanica. KIRIBU'NNAWELL. See China occidentalis. KNA'WEL. Ray. Tournefort calls it the chame- linum vulgare folio glabrofiosculis plurimis. German knot grass. Scleranthus perennis Lin. Sp. PI. 580. It is somewhat astringent, but never employed in me- dicine. KO'LERUS. A dry ulcer. KO'LTO. See Plica polonica KRAUT SAU'ER. Pronounced by the English sour krout. See Brassica. KRIE'BEL KRA'NKHEIT. See Raphania. KRI'MNA. See Alphita. KURU'DU. See Cinnamomum. KUTU'BUTH. An Arabian name for a Avater spider^an insect perpetually in motion. Hence the name hath been transferred to a species of melancholy, called by Sennertus melancholia errabunda. See La CANTHROPIA. KY'MIA. See Cucurbita. KY'N'A. See Opoponax. 348 LAB JLiABA'RIUM, (from labo). Looseness of the teeth. LA BD A NUM. See Ladanum. LA'BEO, (from labium, a lip). See Chilon. LA'BIA. See Processus. La'bia, and la'bium, (xro rev XxSeiv, quo appre- hendimus cibum). A lip. The lips, of which the red part is called prolabium ; the sphincter, orbicul&ris labi- orum, are sufficiently known. When the cuticle here called epithelium is taken off, the appearance of the parts beneath is villous. La'bium lepori'num. The hare-lip ; rostrum, la- bellum, and labrwn leporinum ; lagosto7na ; lagocheilos, consists in a division in the upper lip, from a loss of sub- stance, like that of a hare. The division sometimes re- sembles the letter M, and is then called the double hare- lip. A similar fissure in the under lip is called the spu- rious hare-lip; but this seems never to have occurred. An operation is required, in which we must first di- vide all its adhesions internally with a scalpel, and with a straight pair of scissors, or rather with a sharp scalpel, as the scissors bruise the parts, cut off the callous edges, so as to make an angle at its upper part. The operator must then pierce the upper end of the divided part with a silver pin, armed with a steel point, at about one third of an inch from the edge of the wound ; bring the point nearly to the bottom of the sore, and raise it again through the surface at the distance of nearly one third of an inch. A thread must be next passed across each end of the pin, to draw the lips of the wound together, and like a figure of eight. Another pin is passed through the middle of the lip in the same Avay, and a third near the other extremity of the fissure. The wound is secured by thread in the same manner, round each pin, and the steel points, which usually fasten by screws, are, taken off. A pledget of digestive over the whole will keep the thread soft. Mr. Pott observes, that when the hare-lip is double, it sometimes happens that the middle portion contracts, and the bone projects. In this case, the projecting bone must be removed by means of a chisel; the contracted part of the lip then brought down and detained by a bandage. The operation is afterwards performed as in the single hare-lip, suffering each side to be thoroughly healed before the subsequent operation, is attempted. The pins should not be moved before the sixth or seventh day, and then the stitches must be first cut, to see that the flesh is securely joined before the pins are LAI* moved. When a part of the bone is cut away, the wound must be healed previous to the operation on the lip. See Le Dran's Operations; Heister's Surgery; Sharp's Operations; Bell's Surgery, vol. iv. p. 149; White's Surgery, p. 269. La'bia pu'dendi, cremnoi, labra, arise from the mons veneris, and extend from the fore part of the pubes, whose symphysis is exactly between them, to within a short distance from the anus. They are more prominent, and thick above than below^ composed of skin, cellular membrane, and fat; red within, and out- wardly, about the the age of puberty, covered with hair. The angles of the labia, above and below, are called com7nissure. LABIA LES ARTE'RIA, (from labia, lips). See Maxillaria arteri*. Labia'les glandulje. The labial glands. The membrane which covers the inside of the lips is a con- tinuation of that on the cheeks, perforated by many small holes, which answer to the same number of small glands. See Winslow's Anatomy. LABIA'TUS, (from labia, a lip). See Flos la- BIATUS. LA'BIS, (from Xx^xvu, to lay hold of.) Any for- ceps. LA'BIUM. See Labia. LA'BOUR. See Parturitio. LABRISU'LCIUM,(from labrum, a lip, and sulcus, a deep sore). A chap in the Lip, cheilocace; gene- rally attending swollen lips, and common in scrofula. It usually requires the treatment necessary in that dis- ease; but, as a temporary relief, may be rubbed with the oleum cerae, or with the oleum amygdylarum and spermaceti. This also is the name given to the can- crum oris. LA'BRUM, (xro rov XxQetv, from its power of re- ceiving). See Dexamene. LABRU'SCA, (from labrum, a lip; so called be- cause it groAvs on the sides of fields). See Bryonia ALBA. ^ LABYRI'NTHUS, (XxGvpivb®*). ,The labyrinth. The second cavity of the ear, fodina, lies in the pars petrosa of the temporal bone, which runs forward and inward. It is an oblong body, divided into three parts, called the vestibulum, the cochlea, and the semi- circular canals. The vestibulum (in which the stapes stands) is situated in the middle; the cochlea is the LAC 849 LAC anterior, and lies fonvard and imvard; and the semicircu- lar canals, which compose the posterior part, lie back- ward and outAvard. The three parts of the labyrinth are lined by a fine periosteum, Avhich spreads over, and shuts the two .fenestras of the tympanum. LAC, (from lakak, to lick up, Arabic). Milk is the secreted fluid destined for the nourishment of the ani- nutls arranged by Linnaeus in the class of mammalia, comprchenclingalso, from this circumstance, the cetacea. It is a Avhite, opaque fluid; and, Avhen viewed with a microscope, globules, like those of the blood, appear to swim in it. It is, therefore, most certainly, not an homogeneous fluid, Avhose parts are chemically united, but an heterogeneous one simply mixed. Its resemblance to the blood is striking; and as it is of the colour of the chyle from which the blood is form- ed, it Avas an obvious suggestion that the milk was only chyle again separated from the general mass. Chyle has not, however, been sufficiently analyzed to support or confute this idea. It appears, on the whole, impro- bable, since sugar contains a saccharine matter, and par- ticularly a larger proportion of phosphorated lime than any of the other animal fluids. To which may be added, that milk requires the digestive process as well as other nourishment; and it is never apparently assimi- lated until it has been coagulated. Milk was probably the food of the earliest inhabit- ants of the globe, since their herds, of which their riches consisted, must have afforded an obvious supply of this delicious nourishment. Cheese seems to have been known more early than butter, for it was of im- portance to preserve a supply of food when the milk of the herds would, at least lessen, if not disappear. Butter is obscurely hinted at by Herodotus, but de- scribed more particularly by Hippocrates : each author speaks of the art of making it as being derived from the Scythians. When first draAvn, milk has a faint smell, generally mixed Avith that of the animal which afforded it. This aroma is soon lost on exposure to the air, and much of the delicacy, perhaps the salubrity, of the fluid, seems to disappear Avith it. The sAveetishness, how- ever, remains, but is in different degrees in different animals, depending on the proportion of sugar which it contains. The sAveetest milk is that of the sheep. When milk is at rest, first the aroma disappears, and soon afterwards the surface assumes a yellower colour, and a thick tenaceous scum called cream rises to the top. When this is separated, the milk is of a bluish white colour; and, on standing longer, the curd or cheesy part separates. An oily substance fonns a portion of the milk when first drawn; but the consistence of cream is owing to its imbibing a portion of oxygen from the air; and the curd does not spontaneously sepa- rate till the acid fermentation begins. It is separated, artificially, by a variety of substances, as all the acids, except the carbonic, and the weaker kinds similar to it; by different vegetables, as the galium, the vallantia cruciata, the madder, the bark, and, apparently, other vegetable astringents; by some animal substances, as the stomach of a young animal, hoAvever carefully washed and dried, the livers of turkeys (Spallanzani), 8tc. Jacquin, in his Elements of Chemistry, tells us, that the vegetables only act when cold, or in cold in- fusions. When boiled in milk, or boiling decoctions of the same plants are added, coagulation is retarded VOL. i. rather than hastened. Milk is coagulated also by salts, particularly such as contain an excess of acid, as the cream of tartar; benzoic and succinic salts; by metallic solutions; by alcohol, and all spirituous li- quors ; though the addition of camphor or borated soda will, it is said, prevent this effect Avhen either is dis- solved in alcohol. In every instance, however, the coagulation is firmer and more perfect with the assist- ance of heat. The alkalis Avhich are said to coagulate milk unite in reality Avith the oily part, and produce a soap, Avhich seems to entangle, occasionally, some of the curd. These flocculi, for such is their form, become succes- sively, by boiling, yelloAV and brown. Pure alkalis render the milk more fluid, by equally dissolving the oil and the curd. Lime water seems to procure an im- perfect coagulation. Milk, when urged by heat, gives up its oily portion, which forms a dense pellicle; and that part of it which touches the sides of the heated vessel burns, and gives the whole an empyreumatic taste. If this is prevented1, the serum procured is thin and pure. If, hoAvever, the heat is more violent, an insipid water comes over, fla- voured with the aroma of the milk, which soon be- comes putrid. The remainder is an extract, which, with warm water, again becomes milk, though Avithout the aroma. If this extract be exposed to a strong heat, an empyreumatic acid oil, ammonia, hydrogenous and carbonic acid gases come over. The remaining coal affords kali, muriated kali, phosphat of lime, and occa- sionally a little iron. When left untouched, milk undergoes the acetous fermentation at different periods, according to the heat of the weather and the nature of the animal. In Avarm Aveather, and in ruminating animals, this change is soonest observed. Mare's milk continues longest unal- tered. The tendency of milk to the acetous fermenta- tion is checked, it is said, by boiling. If milk in a moderately warm place be frequently stirred, no separation occurs, and the vinous fermenta- tion comes on. The greatest quantity of spirit, it is said, Avill be afforded by cow's milk, though that of the mare, as the most saccharine fluid, ferments soon- est; and the Tartars prefer it, as affording also more spirit. The putrefactive process comes on slowly. Stipriaan (Memoires de la Societe de Medecinea Paris, 1787-8) informs us, that cow's milk shoAved no signs of putridity after four summer months, asses milk three months, and female milk nearly an equal time. The cream, we have said, is the oil, which has ac- quired a greater consistency by its union Avith oxygen. In the form of butter it is still more intimately united with this principle, and a chemical union apparently takes place as heat is excited. In general, the cream is suffered to rise spontaneously, but in the West its separation is assisted by heat. The milk is put in shal- low earthen pans, and remains in them twelve hours in summer, and twenty-four in winter. The pans are then placed on hot stoves, and the temperature raised, so as to be scarcely short of boiling. On the first ap- pearance of bubbles the pans are removed, and remain at rest twelve or twenty-four hours longer, according to the season. This cream, styled scalded or clotted, is generally agitated by the hand in making butter, and the churn is onlv usedAvhen the raAV cream is employed. LAC 850 LAC The thickest and richest creams are afforded by the sheep and goat; the milk of the mare, the ass, and the female, afford the thinnest. From female milk scarcely any separation takes place, even with the assistance of heat. The fluid separated in making butter is called buttermilk. It is the serum, enriched with some of the oil of the cream. The curd is a true albuminous substance, without smell or taste, nearly insoluble in water, hardened in hot water, soluble in acids, forming, with the vitriolic and marine, brown solutions; with the nitrous a yellow. It is easily dissolved by alkalis, but most powerfully by the mineral; and, when this is pure, during the solu- tion, a volatile alkaline smell arises; a fact not suffi- ciently noticed, and which will admit of some applica- tion. In distillation, an insipid water comes over that easily putrefies; and the remainder, on increasing the heat, blisters, like burnt horn, affording hydrogenous and carbonic acid gas, ammonia, a heavy fetid empyreu- matic oil. The coal contains lime and phosphat of lime. When exposed to a strong heat, in an open fire, curd softens and melts; becomes transparent and tough ; and, when cold, is hard and brittle. The curd of goat and cow's milk is solid and elastic; that of the ass's and mare's milk less solid; of the sheep merely glutinous ; of the female generally fluid, and with difficulty separated. See Caseus. The Avhey is similar to the serum of the blood. The whey separated in making cheese is a watery fluid, without any admixture of oil; but, in its usual state, some of the oily, and some of the albuminous portion are diffused through it. Sweet whey affords sugar of milk: when the milk has been previously sour, it is styled sour whey ; and, by adding a small portion of spirit of wine, and subjecting it to a fresh fermentation, a true vinegar of milk may be prepared (Jacquin). The spirit of milk is apparently not developed till it be- comes acid; the Tartars hasten the acetous fermentation by the addition of oatmeal, and do not distil it till it is strongly sour. Thus milk holds a middle place between animal and vegetable substances. As it undergoes the acetous and vinous fermentations, and becomes very slowly putrid, it resembles vegetables. Its albuminous curd is of an animal nature. Before we proceed to consider the medical properties of milk, we shall describe more particularly the milk of different animals, viz. that of the cow, the human female, the ass, the goat, the sheep, and the mare. The general appearance of cow's milk is Avell known, and to this standard we shall refer the taste and more obvious properties of other milks. It is differently flavoured, however, according to the age and the food of the animal. When near the time of calving, it is more of an animal nature than at a future period; and the milk of farrow cows is, at first, saline. The alliaceous and the umbelliferous plants, horse mint, cabbages, and turnips, give it their peculiar flavour. The leaves of maize are said to render it mild and saccharine; the po- tatoe plant insipid. The Alderrtey, Alpine, and Sardinian cows give a very rich milk : those of the north and of Catalonia an aqueous blue milk. Tessier observed some milk, which was white when draAvn, soon became blue; a change attributed to their eating the isatis (woad). Dr. Garden found, that the milk Avas blue after the cows had eaten of this plant; and it is usually red when they have eaten madder or the fruit of the cactus opuntia. Cow's milk, in an ordinary state, boils at 113°. The carbonic acid gas, the boracic and oxalic acids, do not coagulate this milk when mixed with it, though Stipriaan observes that the latter, if strewed on it in powder, will have this effect. The curds produced by the other acids, are dissolved again by alkalis. When vinegar is employed for the coagulation, the dissolved curd is of a rose colour. Other re-agents acton itnearly as we have said they do on milk in general. The elec- tric fluid thickens it a little. Its specific gravity is 1028. Eight pounds of milk afforded, on distillation, eight ounces of a clear fluid, which retained the smell and taste of the animal's food. This fluid became turbid after some time, but again clear in a heat of twenty- eight of Reaumur, while some light filaments were formed. When filtered it became clear and tasteless, leaving nothing after distillation. The residuum after the first distillation Avas sweet and butyraceous, called by Hoffman franchipan; and, when diluted in boiling water, the white milky fluid is called Hoffman's whey. When distilled, it affords water, a very fluid yellow oil, an acid, a volatile alkali, a thick black empyreumatic oil, and an inflammable gas. The ashes seem to con- tain an alkali and a muriated soda. The first milk after calving (colostrum,*primum, or beastings,) resembles other milk, with the addition of a mucous substance. The specific gravity is 1072. It is yellow, but soon coagulates on the fire, and becomes white. The specific gravity of the second colostrum was 1052. It is more difficult to coagulate, and stirring wholly prevents this change. Rennet changes the first colostrum to 'a jelly, and coagulates the second: the first contains more than three times the quantity of butter, and a much larger proportion of albuminous matter. Both colostra become more quickly putrid than other milk, and seem to contain a large proportion of the gluten of the blood. The cream of cow's milk after standing about three weeks, was covered with a green effervescence, and the under part had a cheesy flavour (Parmentier). The scalded cream acquires this flavour much sooner; and this was the reason for our asserting that some of the curd was probably entangled with it. On distilling this semiputrid cream, the usual results obtained from fat bodies were discovered. (See Adeps.) The milk, last drawn from the cow, has the largest proportion of cream ; and the cream, as it rises in succession on the milk, Avhile at rest, decreases in quantity, and deterio- rates in quality. Thick milk-throws up less cream than that which is thinner, but its quality is better. If the milk is diluted with water, the cream is more copious, but less rich. Previous agitation lessens the proportion of cream; and the proper temperature for its rising most successfully is about 54° of Fahrenheit. Milk in autumn gives more cream than in spring; but it rises soonest in summer. The butter of cows is usually yelloAV: if white, its quality is inferior. If the milk has been kept too cool, the butter is pale, with little flaA-our, and not unctuous or rich. To have butter in perfection, the first drawn milk should be separated, and the first risen cream pre- ferred. Some little acidity must take place previous to LAC 851 LAC the separation of butter, and this must be produced by the agitation, if not before approaching. The cream should, therefore, be kept for some time previous to the churning. The yellowness of butter is probably dwing to the constitution of the animal, but the contact of the air has also some effect, for the internal parts of the mass are whiter than the external. To preserve butter from rancidity, two drachms of sugar, as much nitre, with half an ounce of salt, will be sufficient for sixteen ounces of butter. The rancidity of butter depends, in part, upon its retaining some whey, which holds a caseous matter; for it keeps in proportion to its wash- ing: but, after every care, some of the caseous matter seems to remain, and to this its consistence is owing (Fourcroy). Thus, to melt butter without granulations, we add flour to prevent the cheesy portion falling to the bottom, and keep it in constant agitation. Skimmed milk still retains a portion of the oil and the cheesy matter, which separate on its becoming acid; it is rich and pleasant. This matter is separated also in pellicles, by boiling. When flakes of cheese are put into a fluid alkali they are dissolved, while a consider- able quantity of ammonia is separated, formed by a de- composition of the cheese, and the subsequent union of its hydrogen and azote. The alkaline solution of cheese, when heated, becomes brown, and deposits a portion of animal matjer. When this matter, held in solution, is separated by acids, it is black, melts in the fire like thick oil, and, when cold, is greasy ; the remaining hydrogen, with the oxygen, forming oil, and, with the alkali, be- coming saponaceous. When the cheese is separated from the alkali by an acid, an hepatic odour is per- ceived. The caseous matter is completely dissolved by vinegar, and has a greater affinity to the vegetable acids than to any other. Whey, when fresh, is SAveetish and somewhat saline ; but when filtrated, pellucid. It contains some caseous matter dissolved by an acid, which is separated on the addition of an alkali, and a small portion of sugar of milk. The 7nilk of women is thin, of a bluish colour, of a mild sweet taste, and a pleasant odour. Its specific gravity is 1029. On exposure to air, it is covered with a very thick white matter; but, from this, no butter could be procured. On standing, the portion which separated was still more butyraceous, though still in- capable of forming butter. When distilled, water, a strong empyreumatic oil, ammonia, an acid, and inflam- mable gas, came over. The fluid, then, which Avas deposited from this unctuous matter, was a buttermilk; but its transparency was not changed by alcohol or acids. After evaporation, it afforded sugar of milk, with some cheese. Female milk, Avhen skimmed, did not, in a warm temperature, coagulate in five days; but became turbid and acid. Crystals of sugar of milk were formed, and the thick mother ley afforded muriat of soda. Pellicles rose on heating, as on cow's milk. Human milk is coagulated as cow's milk, except by acids. These, even with the assistance of heat, had no effect. It was also not coagulated by alkalis, but the kali gave it a brown, a red, and at last a black, colour; lime Avater, a deep yellow. The earths, the neutral and metallic salts, alcohol, or the electric fluid, produced no change except on the colour; but the infusion of oak bark and sour milk, previously coagulated, produced a coagulum. The cheese which it affords is finer and more tender than that of any other milk, but does not form a mass. Sixteen hundred parts of this milk af- forded 137 of cream; forty-eight of a matter resem- bling butter; forty-three of cheese, and 117 of sugar. Three hundred parts of this sugar afforded eighty-five of lactic acid. Human milk scarcely becomes sour after a long period. It never passes either to the vinous or putrid fermentations. Human milk differs so essentially in different women, and even in the same woman, at different times, that the results of experiments greatly vary. Parmentier found the results so contradictory, that he suspected some deceit, and employed only milk which he drew himself. The results of his trials Avere, however, still contradictory. This may, perhaps, account for Dr. Clark's assertion, that human milk contains no caseous part, and he could not succeed in coagulating it, by any means, or in any temperature. (Transactions of the Royal Irish Academy for 1788.) What has been sup- posed, therefore, to be a coagulum of the caseous part, may have been only cream; and during the period of the first and second colustrum only Avas it found yellow. At every other time it is white. The milk of the ass is whitish, with some degree of transparency, of a peculiar smell, and a saltish taste, mixed Avith its sAveetness. Its specific gravity is 1023. Alcohol, the metallic salts, rennets, and all the acuds, except the fluor, and the cream of tartar when cold, coagulate it. Alkalis produce a slight coagulation, and different changes of colour Neutrals render it thinner. It coagulates with difficulty when at rest, and the coa- gulum is weak. The cream is of a yellowish Avhite, SAveet, and at first thin. Afterwards it acquires a greater consistence. The whey is sweetish and yel- lowish. Sixteen hundred parts of this milk afford forty-seven of cream; fifty-three of cheese; seventy- two of sugar of milk, which contains about one fourth of acid. The coagulum of this milk does not depend on its caseous matter, for this is spontaneously separated, falling to the bottom in the form of very tenacious par- ticles. The cream is neither thick nor copious, and, with difficulty, assumes the form of butter, Avhich is soft and Avhite, without any peculiar taste, but quickly becoming rancid. The butter milk, which has a mild pleasing taste, must be carefully separated, or it soon again dissolves the butter. The sugar is in small pro- portion, and it contains also a little calcareous muriat, sometimes muriat of soda. It agrees with human milk in being soon converted into whey when the caseous matter is deposited; and in proportion to this deposi- tion the sweetness increases. The milk of the goat is very white, sweetish, and of an unctuous taste. Its specific gravity is 1036. It is affected by re-agents nearly as asses' milk. The cream is very thick, of a mild agreeable taste, and sloAvly pro- ceeds to acidity. It easily forms butter, Avhich is white, firm, and consistent; and, from its thickness, is easily converted into a very rich cheese, which is not soon injured by keeping. The butter milk abounds with cheesy matter, which may be separated by acids. The quantity of cheese which this milk affords is its chief characteristic. The curd is so copious that the Avhey separates with difficulty. The curd is also gelatinous and consistent, while in female or asses' milk it is in 5 Q 2 LAC 852 L A C divided particles. The cheese is peculiarly rich and agreeable. The butter is Avhite and rich, but not as from asses' milk in consequence of a mixture of the curd, for none is deposited on melting. On this account it keeps long without spoiling. Sixteen hundred parts of this milk contain 127 of cream; 72 of butter; 146 of cheese; 70 of sugar of milk, of which one fourth is lactic acid. The saccharine matter appears to be less than in female or asses' milk. Its sugar white when the serum spontaneously evaporates. When artificial heat is used it becomes a jelly, and the crystals are coloured. The serum contains a very small proportion of common salt. The milk of the sheep greatly resembles that of the cow. Its specific gravity is 1035, and it readily runs into the acetous fermentation in summer. When at rest, a thick, rich, SAveet, yellowish crea>n rises in con- siderable quantities, which affords much butter; but it is oily to the taste, and its consistence is not consider- able. It easily becomes rancid if not well washed. Its cheese is rich and viscous, but mild and agreeable. The serum affords a very Avhite sugar. Sixteen hundred parts afford 185 of cream; ninety-three of butter; 246 of cheese; and sixty-seven of sugar, of which one fourth was lactic acid, and as much was obtained from the remaining fluid. All the acids (except the carbonic acid gas), alum, and liver of sulphur, coagulate it. Kali and soda render its colour dark; if caustic, red; am- monia, which also attenuates it, yellow. The neutral salts have no effect on it. The characteristics of this milk are the quantity of cream it furnishes, the quan- tity and richness of its cheese*. The famous Roquefort cheese owes its excellence to the mixture of sheep's curd. Annales de Chimie, iv. 31. The milk of the mare retains the smell of the animal, and it tastes as if water was mixed with it, though its specific gravity is 1045. The mineral acids coagulate it; the phosphoric deprives it of its colour and opacity; the fluor and saccharine acids slightly coagulate it when warm. Lime water precipitates a caseous matter when warm; alcohol renders it slightly curdy; rennet has no effect on it. Mare's milk is remarkable for its fluidity, but it is less so than female's or asses' milk, and more tasteless than either. Parmentier informs us that it easily boils, and is not difficult to coagulate. Its dis- tilled water is nearly inodorous, and its franchipan less copious and unctuous than that of the cow. On a slight heat this milk is covered with pellicles, and the first are the most unctuous. The cream rises soon, is yellowish and clear, but produces no butter. The skimmed milk resembles that of the cow, but the vege- table acids separate slowly the cheese, and in a form re- sembling that from human milk. The serum afforded a vitriolated lime in needle like crystals, and sugar of milk in the form of a saline concretion. The mother Avater was found to contain muriat of lime. Sixteen hundred parts afforded only thirteen of cream; twenty- six of cheese; 140 of sugar of milk, of which about forty Avere lactic acid. From mare's milk the ardent spirit is chiefly procured. The art of making it is of great antiquity, and consists in not permitting the separa- tion of the component parts of the milk, or again uniting them, if separated, till an acidity is observed. The spirit is apparently developed at the same time with the acid. It is remarked by Parmentier, that when cows are diseased, the albuminous curd is the onV part changed. The corresponding part of other animal fluids seems, alone, to suffer from a morbid state of the body. Stipriaan gives a short comparison of different milks, Avhich Ave shall subjoin. The most aqueous, he observes, is the milk of the ass. Then follows that of the marc, the human female, the cow, the goat, and the sheep. Cream was most abundant in sheep's milk; next in the human, the goat's, cow's, ass's, and mare's milk. Butter was in the largest proportion in sheep's milk, next the goat's, coav's, and human milk. Cheese abounded most in sheep's, then successively in goat's, coav's, ass's, human, and mare's milk. Most sugar was afforded by mare's milk, followed by the human, the ass's, the goat's, the sheep's, and the cow's milk. Parmentier di- vides milks into two classes, the serous and the caseous, or butyraceous. The first contains asses, mares, and human; the second, the cow's, the goat's, and the sheep's milks. These facts, Avhich have not been hitherto collected in any medical Avork, point out the absurdity of nu- merous directions, which fill the volumes of dietetic writers, and those authors who have written on the dis- eases of children. Women's milk, as we have said, is so various, that general rules can scarcely be drawn; but if any fact respecting it is better established than another, it is, that acids will not coagulate it. We have already observed, that milk must be coagulated before it can become subject to the digestive powers, and this is consonant to another fact, noticed in the article Digestion, q. v. that, unless the food or drink is delayed in the stomach, though absorbed, it is soon again carried to the excretory organs, as a substance foreign from the habit. This is even the case with Avater. That milk must be coagulated in the stomach is proved, not only by these circumstances, but by in- fants vomiting milk as it is taken in, when any disease occurs in the stomach, and their occasionally vomiting it in a coagulated state, when the discharge has been accidental, or from fulness. We recollect some expe- riments made, many years since, by Mr. Wilson, though we believe not published, in which, after the most at- tentive examination, no acid could be detected in the stomach of infants. We now see, that if it had been there it would not have produced coagulation. Acid, we know, does occasionally abound in the stomachs of infants, because Ave find it changing the colour of the bile; but it is not constantly present, and still less is it necessary to assist the digestive process. To assist in this enquiry, we mentioned the effect of rennet, (the stomach of the calf,) though carefully washed and dried, in coagulating cow's milk, and added a fact from Spallanzani, that the liver of the turkey Avould produce a similar change. Why may not the stomach of a child, and, in a less degree, that of an adult, occasion the coagulation ? But, though this be not granted, we have seen that, when human milk has been once co- agulated, the former coagulum is sufficient to produce this change in fresh milk; and this is certainly the most common cause. From these observations, we may, at least, draw one inference, that absorbents are too com- monly given to children. Acid in the stomach seldom produces any bad effect. It is carried off like any foreign body, and soon neutralized by the bile. Our predecessors, in practice, used them freely; but by LAC 853 LA C employing the animal earths, they fortunately did not alwavs exhibit an absorbent, and only threAv into the stomach a small quantity of an indigestible powder, Avhich was soon again discharged. Such was the Gas- coyne's powder, the pearls, and a great variety of costly and fashionable medicines. In the directions for a milk diet-, equal absurdities prevailed. To prevent coagulation, we are sometimes advised to add aqua ammoniae or lime water (Motherby, fifth edition). We now know that these produce other changes not salutary, and coagulation appears really ne- cessary. We may, indeed, admit, that the coagulum of coav's milk is sometimes too firm, and, with that vieAV, a small stimulus may be necessary to enable the stomach to conquer it; and, for this purpose, a small portion of rum is sometimes added, and, perhaps, some of the warmer spices may be occasionally substituted with more ad- vantage. But to add a medicine which will promote, in order to prevent coagulation—to prevent what is essen- tially necessary to the digestion of the milk, is an accu- mulation of absurdities without example, except in the work we are now attempting to improve. Milk, we have seen, holds a middle place betAveen vegetable and animal foods. It is milder than the lat- ter, and more stimulating than the former; but in its effects on the constitution it approaches more nearly to animal than vegetable aliment. (See Aliment.) The milks preferred as medicinal are chiefly coav's, ass's, mare's, and female milk. The goat's whey is preferred to its milk. Cow's milk, we have found a rich nutritious fluid ; but, by carefully choosing the kind, theage of the milk, the time of milking, &c. it is thinner and more digestible. In many stomachs it is, hoAvever, heavy and indigesti- ble ; and the idiosyncracy of the patient should be con- sidered when it is prescribed. The quantity should, however, be also limited ; for, if in excess, it produces great inconvenience from its bulk. Physicians have been so much afraid of its coagulating, that they have not employed a very convenient form of cow's milk, the slight curd produced by rennet. Cow's milk is often prescribed in hectic cases, sometimes in fevers, and in cases where the fluids are supposed to be acri- monious, as in cancers, cutaneous eruptions, and similar complaints. In many of these diseases it is, however, too stimulating, particularly in fevers, occasionally in hectics ; and, as it has been observed, in the usual pre- paratory diet for the inoculated small pox. In these cases it is diluted Avith water, with decoctions of the farinacea, as in gruel, and Avith whey. Butter milk and whey have been sometimes substituted. Ass's milk is, Ave have seen, a less stimulating fluid, and less nourishing. Its oily matter is in much less proportion, its coagulum weak, and, what is apparently of the greatest consequence, the caseous matter is not entangled with it, but precipitated. The little butter which it contains is readily dissolved in its serum. On these accounts, it appears peculiarly adapted to those states in which every stimulus is highly injurious, as in hectics. In the choice of this milk, there is not, hoAv- ever, sufficient discrimination. If many take the milk of the same animal, convenience, rather than the nature of the disease, determines the time ; and the richer fluid of the last milking may be thus brought to the most ir- ritable habit. The age of the foal is also seldom at- tended to, and the laxative colostrum of the early- period may be given to those whose boAvels are par- ticularly irritable. Female milk has been seldom employed, nor are Ave well aware of its medical effects. It contains a large proportion of cream^ and a small one of cheese. Its coagulum is also tender, and it resists the effects of acids in producing this change. It will be, therefore, pro- bably useful in all cases where ass's milk has been re- commended ; nor can we think it, from the bosom of a healthy young woman, so disgusting a remedy as from the ass. Mare's milk has been employed, but of its efficacy we knoAv nothing. From its ffuidity, and small portion of caseous matter, we should suppose it to be an useful substitute for ass's or human milk. ' The very large proportion of cheese in goat's milk does not seem to render it an eligible aliment for inva- lids, and we believe the whey is chiefly employed. This must probably prove a salutary beverage in some dis- eases, and we have heard many instances of its success. From our own experience, hoAvever, Ave knoAV nothing. The sugar of milk is sometimes separated, but rather for curiosity than use, for it is, we believe, never given medicinally. (See Saccharum lactis.) In the Paris Pharmacopoeia, it is directed to be prepared from the whey of cow's milk, clarified, filtered, and evaporated. Whey is usually prepared by adding an infusion of rennet, and is thin in proportion to the hardness of the coagulum. Cheese whey is peculiarly thin, and merely a saline aqueous fluid. The whey prepared for drinking is an opaque fluid, with a proportion of the oil, and a small quantity of the curd suspended. It is not an easy task to bring it to the most pleasing consistence ; and it is said a small portion of alum is employed for this purpose. The proportion, hoAvever, is so small, that we have not found it give uneasiness even in the most irritable boAvels. Whey is, of course, less nu- tritious than milk, but is a mild soft demulcent, highly useful in the early stages of fever, in hectics, in coughs, and inflammatory complaints of every kind. Milk is used as an intermede, or vehicle, at least to suspend, if not, in part, to render some medicines more miscible Avith Avater. Bark, in powder, is covered very successfully by milk; and with a small proportion of a decoction of liquorice is agreeably disguised. The volatile tincture of guaiacum, and similar preparations, are also very conveniently exhibited in milk. See Dioscorides, lib. ii. cap. 64. Voltelen de Lacte Humano ; Jacquin's Chemistry ; Scheel's Works ; Fourcroy and Chaptal, Annales de Chimie, vol. vii. x. and xxxi.; Jahrig; Parmentier and Deyeux, Journal de Physique, 1790, and 1791 ; Greive on the Koumiss, Edinburgh Transactions, 1788; Clarke on Human Milk, Irish Transactions, 1788; Stipriaan, Livisens, and Bondt, Memoires de la Societe de Medecine Paris, 1787,and 1788; Hoffman's Dissertatio de Sero Lactis; Medical Musaeum, vol. iii. p. 361, Sec; Cullen's Materia Medica. Lac ace'tosum. See Alcaol. Lac amy'gdalje. Milk of almonds. See Emul- sio. Lac asini'num* artifici'ale. See Eryngium. Lac ca'lcis. Milk of lime; water whitened by a solution of quick lime, which is also in part suspended in it. LAC 854 LAC Lac spumo'sum. See Aphrogala. Lac su'lphuris. See Sulphur prjecipita- TtM. Lac virgina'le. See Benzoinum. LA'CCA, (from the Arabic lakah). Lac, or gum lac; ancosa; is a concrete brittle substance, of dark red colour, brought from the East Indies, incrusted on pieces of sticks, internally divided into cells. It is the gummy resinous substance from two species of ficus, viz. they. Indica and religiosa Lin. Sp. PI. 1514, effused in consequence of the puncture of a species of coccus. The nest in which the insect also is sometimes found adhering to the branches is called stick lac. In the cells small red bodies are often observed, Avhich appear to be the young insects. If the stick lac is broken into small pieces, and infused in warm water until it ceases to give any tincture to the liquor, the remainder appears of a transparent, yellowish brown colour, and is called seed lac : and on raising the heat so as to melt the seed lac, it rises to the surface, and is formed into what is called shell lac. When melted, and cast in cakes, it is styled lac in tablets. The seed and shell lacs being robbed of the colouring animal matter, seem to be of an intermediate nature between that of wax and resin, and to partake of the nature of both. They crumble on chewing, and do not soften or unite again ; laid on a hot iron, they in- flame, and soon burn. If distilled like wax, they yield an acid spirit, and a butyraceous oil. Alkaline lixivia, and volatile alkaline spirit, dissolve them into a purplish liquor. With the help of heat, they dissolve in rec- tified spirit of wine. Alum promotes their solution in boiling water. Lac is not used in medicine; but the colouring matters serves as a paint, and the remainder is an ingredient in sealing wax. See Neumann's Che- mical Works. Lewis's Materia Medica. From lac an acid is procured, styled the laccic acid. Dr. Anderson, in 1786, received from the interior parts of Hindostan nests of insects, resembling cowry shells, which he found to be the coverings of the females of an undescribed species of coccus. Some of this matter, Avhich resembled bees' wax, Avas sent to England ; and, in 1794, Dr. Pearson, in the Philosophical Transactions, published an analysis of it. About one quarter of this white lac contains a red- dish acid, which tasted saltish, and not sour, though it changes paper, stained with turnsole, to a red colour. When heated, the smell is that of newly baked bread. The properties of this acid are very distinct; but as it has not been employed in medicine, they need not de- tain us. LACCO'PEDON. See Scrotum. LACERATU'RA,(from lacero, to tear). See Vul- NUS. LACE'RTULI and LACE'RTUS, (from lacertus, an arm). Bundles of fibres. In every muscle, long, slender, soft fibres are found, possessed of some elas- ticity, running parallel with each other, surrounded with a large portion of cellular membrane, and col- lected into what are called lacertuli, in shape like the arm from the elbow to the wrist. These, bound toge- ther Avith a looser, generally adipose, membrane, run into large bundles, divided by cellular stripes, or par- titions, and are then called lacerti. The lacerti running parallel, Or inclined, surrounded Avith a thin cellular membrane, continuous with the partitions, and sepa- rated by a thicker cellular texture from the neighbour- ing fleshy parts, are considered as one-muscle. See Brachium, where the word lacertus is used in another sense. LA'CERUM FORA'MEN, (from Xxx,£a, to tear,) one of the inner foramina in the head, through Avhich the third, fourth, first branch of the fifth, and the sixth pair of nerves pass. Lacerum is also applied to a leaf whose margin is irregular. LA'CRYMA, (from fotxpvfix, a tear). A tear ; and the gum of a tree, which appears in drops like LA'CRYMA ABIE'GNA. See Terebinthina. La'cryma jo'bi, lithospermum, milliujn arundina- ceum, reed millet, Job's tears. Coix lachryma Jobi Lin. Sp. PI. 1378. The seeds resemble tears; and are said to be lithontriptic, but are little used. Raii Historia. LACRYMA'LIA O'SSA, (from lacryma, a tear). See Unguis ossa. Lacryma'lia pu'ncta, are two small orifices at a little distance from the internal angle of the eye, on the edge of the eye lids, which lead to the lacrymal canals and sac. LACRYMA'LIS GLA'NDULA. See Glandula LACRYMALIS. Lacryma'lis ne'rvus. The first branch of the fifth pair of nerves is called the orbitary; and this is subdi- vided into three others, the last of which is called the lacrymal branch; as it is chiefly dispersed on the lacry- mal gland. LACI'NIA COROLLiE, (from lacinio, to perforate). Any part into which the border of a monopetalous corolla is cut. It is applied also to monophyllous ca- lices, and a calyx which has two laciniae is said to be bifid ; or to divisions on the borders of leaves ; hence called LACINIA'TI, jagged, implying an irregularity in the division and subdivision : laciniae, according to Linnaeus, is the same with a part, segment, or cleft. LACO'NICUM. See Balneum. LACTA'NTIUM TABES, the hectic of nurses, chiefly from debility. See Lactatio. "It is charac- terized by every symptom of weakness in the animal and vital functions, to Avhich evening exacerbations and morning sweats succeed, even when there is no peculiar affection of the lungs. Indeed the lungs are apparently never affected, unless there is a constitutional predispo- sition to phthisis. In this disease, the bark and mineral acids, where no pulmonic affection exists, and Grif- fith's mixture, with myrrh and steel, when such is sus- •pected, are the best remedies. If decided hectic symp- toms come on, the disease must be treated as a true Phthisis, q. v. Weaning is often essentially necessary ; but we have in general found it more useful first to try whether lessening the quantity of milk which the child takes will not succeed. Even where hectic symptoms have come on, Ave have thought moderate suckling rather ad- vantageous than hurtful. Much, however, must depend on the mother's health, on that of the child, and many minute circumstances which it is impossible to detail. LAC 855 LAC See Fothergill in the Medical Observations, vol. v.; and Walker on the Memoirs of the Medical Society. LACTA'RIA,(from lac, milk). See Lacticinia. LACTA'TIO, (from lacteo, to suckle). Suckling. The child should suck, if possible, during the first month; for the early milk is not only advantageous to the child, but the discharge prevents many inconve- niences to the mother. If, however, from extreme de- bility, a deficiency of milk, or too short nipples, this is impossible, it should be consigned to a healthy young woman, whose milk is nearly of the age of the child. In general, the health of women during suckling is better than at any other period of their lives. Their appetite is excellent; the steep they have, sound and refreshing; their spirits free; their temper cheerful. If the nurse fails in any of these respects, suckling will be less beneficial either to herself or infant. If she fails in the greater number, particularly in appetite or sleep, she should decline the office. When the new born child is to be suckled by the mother, it should be applied to the breast in ten or twelve hours after delivery; for the milk is by this means sooner and more easily supplied; fever and in- flammation of the breasts more certainly prevented. If the mother does not suckle her child, her breasts should be kept warm with flannels, or with a hare skin, to keep up a constant perspiration. If she does suckle, she should carefully cover the breasts when she first opens her bosom, and when the child is taken from it, as the cold air is sensibly felt in that tender or- gan, the skin quickly corrugated, to which pain, in- flammation, and abscesses often succeed. A wet nurse should be young, of a healthy habit and an active disposition, a mild temper, and whose breasts are well filled with milk. If the milk is good, it is sweetish to the taste, and totally free from saltness : to the eye it appears thin^ and of a bluish cast. The re- gular recurrence of the menses is generally an objection; and it is often a very strong one. The inconveniencies arise from the child being slightly disordered at the commencement of the return; and the symptoms of teething are often aggravated by the irritation which these returns produce. The menses are sometimes supposed to be advantageous, and are said to renew the milk when it is old; but this is an idea without the slightest foundation. A hired nurse is generally kept from her husband; but by this restriction the temper is often ruffled, and more injury than advantage is sustained by the infant. If the nurse's child is of the same age with that she suckles, she will not probably be again with child till the period of weaning arrives. If older, the greater is the probability of her being again pregnant, and the se- paration from her husband more necessary. A child may be safely weaned at seven months, but should not suck more than ten. Changes of nurses should, if pos- sible, be avoided; yet this is rather the caution of ex- perience, perhaps of prejudice, than of reason. Nurses should eat, at least, one hearty meal of ani- mal food, with a proper quantity of vegetables, every day. Thin broth, or milk, is more proper for their breakfasts and suppers than tea; and if the strength should seem to fail, a draught of good ale may be oc- casionally allowed; but spirituous liquors should be avoided. Every mother should, for her own sake, as well as her infant's, attempt to suckle. Yet some constitutions are so peculiarly weak and nervous, that the dread of increasing these complaints is a frequent impediment. It should not, however, at least, hinder the attempt; for weak habits have suckled with advantage even to themselves. If, however, the milk is scanty; if, though copious, it is thin and watery; above all, if the child is restless and uneasy; if it frets and pines; a healthy nurse should be procured. But the experiment should first be made, and the attempt should not be given up unless the child suffers. Let every young mother, however, reflect, that if she cannot give up midnight orgies; if she cannot, when her child, by the most pathetic cries, demands, yield it a genial balmy food, uninjured by fa- tigue, agitation of mind, or indigestion, let her resign her task, or rather forsake her duty. This she may, in part, compensate; but to destroy the health, the con- stitution of her infant, by the opposite conduct, must for ever be a thorn in her heart; a crime which she CANNOT EXPIATE HERE, PERHAPS NEVER. LA'CTAS, (from lac, milk). Lac tat. Salts pro- duced by the union of the acid of the lactic acid, q. v., with different bases. LACTE'A FE'BRIS, (from lac, milk). The milk fever. It is a frequent custom to apply the child only to its mother's breast, when the milk flows freely, on the third or fourth day. A fever is thus, from the irri- tation of the milk, brought on; but it rarely happens to those who have applied the child early to the breast. Where there is a secretion of milk, its due discharge is as necessary as that of the lochia; and the stoppage of either produces fever. Cold, or any cause of fever on the coming on of the milk, may occasion similar incon- veniences. The more immediate causes are a distention of the vessels of the breasts, readily distinguished by the swell- ing of the glands in the axilla; and an absorption of milk becomes acrid by stagnation. It is known by a ri- gor and looseness coming on after the breasts have been inflamed and painful, folloAved by thirst, headach, and burning heat. If the disorder is not violent, it soon spontaneously vanishes by a copious perspiration. If the patient is full and robust, blood may be taken from the arm; but this evacuation is rarely required. A young, strong, hungry child should be applied to the breast; and linen cloths, dipped in fresh cool drawn linseed oil, laid over them : the bowels should be emp- tied by a cooling purge, and the saline mixture, with the usual antimonial preparations, given. These, with a thin cooling diet, will generally remove the disease. If the breasts should suppurate, see Abscessus pectoris and Mammj;; Kirkland on Child-bed Fevers. LACTE'A VA'SA, galactophoriductus,(fromyxXx, milk, and xo<, and *v6ew, as it only differs from the chrysanthemum in the white floret). A name also for the common and other species of camomile. See Cham.emelum. Leuca'nthemum be'llidis fa'cie. See Bellis major. Leuca'nthemum Canarie'nse; chamamelum Ca- nariense. The effects are the same as those of the pel- litory root, if chewed. LEUCA'NTHE VE'TERUM, (from Xetvxos, white, and xxxvOx, a thorn). See Calcitrapa officinalis. LEU'CAS MONTA'NA. See Lamium luteum. LEU'CE, (from Xevxos, white). See Alphus. LEUCOI'UM, (from Aewx«s, white, and tov, a violet) See Cheiri, and Bulbonach. LEUCOLA'CHANON, (from Xev**s, white, and Af#*»«v, a herb). See Valeriana svlvestris. LEUCO'MA, (from Xtvxos, whife). See Albugo. Leuco'ma nephe'lium. See AcHlys. LEUCONYMPH:E'A, (from Xevxos, white, and vv/x/pxtx, water lily). See Nymphjea. LEUCOPHLEGMA'TIA, (from *£»*<>«, white, and Qxeypx, phlegm). In leucophlegmatia, Aretaeus obi- serves, the flesh is not wasted as in anasarca, and it is more easily cured : indeed it is only the beginning of anasarca. Sometimes this word signifies an emphy- sema. LEUCOPI'PER, (from Aewses, white, and zrirepis, pepper). See Piper album. LEUCORRHOZ'A, and LEUCO'RRHOIS, (from Xe vx«s, white, and pea, to fiow). See Fluor Albus. Since that article was printed, we find cantharides proposed as a remedy for this disease, in consequence of its resemblance to gleet. It was given, it is said, by Greenfield with success ; and, indeed, a topical stimu- lant may be occasionally useful. The balsam, copaiba is probably no more. LEVA'TOR, (from levo, to lift up). The name is given to many muscles, whose office it is to elevate different parts into Avhich they are inserted, viz. Leva'tor pala'ti mo'llis, rises from the basis of the skull, near the articulation of the lower jaw, runs LEV 867 LI C doAvn the fauces, passes inwards and fonvards, spreads itself on the palatum molle, and goes to the uvula. . Leva'tor pa'lpebr^ superio'ris, eleva'tor, aperi- ens palpebrarum rectus, named from its straight pro- gress and use by Fallopius and Douglas. It arises on each side from the bottom of the orbit by a small ten- don, and as the fleshy fibres of the muscle pass over the globe of the eye, they gradually spread, and after- Avards terminate by a broad tendinous expansion on the superior part of the tarsus belonging to the upper lid. Leva'tor sca'pulaj, levator proprius of Winslow; musculus angularis, seu patientia musculus is divided at its origin into four little muscles, from the transverse pro- cesses of the four superior cervical vertebrae. The branches join, and form one muscle on each side, inserted into the bases of the respective scapulae above the spine. LEVATO'RES ANI, and ELEVA'TORES, rise with a broad base from the symphysis of the os pubis, the internal part of the ileum, the membrane of the ob- turator internus and. coccygaeus, and the sharp process of the ischium, directing their course doAvnwards as to a centre, and blending part of their fibres with those of the sphincter, the acceleratores urinae, and the anterior part of the extremity of the coccyx, surrounding the prostate gland, the vesiculae seminales, and the neck of the bladder, which they contribute to support. They contribute to expel the faeces; but do not, as is general- ly supposed, very poAverfully compress the vesiculae seminales in coition. Leva'tores commu'nes labio'rum, elevatores la- biorum, rise from the cavity under the os jugate, in the os maxillare, and are inserted, with the zygomaticus major and others, into the angle of the lips, on each side. Levato'res costarum, supracostales, rise from the transverse processes of the vertebrae, and are inserted into the ribs: they are divided into the longiores and the breviores. The latter rise from the transverse pro- cesses, and are inserted into the next rib ; the longiores run over one rib, and are inserted into the next. Levato'res la'bii infekio'ris, elevato'res, par ment ale, incisivus inferior of WinsloAV, and levator menti of Albinus, rise from the sockets of the incisores and are inserted into the loAver lip. Levato'res la'bii superio'ris, eleva'tores, rise from the os maxillare, and descend obliquely under the skin of the upper lip, orbicularis muscle, and the outer part of the alae nasi. LEVIGA'TIO, (from levis, light). The pharmaceu- tical operation, by which hard substances are reduced to an impalpable powder; but unless the instrument is very hard, as much of the stone as of the medicine may be discovered in it. In many instances the sub- stances are levigated with Avater, and suffered to dry on chalk; sometimes the fine powder is separated, after levigation, by washing. If the whole is agitated in water, the coarser parts will subside, while the finer ones may be poured off with the fluid, and will subside after a longer rest. Thus the powder may be obtained of any degree of fineness, according to the time suffered to elapse before the water is first poured off. We ob- serve, however, in the Encyclopedia Britannica, a very convenient instrument called a fanner, which separates the finer poAvder by a blast of air, on the same principle as the machine for Avinnowing corn acts, but know not how it really succeeds in practice, so that we shall not fill our page with the description. LEVI'STICUM, (from levo, to assuage; from its re- lieving painful flatulencies). Ligusticum, angelica mon- tana perennis. Common lovage; ligusticum levisti- cum Lin. Sp. PI. 359 ; is a tall umbelliferous plant, with leaves divided like those of srnallage ; the root thick, fleshy, juicy, branched, and of a broAvn colour out- wardly; a native of the south of Europe. It is peren- nial, flowers in June, and its seeds are ripe in August. This plant hath a strong and peculiarly ungrateful smell: to the taste it is warm and aromatic, resembling angelica, but less agreeable; and its yelloAvish gummy resinous juice much resembles opoponax. The seeds are warm and pungent, of a more agree- able flavour; the roots sweetish, and more pleasant than the leaves; its essential oil is in a small proportion, and an extract made with rectified spirit retains both the aroma and the SAveetness. Lovage is similar to an- gelica and masterwort, as a carminative, sudorific, and deobstruent, and might be a good substitute for either, had we not more effectual medicines in the galbanum and asafcetida. The leaves, eaten as salad, are account- ed emmenagogue. See Raii Historia; Lewis's Mate- ria Medica. LE'VITAS INTESTINO'RUM, (from the food passing quickly). See Lienteria. LIB ANO 'TIS, (from XiZxvos, frankincense). Cachrys, cachrysea, fennel herb, frankincense, atha7nanta libanotis Lin. Sp. PI. 351, more probably laserpitium ferulaeeum Lin. 358, grows on mountains in Italy and Sicily, and flowers in May. It is also a name for seve- ral sorts of laserpitium,ferula glauco folio, ferula 7ninor, rosmarinus, oreoselinum opii, and several other plants. LI'BERANS A'QUA. See Calcis aqua majus COMPOSITA. LIBI'DO. See Pruritis. LI'BRA, (from Xtlgx, a pound). See Pondus. LICHA'NDOS, (from Xeix*>, to lick; because used in the action of licking). Fore finger. See In- dex. LI'CHEN, (from Xeixu, lambo, quia lambendo ser- pant,) a cutaneous disease called lichen, from its re- semblance to the spots scattered over the tuberculated lichen. It is a papulous eruption, sometimes rising into tumours of a more considerable size; but in its milder forms rather a deformity than a disease. The term has been variously applied, and the eruption con- founded Avith herpes, scabies, impetigo, &c. The con- fusion is of little consequence, since the complaint is usually trifling ; and we may define it, with Dr. Wil- lan, an extensive eruption of papulae affecting adults, connected Avith internal disorder, usually terminating with scurf, recurrent, not contagious. This genus he divides into five species, the lichen simplex, agrius, pi- laris, lividus, and tropicus. The first commences with slight feverish symptoms, which in a few days are re- lieved by distinct red papulae about the cheeks and chin, or on the arms ; and in three or four days the same ap- pearances take place on the neck, body, and loAver ex- tremities, accompanied with an unpleasant sensation of tingling, aggravated during the night. The eruption fades in about a week, and the whole surface is covered Avith large scurfy exfoliations, which continue longest in the flexure of the joints. The period of its termination 5 S 2 LIC 868 LIC is seldom the same in any two cases ; and on different parts of the surface of the body there is some difference in the form of the papulae. On the face they are large, rounded, often forming small tubercles like vari; on the neck, breast, and extremities, they are most distinct arid acuminated; and on the hands they resemble obscure watery pustules, Avhich exfoliate without any discharge of fluid. This disease most commonly affects persons of a weak irritable habit, and occurs about the beginning of summer or autumn, sometimes general, at others partial, occasionally disappearing or returning without leaving any scurf, and often without any previous fever. A light cooling diet, or if necessary, some easy laxative, is only necessary. Sometimes the simple lichen is chronical, and then styled scurvy; sometimes critical, and called scabies critica. It sometimes terminates in a dry tetter. The /. agrius, from xypios, immanis, is preceded by a fever approaching the typhus. The eruptions are of a deep dark red, with an inflamed basis, itching and ting- ling after any stimulating food and drink, or in the warmth of the bed. In the morning the uneasiness is in- considerable. Straw coloured pustules are occasionally intermixed, and by the continuance of the complaint the skin is thickened, chapped, and painful. The pustules are usually confined to the upper part of the body. Its continuance is uncertain, and it sometimes ap- pears and disappears ; but if repelled, general constitu- tional disorder follows. If any wound is made by scratch- ing, it is with difficulty healed, and the disease some- times terminates in an ulcerated psora. This species differs from the former in the nature of the fever, the greater violence and obstinacy of the complaint. It is exasperated by mercurials, though calomel has been re- commended in the beginning as a laxative ; and the best medicines are the bark, with the mineral acids. We know not that a perpetual blister or an issue has been tried; but it appears a probable means of relief. The itching is best relieved by the spittle or a little rose pomatum. The lichen pilaris is the lichen simplex, affecting chiefly, or exclusively, the roots of the hair, and from around the hair exfoliations take place. It differs in no respect from the first species. The lichen lividus seems little different from pete- chias, with which they are often mixed, and the disease chiefly confined to the poor, whose diet is frequently unalimentary; it is best relieved by the bark and miner- al acids. No fever precedes. Papular eruptions, resem- bling the lichen lividus, sometimes occur among the secondary appearances of lues ; but in this last the pa- pulae are smaller, more numerous, more generally dif- fused ; their points are, after some time, depressed ; they do not disappear and return, but occasionally ter- minate in a foul ulcer. The lichen tropicus is the prickly heat of tropical cli- mates, resembling the papulae produced by sweating in the more temperate. It appears without any pre- ceding disorders of the constitution; but the papulae, about the size of a small pin's head, are numerous, of a vivid red, and elevated so as to produce a con- siderable roughness in the skin; but no redness or inflammation surrounds them. The eruption is chiefly confined to those parts of the body which are usually covered, and sometimes appears on the forehead conti- guous to the hair, though never on the palms of the hands, the soles of the feet, or on the hairy scalp : flan- nel, or warm clothing, increases the number of the pa- pulae. Small pearly pustules, containing a limpid fluid, are often intermixed with the prickly heat, when perspi- ration is very copious, more especially on the breasts and about the wrists. They have no disposition to ulcerate, though violently scratched, but terminate in scales. A troublesome itching attends the prickly heat, and pre- vents sleeping during the night, with an acute sensation of pricking, which often also takes place suddenly after drinking any warm liquor. The eruption is sometimes stationary, appearing equally vivid in the day and night; sometimes quickly disappearing and returning, without any obvious cause; but whenever it continues for any length of time, the papulae throw off minute scales, and are succeeded by a fresh crop, without leaving any ves- tiges on the skin. Persons of a fair complexion, With red hair, and a soft skin, are more liable to this eruption, and have it in the greatest quantity. Those of dark complexions have it slightly, or remain free from it. As the prickly heat is considered to be a salutary eruption, no attempts should be made for its repulsion. Its sud- den disappearance is rather the effect of internal disorder than a cause, and occasioned by fever, or any slight complaint of the stomach : in the latter case a stimulus applied to that organ, as spirits, or warm liquids, repro- duces it. Its appearance on the skin of persons in a state of convalesence is always a favourable sign. To alleviate ihe itching and tingling of the prickly heat, a light and cool dress, and avoiding warm liquors, have been found most serviceable. A vivid eruption of papulae, someAvhat analogous to the prickly heat, appears in our own climate, on the arms, hands, face, and neck of labourers, and other per- sons who use violent exercise during the hot months of summer. It produces a sensation of tingling, a smart- ing rather than of itching, and disappears in a short time without any particular consequences. See Willan on Cutaneous Diseases. In veterinary medicine the term lichen is applied to a species of leprosy and warts which grow on horses' legs. In botany it is called liverwort, and is a floriferous and seminiferous moss, whose flowery little heads are furnished with many grains, variously shaped, producing as they ripen several little monopetalous flowers. The seeds, which are small, flat, and orbicular, are contained in some peculiar open capsules, resting upon the plane of the leaves, and are sometimes found in the same plant that bears the little heads, sometimes in other plants of the same species. Besides these flowery heads, in some species there are umbellated heads of different figures, which produce neither flower nor seed. The pedicles of both species are for the most part naked, and proceed from no vagina. The leaves are of an herbaceous con- sistence, and of an indeterminate figure, widely spread- ing, and running out into various roots from their back part. Every plant under the name of lichen is warm and astringent; and this term is applied to the muscus pyxidatus, hepatica vulgaris, &c. besides the succeeding. Li'chen arbo'reus pu'llus, muscus cruste. Tree liverwort, lichen plicatus Lin. Sp. PI. 1622, grows on trees, and is used instead of the pulmonaria arbo- rea. It is astringent, and chiefly used in pulmonary haemorrhages. LIC 869 LIG Lichen ctne'reus. Ash coloured ground liverwort; lichen caninus Lin. Sp. PI. 1616. It consists of roundish thick leaves, divided about the edges into obtuse segments, flat above, of a reticular texture below, fastened to the earth by small fibres, of an ash grey colour, by age turning darker or reddish. It grows on commons and open heaths, spreads quickly on the ground, and is found at all times of the year, but sup- posed to be most active from the end of autumn to the Avinter. A poAvder, called pulvis antilyssus, used to be formed of two parts of this moss, and one of black pep- per : 3i- ss- m half a pint of cow's milk, for four morn- ings successively, was to be taken fasting. (See Hy- drophobia.) It has now fallen into disrepute ; and does not appear to be possessed of any useful degree of medicinal virtue. Li'chen isla'ndicus, Lin. Sp. PI. 1611 ; lichen terrestris; lichenoides; and rigidum; eryngo leaved, eatable,-. Iceland lichen, is a native of Britain, and grows both in Scotland and Wales. It is foliaceous, erect, large; leaves crowded, connected, about two inches high, stiff when dry, but soft and pliant when moist: they are variously divided, without order, into broad distinct segments, turned in at the edges, and fringed with short strong bristles; the upper surface is smooth, concave, shining, of a pale green, or chestnut colour, but red at the base ; the under is smooth and whitish, a little pitted and sprinkled Avith very minute black warts : the fructifications are large, of a reddish colour, and placed on the lobes of the leaves. This plant is extremely mucilaginous, has a bitter and someAvhat astringent taste, and is considered as a laxative and an anthelmintic in its recent state : but its bitterness and aperient quality are in a great measure destroyed by drying, or a slight infusion. The Icelanders make a flour of it, called fialgras, either by first Avashing and cutting the plant into small pieces, or by drying it, putting it into a bag, which is well beaten, and Avorking it into flour by stamping. This is tolerably agreeable and grateful food. As a medicine, Scopoli and Haller recommend it in coughs and consumptions ; and it has proved effi- cacious in dysentery and diarrhoea. Dr. Hertz found it so successful in dysentery, that after the repeated ad- ministration of emetics and cathartics he seldom used any other medicine, to which he occasionally added opium. Dr. Crichton recommends it in phthisis attend- ed with hamioptoe and pituitous or mucous discharges; and thinks he has found it of considerable service. It is given in decoction, made by boiling one ounce and an half in a quart of milk, over a slow fire, exactly a quar- ter of an hour. The dose is about a pint in the day. If the milk disagrees, water may be used. This medicine has lately become fashionable ; but we have only found it a mild nutrient. The bitter is apparently of the nar- cotic kind, and at times is cold and heavy on the stomach. If this is taken away by a slight previous infusion, a mucilaginous, or rather a farinaceous matter, only re- mains, without apparently any distinguishing property. At Berlin it seems to have been used with differentsuc- cess. M. J. C. Fritze thinks it a valuable medicine, even when purulent matter is expectorated; and he added to the decoction, either in milk or water, the flowers of St. John's wort and coltsfoot. F. Fritze, in his Clinical Annals, chiefly confines its utility to its mildly nutritious powers; and Scheffer A\-as usually un- successful with it, except in recent, apparently catarrhal, cases. Li'chen pyxidatus, Lin. Sp. PI. 1619, (from pixis, a cup, in consequence of its bearing little cups). See Muscus pyxidatus. LICHENOI'DES, (from lichen, and eifos, likeness). See Lichen IslanDicus. LI'EN, (from Xeios, soft, or smooth). See Splen. Li'en sina'rum. See Faba .Egyptia. LIENTE'RIA, (from Xeiov, smooth, and evlepov, the gut). A lientery. Levitas intestinorum, q. v. In Dr. Cullen's system it is the fifth species of diarrhoea; defined a diarrhoea in which the aliments are quickly hurried through the body in a nearly undigested state. Fernelius attributes this disorder to a weakness of diges- tion, Friend to an obstruction of the intestinal glands, and Fr. Sylvius to an obstruction of the orifice of the lacteals. Actuarius observes, that an inveterate diarrhoea or dy- sentery most commonly produces the distemper. The fault is generally in thp stomach, as the digestion is not complete ; and the unaltered food producing an unusual impression, excites the action of the intestinal fibres, and probably also of the mucous folicles. The chief remedies are warm strengthening medicines, with mo- derate exercise and warm clothing. See Diarrhcea. Liente'ria sponta'nea. See Diarrhcea. LIGAME'NTUM, (from ligo, to tie). Colligamen,^ copala, syndesmos, a ligament. The ligaments are tendinous, inelastic, glistening bodies. Every articu- lated bone is furnished with a capsular ligament, which is composed of two layers : the external layer is the stronger, formed by the periosteum; the inner is thin and uniform. This part of anatomy, though so important in many respects, has been, however, greatly neglected, if we look at those aids Avhich are not derived from actual dis- section. The representations of the ligaments have, in general, been mean, incorrect, and inelegant. While each bone is delineated so as to display every little pro- minence and furrow by Albinus and Le Sue; while each unimportant muscle is represented in all its va- rieties by Bidloo ; the ligaments have been little noticed. The minute accuracy of Soemmering cannot find, in the fasciculi of Haller, the discriminating genius of Albinus. De Corp. Fabrica, v. xxxi. In Vesalius we perceive the ligaments of the loAver limbs delineated, and in Winslow they are de- scribed. Walter has figured and described the liga- ments of the lower extremities (Disput. Anatom. Hal- leri, vol. iv.) ; Schwencke, in his Haematologia, those of the acetabulum : but the first professed work in which all the ligaments were described and delineated, was that of Weitbrecht, published at Petersburgh, 1742, in quarto. His dissections were numerous; and he not only collected the observations of former anatomists, but compared them with Avhat his scalpel had shoAvn. His engravings, however, imperfectly represent the ob- jects ; and some ligaments are omitted, particularly of the os sacrum. Yet till lately Weitbrecht was our only assistant, and his plates have been professedly copied in an elegant work on the bones by Losche, concluded at Erlang, 1796 ; and in another by Schenkc, published at Leipsic in 1795. In these, however, the objects are LIG 870 LI G diminished, and the representations are consequently still more distant from nature. Somewhat before these copies of Weitbrecht, Loder published his anatomical tables at Weimar, viz. in 1794; and, perceiving that this part of anatomy had received less attention than some others, introduced new plates of the fresh joints, from his OAvn preparations. The abilities of the engraver were not equal, however, to the diligence and ability of the anatomist; yet Loder greatly excelled his predecessor. The order of time, rather than the improvement, leads us to speak of Mr. J. Bell's plates of the joints, subjoined to those of the bones. The errors of the osteology are, however, con- tinued in the ligaments; and the plates are so miserably executed, that Avithout the explanation no anatomist could guess at the object before him. Anatomical plates are, however, often miserably executed ; and, in a Dic- tionary now publishing, we shoAved a view of the basis of the brain to several anatomists, Avho supposed it a herniary sac; and, indeed, every thing but what it Avas. Morgagni long since observed, that many of the liga- ments remain to be more accurately examined than in Weitbrecht's work ; and that to which Ave have been in- debted for our plates is, undoubtedly, the most perfect which has yet been published. We mean the Syndes- mology of Caldani, published at Venice, in imperial folio, 1803. The elegance, the accuracy, and the mi- nute precision of the descriptions have led us to copy from it freely; and we have engaged in this short ac- count of what was before done, to show the importance of what we have added to the stock of the English ana- tomist. Ligame'ntum annula're. The appellation of annular ligament, or frenu7n, is given to that on each ankle and each wrist, rather on account of their use than their figure; they confine the tendons of the muscles which pass through them. Ligame'ntum arterio'sum. See Ductus arte- riosus. Ligame'ntum cilia're. White, striated, liga- mentous fibres arise out of the choroid membrane, from the ciliary circle, which are covered with a black pig- ment, and are attached to the membrane of the vitreous humour, where it joins the crystalline lens. The fluc- tuating extremities of these striae are spread on the edge of the lens, but not united with it. The whole is ge- nerally described under this term. Ligame'ntum co'li de'xtrum. The mesentery hav- ing reached the end of the ileum joining the colon, the lamina which is turned to the right side forms a small transverse fold, distinguished by this appellation. Ligame'ntum co'li sini'strum. The mesen- tery, here called mesocolon, having passed beloAV the left kidney, contracts and forms a transverse fold thus named. Ligame'ntum co'lli vel nuch-e. See Cuculla- ris. Ligame'ntum cuta'neum o'ssis co'ccygis. It passes anteriorly from the extremity of the os coccygis; is very slender, and divides into two portions at the orifice of the anus, which run in the membrana adiposa, and, when expanded, are inserted in the skin on each side of the anus : they continue to divaricate, and are lost on the two sides of the perinaeum. Ligame'ntum dentioula'tum. Between the ante- rior and posterior bundles of fibres Avhich form the spinal nerves, a ligament is connected by a number of threads, to each side of the pia matral covering of the spinal marrow, through its Avhole length, for its support. As this ligament is fixed by a number of teeth to the inner side of the sheath formed by the dura mater, it has been called denticulatum. The greater number of these teeth run transversely ; some ascend,others descend; all split into fibres, which are incorporated Avith the fibres of the inner layer of the dura mater. From the conical lower end of the spinal marrow, a cord is produced, which reaches to the os coccygis, and there splits into threads, which may be considered as the termination of the last teeth of this ligament. Ligame'ntum Fallo'pii. See Ligamentum Pou- PARTII. Ligame'ntum he'patis suspensorium, the remains of the umbilical vein. Ligame'ntum intermaxilla're. A ligament on each side of the face, which connects the two jaws, and receives the posterior fibres of the buccinator muscle. (Winslow.) It is strong and broad, fixed to the outside of the upper jaw, above the last dens molaris, and at the side of the apophysis pterygoidaeus internus. By the lower end it is fixed on the outside of the loAver jaw, be- low the last dens molaris. Ligame'ntum latum, or suspenso'rium hepatis, is made up of the double membrane of the peritonaeum, which covers the liver on each side, and meets to be joined by the sternum. Ligame'ntum Poupa'rtii, or Fallo'pii. Poupart's " ligament. It is only the lower border of the descending oblique muscle of the belly stretched from the fore part of the os ilium to the pubes. Ligame'ntum pu'bis interosseum, is a strong trian- gular ligament, fixed by two of its edges in the inferior branches of those bones, all the Avay up to their common symphysis; the third edge, Avhich is lowest, is loose; and this whole membrane, the middle of which is per- forated by a particular hole, is stretched very tight be- tween the two bones, and under their cartilaginous arch, to which it adheres very closely. Ligame'ntum rotu'ndum. The round ligament. One of these is found on each side of the uterus; and each is composed of a plexus of blood vessels upon the fore part of the ligamenta lata, running in the duplica- ture of these ligaments. From the corners of the fun- dus uteri, they pass through the annular aperture of the obliquus externus, and are lost in the middle and upper part of the fat in the groin. Ligame'ntum suspenso'rium. See Corpora caver- nosa penis. LIGA'TIO, and LIGATU'RA, (from ligo, to bind). A bandage, or ligature (see Fascia) : a stiffness of the joint, and sometimes that impotence supposed to be induced by magic. Ligatu'ra ve'neris. Camphor, which is supposed to check the venereal appetite. See Camphora. LIGNUM, (from lego, to gather). Wood ; because its branches are gathered into bundles for domestic use; a term applied to many medical substances; as, lignum ALOES, LIGNUM GUAIACUM, LIGNUM QUASSIA, &C vide In verbis. LIG 871 LIM Li'gnum Campechia'num. See Campechenese lig- num. Li'gnum colubri'num; strychnos colubrina Lin. Sp. PI. 271. It is of the same genus, perhaps the same species, which affords the nux vomica, and is, like it, in- tensely bitter and acrid. Like every poisonous sub- stance, it excites the greatest commotions in the system, and is emetic, cathartic, diaphoretic, and anthelmintic, seeming to affect also the intellectual powers. As its name imports, it has been given to those bitten by ser- pents, to cure intermittents, and to destroy worms. Li'gnum moluccense A'el pavanjE. The seeds of the tree, croton tiglium Lin. Sp. PI. 1426, which affords this wood are called grana tiglii; and these, as v, ell as the wood, are highly acrid, producing the most violent commotions in the whole body, Avith discharges from almost every excretory. The oil of the seeds is, hoAvever, perfectly mild; and the genus is nearly allied to the ricinus which affords the castor oil. Li'gnum nephri'ticum. It is supposed that this wood and the Behen nuts are from the guillandina mo- r'mga Lin. Sp. PI. 546. The first is of a pale yellow, though it tinges wood of a fine blue colour; the taste is slightly acrid and bitterish. The nuts are mucilaginous and oily; their oil keeps long without rancidity. It has been used in itch, besides the disease from Avhich its name is derived. Li'gnum rho'dium, probably from the genista ca- nadensis Lin. Sp. PI. 997. Much confusion has arisen respecting the real tree from which this wood is taken, in consequence of its being supposed the same Avith the as- palathus of Dioscorides; for the aspalathus of Galen Avas abark. The aspalathus of the moderns was the calambour wood, or the lignum aquilae, resembling the lignum aloes. The lignum rhodium, at present sold", is in long crooked pieces, full of knots, of a reddish yellow colour. The largest, smoothest, most compact, and the deepest coloured, h> preferred. The taste is bitterish, and some- what pungent. It smells strongly like a rose; and the wood, as well as the oil, is supposed to be sudorific. Li'gnum se'rpentum. The Avood of the ophioxy- lum serpentinum Lin. Sp. PI. 1478. LIGU'STICUM, (from Liguira, the country Avhere it flourished). See Levisticum. LIGU'STRICUM. See Seseli vulgare. LIGUSTRUM, (from ligo, to bind, from its use in making bands). Privet. Ligu'strum I'ndicum; alcanna, Cyprus Dioscoridis et Plinii, elhanneArabum. Eastern privet; the henna of the Turks and Moors, and lausonia inermis Lin. Sp. PI. 498. It is reckoned emmenagogue, but is little used, except to impart a red colour to the nails of wo- men and the beards of men. Phillyrea, or mock privet, is said to be an astringent; but, like the rest, is neglected in practice. Ligu'strum vulga're, ligustrum Germanicum, primprint, or common privet; ligustrum vulgare Lin. Sp. PI. 10 ; is a shrub Avith rough pliant branches, and much used for hedges in gardens; the flowers grow in spikes, and are of a Avhitish colour, followed by clus- ters of black berries : they appear in May and June; the berries are ripe in September. There are other plants of this name reckoned some- what astrint'cnt, and useful in hysteric disorders, but they are never used. LILIA'STRUM ALPI'NUM MIXUS,(fromMw/», the lily, which it resembles). Spider avort. Phalan- giu7n allobrogicam, anthericum liliastrum Lin. Sp. PI. 445. This plant is chiefly used as an ornament in gar- dens, though it is said to resist poison, and to be useful in relieving cholic. LI'LIO HYACI'NTHUS, (from lilium, and hyaci7i- thus, because its roots resemble those of the lily, and the floAvers those of the hyacinth). The lily hyacinth. Scilla lilio hyacinthus Lin. Sp. PI. 442. The roots like those of the lily, promote suppuration. LI'LIUM, (from Xstos, smooth, graceful). The LILY. Li'lium convallium minus. See Monophyl- LON. Li'lium a'lbum. The common white lily, lilium candidu77i Lin. Sp. PI. 433, is perennial, a native of Syria and Palestine, common in our gardens, and fiow- ers in June. The flower gives an agreeable flavour to expressed oil, and the roots are extremely mucilagi- nous; boiled with milk or water, they are useful in emollient and suppurating cataplasms: but the bread and other farinaceous poultices possess equal advantages. Dr. Alston thinks the roots are of the nature of squills. Godorus, serjeant-surgeon to queen Elizabeth, cured many dropsical people, by giving them bread in Avhich these roots Avere baked. Li'lium conva'llium convellaria Maianthemum, May lily, and lily of the valley, convallaria majalis Lin. Sp. PI. 451. Its flowers are smaller than any other lilies, have a penetrating bitter taste and a fragrant smell : the bitter remains both in the spirituous and Avatery extract; and is nearly as purgative as aloes. The dried flowers are a strong sternutatory; and the roots possess the bitter and purging qualities of the flowers. The floAvers Avere formerly used in nervous complaints, sometimes in spasmodic asthmas, or catarrhs. Li'lium ru'brum, hemerocallis fulva Lin. Sp. PI. 462, lilium purpurocroceum, lilium croceum. Orange lily. The leaves are cooling, and the roots aperient and stimulating. Li'lium Paracelsi, a fanciful term of that enthusiast for a very pungent penetrating alkaline tincture. LIMACES. Snails. The common garden snail; Umax agrestis Lin. Syst.Natur. 1082, is viscid and glu- tinous, supposed to be highly nutrient, and employed sometimes, seemingly Avith advantage, in hectics. The gluten of the I. maximus cinereus L. 1081, is used as a re- solvent liniment in glandular tumours. See Mollusc a. LIMATU'RjE FE'RRI, (from lima, a file). See Ferrum. LIMO'NIUM, (from Xetftav, a marsh, from its co- lour,) sea lavender; statice limonium Lin. Sp. PI. 394, is astringent, and said to be given with success in diarrhoeas, dysenteries, menorrhagia, and all kinds of hae- morrhages. The roots and leaves are chiefly used. A name also for behen rubru7n and beta sylvestris. LIMONUM (from Xetftov, from the green colour of its unripe fruit, or from the Hebrew term ri7non). The lemon tree ; citrus medica, malus medica and persica Lin. Sp. PI. 1100, 0, is a native of Asia, but cultivated in the Avarmer parts of Europe. Linnaeus reckons the citrons and lemons to be only varieties of one species, distinguished from the oranges only by the pedicles of the leaves being naked. LIxN 872 LIS The yellow rind of lemons is a grateful aromatic, and very commonly used in stomachic tinctures and infu- sions, as it conceals the disagreeable flavour of many bitters. It affords an extremely volatile essential oil, of a pale straAV colour, in smell as agreeable as the fresh peel, which is employed as a perfume; but often adul- terated with spirit of wine, or with oil of turpentine. If it is adulterated Avith oil of turpentine, on adding a little spirit of Avine, the mixture becomes milky; if with spirit, the addition of oil of turpentine has the same effect. The juice of lemon is more acid than that of oranges: half an ounce of good lemon juice saturates about a scruple of fixed alkaline salt; and this mixture, with the addition of a small quantity of any aromatic water, is useful in relieving nausea and vomiting; especially if taken during its effervescence. It is called the saline draught of Riverius, is cooling, and from this effect pro- motes perspiration in fevers. The juice often allays hysterical palpitations of the heart, and, in jaundice, four or six ounces taken in a day are highly useful. Its other properties are similar to those of the orange juice. The salt of lemons usually sold is the salt of wood sorrel, the oxalic acid differing, however, but slightly from the citric, and flavoured with the essen- tial oil of lemons. The concrete salt is pure acid se- parated from the mucilage in the way recommended by Scheele, viz. uniting it with calcareous earth, and se- parating the acid by means of the vitriolic. As an an- tiscorbutic, lemon juice is generally taken on board of ships; but it spoils by long keeping, unless a small por- tion of ardent spirit be added. It is sometimes boiled to the consistence of a rob ; but the mucilaginous part is then burnt, which gives a bitter flavour, and the acid is in part decomposed : indeed, for all the purposes of an antiscorbutic the juice must be fresh. See Neu- mann's Chemical Works; Lewis's Materia Medica. LINAGRO'STIS, (from Xivov, cotton, and xypoo-Its, grass; from the softness of its texture). See Panicum. LINA'RIA, (from the resemblance of its leaves to those of flax,) osiris urinaria, flax weed, or com- mon toad flax, antirrhinum linaria Lin. Sp. PI. 858. The common sort resembles the esula minor so closely, that it cannot be distinguished before the flowers ap- pear but by breaking the stalk, as the toad flax is destitute of the milky juice. It is perennial, grows wild about the side of dry fields, and flowers in June and July. If the leaves, which are bitterish, and of a saline taste, resembling in smell, when rubbed, the elder, are inwardly used, they are diuretic and purga- tive and particularly powerful in the latter view. The plant has been supposed also an aperient and deobstruent, and used in jaundice. Externally they have been com- mended against the piles. A name also for a species of elychrysum. LINA'RIA HEDERA'CEO FO'LIO. See Cym- balaria. LI'NCTUS, (from lingo, to lick). Lohoc eclegma, elexis, eclectos, illinctus, lambative; a composition thicker than syrup, but softer than an electuary, first made to be licked from a stick of liquorice, and then gradually swallowed. A linctus is usually formed of mucilages, or of oils mixed by means of mucilage, and often slightly acidulated. It is chiefly used in disorders of the inward parts of the mouth, the fauces and oeso- phagus, as in aphthae, and tickling coughs from defluc- tions of thin serum; but it soon palls. LINEA A'LBA, vel CENTRALIS, (from linum, a thread, and album, white, from its appearance and colour, or situation). It extends from the os pubis to the cartilago ensiformis, and so high as the navel it is a mere line, but above broader. It is formed by the union of all the tendons of the abdominal muscles, which, by their united action, compress the belly. In this line the trochar, in tapping, is often introduced, and it is divided in hysterotomy, as the wound is attended with but a slight haemorrhage. LI'NEiE SEMILU'NARES terminate the lower part of the external oblique muscle of the abdomen, and are lost at the upper part. Li'ne.s transve'rsje pass between the linea alba and lineae semilunares, formed by the tendinous lines of the recti muscles. They are not directly transverse, as often represented, but irregularly waved. LINEA'TUS, (from linea, a line). A leaf whose surface is streaked with lines. LINGO'DES, (from Xiyya, to sound). An appella- tion of fevers attended with an hiccough. LI'NGU A, (from lingo, to lick). The tongue, glot- ta, plectrum. This term is also applied to some vege- table substances, from their similarity in shape to the tongue. In animal bodies it is composed of two parts; the inferior is a mass of muscle; the upper surface is, towards the apex, full of papillae, which, when traced backward, become more irregular and flat, whence au- thors distinguish the papillae pyramidales, capitatae, and lenticulares; but each kind is a mass of vessels running from the basis towards the apex. Near the epiglottis the surface of the tongue is glandular; and near the middle is*a chap, called the foramen cecum, first de- scribed by Morgagni, and since supposed by Vaterus, without foundation, to be the orifice of salivary ducts. Under the papillae, on the.surface of the tongue, are fleshy fibres running in every direction; to these its great variety of motions is owing: under the tongue is a mem- branous substance, called frenum, or filetum; the part next the root is called cephaline; the tip, proglossis. Li'n'gua a'vis. The seeds of the ash so called from their resemblance. See Fraxinus. Li'ngua cani'na. See Cynoglossum. Li'ngua cervi'na, calcifraga, phillitis scolopendri- um, asplenium scolopendrium Lin. Sp. PI. 1537. Hind's or hart's tongue, is a plant with long, uncut, narroAv leaves, of a bright green colour, standing on long hairy pedicles, without any stalk or manifest flowers: the seeds are a fine dust, lying in large, rough, brown, transverse streaks on the backs of the leaves. The plant is perennial, found gi*een every season, delight- ing in moist, shady, stony places. The leaves are commended as aperient and corroborant, particularly in diseases of the viscera; but not at present employed. Li'ngua serpe'ntis. See Ophioglossum. LINGUA'LES, (from lingua, the tongue). The ninth pair of nerves. See Hypoglossi externi. Lingua'les gla'ndula ; those at the basis of the tongue. See Lingua. Lingua'lis mu'sculus. The muscle of the tongue, rises from the basis of the os hyoides, and runs to the tip of the tongue. It consists in general of fleshy fibres, which run in many directions; but L1N 873 LIP those fibres chiefly distinguished by this appellation turn the tongue laterally and dowiiAvards. Mr. Home has shoAvn, that the tongue fs by no means an irritable muscle, and that any part of it may be cut off' with little danger. LINIME'NTUM, (from lino, to anoint), Lini- mf.m, hypaleipton,litus,perichrisis, is a thin ointment, and principally designed for an application Avhere the tenderness of a part will not admit of a hard one. Sometimes the term is applied to an application almost fluid ; but when it approaches this state the appropriate application is a wash. The minute precision of the ancient pharmaceutists is noAV, however, often disre- garded. Linime'ntum a'lbum. See Spermaceti. Linime'ntum arce'i. See Elemi. Linime'ntum bitu'mints ammoniatum. R. Petrolei Barbadensis ± i. ss. aquae ammoniae purae 5 ss. m. This is a strong stimulant, applied in diseases of the hip. Linime'ntum ca'mphor.s compo'situm. R. Cam- phorae 3 ij- olei olivae ? i. aq. ammon. purae % iij. m. in oleo prius solvatur camphora, deinde adjiciatur aqua ammoniae purae; an application of use in deep seated inflammations, and to hasten suppuration. Linime'ntum ca'mphor.e ammonia'tum. R. Spiritus camphorat. £ij. aquae ammoniae purae 3 ij. m. used in chronical enlargements of the joints, and other affec- tions, which require the use of external stimulants. Linime'ntum ceru'ss^e cum sapo'ne. See Plum- bum. Linime'ntum oleo'sum. See Ambusta. Linime'ntum sapona'ceum, Uni7nentum ,sapo7iis, for- merly called opodeldoc, and saponaceous balsam, and chiefly employed for external purposes in rheumatic pains, sprains, and bruises. The London college di- rects the folloAving very liquid form, because the soap acts more advantageously Avhen diluted.—Take of the spirit of rosemary, Jfoi.; hard Spanish soap, three ounces ; camphor, one ounce ; digest the soap in spirit of rosemary until it is dissolved, and add to it the cam- phor. Ph. Lond. 1788. See Opodeldoc. LINNiEA, borealis Lin. Sp. PI. 880. Its leaves are bitterish and subastringcnt. They are employed in de- coction as a fomentation in rheumatism, and the infu- sion in milk has been recommended in sciatica. LINO'SYRIS, (from Xtvov, flax). An herb Avhose leaves resemble those of flax. See Elichrysum. LI'NQUART. See Discessus. LI'NTEUM, lint, (from linum, flax; of which it is made). When lint is used in a flat oval form it is called a pledget; when cylindrical, a dossil. It is used as a medium for applying ointments, to stop haemorr- hages, and, in the form of a dossil, to prevent wounds from closing. When merely to defend wounds is re- quired, poultices are now preferred to lint. See Car- basus. LI'NUM, (from Xnos, soft, smooth; from its smooth texture). Flax. Linum usitatissimum Lin. Sp. PI. 397, is properly called line, only while standing green in the field, Avithout any inner bark : when the inner bark is perfected, it is called flax. Line, or lintseed, is of a reddish brown colour, glossy, flat, slippery, nearly oval, and pointed, with an unctu- ous, mucilaginous, sweet taste, but no smell. On ex- vol. 1. pression much oil is obtained from it, which, if draAvn Avithout heat, is insipid, but does not congeal Avith the winter's cold, nor form a solid soap Avhen mixed with alkalis, but acts more poAverfully than any expressed oil as a menstruum on sulphureous bodies. When this oil is SAveet it is emollient; when rancid, it is said to be more powerful as an expectorant. It is supposed to be more healing than the other oils of this class, and con- sequently more often employed in pulmonary com- plaints, in colics, and constipations of the bowels. In burns and scalds, and Avhen Avomen's breasts are in- flamed from the milk stagnating in them, it affords considerable relief. If the seeds are boiled in Avater, they afford a large quantity of mucilage ; but if designed for internal use, an infusion is more agreeable. Infu- sions of lintseed are emollient and demulcent, of use in tickling coughs, stranguries, Sec. A spoonful of the seeds unbruised is sufficient for a quart of Avater; but liquorice root is often added, and, with the addition of colt's foot leaves, it is called the pectoral infusion. The mucilage obtained by inspissating the decoctions is an excellent addition for reducing powders of an un- pleasant taste into the form of an electuary. The seeds may be used for promoting the digestion of abscesses after the oil is expressed from them ; but such applica- tions are generally made by stirring a sufficient quantity of the meal into boiling water to form it of a proper consistence. A cataplasm of this kind is esteemed as an emollient; but the lintseed meal alone is so mucila- ginous that it requires the addition of some soft bread to adapt it for this purpose. See Lewis's Materia Medica. It is the name also of some of the finer species of Amianthus, q. v. Li'num catha'rticum, Lin. Sp. PI. 401, linum mini- mui/i, chamelininn, mountain flax, mill mountain, and purging flax, is a small plant, with little, oblong, smooth leaves, having one rib running along the mid- dle. The stalk is slender, reddish, divided toAvards the upper part into fine branches, bearing on the tops white floAvers, followed, as in the common flax, by roundish ribbed capsules, with ten flattish unctuous seeds in each. It is annual, and grows wild on chalky hills and dry pasture grounds; is an effectual, safe purge; for which purpose a handful of the fresh leaves infused in wine or whey, or a drachm of the leaves in poAvder, is sufficient. See Raii Historia ; LeAvis's Materia Medica. LIPARIS, (from Xtros). Fat. LIPAROCELE, (from Xtros,fat, and xtjXv, a tumour). Any tumour containing a fatty substance. LIPODE'RMUS, (from Xeira, to leave, and fopfut, the skin). See PrjEPutium'. LIPOMA, (from Xtros, fat). An indolent, fatty tu- mour, often fluid in the centre. LIPO'ME. See N^evus. LIPOPSY'CHIA. See Leipopsuchia. LIPOTHY'MIA; Leipothy'mia, (from Xeiru, to leave, and Sv/tos, the 7nind). Fainting. Deliquium animi, defectio, exanimatio, syncope, asphyxia; virium lapsus; in a greater degree, apopsychia, and echysis; syncope of Dr. Cullen, who places it in the class neuro- ses, order adynamia; defining it the motion of the heart diminished, or at rest for some time. The species are, 1. Syncope cardiaca, when it often returns without any evident cause, Avith A-iolent palpitations of the heart at 5 T LIP 874 L I Q intervals ; from some fault of the heart, or contiguous vessels. 2. Syncope occasionalis, when it arises from a manifest cause, from an affection of the whole system. Each is styled idiopathic : the symptomatic species are, sy7icope fcbrilis, exanthematica; stomachica; hysterica; arthritica; scorbutica. The ancients named it cardia, when caused by anger: and what we termed syncope they called Cardiaca passio, q. v. In this disease the pulse and respiration become sud- denly weaker than usual, and, to the perception of the attendants, seem often wholly to cease. In its slightest degree the patient constantly perceives and under- stands, without the power of speaking; and this often happens to those who are disturbed with flatulencies, Avithout any remarkable alteration in the pulse.—If he loses his feeling and understanding, with a considera- ble sinking of the pulse, it is called a syncope. If so violent Uiat the pulse seems totally to have ceased, with- oui any discernible breathing, and a manifest coldness of the whole body, with a Avan livid countenance, it is some- times followed by death, and called an asphixy, or a total resolution. This last degree, in most instances, constitutes, according to Dr. Cullen's arrangement, varieties of apoplexy, and these chiefly of the species which he calls venenata. The causes are either an excess or a deficiency of blood, a loaded or disordered stomach, violent pains, nervous complaints, passions of the mind, a polypus in some of the principal blood vessels, and opiates, or ac- tive deleterious medicines, or effluvia. The different degrees of this disorder should be dis- tinguished from hysteric fits, epilepsy and the apoplexy. In the two former diseases there are generally spasms; in the latter the breathing continues, and is laborious, or stertorous. When either disease is without these appropriate symptoms it becomes syncope, or distinc- tion is of little importance, as the remedies are the same. Those subject to frequent faintings, without any ma- nifest cause, usually die suddenly, and polypi are found in the large blood vessels. When anger, in weak per- sons, or worms, is the cause, the disease is dan- gerous. During the fit, cold Avater, or vinegar and water, may be sprinkled on the face, and a little of the same poured doAvn the throat. Strong vinegar, or volatile spirit, may be held under the nostrils, the extremities well rubbed, and, as soon as the poAver of SAvallowing returns, a glass of Avine, brandy and Avater, of fetid tincture, or of the spirit of hartshorn Avith water may be given. When"the fit is over, the cause must be diligently examined, and the morbid state of the system, from which it seems to arise, will determine the plan of treat- ment. When no distinct cause can be assigned, when the face is livid, and the breathing difficult; when the left hand is cold, and the patient cannot be easy on ei- ther side; when it is brought on by extraordinary exertions, by exercise, or whatever increases the circu- lation through the lungs, we have much reason to fear that it proceeds from an affection of the heart. This is sometimes an enlargement of its cavities, or its conti- guous vessels; sometimes an accumulation of water in the pericardium or lungs, or ossifications of the valves. In such circumstances medicine is of little avail. Small bleedings, easy laxatives, camphor, Avith nitre, and whatever lessens the impetus of the blood, are advan- tageous. The most perfect repose of body and mind, the mildest food, and the most cooling liquors, are ne- cessary. A blister from some part of the chest has also been found of service. It often happens, however, that syncope arises from fulness of the stomach and boAvels, and, in the greater number of cases, emetics, with repeated laxatives, will succeed. These, at least, should be tried before die patient is alarmed Avith apprehensions of a topical affec- tion of the heart. Excess or deficiency of blood are obvious causes, and easily removed, at least for a time; but one less within our power is that general mobility of the system where every excitement is followed by a proportional sinking. Tonics and cold bathing will have some effect; but the cure is only found in the torpor of advancing years. See Asphyxia. LIPPITU'DO, (from lippus, blear eyed). See Epi- hora and Xerophthalmia. Celsus means by it an ophthalmia. LIQUEFA'CTIO. Melting. The fluidity of a body when exposed to heat, probably from the combination of caloric. Though we know bodies permanently aeri- form, Ave know none permanently fluid, except alcohol and ether ; and those are apparently such, because they have not been exposed to the requisite degree of cold. It is not necessary to liquefaction that the body wets; for this effect is owing to the greater attraction of the fluid particles to the body than to each other. Quicksilver is fluid, but does not wet. Melted lead does not ad- here to a polished iron immersed in it. LIQUIDA'MBAR,(from liquidus, and ambar). Sty- rax liquida, acer virginianum odoratum, liquidambar stiracifiua Lin. Sp. PI. 1418, is a resinous juice, of a yellow colour, inclining to red; about the consistence of turpentine; by age hardening into a brittle resin. It is moderately warm and pungent, but rarely met with genuine, and chiefly used as a perfume. See Lewis's Materia Medica. LIQUIRI'TIA, (from liquor, juice; or the Welch term elikoris). See Glycyrrhiza. LIQUOR CYRENIACUS. See Benzoinum. LiquoR .ethereus. See .Ether. Liquor cereris. See Alla. LiquoR metallicus. See Argentum vivum. LiquoR salis. See Circulatum. LiquoR veneris. See .Erugo s.ris. LiquoR a'mnii, in midwifery called the avaters, is the fluid in which the fcetus swims during gestation. The quantity of this fluid is different in different wo- men, and in the same woman in different pregnancies. It is largest in the earliest months, and when the mother is past the prime of life, or the child is weak-. At par- turition the waters, as they are called, exceed two quarts, and sometimes scarcely two ounces. There are, occasionally, what are styled false waters, Avhich are fre- quently discharged at different periods of pregnancy; but if the amnios be really ruptured, labour is inevitable. It is noAv admitted that this fluid is exhaled from the vessels of the fcetus, and does not contribute to its nour- ishment. See Fcetus and Amnion. LiquoR mineralis anodynus Hoffmani. Hoff- man, the inventor of this medicine, highly extols it LIT 875 LIT as an anodyne and antispasmodic. In the Paris Phar- macopoeia the folloAving formula is given ; but it is not certainly knoAvn to be that which Hoffman employed, as he never revealed it. Hoffman's mineral anodyne liquor.—To one pint and a half of highly rectified spirit of wine, placed in a large glass retort, pour, by little and little, through a long stemmed glass funnel, half a pound of concen- trated oil of vitriol. Stop the mouth of the retort; digest for some days; and then distil with a gentle heat. At first a fragrant spirit of wine will arise, and after it a more fragrant volatile spirit, which is to be caught in a fresh receiver: the receiver being again changed, a sulphureous volatile acid phlegm comes over; and, at length, a sweet oil of vitriol, which should be immediately separated, lest it be absorbed by the phlegm. Mix the first and second spirits to- gether; and, in two ounces of this mixture, dissolve twelve drops of the sweet oil just named. If the liquor hath any sulphureous smell, re-distil it from a little salt of tartar. This liquor is a mixture of what is styled the sweet spirit of vitriol, ether, and the oleum vini; a preparation not very different, probably, from the ether of Tickel. It is imitated in the Lon- don Pharmacopoeia, by adding three drachms of the oleum vini to two pounds of ether; and that of Dub- lin orders it to be prepared by draAving over one half of the residuum, after the vitriolic ether is separated. It is given as a sedative, and antispasmodic, in hysteric, arthritic, and other painful complaints ; to adults from thirty to an hundred drops, or more, with some sugar, or in an appropriate mixture. See JEther. LITHAGO'GUS, (from Xt6<&-, a stone, and xya, to bring away). An epithet for a medicine that expels the stone. LITHA'RGYRUM, (from Ait®- and xpyvp®>, sil- ver). Litharge ; lithargyrum auri, almakanda, almakarb; chrysitis, chrysitis spodos; cycima; cdlci- teosa, argyritis ; cathmia. Litharge was usually pre- pared from the lead employed in refining silver ; and it was of a deep yellow, or of a whitish colour, according to the different bodies mixed with it, or' according to the different degrees of heat to Avhich it was exposed. If its colour is dark it is called litharge of gold, alatam ; if light, of silver, almar- carida. This method, however, is not sufficient for the supply ; and it is often prepared by melting oxidized lead by a hasty fire. There are a very great variety of medical compositions, of which litharge, or some of its preparations, make the principal, and ahvays a material, ingredient. LITHA'RGYRI ACETATI A'QUA, (see Plum- bum,) is made by dissolving two pounds, four ounces of litharge in a gallon of distilled vinegar, by boiling to six pints. Litha'rgyri aceta'ti cre'mor. See Plumbum. Litha'rgyri composita AquA. See Lotio hydrar- l,YRI acetati. Ceratu7n saponis is, strictly speaking, a preparation of litharge, and is made by boiling a pound of litharge Avith a gallon of vinegar over a slow fire, constantly stirring it till it thickens; then adding ten ounces of vcllow Avax, eight ounces of soap, and a pint of olive oil. Collyrium lithargyri acetati.—\. Let ten drops of the water of acetated litharge be added to four ounces of rose water; 2. To the above let tAventy drops of camphorated spirit be added; but mix the spirit Avith the acetated litharge before the Avater, which must be added afterwards, to prevent the camphor from separating. LinimentU7n lithargyri co7nj-ositum.—R. Unguenti lithargyri cum aceto ^ ss. camph. gr. viij. cerussae acetatae gr. xvi. opii pulverizati gr. viij. m. with this the inflamed edges of the eye lids are sometimes or- dered to be anointed at bed time. Lotio lithargyri acetati camphorati. See Ambusta. Emplastrum lithargyri. See Emplastrum com- mune, and Emplastrum. » Lotio lithargyri acetati, is made by adding one ounce of rectified spirit of wine, to .two pints of dis- tilled Avater, mixed with two drachms of the Avater of acetated litharge; two drachms of proof spirit, added to the same quantities of the other ingredients, forms the aq. lithargyri acetati composita of the London Pharmacopoeia. Cataplamna lithargyri acetati. See Plumbum. Ceratum lithargyri.—R. Emplastri lithargyri; adipis suillae aa ^ iv. cerae flavae ^ ss. colliquantur, et quando fere frigida fiat mixtura, adjiciantur aquae lithargyri acetati J ij. agitentur simul donee frigescant. For su- perficial sores, or ulcers Avhose edges are inflamed, this application is much recommended. Unguentum lithargyri acetati, made by adding half a drachm of the aqua lithargyri acetati to an ounce of unguentum cerae, is applied to small ulcers, whose edges are in a state of inflammation, and preferred to the unguentum cerussae acetatae, because it is more readily made, and does not soon groAv rancid. See NUTRITUM UNGUENTUM. Unguentum lithargyri compositum—R,. Emplast. li- tharg. lb ss. adipis suillae pp. ^ iv. olei olivae, unguenti cerae, aa. ^ vi. aceti uncias: quatuor; aquae lithargyri acetati ^ ij. After the unctuous ingredients are melted together and suffered to cool, the water of acetated litharge, and the vinegar, are to be gradually incorpo- rated. This ointment is applied with great effect in inflammations of the skin. Ceratum lithragyri acetati.—Take water of acetated litharge, two ounces and an half by measure; yellow Avax, four ounces ; olive oil, nine ounces by measure ; camphor, half a drachm : rub the camphor with a little of the oil: melt the wax with the remaining oil; and, as soon as the mixture begins to thicken, pour in by degrees the water of the acetated litharge, and stir con- stantly till it is cold: then mix the camphor previously rubbed with oil. Ph. Lond. 1788. LITHI'ASIS, (from XtBos, a stone). The Gravel or Stone ; more commonly the disposition to this dis- ease. (See Calculus and Adamita.) Also a tumour on the eye lid, containing a hard concretion between its coats. LI'THIAS, (from XtBos a stone). Lithiat. Salt formed by the union of the lithic acid, or acid of the calculus and different bases. LITHODE'NDRON, .(from XtOos, and fevfav, a tree). Coral ; from its resembling a petrified branch. See Corallium. LITHOEIDES, (from XtOos, and et fos, form; from its hardness). See Temporum ossa. 5 T2 LIT 876 L 1 T LITHONTRI'PTICUS, (from x,6os, a stone, and Spvr}u, to break). An appellation of medicines sup- posed to break or dissolve the stone in the bladder; cal- culifragus. Though the different stones generated in the human bladder may require different solvents when out of the body, and though art has not yet afforded a medicine, which, when injected into the bladder, will, without injury, dissolve the contained stone, Ave must not conclude that no medicine has this power, Avhen taken into the stomach, for the solvents already mentioned (see Calculus) certainly produce some effect on the urine; and more powerful ones may be found, Avhich will destroy the stone, Avithout hurting the human body. The water into which the boiled white of egg melts will liquefy myrrh, but will give no uneasiness to the eye. We have spoken already of the greater number of lithontriptics, particularly the alkalis and the bitters, which act, as avc have said, by checking the acidity in the stomach, on which the formation of calculus appears to depend. To the authorities before quoted, that the alkali penetrates with undiminished properties to the bladder, or at least with properties Avhich arise from its union with the lithic acid, Ave may add that of professor Mascagni, of Sienna, supported by that of Hufeland. The pure kali, it is remarked, may be taken in the quantity of a drachm daily, in a pint of veal broth, or a quart of pure Avater; and the carbonated kali in three times that dose. The liquor lithontripticus Loosii consists of a drachm of muriated lime dissolved in two ounces of pure water, of which thirty drops are to be taken four times a day, and the dose increased as the stomach can bear it. The aerated water, viz. water combined with carbonic acid gas, or with carbo- nated alkali and this gas, in excess, have been often used with success as lithontriptics. LITHOPHY'TON, (from Xi6os, a stone, and Qv\ov, a plant). A lithophyte, keratophyton coral; a species of plant of a horny substance, seeming to be of a middle nature betwixt avooc! and stone. Lithophy'ton nigrum. See Corallium nigrum. LITHOSPE'RMUM, (from Xieos, and o-rep/tx, semen; from the hardness of its seed). Milium solis, Mgonychon, atonychum, gromwell, graymill, li- thospermum officinale Lin. Sp. PI. 189, is a rough plant, with stiff branched stalks, oblong acuminated leaves, set alternately without pedicles, and whitish monopetalous flowers, scarcely longer than the cup, followed by roundish hard seeds. It is perennial, grows Avild in fields, and floAvers in May and June. The seeds are diuretic; but rarely used. See Lewis's Materia Medica. It is also a name for the lacryma Jobi. LITHOTO'MIA, (from XtSos, a stone, and refjoa, to cut). Cystotomia. Lithotomy, or cutting for the stone. This operation Avas performed in the time of Hippo- crates, but confined to one family; and, in the oath to be taken by practitioners, this operation is forbidden, apparently, because those to whom so delicate an inci- sion was familiar would perform it more dexterously. The method employed Ave shall soon describe as that Avith the " lesser apparatus." This method Avas im- proved in the sixteenth century, by Joannes de Ro- manis, Avhose operation Avas styled that Avith the ugreater," as it Avas a more complicated " apparatus.'' It is described by Marianus Sanctus, who Avrote so clear and comprehensive a description of the operation, with the parts concerned, that it includes every method of opening the bladder, and very plainly hints at the improved lateral method. The high operation was first proposed by Franco, a French surgeon, in the same- century. The various inconveniences which attended each rendered the attempt uncommon, till a. French priest, Frere Jacques, probably catching the hint from Marianus, attempted the lateral method; which, though unskilled in operations, and indifferently provided with instruments, he executed Avith a success which excited the applause of the world, the indignation, and, at last the emulation, of the faculty. Various improvements have been since made, which Ave shall notice in their place. We have already spoken of the symptoms of Cal- culus, vide in verbo, nor need Ave add to them, since the ultimate decision depends on the sound. This is, in fact, a part of the operation. When a stone is suspected to be lodged in the blad- der, and a fuller examination is necessary, an instru- ment called a sound is introduced into the bladder, if possible, to feel the stone. For this purpose, Mr. Sharp directs " the patient to be laid on an hori- zontal table, with his thighs elevated, and a little ex- tended : the sound, previously Avarmed and oiled, is then passed, with the concave part toAvards the opera- tor, until it meets with some resistance in the peri- nuaem, a little above the anus: it must then be turned without much force, pushed gently on into the blad- der ; and if it meets Avith an obstruction at the neck, its extremity is raised upwards, by inclining its handle. If it do not then slip in, it should be withdraAvn a quar- ter of an inch, the fore finger introduced into the rectum, and the point lifted up, Avhich will facilitate its admission." See Catherismus. When the sound enters the bladder, it must be moved round in every direction. It sometimes at once strikes against the stone, and by no artifice is the stone again found. Sometimes none meets the instru- ment. As its weight may drag the bladder doAvn on the rectum, the finger should be introduced into the gut, and that part of the bladder raised, or the body should be moved into different positions. We have remarked, that in discovering a stone Ave are more often indebted to chance than to skill; but, if once found by an experienced surgeon, the operation may be performed. We say by an experienced surgeon, since it is said that pieces of sand may strike against the catheter, and give the sensation of a stone. This, however, will not mislead a person who has once felt it. The sensation imparted by the instrument is not deci- sive of the size of the stone; and a small stone is often as readily found as a large one : but if inclosed in a sac, or if adhering to the bladder, the wrinkles of the inner coat defend it, and the sound will not detect it. If the patient uses some exercise before the search, it may detach the stone from slight adhesions. After the operation, children relapse more frequently than adults; and adults run greater hazards in the operation than children. The method employed from the first attempts to LIT 877 LI T extract the stone has been called the Celsian, sometimes the Guidonian, operation, cutting upon the gripe, or Avith the lesser apparatus. This operation will appear to be an obvious one; but the term apparatus is im- proper, since it only requires a common scalpel, and occasionally a hook. The child, for it is confined to children, though Paulus of .Egina observes, that he h.-.s practised it in a more adult age, is held in an ob- lique position, and the finger, introduced into the rec- tum, is employed in pressing the stone forward against the perinaeum, and confining it. The operator then cuts on it, and extracts it, assisting the extraction, if large, with the hook. Heister tells us, that he con- tinued to employ this mode of operating in young sub- jects. The operation Avas too simple, perhaps, for modern refinement, but it had also some inconveni- ences. It was not easy to find the stone from the rectum, or to confine it against the perinaeum, for the lime necessary to extract it. The operation also was confined to young subjects, where the parts were thin, and the pressure of the stone against the very sensible bladder was often followed by mortification. The method of De Romanis, or Avith the greater ap- paratus, Avas suggested by the facility Avith Avhich stones are extracted from the female bladder, in con- sequence of the greater size of the urethra, and its running in a less curved direction. He supposed that if the urethra in men could, by any operation, be so far curtailed, as to resemble this canal in women, the operation Avould be equally easy. This method Avas discovered about the year 1520, but not publicly de- scribed by Marianus till fifteen years aftenvards. We are expressly told, that the urethra must be divided from a little above its curvature, till the incision reaches the curvature. Then the urethra is strait and dilatable. It is consequently dilated by proper instru- ments, and the stone extracted. The plan appears plausible, but it seems, on the whole, impracticable to extract a large stone in this way; and we are led to suspect that De Romanis, under the pretence of dilat- ing the urethra, really divided the neck of the .bladder. Whether he was aAvare of this division, and dared not direct it, since Hippocrates had spoken of wounds in the bladder as fatal, Aphor XVIII. lib. vi., and Celsus had repeated the observation, V. xxvi. or that it was an accident Avhich accidentally followed, is uncertain. Le Dran, however, found, on dissection, that, in almost every instance, the neck of the bladder was split or divided; and Falconet, Avith other authors, have con- tended, that this division was intended, though dilata- tion only Avas described. The inconveniences of this operation are too obvious to be detailed. Were dilatation only meant, the effect of this violent and continued distention Avould be in- continence of urine. Were laceration, as must be very often the case, to take place, mortification would generally ensue, and such Ave find Avas frequently the consequence. At least, the greater number of patients died; and these fatal events gave an importance to the improvement first attempted by Frere Jacques. v But one other operation was previously suggested. Peter Franco, already mentioned, operating on a f hild of tAvo years old, found the stone too large to be removed through the Avound; accident suggested the possibility of opening the bladder above the pubes, which he effected, and extracted the stone Avith suc- cess. Yet alarmed, apparently, at his OAvn temerity, he never repeated the attempt, and dissuaded his fol- lowers from the operation. Even candour might sug- gest that he really failed ; but, when it Avas recollected that, just above the pubes, the peritonaeum did not cover the bladder, and that, of course it might be open- ed, without opening the cavity of the abdomen; Avhen to this was added, that the bladder, Avhen dilated, rose far above the pubes, and that a wound might be safely made of an extent to extract any stone Avhich might be contained in that cavity; it did not appear to be a very- extravagant attempt. In fact, after Hildanus, Riolan, Dionis, and others, had given a reluctant consent to the trial, and admitted its safety, it Avas often attempted. before it Avas publicly recommended, by James and John Douglass, and practised by the latter, by Heister, by Cheselden, and others, in the former part of the eighteenth century. There are many objections to this method; but, on a.gain going over the subject in the original authors, for the purposes of this short history, we were surprised to find them so feAv and inconsiderable. It is certainly not necessary to distend the bladder very considerably; yet, on the Avhole, it is expedient to do so, and to re- tain the urine for a time longer than usual, several days previous to the operation, to give the bladder greater facility of distention. The distention need not, hoAvever, be so great as to injure its tonic power. The operation indeed, for reasons which we cannot explain, has not usually succeeded, when the patient has ex- ceeded the age of thirty, or in those whose bladders are small. When the kidneys are diseased also, it is said that the modern method succeeds better. A singular and unexpected inconvenience, hoAvever, Avhich the ad- vocates of this operation endeavour to elude, is the difficulty of healing the Avound. The muscular fibres of the bladder are circular, more thick and strong round the sphincter, in fact, thus forming the sphincter itself. When the distention of the bladder, therefore, excites the action of its fibres in general, the resist- ance is less at the wound above than at the sphincter beloAV; and, indeed, it is so little at the Avound, that Avhen the high operation has followed, at the interval of a day, the puncture through the perinaeum, the urine is discharged above. The dressings are, therefore, constantly wet, and the wound soon becomes fistu- lous. But whatever may have been the advantages or in- conveniences, they have all yielded to the operation proposed by Frere Jacques, whose name it has been said was Beaulieu, and Avho came to Paris in 1697, from the provinces, destitute of money, clothes, and victuals. He Avas of an open, ingenuous temper, great simplicity of manners, requiring only what Avould repair his in- struments and mend his shoes. His operation is that which Ave shall soon describe as the lateral, but hL in- struments Avere coarse, often a razor, or a common penknife; his manner rash and violent, Avithout any fixed plan, or any knowledge of the anatomy of the parts. He soon lost his credit at Paris, and repaired to Holland, where he scarcely succeeded better; but we find him in Germany, fifteen years afterwards, greatly improved, and very successful. It is said, that he had been the servant of an itinerant practitioner. LIT 878 LIT from Avhom he had learned the art, which, from want of anatomical knowledge, he Avas unable at first to practise Avith advantage. The physicians of Paris, though they did not treat the good friar with much candour, artfully availed themselves of his hint. The same operation was sup- ported by Meri, but first practised by Mareschal. The lateral operation was soon improved by Rau of Amster- dam, by Heister, and Cheselden; and, in its present state has superseded the three former. On this ac- count Ave have not described them more particularly; but it was necessary, in giving a general vieAV of the subject, to notice the attempts and errors of others. If our readers derive from this comprehensive sketch as much entertainment and improvement as the author has done, they will not regret the little time they will have employed in the perusal. The lateral operation is described by Mr. Sharp in the following Avords from Mr. Cheselden: " The pa- tient being laid on a table, with his hands and feet tied, and the staff passed, as in the old way, let your assist- ant hold it a little slanting on one side, so that the direction of it may run exactly through the middle of the left erector penis and accelerator urinae muscles; then make your incision through the skin and fat, very large, beginning in one side of the seam in perinaeo, a little above the place wounded in the old way, and finishing a little below the anus, between it and the tuberosity of the ischium. This wound must be car- ried on deeper between the muscles, till the prostatae can be felt, when searching for the staff, and fixing it properly if it had slipped, you must turn the edge of the knife upwards, and cut the whole length of that gland from within outwards, at the same time pushing down the rectum Avith a finger or two of the left hand, by Avhich precautions the gut will always escape wounding; after this, introduce the foreceps to take out the stone. After the operation is ended, if there is an haemorrhage from the prostate gland, a silver canula of three or four inches long, covered with fine rag, may be introduced into the bladder, and left there two or three days; for it rarely fails to check it:—the pa- tient may also take an opiate. If the wound does not bleed, a little dry lint, or a pledget of digestive, may be laid in it. If a pain is felt near the bladder soon after the dressings are finished, a bladder of warm wa- ter may be applied over it; and if it increases, as there will be much danger therefrom, bleeding and clysters will be necessary." The present improved practice demands, however, a minuter detail. When a stone has been discovered by the sound, and the operation is determined on, every source of irritation must be removed. The patient, if plethoric, should be bled, the bowels emptied by mild, but sufficiently active, laxatives, interposing a dose or tAvo of calomel, and giving some doses of helleboras- ter to evacuate worms, should any be present. The Avarm bath and opiates are advised occasionally, but are apparently unnecessary. The diet should be light and mild, and diluent liquors drunk freely. It is recom- mended that the bladder be moderately filled previous to the operation, that, in the incision, the exterior part only should be wounded: but as the incision is made on the staff, this appears to be an useless refine- ment. The patient is placed on a table, about three feet high, and bends fonvards so as to take each foot in the cor- responding hand; the Avristsand ankles are respectively- confined by a broad tape. The buttocks are then, by pilloAvs, raised above the shoulders, and brought forward a little beyond the table. The sound is introduced, and the stone again sought for. If it Avas before certainly discoverrd, though it should not be at this time found, the opera- tion generally proceeds; but if the slightest doubt ex- isted in the previous searches, and it cannot now be felt, a prudent surgeon will defer the operation. If it be determined to proceed, the surgeon makes an inci- sion from the symphysis of the pubes, just beloAV the scrotum, doAvmvards and outwards to the part between the anus and the tuberosity of the ischium, a little beloAV the basis of the process. His next incision he carries nearer the raphe and anus, to avoid dividing the pudica. He thus divides the transversalis penis and part of the levator ani, so as to enable him to feel the prostate. He must guard against cutting the crura penis, Avhich he can easily feel, and the rectum, which is best secured by introducing a finger into it. He must now feel for the grooved staff, which his assistant must keep against the side of the raphe, by- pressing its handle back against the right side of the patient's abdomen. The operator must find the staff steadily opposed to him, from the bulb of the urethra to the prostate gland, and on this he must cut, from below upAvards, till the staff can be felt perfectly bare, and the incision will admit the finger, which not only- keeps the parts stretched, but guards the rectum from injury. The next step is to divide the prostate gland and the neck of the bladder. This is -sometimes performed by the knife, but the gorget, or, as the French call it, the gorgeret, is employed for the purpose. Its beak is fitted to the groove of the staff, and along it this hol- low conical instrument was forced into the bladder, tearing in its passage the neck of the bladder and the prostate, till Mr. Hawkins bent the edges a little more outwardly, and gave them an edge. This cutting gorget is now preferred. As the groove in the staff is continued to its end, the beak of the gorget slides easily off; and this part of the operation is so nice and important, that the operator usually chooses to manage both instruments himself. When the gorget is in the bladder, the urine flows out, and the operator usually attempts to feel for the stone with his finger. Whether he can discover it or not he introduces the forceps, and attempts to take hold of it; opening the forceps Avhen he perceives them touch the stone, and cautiously sliding a blade under the stone, the other is of course over it. The forceps are rough at the hollows, and finely polished betAveen these and the rivet, so that if the stone comes near the latter, it slides to the former. The operator must hold the stone with sufficient firmness to prevent its sliding, but not so closely as to break it, if brittle, and must extract it slowly and steadily. In general, one blade of the forceps should be under the symphysis of the pubes, and the other obliquely below. When the stone is small, it often falls below the line of the instru- ment; and, in this case, some operators recommend bent forceps, but it is better to introduce the finger LIT 879 LIT into the rectum to raise the stone, for by the bent for- ceps the bladder is often injured. Should the blades of the forceps appear distant, it is probable that the stone is large, or that it is held disai.;\ antageously. The last is most frequently the case, and the operator should therefore loosen his hold in order to take it in a more convenient position. It has scarcely ever happened that the stone is too large to "be extracted, if draAvn for- Avard cautiously, assisted by the finger. Should it slip and fall back at the edge of the wound, the sound and the gorget must be again introduced to guide the forceps. If the stone is broken, the larger pieces should be extracted by the forceps, and the smaller with a scoop. Afterwards warm water is to be injected, and the pa- • tient raised to an upright posture. We think, how- ever, that the anxiety for evacuating the smallest par- ticles has been too great, and that their discharge may be safely trusted to the first flow of urine. If an artery bleeds, it must be confined by a liga- ture ; but if this is impracticable, a roller should be placed in the wound, preserving a passage for the urine by a canula. The body should then be raised, so that the AV-ound may depend ; and in this state the patient must be placed in bed. The operation sometimes fails by the incision being made too far toAvards the urethra; for wounds in the urethra cannot facilitate the extraction of the stone; and, in these instances, the bladder is opened imper- fectly, and the gorget slips into the cellular membrane. The urethra is indeed divided by the cutting gorget, with the neck of the bladder; but the perfection of the operation consists in making a fair and proper opening into the bladder itself. Sometimes, when the operator has not made a fair, bold incision, too much is trusted to the gorget, and the bladder is lacerated. We know from De Romanis' operation, that lacerations of the bladder are not ahvays fatal, as w ell as from the lateral method, previous to the introduction of the cutting gorget. But there is much reason to believe that such lacerations are at least dangerous, and probably some of the fatal events may have been from the mortifica- tion subsequent to such violence. Another error is carrying the incision too Ioav, or in the lower part too near the raphe, by which the rectum is wounded, and the faeces afterwards constantly dis- charged from the Avound. The error is not indeed fatal, but the future life is truly miserable.* The place at which the proper incision must be made is indeed limited ; but it is so nicely defined, that we have heard a professor declare he could perform the operation in the dark; and Ave once kneAv a celebrated operator who remarked, that he declined the operation, rather from the bluntness of his touch than of his sight. After the operation tired nature sinks to rest; but from forty to fifty drops of laudanum are usually given to take off irritation. After a feAv hours, however, pains, apparently spasmodic, come on in the lower part of the abdomen. These are relieved by anodyne clysters and fomentations. Should the pain increase, and the belly- become hard, the case must be treated like enteritis; but anodynes may be more freely given, and Avarm clysters frequently thrown up. The Avarm bath is in these circumstances often useful. In many rases, however, notwithstanding every care, mortifi- cation comes on, the Avound appears foul and livid. In better circumstances it looks healthy; in a day or tAvo the urine is discharged from the urethra, and a cicatrix is formed in about six Aveeks or two months. Incon- tinence of urine, which often follows, is relieved by tonics and cold bathing. Calculus in females is by no means a common com- plaint, and the operation is rarely required. When the neck of the bladder and the urethra are opened from the vagina, great inconveniences occur in future labours, from the contraction induced by the cicatrices; but, when the operation i* performed, these parts are usually divided by the cutting gorget. We suspect that, in women, what is called the high or De Romanis' method would be most advisable ; but as the urethra is so easily dilated, there are feAv stones that could not be extracted without cutting. Mr. Bromfield describes the following method of dilating the urethra, apparently better than by means of tents. With the assistance of a straight, blunt, director, he introduced into the bladder the closed end of the apendicula intestini caeci of-a small animal; and leaving out, at a proper length, the open end, he filled it with warm water by means of a syringe, and pre- vented the water's escape by a ligature. He then, by twisting the exposed end of the tube, forced the con- tained Avater forwards, and this operation was repeated from time to time, till the neck of the bladder Avas so much opened, that the forceps might have easily been admitted, if required. The stone, however, was pro- pelled by the urine, and the instrument was not neces- sary. After the passage of the stone, the parts were fomented with warm milk, and with camphorated spirit of wine. Very little inflammation came on, and no disagreeable symptom. See his Observations and Cases, vol. ii. Mr. Gooch extracted a stone of four ounces weight, through an incision Avhich he made from the vagina into the bladder. This operation was attended with very little trouble, either to himself or the patient; the ulcer soon healed by the use of soft balsamic in- jections, and no inconvenience Avas observed after the healing of the parts. See Cases and Remarks, vol. ii. p. 182, 8cc. Stones impacted in the urethra are often discharged by the efforts of nature, and it is frequently astonishing to Avhat a degree the canal may be dilated. Gentle means are therefore first necessary, and oily frictions, gentle pressure, Avith the semicupium, and large doses of opium, Avill often succeed. If an operation is re- quired, the skin should be drawn forward, and the urethra divided on the stone. The skin, when restored to its former position, will prevent the urine from flow- ing through the wound, Avhich will often heal by the first intention. The operation should not, hoAvever, be so long delayed as to alloAv inflammation to come on, for mortification Avould be the consequence. When the stone is impacted near the neck of the bladder, the oper- ation is the same as cutting on the gripe. When near the orifice of the urethra, the canal may be dilated by elastic forceps. When near the scrotum, it should be either pushed backwards or forwards, and treated ac- cording to the plans already described. See Sharp's Operations of Surgery. Sharp's Critical Enquiry. Heister's Surgery. Bromfield's Cases and Observations, vol. ii. ch. 8. Le Dran's Operations. Heister's Dissertation on the High Apparatus. Bell's Suigery, vol. ii. p. 41, Sec. L O C 880 L O C LI'TRON. Nitron. See Anatron. LI'TUS, (from lino, to anoint). See Linimentum. LIVER OIL. See Oleum jecoris aselli. LI'VIDL'S MUSCULUS, (from A«&«, blackish, from its colour). See Pectineus. L1X, (from X>s, light; or from the Hebrew term lus). See Clavkllati Cineres. L1X1V1ATIO, the separation of salts by solution. LIXI'VIUM, (from lix, wood ash). A lev. That is, Avater impregnated with the salts of burnt vegetables. Lixivium ta'rtari. See Kali AquA. Lixivium sapona'rium. See Kali puri AquA. LOBE'LIA. An American plant named in honour of Lobel, found in woods and dry marshes. With the root of the lobelia syphilitica Lin. Sp. PI. 1320, the American Indians cure the most virulent pox. Five or six of the plants are boiled in water, and the patient drinks as much as he can of this decoction, in the morning and during the day. It soon purges, and the strength of the decoction is increased or lessened as the patient can bear the evacuation. If any part is sore, it is to be washed with this decoction, and thus in two or three weeks a cure is performed. Every part of this plant abounds with a milky juice, and has a rank smell. The root, which is the part preferred in medicine, in taste resembles tobacco, and sometimes excites vomiting. A handful of it, dried, is boiled in twelve pints of distilled water, till they are reduced to eight. The patient begins Avith half a pint, morning and evening, then more frequently if the purgative effect is not too violent. Should it be so, the medi- cine must be omitted for three or four days, and then again taken, till the cure is completed. The ulcers are to be washed with a decoction of the root, and if deep and foul, sprinkled Avith the poAvder of the inner bark of the ceanothus Americanus Lin. Sp. PI. 284. We OAve this description to Sir W. Johnson's influence, Avho received it from the American Indians. The prac- titioners of their country, hoAvever, do not repose in it much confidence, and seem to think its purgative ef- fect the most striking. LOBE'LLUS, LO'BULUS, (a dim. of lobus, a lobe). A small lobe. The cells of fat are called lobuli adiposi: and the extremities of the bronchiae, which end in little knobs, are called lobuli pulmonum. Winslow calls the lobe of the ear lobus, or lobulus. See Auricula. LO'BUS ECHINA'TUS. See Bonduch Indo- RUM. ' LOCA'LES, (from locus, a place). Diseases that affect, or have their seat, only in a particular part of the body. See Morbi organici and Plague. LOCA'LIS MEMBRA'NA. See Pia Mater. LO'CHIA, (from Xoxevu, to bring forth). The DISCHARGES OF THE UTERUS AFTER CHILD BIRTH, gynacia, the third species of Dr. Cullen's 7nenorr- hagia, which he defines, a sanguinary menorrhagia in lying-in Avomen. This discharge arises from the distended vessels, and proceeds till the removal of the distention admits of their contraction. In weak, ex- hausted constitutions, the discharge often continues for several days, and then only becomes a disease. In healthy habits it continues to flow freely for an hour and more, and the discharge afterwards lessens; in a feAv days it becomes less red, and then greenish. The redness begins to disappear when the breasts fill Avith milk. Its quantity is generally less after a miscarriage than Avhen a woman goes her full time; and it sooner stops when a woman gives suck, than when she does not. The lochia may produce disease Avhen deficient or redundant. The discharge in many Avomen is incon- siderable ; but, as this appears constitutional, no incon- venience arises. When exposed to cold, or fever comes on, the discharge often suddenly stops, the belly swells and is sore; a heavy load is felt in the loAver part of the abdomen and in the loins; the pulse is full and hard; pain in the head and back; a nausea, sometimes a vo- miting, and a difficulty of breathing, come on. Fever- ish symptoms, particularly rigor, generally precede the suppression of the discharge, rather than folloAV • it, and are the cause, instead of the effect; though the effect so soon follows, that it is often difficult to say Avhich has preceded. Violent passions will sometimes check the lochia, and sudden grief be equally injurious. Errors in diet, and particularly in- dulgence in spirituous liquors, seems occasionally to bring on a spasmodic stricture, accompanied often with fever. A diarrhoea, or any other copious discharge, will also check the Aoav, though Avith less inconveni- ence. The nearer the period of the suppression is to that of delivery, the greater is the danger; and the occasional returns of the discharge are symptoms of re- covery. The lochia sometimes diminish gradually, and sometimes cease at once. A delirium, in many instances, succeeds, occasioning convulsions and death, and if the patient escapes with life, she sometimes continues lunatic. In general no medicine will force the return; and our chief attention must be directed to procure a relaxation of all the extreme vessels. When the patient is full and plethoric, the pulse full and hard, the face flushed, it fias been the practice to bleed copiously, and this has been attended Avith success, even no fever has come on. It must, however, be done early and boldly, or it will be injurious. As this then is the case, the practitioner should be cautious in Avhat constitutions he makes the attempt. Emetics are often remedies of importance in this complaint, and should be repeated. To these the re- laxing diaphoretics should succeed; and when any organ is overloaded, in consequence of the suppression, a blister applied to the part will be of singular ser- vice. Cathartics are equally necessary, but we should be cautious lest too great a discharge from the bowels prevent a return of the salutary evacuation. It is ne- cessary to relieve too great fulness, and equally proper to avoid irritation; and the infusion of senna with man- na, or castor oil, so as to procure two or three motions, will be sufficient. We must then return to the mild relaxing diaphoretics, avoiding great heat, and admit- ting free air, if not too cold. In the usual course, the milk is the vicarious dis- charge of the lochia. This evacuation should there- fore be encouraged by warmth to the breast, by glasses; but, above all, by applying a strong, healthy child. If a flow of milk can be determined to these organs, the woman is secure. This, however, is often with difficulty obtained; and we more frequently find, that by removing congestions of every kind, supporting the patient with mild, nourishing food, she gradually LON 881 LOT covers without a return. We need not add, that the disease is highly dangerous. The spirits, whatever be the cause, are usually much depressed, and it will be right to cheer our pa- tient in this period of peculiar distress and disappoint- ment, by every favourable representation. In fact, however, the lochia are seldom wholly checked with- out accession of fever, which, from the time of its attack, is styled puerperal. (See Puerperalis febris.) The idea of checking the discharge by rising too soon, if cold be avoided, is truly ridiculous. The lochia are so7netimes redundant; but this disease must be distinguished from flooding during labour, from an attachment of the placenta to the os uteri, or other causes. The complaint we now speak of is the dis- charge subsequent to labour; and, in this place, we cannot add to what we have said in the article He- morrhagic, q. v. As the disease is rapid and, violent, so our remedies should be proportionally active and continued. Fainting should not be obviated; and the practitioner should be particularly cautious that no irritation is kept up from any accumulations in the rectum. Ligatures on the lower extremities are not only useless, but soon become injurious. LOCHIORRHCE'A, (from XoXix, the lochia, and pea, to fiow). An excess of the lochia after they become pale or whitish. LOCULAME'NTA, (from loculus, a bag). The cells in the fruit of plants where the seeds are lodged, divided by small partitions. See Capsula. LOCU'STA, (quasi locus ustus, because from their influence corn is apparently burnt). The grasshop- per ; the outer covering of the flower and grain of corn which incloses the chaff; and a name for the lactuca agnina. LO'GAS, (from Xeya, to elect). The white of the eye. See Adnata. LO'HOC. See Linctus. LO'LIUM, (from Xxiov oXett, segetem perdere,) aira, gramen loliaceum,lolium tremulentumlAn. Sp. PI. 122; darnel, ivray, and cockle. It is distinguished from other corn by its slender flat ear, but is not used in medicine. It is said to produce drunkenness if taken inwardly, and to prevent it if ap- plied outwardly. It is certainly.a narcotic, and impru- dently taken has been highly injurious. See Raii Historia. LOME'NTUM FA'BjE, (from Xetoa, to levigate). Bean meal, or bread made from it. See Faba ma- jor. LONCHI'TES, (from Xoyx*>, a lance, because its leaves are sharp pointed). Filix aculeata, polypodium lonchitis Lin. Sp. PI. 1548. The root is aperient and diuretic, but not used in the present practice. LONCHO'TON. See Vitriolum. LO'NGANON, (from longus, long). See Rectum INTESTINUM. LONGI'SSIMUS DI'GITUS. See Digitus. Longi'ssimus dorsi, is a muscle named from its length, and has the same origin with the sacro-lumbaris. It is inserted by several digitations into the ribs on the inside of the upper part of this muscle; between it and the complexus the transversalis colli of Albinus is seated, which runs from the transverse processes of VOL. I. the vertebrae of the back to those of the neck, and raises the body. Longi'ssimus o'culi. See OBLiquus majob oculi. Longi'ssimus po'llicis ma'nus. See Flexor tee- th INTERNODII POLLICIS. LO'NGUS COLLI, (from XoyX>i, a lance). Rises from the two upper vertebrae of the back, and is in- serted into the three upper vertebrae of the neck. It is made up of two plates, which decussate each other; and receives slips from some of the lower transverse processes of the neck. Its office is to bend the neck. LONI'CERA PERICLYME'NUM. See Capri- folium. LOOK, a gum resin, whose source is unknown. It is a stimulant, and supposed to be a resolvent. LOPE'ZIANA RADIX, a root brought from Goa, and first described by Gaubius in his Adversaria. It is brought to us in pieces, about two inches thick; of which the woody part is lightish and white, the me- dullary part more dense and reddish. The bark is rough, wrinkled, brown, soft, and apparently Avoolly, covered with a paler cuticle. Neither had any strik- ing smell or taste; but it was found highly useful in colliquative diarrhoeas, especially in the last stages of phthisis, appearing to act rather as a narcotic than an astringent. Gaubius thinks that it resembles the sima- rouba. LOPHA'DIA, LO'PHIA, (from XoQts, the hinder part of the neck). See Spina. Lophia sometimes signifies the upper part of the back of the neck. LO'PIMA, (xort^a, to decorticate). See Castana. LO'RA. See Deuteria. LORDO'SIS, (from Xopfos, bowed or bent inward,) is an incurvation of the spine toward the fore parts; and the opposite to gibbosity. It is synonymous with lumbago, tabes dorsalis, and with a curvature of the legs inward. LORICA, (from lorica, a coat of mail). A lute with which glass retorts, 8cc. are coated, before they are put into the fire. LO'RIND MATRI'CIS. An epilepsy, or a con- vulsive disorder supposed to proceed from the uterus. LO'TIO,(from lavo, to wash). A lotion; an exter- nal fluid application. When used on the eyes, it re- ceives the name of collyrium; on the face, a lotion; on any other part an embrocation. It is the appellation of clyster, and a name of the urine. Lo'tio alu'minis. See Inflammatio. Lo'tio ammo'nle muriate, Lo'tio ammo'nie ace- tate. See Inflammatio mamme. Lo'tio ammo'nie muria'te cum ace'to. See In- flammatio. Lo'tio spirituo'sa. See Ambusta. LO'TUS, (from Xa, to desire, from the deliciousness of its fruit). The species used in medicine are noticed under the different names they bear. Lo'tus a'rbor, Celtis Australis Lin. Sp. PI. 1478, the lote or nettle tree, grows in the southern parts of Europe; its berries are astringent. Lo'tus urbana, trifolium odoratum, melilotus ma- jor odorato violacea, trifolium m. officinale Lin. Sp. PI. 1078. Sweet trefoil. The seeds, leaves, and flow- ers, are supposed to be anodyne and diaphoretic. 5 U LUE 882 LUE LOXA'RTHRLTS, (from Xo\os, oblique, and xpdgov, a joint). An obliquity of the head of bones, and the muscles annexed; of the joint to a degree of deformity, without luxation or spasm. LUCE (Eau de). See Alcali. LU'CIDUM SAL, (from luceo, to shine). See Gemme sal. LU'CIDUS LA'PIS, (from the same). See Bono- NIENSIS LAPIS. LUCI'NA, (from luceo, to shine). Diana. See Alilat. LU'DUS HELMO'NTII, (from its resemblance to a die). A roundish mass, which seems to have cracked in drying, and the interstices to be filled up by a cal- careous matter, which frequently rises above the sur- face. The Avhole is an argillaceous clay, and the mass consists of prisms of different sizes separated by the calcareous matter. See Haiiy, iv. 455. Paracelsus described the cubic pyritae, which are like dice, and called them ludi: Helmont mistook him, and supposed this stone, which is mostly divided into squares, by the cracks to be the substance. The spar that fills up the cracks is only to be used; for it is that alone Avhich promotes urine, and is supposed a remedy for the stone. LU'ES, (from luo, to dissolve, because it produces dissolution; or from the Hebrew term, laugh, to absorb,) the pestilence in men, and the murrain in beasts. Lu'es dei'fica. One of the ridiculous names for the epilepsy. Lu'es neuro'des convulsi'va, a mild typhus. Lu'es vene'rea. The venereal disease. Aphr'o- disiacus and Gallicus morbus, grand gor, Patursa mor- bus Indicus and Neapolitanus. Dr. Cullen names it syphilis, and places it in the class cachexia, and order impetigines, defining it a contagious disease, arising after impure coition, and a disease of the genitals; ul- cers of the throat; corymbose papulae of the skin, par- ticularly at the margin of the hairy scalp, running in scabs and scabby ulcers; pain in the bones, and exos- toses : one species only exists. The source of this disease has occasioned much con- troversy, which, though not interesting in the result, is not Avithout curiosity, and a slight attention to it is, on this occasion, necessary. It has been generally sup- posed that the venereal disease is a native of America, and was brought to Europe by Colon (Columbus); an opinion supported by the apparently minute accuracy of Dr. Astruc, whose evidence has not been carefully appreciated, neither has the whole been properly ad- duced. Columbus returned from his first voyage in 1494, and from his second in 1496; but there is not the slightest pretence that the disease Avas brought' to Europe on his first return. His seamen are said to have been in good health; and in his.life, collected from his own MSS., by his son Ferdinand, not a word occurs of any disease of this kind. Columbus too re- turned in March, 1494: at this time the disease began to rage in Naples. He landed in Portugal; but in this country the disease did not appear till two or three years afterwards. The medical authors who wrote in 1496 mention it as a new disease " then raging," andsomeof these date it two years before. Hock de Brakenaw, a professor of medicine at Bologna, fixes its era in 1494; and he wrote only eight years afterwards. Ca- taneus, who Avrote in 1505 at Genoa; and De Vigo, physician to the pope, whose work was published in 1512, both professional men, living almost on the spot, and so very near to its first appearance, fixed its earliest era in 1494. Pin tor, a Spanish physician, who resided at Rome as physician to Pope Alexander VI. from 1492 to 1502, and who wrote in 1499, fixes its era also at 1494. Fulgosius, and some other au- thors, assign an earlier period to its appearance; but there is much doubt whether it was known before the end of 1493. Coccius, in a work published at Venice in 1502, dates its era in 1495 ; and Jean de Bourdigne, the French historian, remarks, that it began to rage in Erance in 1495. The evidence of Columbus importing it, on his return from his second voyage, is more strik- ing, but equally inconclusive. He returned in 1496, and Oviedo describes Moses Peter Margarita as affected " with the distemper." He observes, that he had so many pains that he believes he had also the pains of that disease. The tAvo hundred and twenty-five soldiers who returned with him were undoubtedly in a wretched state of health; but previous to their embarkation they had been besieged in their camp by the Indians, and reduced to live on the most unwholesome food. In this state they crossed the Atlantic. They are described not as having bubos, or cutaneous eruptions, but as of the colour of saffron. It is singular, that if the venereal disease was of Ame- rican origin it should not be traced by cotemporary au- thors to America. The new world was never accused of sending us this scourge till after the third voyage of Columbus, and then, indeed, it was received from thence, though undoubtedly first carried there ; nor has any author shown that it was endemic in America. They indeed describe a cutaneous disease, Avhich still exists, and is styled at present the yaws, of which the pain is apparently a modification. The origin of lues, though seemingly connected with the discovery of America, is more strictly so with the expulsion of the Moors, Avho, driven from Spain, retired to Italy, and resided on the outside of the Appian gate at Rome, when some of them clandestinely entered the city. The cutaneous diseases of that race engrafted on constitutions enfeebled by the plague, or united with the prevailing epidemic, apparently produced a new and distinct disorder. We shall sum up the whole in the Avords of a critic in a periodical journal, who has seem- ingly examined the subject Avith considerable attention in the original authors. " The summary of the Avhole may be very short. In Italy, from the year 1491 to 1495, from the great inun- dations and severe droughts succeeding each other, pestilential fevers of the most fatal kind prevailed. The disease was styled the plague; but it appears to have been only a fever attended with the most violently putrid symptoms, among which were glandular abscesses, sores, and blotches, Avhich discharged a malignant sanies. Those Avho recovered did not soon return to perfect health: the abscesses remained in a chronic form, and the whole mass of blood was ir.fected. In this state the disease seems to have been communicated by infec- tion, at first from the most general contact; and it\vas continued in this highly infectious state many years, LUE 883 L U K when it Avas attended with fever, often of the putrid kind. In better situations it sooner assumed a chronic appearance, and by degrees fixed itself in those parts, so as to be communicated only by personal connection. It is particularly observable, on a minute examination of the authors, that venereal symptoms mixed themselves with those of fever: or, in other AA'ords, the peculiar symptoms of that epidemic were such as have since discriminated syphilis. These symptoms continued sub- sequent to that fever, and Avere at last communicated by infection to those Avho never had the fever." See Astruc, Swediaur, and J. Foot, on the Venereal Disease; Becket, Philosophical Transactions, vol. 30 and 31; Sanchez' Historical Investigation into the first appear- ance of the Venereal Disease in Europe; Hensler's two Treatises on the American Origin of the Venereal Dis- ease ; Girtanner's Treatise, in 3 vols. 8vo. at Gottin- gen ; Gruner's supplementary volume to the Aphro- disiacus of Luisinus, published at Jena; Perenottis' Ge- neral and Descriptive History of the Origin, &c. of the Venereal Infection, 8vo. Turin; Critical RevieAV, vol. 65 ; Second Series, vol. 5 and 10. The lues is at present received from infection only, and it usually shoAvs its source by the tumour of the glands, interposed between it and the receptaculum chyli, as in the lymphatic glands of the groin, when re- ceived in venereal embraces; in the axilla when by wounds in the fingers, either in dissection or obstetri- cal labours ; and in the neck when received by child- ren suckling, or, as was formerly the case, by kissing. Where the skin is thin, as in the first and last instances, it is absorbed from the-surface, but not from the fingers, unless there is a Avound. Swellings of the lymphatic glands are not always the consequence of infection. Sometimes no stoppage occurs, and sometimes, as in the glands of the mesentery, either from anastomosis, or a lymphatic escaping a gland (see Lactea vasa), no inflammation takes place. When children receive the infection from their mothers they are sometimes born Avith eruptions, chiefly discovered about the nates; but sometimes the disease is not discovered till after about three weeks or a month, when foul ulcers, blotches, or brown copper coloured eruptions, appear about the mouth, the nates, or other parts. It is contended by some pathologists, that, as there appears to be no in- fection of the blood, it is not probable that the fcetus should be diseased in the uterus. They consider, there- fore, the infant as infected at the period of its passing through the vagina. If it were certain the venereal ulcers were never observed at the birth, we might admit this idea; but we think we have in more than one instance discovered them when the child Avas first Avashed; and though Ave admit the general mass to be Avithout any discoverable taint, we know not but that some separation may take place in the maternal part of the placenta. It is sufficient at this time to admit that the child is often infected from the parent; and Avhen the lues has continued, in either parent, for a long period, though then apparently free, the child will soon sink with numerous anomalous symptoms resem- bling, though distantly only, the lues. As a running and discharge distinguish a gonorrhcea, so does a small, hard, irritable pimple usher in the more decided lues. This pimple, called a Chancre, q. v., is very general, Ave believe universal, but so little painful, that it often passes unobserved. In this v.atc it seems to convey no infection, and for a time no matter is certainly absorbed from it; but, at an inde- finite period, the glands in the groin begin to swell, and a hard, painful cord, an inflamed lymphatic, may some- times be traced along the back of the penis to the tumid gland (see Bubo). As the chancre occasionally passes unnoticed, so a bubo, as we have said, does not ahvays occur, and the patient continues in a delu- sive security, unsuspicious of any disease : yet, if either is attended to, the disease might probably be checked in its bud. We would not, however, enforce such an idea; and we have rather recommended discussing bubos, for this reason, that Ave avoid a troublesome sore, and at last cannot escape from a mercurial course. It is not, however, by suppuration that the future lues can be averted, but by an extirpation of the gland; yet even this, for the reasons already assigned, Avould not offer a perfect security. When neither chancre nor bubo calls the attention to the disease, little inconvenience is felt for some Aveeks, sometimes many months. It has been contended that the infection may be dormant for many years; but this is certainly not true, and the idea has been cherished to excuse fresh infection. So frequently do patients de- ceive us in this respect, that it is not easy to fix the limits of the poison lurking unobserved. Perhaps from three weeks to six months some symptoms are usually to be discovered. If minutely examined, the first ap- pearances are a salloAv countenance, languor, and list- lessness; copper coloured spots on the breast, the arms, and the face, particularly on the forehead, and round the roots of the hair. These by degrees become scaly, occasionally discharging a thin fluid, Avhich forms a scab. Soon aftenvards an uneasiness is felt in SAvallow- ing, and a livid, flabby inflammation is observed in the throat, with deep ulcers, covered at the bottom with a slough, whose edges are ragged. There is no very marked difference between these and the ulcers of the angina gangrenosa ; but they are distinguished by the absence of fever, and their continuance Avith little, sometimes scarcely any, loss of strength. These ulcers occasion a hoarseness, and, if near the Eustachian tube, a deafness ; and by degrees cover the fauces, or at least extend far over them. If still farther neglected, pains are felt in the bones, chiefly in the harder long bones, as the shin and arms, often in the skull, particularly over the eyes, and at the bottom of the orbits. A swelling conies on the shin bones, and sometimes on the os frontis, which, if neglected, cor- rodes into a foul ulcer, with a caries, penetrating to the brain. The ulcers on the shin and humerus assume the same appearance; the palate bone equally suffers, and the meat in deglutition is returned through the nostrils. The bones of the nose soon share a similar fate, and the nose sinks flat on the face. When the pains of the bones commence, the strength begins to fail, and, long before these extremities, is so much re- duced that the patient crawls with difficulty. Hectic fever comes on, and death closes the loathsome scene. In the earlier histories of this complaint the symptoms are more various and more dreadful; but on these Ave need not enlarge, as we have continued the description far beyond the point at which the disease is usually suffered to arrive. In the whole of this course the 5 U 2 LUE 884 LUE blood is apparently untainted. It will not at least com- municate the infection ; for the matter is largely diluted, and probably sheathed by the albumen. When de- posited in the glands, without this medium, its virulence is discovered. By what power it is deposited is among the arcana of physiology, Avhich we can only approach by conjecture (see Secretion). The poison itself seems to possess an assimilatory property ; and, when in a considerable degree of concentration, to be highly de- leterious, affecting, by its sedative powers, the nervous system, and even the mind ; for a despondency, which the removal of the symptoms cannot relieve, is among its effects when far advanced. These general appearances are often accompanied by still more distressing local ones. Though we have only mentioned the chancre as the first symptom, it is some- times followed by painful ulcers, spreading, unobserved, under the prepuce, and gradually destroying the glans, sometimes the Avhole penis. A suppurated bubo is often equally destructive, forming numerous extensive sinuses which assume the appearance of cancer. Abscesses form in the perinaeum, producing fistulous ulcers in the blad- der, through which the urine issues, and tubercles, styled condylomata, round the anus, almost close the sphincter, or suppurate in fetid, ill conditioned ulcers. If such and so distressing were the forms of the dis- ease, and they were much more so at its first appear- ance, we cannot be surprised at the terror which seized the earliest practitioners, who witnessed its devastations without the power of being able to check them. Mer- cury, its only remedy, was, however, soon discovered, and applied, apparently, at first with a happy boldness by empirics; for quacksalber, the German appellation of this metal, was the root of the opprobrious appellation, a quack; though quackery now in a more extensive sense may be found among those who claim a regular education, as Avell as those whose medical merit lies in the diploma they have purchased. Mercury is supposed to be a specific in this disease, in other words to oppose its course by properties pecu- liarly its own. If we bring this idea to a more rigorous test, it will, we think, amount to this ; that mercury, by a chemical combination with the virus, destroys its efficacy. This is a subject which, when treating of mercury (see Argentum vivum), we reserved, and it is one which has occasioned much controversy. As usual, we must state the outline in a summary way. If mercury acts as a specific, its effects would probably be in proportion to its quantity; but in reality they are in proportion to its active state, or rather to its oxygena- tion. If, too, it acts in this way, its effects should be the same whether it produced any sensible evacuation or not, for if the poison was destroyed we should be indifferent about its discharge; but this is not the case, for it never cures without inducing some evacuation. The difficulties which stand in the way of its acting as an evacuant only are considerable. The poison is said to possess an assimilatory power, so that whatever por- tion is discharged, should any remain, the disease must recur. To this we can only reply that, probably, mer- cury promotes the evacuation more rapidly than the as- similatory power produces new supplies; and as the poison, when formed, is conveyed to the skin, from whence it is most readily eliminated by the mercury, we can easily perceive that in no long period the cause must be removed. Yet were this the only effect other eva- cuants should be equally serviceable; and indeed it will be alleged, that those Avhich are determined to the skin, and possess a power of stimulating the extreme vessels, are powerful antisyphilitics. Of this kind it is said are the mezereon, the sarsa, the guaiacum, and probably the volatile alkali; those which operate by the intestines, as the lobelia, and some others, are supposed to be equally useful: but let their respective powers be urged so far as facts will warrant, or as the prejudices of their admirers will carry them, each will be found greatly inferior to mercury, except in a warm climate, where the disease is slight and manageable, often yield- ing to the power of nature alone. Again: Avere mer- cury a specific, its power would be peculiarly striking in the local complaints. It has been said, that the mat- ter of a chancre mixed with a mercurial preparation will not convey the disease; but the experiment has not been so carefully made, or so attentively repeated, as to induce us to rest on it with confidence. But will any one contend, that in venereal sores mercury is not an application more certainly and speedily useful than any other ? The smarting of an irritable chancre is greatly mitigated by the dry calomel in powder; the discharge of a bubo meliorated by mercurial ointment. It will be alleged that any Avarm stimulating applica- tion will be equally beneficial. In gonorrhcea, indeed, it will be so ; but gonorrhoea and syphilis are certainly distinct in thei«r causes, their progress, and effects. While, therefore, it is highly probable that mercury acts as a stimulant and a tonic, supporting more actively and steadily the action of the cutaneous vessels than any other medicine, we cannot deny that it has some che- mical effect on the poison itself, either diminishing its virulence, or disposing it more readily for evacuation. This peculiar quality is still in obscurity, but we may be allowed to suggest whether it is not at least connected with the oxygen of its preparations. We have occasionally indulged ourselves in conjectures, but have not suffered them to detain us long. We shall now, therefore, shortly remark, that mercurial prepara- tions are, as already observed, active in proportion to the oxygen which they contain; that other substances con- taining a proportion of oxygen are useful in at least ar- resting the progress of the poison; that the salloAv complexion, the inert, inirritable state of the sores, as well as the appearance of the matter discharged, show that there is a great deficiency of oxygen in the system. If then the mineral acids are only partially effectual in removing syphilis, may we not contend that, besides the oxygen, the steady diaphoretic effect of the mercury is required ? When the sarsa and mezereon fail, may it not be alleged that the oxygen is wanting ? They do not, indeed, fail in warm climates, where, though the disease is milder, the^oxygen is apparently more copi- ously separated in the ordinary functions. To the numerous and crowded list of remedies for this disease, M. Acharius of Stockholm has lately added tar-water. Alone, it is said to cure, or to be a powerful auxiliary to mercury or the nitric acid. We need not attempt to connect this opinion with our former observations, till experience has more fully ap- preciated the value of the proposal. , In whatever way mercury acts, it is admitted to be the only remedy which we can depend on in this LUE 885 LUE climate. Various are the opinions respecting the pre- paration to be chosen, the forms of administration, and the conduct of the plan. Every practitioner has his predilections and his prejudices respecting particular preparations; but we are coming back to the earliest views, and it is now generally agreed that the mercu- rial pill, and the friction with mercurial ointment, are most commonly successful. Of the other internal mer- curials, perhaps calomel is equally useful with any other; and though we have, for a long time, employed mercurius calcinatus, we know not that it is superior in efficacy; but to this part of the subject we must return. In the earlier periods, mercury was employed so freely, or rather so rashly, that the most fatal con- sequences often ensued. The loss of the teeth and the injury of the sight were among the slightest of these ; and sometimes a fatal apoplexy has supervened, which yet occasionally happens, though the event is peculiarly rare. Terrified by these events, practitioners began to think that mercury in very large doses was unnecessary ; and the quacks at last contended that their boasted nostrums contained none. In their preparations, indeed, the most active mercurials are employed, and they de- pend on the colour and the density of their medicine to elude the detection of the mineral; but modern che- mistry has too many resources to be so easily baffled, as our remarks in the article Argentum vivum will evince; to which we could add some experiments of our own. Others, melioris notae, assert, that they can cure the disease without salivation ; and practitioners of credit do not often require confinement. Yet, in such cases, relapses we have found not uncommon ; and though confinement may be sometimes dispensed with in warm weather, it will be more safe to enjoin it. The severity of the old process is greatly mitigated since the days of Pott, and the last author of that school who countenances it is, we believe, Mr. Howard. Yet when the disease has long continued, Avhere the bones are greatly affected, and every part of the system seems to be contaminated, this severity should still be em- ployed. Without it, in such cases, there is no safety. In more recent complaints, a milder course may be trusted; and a spitting, not exceeding a pint in a day, continued for about three weeks, or a month, will often effectually cure. It must, however, be remembered, that the longer the disease has continued, the more in- timately it appears to have penetrated, the more active must be the salivation, and the longer should be its duration. In general, gargles, and any applications, except the mildest, should be avoided; for though the topical complaints will be sooner relieved, these should be left as indices to enable us to judge of the state of the constitution. In cases where discovery is dreaded from these local affections, this precaution may be disre- garded. It has been a question, whether, when other dis- charges are increased, salivation is necessary. When the cutaneous evacuation, or the urine, is evidently and copiously increased in quantity, it is highly pro- bable that the disease will be equally removed. Yet no prudent practitioner will wholly depend on these discharges. We know only that mercury is accumu- lated in the system by its affecting the mouth; and un- less accumulated, the disease will not be cured. Yet many persons no quantity of mercury will salivate, and to increase the dose beyond due bounds may be dan- gerous, as a most profuse and violent spitting some- times attacks at once. In such instances, we have found it advantageous to employ the assistant medicines, as the mezereon, 8cc.; and to watch the progress of the local complaints. When these have yielded, and the constitution in general is amended, the omission of mercury may for a time be alloAved, and it may at a future period be commenced with more success. When we have perceived from these indices that little has been gained, rubbing calomel on the gums, a practice recommended, we believe, first by Mr. Cline, has suc- ceeded, though troublesome ulcers in the mouth have sometimes followed. When mercury has conquered the general disease, the local ones often continue troublesome. The sores in the throat are, indeed, frequently the effect of the remedy, and may be distinguished from true venereal sores by their being less deep and foul, with edges less ragged, or insensibly lost in the ephelion. These may be healed by discontinuing the medicine, and using gently astringent gargles. The nocturnal pains, the gummata, tophi et nodi, and the venereal excre- scences, often continue after the constitution is wholly cleared. The mezereon will relieve in many instances the pains ; and the warts must be treated, like any others, with caustics, or the knife. The gummata we have already described, and need only add in this place, that if the mezereon, Avith the topical application of mercurial ointment, does not succeed in reducing them, they will at least be no longer painful; but, should the patient still wish to be effectually cured, the surgeon may make an incision on the bone, and cut out the tumefied part, bringing on a suppuration to complete the cure. The process is, however, painful and troublesome; nor is it advisable on the head, since the node often arises in the diploe of the scull, and each lamella is equally affected. The doses of mercury must be managed with caution, and very slight ones first employed. If we give the mercury oxygenated by triture, about four grains of the blue pill of the Edinburgh Pharmacopoeia, which contains a grain of mercury, will be sufficient, if re- peated three times a day. If calomel or mercurius calcinatus is employed, a grain night and morning at first, or two grains at night, guarded with a grain of opium, lest it should irritate the bowels, will be a proper dose. If the ointment is preferred, half a drachm of the strong mercurial ointment may be rubbed in night and morning. In about a week or ten days, by either plan, the mouth will be slightly sore, and the repetition may be regulated by its degree, or by the violence or duration of the complaint. In many cases the bowels will be so much affected by the mercurial, that no doses of opium will check the pain or diarrhoea: in many the salivation comes on so rapidly that the effects on the disease cannot be depended on. Sometimes opium, sometimes the haematoxylon, the catechu, the kino, the oak bark, or tormentil, will check the dis- charge on the bowels; and the Dover's powder, pulvis ipecacuanhae compositus, with a warm regimen, and a flannel shirt, prevent its affecting too soon the mouth. LUE 886 LUE In each instance, we must proceed very cautiously Avith the medicine, to accustom the constitution to its irrita- tion. The other preparations chiefly in use are Plenck's powder, the solution of the sublimate, the mercurius acetatus, and alkalisatus. From these we seem to de- rive no peculiar advantage, nor are the two latter, as is pretended, less irritating to the bowels. Plenck's gummy solution of mercury sometimes appears to be so, but is not on the whole superior. The solution of the muri- ated mercury, introduced by the baron Van Swieten, Avas for a long time trusted. It affected the bowels only in a slight degree; and when its menstruum was corn spirit, it sat easily on the stomach. It soon ap- peared to check the disorder, but here unfortunately its merits rested. When the complaints were diminish- ed, the medicine Avould affect no more, even though the dose was increased ; and in some instances, even during its use, the worst symptoms appeared to return. Fumi- gations, Avhich were formerly much employed, are noAV seldom trusted, and seem chiefly useful by bringing on, more rapidly, mercurial effects on the salivary glands. In a very low state of the constitution, Avhen hectic symptoms prevail, mercury is of doubtful efficacy-; but cautiously and gradually administered, it does not in- crease hectic symptoms ; and it is not difficult, even dur- ing the progress of phthisis, to arrest, in a great measure, venereal symptoms. Though its action on the salivary glands is necessary to show that it is introduced in sufficient quantities, yet when these are soon affected, as we have said happens in some constitutions from idiosyncracy, and very generally in scorbutic habits, there is no opportunity for its power being communicat- ed very generally to the smaller vessels. In such cases it must be resigned, if a Avarm regimen and the re- laxant diaphoretics, just mentioned, will not direct it to Other excretories. In these and similar cases Ave must apply to Avhat may be called the accessary specifics, and we fortu- nately have some active medicines of this class. Among these Ave may reckon the mineral acids, particularly the nitrous. The nitrous acid was warmly recom- mended to us from the experience of the Indian prac- titioners. Our expectations, often deceived by pomp- ous promises, were not raised high when we were in- formed that its effects were equal to those of mercury; but, though far inferior, it is a medicine highly useful. The nitrous acid will not cure lues, but it will arrest the symptoms and restore the strength in those intervals when mercury can be no longer borne. It will some- times in these intervals seem even to advance the cure, and we can truly add, that the methodus medendi has not for many years received a more powerful auxiliary. The other accessary antisyphilitics are the bark, opium, china root, guaiacum, sassafrass, astragalus, lobelia, lu- pulus, dulcamara, sarsa, and mezereon. We have arrang- ed them in what seems the order of their efficacy, com- mencing Avith the least powerful; omitting the volatile alkali, muriated barytes, the juniper, the cicuta, the green rind of the walnut, the bardana, and saponaria, as of very inconsiderable, if any, poAver. On the indivi- duals of the former class Ave shall add a few remarks. The Peruvian bark has, alone, no power of checking the progress of the syphilitic infection. Yet it is often highly useful in lues, when mercurial ulcers occur in the mouth; Avhen the ulcers of suppurating bubos as- sume a livid appearance, or those in the perinaeum are foul, Avith deep sloughs. It has been contended that it meliorates venereal symptoms; but, in reality, it only lessens their painful irritation by diminishing irritability. The cicuta, and the green rind of the walnut, in the second class, act in the same manner, if indeed they have any effect. Opium has been celebrated as a certain antisyphilitic, and, in many instances, it has had apparently a poAver- ful effect. This, hoAvever, is temporary only, and the symptoms have returned with increased violence. It acts like the former medicine by lessening irratibility, and in some measure perhaps as a diaphoretic. In this way it is peculiarly useful in mercurial ulcers. The china root, theguaiacu7n,sassafras, astragalus, escapus, lobelia syphilitica, lupulus, and dulcamara, are not found to ansAver the high expectations formerly entertained of them. The three first are occasionally ingredients in diet drinks, and the three last are, in this country, scarcely ever prescribed. The sarsaparilla has retained a considerable credit, and is even iioav generally employed. What its effects may be in a recent state we know not, but we have found its powers inconsiderable in this country, though Ave have given large doses in substance. It appears to be chiefly mucilaginous, Avith few sensible properties, Avhich would lead us to suppose it active. The mezereon, on the contrary, is a powerfully sti- mulating diaphoretic, from a plant strongly narcotic, and seems to combine the united virtues of the rest. It has alone often effected all that has been expected from the others, which in many instances seem to overwhelm instead of adding to its powers. If we examine these antisyphilitics Ave shall find them in general narcotic; in a few instances merely mucilagin- ous,and in general diaphoretic. If thesarsais notmerely mucilaginous, it is diaphoretic. From each property we perceive that some advantages may be derived in lues; and when all are combined, the effects may be more salutary. In the mezereon we combine the diaphoretic and the narcotic; in the sarsa, the former with the demulcent; in juniper, the bardana, the sas- safras, and the guaiacum, we have probably only the diaphoretic,or with a less degree of the mucilaginous; in the dulcamara, lupulus, astragalus, the green rind of walnut, bark, and opium, the narcotic only. The same vieAvs assist us in forming a judgment of their compa- rative merit; but their order was long since fixed by experience, before we had occasion to examine the source of their efficacy. Above all we must reflect, that those which have any claim to a diaphoretic poAver are given in decoction, by which the active particles are attenuated and conveyed to the skin; and these only are useful where the disease has penetrated to the minutest vessels. Mr. Bell observes, in his Treatise on Ulcers, that those which are the result of a venereal taint of a long continuance, are singular in the appearance of their dis- charge. It is at first thin, but soon becomes tough and viscid ; having a very loathsome, though not the ordinary, putrid smell, and a singular greenish yellow colour. In such ulcers as have a lues of long continuance LUM 887 LUM for their cause, Ave should depend on the effect of mer- cury given internally, contenting ourselves with such external applications as will keep the sore clean. In this manner the different ulcers are, as we have said, indices that the disease is eradicated from the habit. Venereal ulcers are apt to inflame, and are then pain- ful ; but a saturnine poultice will relieve the inconve- nience, and the unguentum cereum Pharmac. Edinb. will be only required. If the ulcer is seated near a bone, the appearance of fungous flesh will lead to a suspi- cion of caries; and besides the proper treatment for carious bones, mercury must be administered. These ulcers are often obstinate, though every venereal symp- tom is removed ; and this is frequently owing to some other disease, Avhich will require attention. The sores, however, will sometimes not heal from the effects of mercury, and then the bark, opium, or both, with a nourishing diet, a pure air, and moderate exercise, will usually succeed. If the sloughs on these ulcers are tough, dressings that gently stimulate will be required; and two drachms of the nitrated quicksilver may be added to an ounce of the unguentum resinae flavae for this purpose. When a gland is the seat of an ulcer, a salutary suppuration is Avith difficulty produced, and the gland, at least the hardened part of it, must be destroyed by repeated applications of the argentum nitratum. See Bell on Ulcers, vol. vi. p. 381, &c. An eruption of the skin is sometimes also the conse- quence of a free use of mercury, attended Avith a fever, usually idiopathic. The skin is affected with a prickling sensation, and a rash follows, which terminates in branny scales. The skin, however, is left in a state peculiarly tender and irritable, which is relieved by bark or opium, but, above all, by the mineral acids. When venereal ulcers appear cancerous, fresh air, a fuller diet, abstinence from mercury, and hemlock applied outwardly, or given inwardly, will sometimes succeed. A more speedy effect has been observed from eating several lemons in a day. See some observations of this kind in the London Medical Transactions, vol. ii. p. 338, &c. Venereal ulcers in the throat may be conveniently relieved Avith the following: R. Hydrar- gyri muriati, gr. x. acidi muriatici, gut. v. tinct. lav. c. 3 i. m. cap. gut. v.—xx. bis. die, in aq. pura vel jusculi avenacei. Astruc on the Venereal Disease, or Chapman's Abridgment of Astruc; Heister's Surgery ; Fordyce's Elements, part the second; Falck's Treatise on the Venereal Disease; Fordyce's RevieAv of the Venereal Disease; White's Surgery, vol. iv. p. 399, 423 ; Swe- diaur, Plenck, Howard, Bell, and Hunter, on Venereal Complaints; Pearson's Observations on the Effects of various Articles of the Materia Medica in Venereal Complaints. LU'JULA, (corrupted from the diminutive allelu- JULA, q. V.). ACETOSA. LUMBA'GO, (from lumbus, a loin). Pain in the loins. See Rheumatismus and Arthritis. Lumba'go psoa'dica, and apostematosa. See Arthropuosis. LCMBA'LIS MU'SCULUS, (from the same). See Psoas. LUMBA'RES NE'RVI, (from the same). The lumbar nerves pass out from the spinal marroAV through the vertebrae of the loins, and become larger from the first to the last. The first lumbar nerve throws a large branch backward, and two filaments to the in- tercostal : the trunk of the nerve goes through the psoas muscle, then to the spine of the os ilium, at Avhose an- terior superior process it throws off several branches to the muscles, and one to the spermatic cord in the male, and to the round ligament of the female. The first going to join the second, sends off two filaments; one of which goes to the spermatic cord, the other passes under the Poupart's ligament to the groin; from this the pain felt in the thigh during a fit of the stone is ex- plained. The second lumbar nerve lies on the inside of the psoas muscle, goes through its head, and runs along it; then passes through the annular aperture of the obli- quus externus to the scrotum in males, and the labia in women. The second lumbar nerve joins with the third; and that again communicating with the fourth, forms the crural nerve. See Cruralis. The fourth and fifth lumbar nerves, and the three first sacral, form the sciatic nerve, Avhich, passing out at the great sciatic notch, runs down between the tuber- culum ischii and trochanter major, along the internal and posterior part of the thigh, between the biceps and seminervosus, as far as the ham, rather nearer the inner condyle of the os femoris than the outer. See Cauda EqUINA. Lumba'res arte'rie go out posteriorly from the inferior descending aorta, in five or six pair, in the same manner as the intercostals. The upper ones send branches to the neighbouring parts of the diaphragm and intercostal muscles, and supply the place of semi- intercostal arteries; they are also distributed to the psoas, and other adjacent muscles; and, by perforating the oblique muscle, they become external hypogastric arteries. They also go to the vertebral muscles, and enter the spinal canal. Lumba'res ve'ne proceed from the vena cava, near the bifurcation, and principally on the right side ; some- times from the left iliac vein; this branch communi- cates' with the azygos and intercostal veins. LUMBA'RIS EXTE'RNUS. See Quadratus LUMBORUM. Lumba'ris inte'rnus. See Psoas. Lumba'ris regio. The region of the lions is the posterior external region of the belly, extending from the lowest ribs on each side, and the last vertebra of the back, to the os sacrum, and the neighbouring parts of the os ilium. The sides of this region are strictly called the loins, and include also the musculus quadratus lumborum on each side of the loAver portions of the sacro-lumbares, of the longissimi, and latissimi dorsi, the musculus sacer, 8cc. LUMBRICA'LES MU'SCULI, (from their resem- blance to a Avorm,) vermiculares, fidicinales, fiexores primi internodii digitorum, the productions of the flexors of the fingers and the toes: originating from their respective tendons, after encircling the basis of each finger and toe they join with the extensors. Their office is, Avhen the extensors have done their utmost, to finish the extension, and, when the flexors have done their utmost, to finish the flexion. LU'MBRICI, (a lubricitate, from their slipperiness). The lumbricus, which aboupds in the intestines of young persons, resembles so nearly, in its general LUM 888 LUM appearance, the earth worm, that it has been considered as the same animal. It is, however, distinct, and is the EXfiivs sroyyvXx of the ancient physicians, distinguished from the earth worm by wanting the elevated ring in the middle of its body. The body of the ascaris lum- bricoides, for this is its generic name, is round ;* its head furnished with three vesicles, placed in a triangu- lar form; generally from twelve to fifteen inches in length, and about the diameter of a goose quill. The head may be distinguished by the three vesicles men- tioned, and the triangular space between is the mouth of the animal. The tail terminates suddenly in a very sharp point, and near it the orifice of the anus may be distinctly seen. Near the middle of the body is a cir- cular depression about three lines in extent, in which is an aperture like a small point. This band is most conspicuous when the body of the worm is distended, and it seems wanting when the body is collapsed. Just below the mouth are two small transverse clefts, which Bruguiere calls stigmata, and thinks them the organs of respiration. Two longitudinal lines extend, through the Avhole body of the worm, which are the tendons to which the semicircular muscles are attached. The animal, how- ever, does not move, like the earth worm, by a vermi- cular motion, but curls its body in circles, from which it extends the head. A number of vesicles sur- round the intestinal tube, which proceeds, without any change of direction, from the head to the anus, but they do not extend beyond the depressed band. Below it the connecting medium appears to be a common cel- lular substance. These vesicles are filled with a mucous, probably a nutritious, fluid. The intestinal canal con- tains a dark green fluid, resembling the meconium of infants. But even from the lower part of the canal fila- ments appear to arise, which probably convey a portion of nourishment, though the great reservoirs are in the upper portion. The most singular part of the worm is what may be considered as its uterus. Just below the depressed band a white vessel is seen, which soon divides into two, and after running some way in a cylindrical form, they quickly become smaller, and at last are mi- nutely convoluted, embracing on all sides the intestinal tube. These vessels, forced by the agonies of the worm through the particles of the abdomen, appeared to Mr. Church the young of the animal, which he, of course, considered as viviparous. It is, however, generally agreed that the lumbricus intestinalis is oviparous. The lumbricus terrestris has but one vesicle, is flat towards the tail, and has bristles on its under side, which it can erect at pleasure. Its annular muscles are large, and of a dusky red; and on its under surface is a large semilunar fold of the skin, into which the animal can draw its head. It has also three lines on its upper surface. The intestinal lumbricus is seldom solitary, but in very few instances appears to be injurious. Its source is unknown; for it has not been found in any other situation. When first discharged they are semitrans- parent, and of a dilute red colour, but they soon be- come yellowish. They are usually found in the je- junum and ileum, rarely in the large intestines, and still more so in the stomach. In each they appear to be escaping from the body, when fever renders their situa- tion uncomfortable, or active anthelmintics force them with the mucus from their seats. Lamarck Systeme des Animaux sans Vertebres; Histoire Naturelle des Vers, par Deterville, (suite de Buffon); Pallas de intra Viventibus; Hooper's Me- moirs of the Medical Society, vol. v. See Vermes. Lu'mbrici la'ti. See Tenie. LUMBRICO'RUM SEMEN. See Santonicum. LUMBRICUS TERRE'STRIS. (See Lumbricus intestinalis.) The earth worm is supposed to have an antispasmodic and diuretic virtue. If worms are moistened with vinous spirits to prevent their putre- faction, and placed in a cellar, they deliquesce ; and the liquor, when mixed with alkaline salts, is said to yield crystals of nitre. They have been employed for the same purposes as snails. Lu'mbricus e'dulis. A species of lumbricus found on the southern sandy shore of Batavia, is considered as a delicacy; it is described by Pallas, who thinks it the same as the teredo, described in the twenty-sixth volume of the Philosophical Transactions. See Spi- cilegia Zoologica Fasciculus, x. 10. LU'MBUS, (a lubidine). The loin. Lu'mbus ve'neris. See Millefolium. LU'MEN, (quasi lucimen, a luceo, to shine). The effects of light on the human system have not yet been explained. We have of late only began to perceive with clearness the causes of its influence on vegetables and some chemical preparations. We find, in general, that light separates oxygen ; that it changes the nitric into the nitrous acid, and the oxymuriatic to common mu- riatic acid. We find, also, that it deprives many prepa- rations of their peculiar colour, particularly phospho- rus; and it seems greatly to influence the process of crystallization. Some preparations must be exposed to a strong solar light, as carmine; for a cloud, it is said, will spoil the colour, and the argentum fulminans re- quires to be exposed to the light of the sun for many days. If we ascend to the vegetable kingdom, we shall find that the absence of light deprives the leaves of their co- lour; and Humboldt, who discovered some vegetables in the deepest shafts of mines, found that the shapes of the leaves were not the same. If plants, then, will grow without light, we must not consider their growth as wholly depending on the decomposition of water, in consequence of light; but we have reason to consider the colour as depending not only on the decomposition of the water, but of the carbonic acid gas also. Animals confined without light are often of a white colour; but this must be confined to those who usually live in the open air; for the mole, the pangolin, and some others who scarcely ever see the day, are not white. The particular cause of this change has not been examined. It is not apparently from a deficiency of oxygen. Some animals emit light in their motions, and this light is connected with their life and activity, as in the lampyris, the glow worm, the insects in oyster shells, and those which illumine the sea in a storm. In these it seems that light enters into the composi- tion of those fluids to which their activity is owing, and, indeed, every fact now noticed shows that light is a body, and may form a component part of other bodies. We are not acquainted with the effects of light on the human body. We know that the oxygen.is a powerful LU P 889 L U T stimulus, and that colour, health, and vigour, arc often in excess Avhen this air is breathed; but it seems probable that this is the case when the oxygen is in a loose uncombined state, and that light is salutary in promoting its separation. These speculations are, how- ever, uncertain, and it is still more so, whether light is really a component part of our bodies. When we reflect, however, that the general health is apparently connected with light, that the peculiar acid of the animal system, the phosphoric, has a powerful attrac- tion for this element, and appears to contain it, not only in a chemical combination, but, when in the form of an oxide, unites with, and allows it to separate without decomposition, we may suspect it to be a more power- ful -agent in the animal economy than has yet been supposed. For the physical properties of light, see Haiiy Traite dela Physique, vol. ii.; Cavallo's Natural Philosophy, vol. iii.; and the article Oculus. For the chemical, see Exeter Essays. LU'NA, (from the Hebrew term lun, the night). See Argentum. Lu'na philosopho'rum. See Antimonium. LUNA'RE OS, (from luna, the moon). The second bone of the first row in the wrist, because one of its sides resembles a crescent. See Carpus. LUNA'RIA, (from luna, the moon; from the shape of its leaves, like a crescent). An appellation of many plants whose leaves are reniform, but more peculiarly applied to the osmunda of Linnaeus. LUNA'RIS PILU'LA, (from luna, silver). See Causticum lunare, under Argentum. LUNA'TICA, ischu'ria, (from luna, the moon). A periodical suppression of urine, noticed by Sauvages. See Ischuria. LUNE'TRIA is, in the chemical jargon, a species of hectic, curable in one period of the moon. LUPA'RIA, (from lupus, a wolf; supposed to de- stroy wolves). Aconitum Ponticum folio Platani, Ly- coctonum luteum, aconitum lycoctonum Lin. Sp. PI. 750. Yellow wolf's bane. Like the other species, it is poisonous. LU'PIA (from Xvrea, to molest). A kind of tu- mour like a ganglion, hard, and not peculiar to any part of the body: when it is in the inside of the eyelid it is called chalaza; when about the joints lupia. Dr. Cul- len uses it as a generic term for wen. See Nevus. LU'PULUS, (xvrn, dislike; from its bitterness,) ha- mulus convolvulus perennis, humulus lupulus Lin. Sp. PI. 1457. The hop. This plant hath hollow stalks, and broad serrated leaves, cut into three or five sharp pointed sections. On the tops grow loose scaly heads, among which are small flat seeds. It is perennial, grows wild in hedges, and the bottom of hills, in various parts of Europe; but those used are cultivated in plan- tations. In August and September the scaly heads are dried in kilns with a gentle fire. The scaly heads have a bitter, warm, aromatic taste, yielding their virtue to proof and rectified spirit, by ma- ceration without heat; and to water, by Avarm infusion. The extract obtained from the spirituous tincture is an elegant bitter ; but hops are only at present used for preserving malt liquor. Like many other bitters, the cold infusion is more grateful than that made Avith boil- ing water; but the quantity must be larger. Hops have VOL. I. been suspected of a narcotic power, and there is said to be an act of parliament prohibiting their use in beer. On the other hand, a pillow of hops has been said to procure sleep. Hops have been lately, like other narcotic bitters, recommended in gout. The Spaniards boil a pound of hop roots in a gallon of Avater to six pints, and drink half a pint of the decoction, whilst in bed, every morning, as a remedy for the lues venerea. See Lewis's Materia Medica. LU'PUS. The wolf cancer; because it devours rapidly the flesh, like a wolf. It is the noli me tangere in the seventh order tubercula of Willan. See Cancer. Lu'pus philosopho'rum. See Antimonium. LUSCIO'SUS, and LUCI'TIOSUS, (from luscus). One who only discerns objects that are very near the eye. See Nyctyalops. LUSITA'NICUM DECO'CTUM. See Sarsapa- rilla. LUTE'A, LUTE'OLA, (from Utum, mud; because it grows in muddy places, or is of the colour of mud,) struthium, dyer's weed. Reseda luteola Lin. Sp. PI. 643. The root, boiled with salt, dyes wool of a fine yellow colour. Dioscorides recommends it as useful in the jaundice, and, indeed, every thing yelloAV was em- ployed in the same disease; but the present practice does not notice it. LUTUM, (from Xvlos, soluble). Lute. Cemen- tum. Many chemical vessels require to be covered with coating, to preserve them from being broken or melted in the fire, or to close exactly their junctures. These coatings are, in general, called lutes. Glass ves- sels may be covered with a mixture of equal parts of coarse sand and stiff clay, mixed Avith water and a little hair, so as to form a liquid paste, which must be spread with a brush upon the glass; and when dry, covered with another coat, until the covering is sufficiently thick. When a glass is to be exposed to the action of the fire, a coating of fat earth and fresh horse dung is recom- mended : the earth is suffered to macerate for some hours in water; and, when properly softened, it must be kneaded with the horse dung into soft paste, to be spread with the hand upon every part of the retort. The horse dung is useful, as containing a serous fluid, which hardens by heat, strongly connects all the parts together, and Avith filaments of hay, contributes to cement them very firmly. The dung must be fresh : for, when altered by fermentation, it does not possess the same virtues. Retorts, luted in this manner, resist the action of the fire very poAverfully, and the adhesion of the lute is such, that, even should the glass break during the operation, the distillation may be still car- ried on. The lutes with which the joining of vessels are closed are of different kinds, according to the nature of the substances to be distilled. When vapours of watery liquors, and such as are not corrosive, are to be pre- vented from escaping, it is sufficient to surround the joining of the receiver to the nose of the alembic, or of the retort, with slips of paper, or of linen covered with a mixture of wheat flour and water, of the consistency of soft paste; slips of bladder, wetted, will be often suf- ficient if carefully applied. When more active vapours are to be secured, the lute may consist of a soft paste made of quick lime extinguished in air, and mixed with the white of egg. When corrosive acid vapours LUX 300 L I) X are to be confined, what is called the fat lute is neces- sary. Fine clay, well dried and poAvdered, must be sifted through a silken searce, then moistened with water, and beat into a stiff paste with boiled lintseed oil, applied to the junctures, and secured by means of slips of linen : these slips must be covered with the lute made of quenched lime and white of egg. Chaptel's Elements of Chemistry. LUXA'TIO, LUXATU'RA, (from luxo, to dislo- cate) . Dislocatio; aberratio ; eluxatio ; emotio; elongatio; ecptoma; ecclysis; lygismos; delocatio; exarthrema; olis- thema; a luxation, or dislocation. A slight dis- location is termed diacinema; parathrema; an incom- plete one, contortio or declinatio. Dr. Cullen places it in the class locales, and order ectopia, which he defines a bone removed from its seat in the joints. To which may be added, " causing an impediment to voluntary motion:" a compound luxation is when a AA-ound, frac- ture, or a violent contusion, attends. Luxations from internal causes are thus distinguished: 1. The limb is so relaxed, that it may be easily moved in any direction. 2. A cavity about the joint, and a hollowness between the bones, may be felt Avith the fingers. 3. The dislocated bone, if replaced, soon escapes spontaneously, from the weakness of the liga- ment and muscles. 4. The dislocated limb is frequently longer than the sound one, and attended with neither pain, inflammation, nor convulsion. 5. It generally hap- pens to the upper part of the femur, or humerus, and sometimes to the articulation of the foot Avith the tibia. When owing to an external injury, the diagnostics are uncertain, when the joint is swollen from a violent con- tusion or distortion/ In such cases we must suspend our judgment; and could we decide until the in- flammation and tumour were abated, attempts towards a reduction would be improper. The more readily to discover a luxation, it may be observed, that when the head of a bone is removed out of its place, the other end will be distorted in an opposite direction. A tu- mour is also generally observable where the dislocated part of the bone is seated, and an hollowness from Avhence it receded; though, in a muscular part, the tu- mour and cavity are not easily perceived. In consequence of a luxation, the symptoms differ as the parts affected are different: in general, there is an immobility, or a defective motion of the dislocated limb; a distraction of some muscles, and a relaxation of others; violent pain and inflammatory tension of the joint; a torpor of the subjacent parts ; a compression of the neighbouring vessels, from whence an atrophy, gangrene, pain, cedematous swellings, or convulsions, may ensue. Compound luxations are more dangerous than com- pound fractures. Boerhaave observes, that the worst luxation is produced by a solution or a separation of the epiphysis from the body of the bone. In general, the prognostic should be cautious, but the difficulties and uncertainties are greater in proportion to the dis- tance of the dislocated bone from its proper place; the figure of the luxated limb; the part in which the luxa- tion is seated; the parts pressed, or intercepted ; the pain, inflammation, or other violent symptoms. It will be obvious that a partial dislocation may be more easily reduced than a more complete one; and a fracture attending will render the cure more doubtful: indeed, if a fracture near the joint is accompanied with a luxation, a stiff joint must be expected, if the limb can be saved. After a limb has been some time lux- ated, it forms a socket for itself, and its old cavity is usually filled with a fatty substance, but not with in- spissated synovia, as has been asserted. The attempt is, in this case, hopeless, and generally unnecessary; for the limb, in its new position, retains some degree of motion, and is perhaps more serviceable than it Avould be after the inflammation which would arise from un- successful attempts. Indelicate constitutions, and ad- vanced periods of life, luxations are more easily reduced than in the young and strong, whose muscles resist verv powerfully. The object of the surgeon is to reduce the luxation, an operation called e7nbole; and to retain the limb in its proper situation. If inflammation or tumour is consi- derable, they must be removed before a reduction is at- tempted. Mr. Pott justly observes, that the resistance ol" the muscles is the only cause of the difficulty of reduc- ing luxations ; that much force is never required, pro- vided the muscles are relaxed by a proper position of the limb ; and that in recent cases, at least, the capsularliga- ment will rarely, if ever, impede. The extension should be gradual and continued, until the dislocated bone is on a level with the cavity from Avhence it receded. If the head does not then spontaneously return, it must be as- sisted by pressure, employing the dislocated bone as a lever. Dr. Hunter seems to think that a rupture of the capsular ligament is a greater impediment to reduction than the contraction of the muscles. It cannot be de- nied, that, in violent luxations, this ligament is often broken; but this is by no means an universal conse- quence. Both recommend gentle extension, and to avoid violence. When the external parts are violently bruised, gene- ral and topical bleeding, saturnine applications, &c. are necessary. The limb must be laid in an easy posture, and the tumour allowed to subside before the real na- ture of the case can be understood, or any attempt made to reduce the displaced bone. The great impediment, we have said, is the strong power of the muscles, Avhich not only resists the extension", but often throws the bone into a different cavity from that to Avhich we wished to direct it. When a fracture accompanies dis- located bones, a firm callus must be allowed to form before the reduction is attempted; but, if the fracture be at a distance from the dislocation, or in very small bones, where the power of the muscles is inconsider- able, this precaution may be neglected. After the luxation is reduced, leeches and saturnine applications should be employed, the pains moderated by opium, and fever diminished by cooling medicines, laxatives, and a low regimen in every respect. The most perfect tranquillity is absolutely necessary. 1. Ca'lcis luxa'tioo'ssis. Luxation of the heel bone. Whether luxated inward or outward, a cavity on one side, and a tumour on the other, discovers it; and the pain is severe. The treatment is the same as is directed when the bones of the hand are luxated. 2. Ca'pitis luxa'tio vel cra'nii. Luxation of the head. A separation of the bones of the cranium from the hydrocephalus is by some called a luxation of the head; but in general, is meant a luxation of the upper vertebra of the neck. In this case, the patient LUX 891 LUX being seated upon the ground, and supported by an as- sistant, the surgeon standing behind should raise the head from the breast. The assistant should press doAvn the shoulders, and the head be gradually drawn up, till the dislocation is reduced. If this does not happen Avith moderate extension, it may, at the same time, be gently moved from side to side. A sudden crack or noise is heard on the reduction being completed. See Bell's Surgery, vol. vi. p. 183, 195. 3. Ca'rpi luxa'tio. Luxation of the wrist. One or two of the bones in the wrist are sometimes removed from their place, which is discovered, as usual, by a tu- mour and a cavity, with violent pain. If the luxation is recent, it must be treated as a luxation of the hand. Bell's Surgery, vol. vi. p. 89, 246. White's Surgery, p. 163. I. Clavi'cule luxa'tio. Luxation of the clavicle. When this accident happens, the sooner the reduc- tion is performed the better; for long continued luxa- tions of the clavicle are rarely cured. The clavicle may slip from the sternum either out- ward or iiiAvard; in the first case a preternatural tumour is observed about the joining of the bones : in the latter case a sinus is observed in the part affected, the aspera arteria, the carotids, the contiguous nerve, and the oesophagus, are compressed. The general directions recommended, in case of a fractured clavicle, when the accident hath happened near the breast bone, are suffi- cient in this as well as with respect to a luxation hap- pening next the acromion. The last is sometimes not easily distinguished from a luxated humerus. Pare ob- serves, that in this case the upper part of the clavicle starts upwards, and a hollow cavity is observed where the clavicle is separated from the acromion : the pain is violent, and the patient cannot move the arm upAvards. If the reduction is not speedily effected, the arm will soon become paralytic. The greatest care is required in the use of bandages, lest a stiff or a luxated arm should remain. If the bone is luxated near the sternum, and is started out- ward, besides bolsters to depress the end of the bone, the capelline bandage should be applied; but if inward, the stellate bandage is preferable, on account of its keeping the shoulder back. If the luxation is next the scapula, the spica with two heads may be used. If both clavicles are displaced, the double spica must be employed, as directed in luxations of the humerus and scapula. See Bell's Surgery, vol. vi. p. 204; White's Surgery, p. 157. 5. Co'ccygis o'ssis luxa'tio. Luxation of the os coccygis. This bone may be forced inward by a blow, or outward by a difficult birth. In this case, the pain is felt in the lower part of the spine, and inflammation, sometimes with suppuration, in the rectum, is pro- duced. Independent of these symptoms, the sight and touch will discover the disease. In the latter case the bone may be replaced by pressure Avith the thumb : in the former the fore finger dipped in oir must be intro- duced up the anus, to press the bone outward, while the other fingers, applied externally, guide it to a pro- per place. The T bandage is necessary, and the patient must be kept in bed; and, when he rises, sit in a perforated chair. See Bell's Surgery, vol. vi. p. 201; White's Surgery, p. 157. 6. Co'lli Luxa'tio. Luxation of the neck. A luxa* tion between the head and the upper vertebra of the neck is immediate death, from the pressure on the me- dulla oblongata, or medulla spinalis. When a man is said to have broken his neck, there is a partial luxation of the first or second vertebra only; and in this case the chin is fixed to the breast, Avhich prevents his speaking, swalloAving, or moving the parts below. If an assistant is at hand, he must follow the directions given for the luxation of the head; or, to gain more power, he should immediately turn the patient on his back, and setting his feet against his shoulders (being, himself seated on the ground), place his hands below the "patient's ears, and draw the head towards him, gradually increas- ing the force Avith Avhich he pulls, and, in pulling, move the head from side to side. After reduction, the part should be bathed Avith spirit of wine. White's Surgery, p. 186. 7. Costa'rum luxa'tio. Luxation of the ribs. If a rib is forced imvards, the pleura is injured, and excru- ciating pains, inflammation, difficulty of breathing, cough, ulcers, and immobility of the body, follow. These complaints, with the external appearance of the side, evidently discover the misfortune. This luxation happens between the rib and the spine. Luxations internally are with difficulty reduced, be- cause neither the hands nor any instrument can be ap- plied to elevate them. The patient may be laid on his belly over some cylindrical body, and the anterior part of the rib being moved gently towards the back, or shook a little, the head may probably recover its situa- tion. If this fails, the method proposed for fractures of the ribs, when they are forced inwards, and a splinter offends the pleura, may be employed. But, if the symptoms are not urgent, nor the heads of the ribs much removed, every violence should be avoided, as luxated ribs have often remained so without danger. The bandage should be a napkin and scapulary, and compresses squeezed out of camphorated spirit of wine applied. See Bell's Surgery, vol. vi. p. 208. 8. Digito'rum ma'nus luxa'tio. Luxation of the fingers. The joints of the fingers may be luxated in every direction; but an easy extension, and gentle pres- sure Avith the finger and thumb will readily reduce them. See Luxatio metacarpi 16; Bell's Surgery, vol. vi. p. 249 ; White's Surgery, p. 163. 9. Digito'rum pe'dis, et o'ssium pe'dis luxa'-tio. Luxation of the toes and bones of the feet. A disloca- tion of these bones produces great pain, inflammations, and sometimes convulsions, if speedy assistance is not obtained. They are reduced as directed in the case of bones in the hand being the subjects of this accident. The toes are treated as directed for the fingers. See White's Surgery, p. 167. 10. Fe'moris o'ssis luxa'tio. Luxation of the thigh bone. A fracture of the neck of this bone is sometimes mistaken for a luxation. The head of the thigh bone may be luxated downwards, forwards, in- wards, outwards, and backwards. This luxation, like that of the humerus, is always perfect, and most fre- quently happens inward and dowmvard, the head of the bone tending towards the large foramen of the os pubis. When the luxation is outwards, the bone generally slips upwards at the same time; if inwards and doAvn- 5X2 LUX 892 L t X Avards, the leg is longer and more bent than the other, and the knee and foot turn outwards: the head of the bone is thrust near the lower part of the inguen and the foramen of the os pubis; sometimes the pressure of a nerve, which communicates with the bladder, or of the crural, causes a suppression of urine, or a numbness in the leg. A hollow cavity is perceived in the buttock, usually filled by the great trochanter; and if the reduc- tion is long neglected, the limb withers. The patient will be always lame; the knee of the luxated limb can- not be brought to the other; and the chief pain will be felt in the groin, without the grating observed when the bone is fractured, on moving the limb. If the luxation is backwards, the limb is drawn upwards, and a cavity is perceived in the groin, with a tumour in that part of the buttock where the head of the bone and the trochan- ter are lodged. The limb is shortened, the foot bends inward, the heel does not touch the ground, but the pa- tient seems to stand on his toes, and the luxated limb is more easily inflected than extended: in this case, many stand and walk firmly without the bone being reduced, provided their shoe has a higher heel. A fractured neck of the thigh bone is distinguished from a luxation of its head, when the thigh bone is lux- ated by an abscess, without any external violence, but only by walking or rising up; when unattended with pain, tumour, or inflammation; or when the whole limb may be bent, and turned about the acetabulum without the noise usually heard in fractures: the contrary signs indicate a fracture. In reducing the luxated head of the thigh bone, a longitudinal extension will not suffice, but it must be according to the direction of the cervix. " When a thigh is dislocated inward, or outward, follow," says Mr. Kirkland, " Celsus's advice in laying the patient on one side, so that the part into which the bone hath slipped be always uppermost, and that from Avhich it hath receded, lowermost; by Avhich means the exten- sion may be made in any direction you have a mind, and your own invention will point out to you twenty ways of securing the patient upon a bed (for a table is usually too high), so that a proper resistance be made to the extension. This done, the knee bent, and a towel fixed properly above it, you must place yourself on that side of the thigh to which the bone is dislocated, with your knee near the head of the bone, and both hands on the opposite side of the knee of the patient, an assistant being fixed at the ankle. The extension may then gradually be begun by three or four men, with the thigh rather in a state of flexion; and when there is reason to think that the head of the bone is brought to a level with the socket, the extension being steadily continued, the knee may be bent near to the abdomen, and, at the same time, whilst the khee pushes the bone towards its place, the ankle must be moved in the same, but the knee of the patient in a contrary, direction. Thus the head will always go into the socket, pro- vided a due extension is made before you attempt to return it." Sometimes the head of the thigh bone is pushed be- tween the ischium and sacrum; in this case, except the patient is exhausted, before attempting the reduction, it will be most eligible to reduce him by brisk cathar- tics, given at short intervals; for the case, in this way, is better ascertained, and the reduction more easily ef- fected. London Medical Journal, vol. v. p. 412 ; Bell's Surgery, vol. vi. p. 252; White's Surgery, p. 163; Edinburgh Medical Commentaries, vol. ii. p. 40. 11. Fi'bule luxa'tio. Luxation of the fibula. This bone may be separated from the tibia, either at the lower or superior part. In the former case it ge- nerally proceeds from a luxation of the foot externally; this bone must, therefore, be reduced, bound up, and the case treated according to the directions given for luxations of the knee and patella. See Bell's Surgery, vol. xi. p. 273. Malle'oli luxa'tio. Luxation of the ankle. See N° 21. 12. Ge'nu luxa'tio. Luxation of the knee, is usu- ally partial. If complete, it is easily reduced, but can- not be retained, because the cross ligaments are broken. A luxated knee pan is a necessary attendant of a lux- ated knee, and often taken for it; but in a proper luxa- tion of the knee the tibia recedes from the femurr either backwards or to either side, but never foi'Avard, because the patella hinders it. In this part dislocations are easily discovered. If the luxation is partial, the patient must be placed on a table, one assistant taking hold of his thigh, and another extending his leg; in the mean time, the opera- tor may reduce the bone with his hands. In children and young persons, if the extension is made Avith vio- lence, it endangers a separation of the epiphyses, a worse disease than the luxation. See Bell's Surgery, vol. vi. p. 269; White's Surgery, p. 165. 13. Hu'meri luxa'tio. Luxation of the humerus. The head of this bone may slip out before, behind, (even under the scapula,) or dowmvards; but never upwards, except the acromion and coracoid processes are fractured. When the humerus is luxated downward, there is a cavity in the upper part of it perceptible to the eye in some instances, but to the finger in all, and a tumour in the arm pit, because the head of the bone is lodged there. The luxated arm is longer than the other, and Avhen it can be moved or extended, it gives" exqui- site pain in lifting it to the mouth. Fresh luxations are most easily reduced; those of long continuance are restored with difficulty ; but if the head of the humerus adheres to the adjacent parts, which after a long time usually happens, a reduction cannot be effected by any means. See Medical Obser- vations and Inquiries, vol. ii.p. 340. To reduce the humerus, bend the fore arm, and let an assistant support it; then elevate the arm so that the elboAv may be advanced somewhat above the shoulder, bringing it a little inward. An assistant must then make the extension, Avhilst another counteracting him, draws the inferior angle of the scapula backward to- Avard the spine, and presses the acromion a very little dowmvards: the operator, with his fingers in the axilla, presses the head of the bone upward as soon as he per- ceives the extension to be sufficiently made, and at the same time, with his other hand, brings the elbow of the luxated arm to the patient's side. An extension made downwards, or even horizontally, more frequently fails, than when it is made in some degree upward. When the luxation is forward, that is, when the head of the humerus is under the pectoral muscle, there is a cavity under the acromion, but the head of the luxated bone projects towards the breast more than Avhen in the L I X 893 L U X axilla; and if the arm be moved, a more acute pain is felt than in the preceding case; for the great artery and the nerves of the bones are much pressed. If this luxation is not easily reduced by the method directed, when the head of the humerus is in the arm pit, let a pulley from the top of a room be fastened to the luxated arm, just above the elboAv, and the patient gradually raised from the ground by it: this at least brings the head of the humerus into the axilla, and it may be re- stored into its proper place by the means just described. In this process the fore arm must be brought tOAvard the breast, that the muscles may be relaxed. If the luxation is backAvard, the elbow approaches the chest, and the head of the bone is prominent on the outside of the shoulder; the arm cannot be moved from the breast, nor extended without great agony, and the lower angle of the scapula Avill be somewhat pushed out. In this case the general process may be the same as when the head of the humerus is under the pectoral muscle. If there is no pulley, a tall strong man may take the patient's arm over his shoulder, and gently raise him from the ground, and the operator may push the head of the dislocated bone into its place as the body becomes suspended. This method of suspending the patient is not so severe as it may seem; for as ho force is used about the shoulder to make a counter extension, the pa- tient does not suffer from those troublesome excoria- tions and contusions Avhich too commonly attend the other methods. It is generally agreed that machines for reducing a luxated humerus are never needful. Freke's command- er is preferred to all the other instruments used for this purpose; as in the use of it the limb may be moved in all directions during the extension, and the situation of the head of the bone can be examined ; but great care is required to keep it perpendicular to the side of the patient. As in other luxations, bleedings, 8tc. to prevent or check inflammation and swelling, must be used after the reduction, and the arm suspended by a sling. See Medical Observations and Inquiries, vol. ii. p. 373; Bell's Surgery, vol. vi. p. 211 ; White's Surgery, p. 158. 14. Ma'nus luxa'tio. Luxation of the hand. The hand may be luxated backward, forward, and on each side; but a luxation backward or forward is most frequent. Each accident is readily distinguished. From the distortion of the strong ligament, and the pressure on the tendons, there is exquisite pain and a rigidity of the fingers ; and inflammation, tumour, ab- scess, gangrene, and a caries of the spongy bones of the carpus often follow, seldom curable but by amputation. A recent inconsiderable luxation is more easily managed, and it should be speedily reduced, by extending -the hand and arm in opposite directions; and by placing the cavity of the extended hand on a table or some other flat body, that the tumour may be depressed. This me- thod is necessary, whatever part of the hand is luxated. See Luxatio metacarpi, 16. 15. Maxi'lle inferio'ris luxa'tio. Luxation of the lower jaw. This bone is usually luxated forwards on one or both its sides. If one side only is luxated, the chin inclines to the opposite side, and on the dislo- cated side the mouth is wider open. When both sides are dislocated, the mouth gapes wide, the jaAV starts forwards, and the chin falls toAvards the breast, so that the patient cannot shut his mouth, speak distinctly, nor swallow with ease. This accident may happen from a blow, or from yaAvning. When one side only is dislocated, it is easily reduced ; but when both sides suffer, the patient must be placed in a low seat, with his head secure against the breast of an assistant; then securing the thumbs from being bit, place them on the patient's teeth, as far back as you conveniently can, at the same time fixing your fingers on the outside of the jaw : when you have secure hold of the jaw, press it dowmvard, backward, and upAvard. If all this is done almost in the same instant, the reduc- tion will be complete; or, as Mr. Bell says, when the fingers are applied as directed, the surgeon must pull the under jaw forward, till he finds it move somewhat from its situation ; and he should then press the jaw forcibly down Avith his thumbs, and moderately back- ward Avith the palms of his hands, when the ends of the bone Avill immediately slip into their situation. If only one side is luxated, the same mode will suc- ceed, if the affected side be pressed most forcibly down- wards and backAvards. Bandages are useless in this case. See Bell's Surgery, vol. vi. p. 189, 190 ; White's Surgery, p. 155. 16. Metaca'rpi luxa'tio. Luxation of the Meta- carpus. See Manus luxatio. Mr. Bell observes, that in the reduction of these dis- locations (viz. of the metacarpus and fingers), the bone should not be pulled down till it be somewhat raised or elevated from the contiguous bone; for, as all the bones of the fingers and thumbs, as well as those of the me- tacarpus, are considerably thicker at their extremities than in any other part, these projections are apt to be forced against each other when the extension is made in a straight direction. See Bell's Surgery, vol. vi. p. 249, 251 ; White's Surgery, p. 163. 17. Na'si o'ssis luxa'tio. Luxation of the bone of the nose. This accident is easily discovered by the eye and the touch. The reduction is effected by a quill put up the nostrils, and then with the fingers replacing the bones. After the reduction a sticking plaster may be applied. Bell's Surgery, vol. vi. p. 184. 18. Olecra'ni luxa'tio. Luxation of the elbow. A perfect luxation of this joint rarely happens, ex- cept the olecranon is fractured, or the ligament greatly weakened. This luxation may be backAvard (which is most frequent), forward, outward, or inward. If backward, the arm appears crooked and shorter, and cannot be extended: in the internal part of the flexure the humerus will be prominent; in the external, the olecranon, with a large cavity between both bones. When from the fracture of the olecranon, the elbow is pushed forward, the os humeri will stick out behind, the ulna is prominent on the fore part, and a cavity ap- pears in proportion to the luxation. If external, the tumour is so too, and vice versa. In a violent luxation, or one of long standing, the bone cannot be replaced without great difficulty, as the ligaments are strong and the processes numerous. Re- cent and slighter luxations are more easily restored. If the ligaments and tendons are rigid, emollient ap- plications should be used some time before attempting the reduction ; the egg liquor is useful in this case. See Anchylosis. LUX 894 LYC In reducing this luxation an extention must be made, until the fore arm can be bent; and then the reduction is easily accomplished by bearing upon the lower end of the humerus Avith one hand, and by taking hold of the wrist and bending the elbow Avith the other. If it is on either side, the hand of the patient must be turned inward or outward, at the same instant, as the case requires. After reduction, the arm should be hung in a sling for some time, that the parts may recover their tone. See Bell's Surgery, vol. vi. p. 239. White's Surgery, p. 162. 19. Pate'lle luxa'tio. Luxation of the knee pan, may happen externally and internally. In order to its reduction,.the patient's leg must be pulled straight, or if he can, he may stand on it erect; then the operator, taking firm hold of the patella with his fingers, may force it into its place. Nothing but rest is afterwards required. Bell's Surgery, vol. vi. p. 267. White's Surgery, p. 165. 20. Pe'dis o'ssium luxa'tio. See 9. 21. Ta'li luxa'tio, seu malle'oli. Luxation of the ankle. Dr. Hunter observes, that when there is a luxation of the malleolus internus, there is generally a fracture of the fibula ; but that if the person is of a Aveak constitution, ligaments may be relaxed without a fracture. If the ankle is luxated inwardly, the bottom of the foot turns outward; if outwardly, the contrary. If forward, the heel becomes shorter, and the foot longer than usual; if backAvards, the heel is lengthened, and the foot shortened. This kind of luxation is usually attended with great pain, and other very violent symp- toms ; and the difficulty of reducing the ankle is pro- portioned to the violence of the cause. The patient should be placed on a table or bed, and the leg, with the knee bent, firmly secured by an assistant or two. The foot is now to be put into that situation which tends most effectually to relax all the muscles which belong to it; and an assistant must be desired to ex- tend it in that direction till the most prominent point of the astragalus has clearly passed the end of the tibia, when the bone will slip, or may be easily forced into its place. The patient should keep in bed until the fever and the symptoms of irritation leave him, and he is in some measure able to rest upon his ankle. See Bell's Surgery, vol. vi. p. 274. White's Surgery, p. 166. 22. Vertebra'rum luxa'tio. Luxation of the vertebra. The vertebrae are rarely perfectly luxated. Those of the neck and loins are more subject to this accident than those of the back, because they are more moveable and smooth, are destitute of those cavities with which the vertebrae of the back are furnished, and have a thicker cartilage interposed betwixt each. Luxa- tions of the vertebrae must be imperfect, unless at- tended whh a fracture, and a laceration of the spinal marrow, an accident quickly fatal. The imperfect luxations are scarcely less fatal; and they most fre- quently happen in the upper vertebrae of the neck. Dislocation or crookedness of the dorsal vertebrae side- ways, is called contortio. The vertebrae pf the back cannot move in any great degree without a fracture : their upper or lower apo- physes, and sometimes only one, is misplaced; for great violence is generally required in order to a partial luxation. When a vertebrae is luxated without a fracture, the body leans to one side, or forward: if the lei side is affected, the patient leans to the right, and vice versa. The common signs of a luxation of the vertebrae in the back are, that the back is crooked and unequal; the patient can neither stand nor walk, and his whole body seems paralytic; all the parts below the luxation arc insensible and immovable; the excrements and the urine are retained, or discharged involuntarily; the lower parts mortify, and the patient soon dies. All the luxations in the spine are very dangerous, from the injury done to the spinal marrow, and the difficulty of reducing them. The danger is also greater, the nearer the luxation is to the head; as from the vertebrae of the neck and back, the nerves which supply the heart and intestines are chiefly derived. When several vertebrae are luxated, the bad symptoms are not so violent. For reducing the vertebrae of the neck, see Colli luxatio. When both the apophyses of the vertebrae are dislocated, the patient must be laid on his belly over some round body, and two assistants may depress both ends of the luxated spine on each side, Avhich elevates, and gradually extends the vertebrae, the spina dorsi being thus bent in form of an arch. The surgeon next presses down the inferior dislocated and prominent vertebra, and, at the same instant, expeditiously pushes the superior part of the body upwards. If the first attempt fails, it must be repeated two or three times. When the left apophysis only is displaced, after the patient is laid in the same posture, one assistant may depress the left coxa, and the other the right humerus; and the reverse, if the injury is on the other side. After the reduction, it may be necessary to take some blood, and compresses wrung out of spirit of Avine should be applied, and then the napkin and scapulary. See London Medical Journal, vol. i. p. 32,6, 327. Bell's Surgery, vol. vi. p. 196; and White's, p. 156. Boer- haaVe's Aphorisms. Petit's Diseases of the Bones. London Medical Observations and Inquiries, vol. ii. p. 99, &c. Gooch's Cases and Remarks. Pott's Gene- ral Remarks on Fractures and Dislocations. Kirkland's Observations on Pott's Remarks. Medical Museum, vol. ii. p. 406. Heister's, Wiseman's, Bell's and White's Surgery. LUXU'RIANS, (from luxurio, to exceed). A flower is called luxuriant, when the teguments of its fructifi- cations are augmented so as to exclude some other es- sential part. Double floAvers, which are luxuriant ones, seldom produce fertile seeds. LYCA'NCHE, (from Aewsas, a wolf). A quixsv; because the noise in breathing is supposed to resemble the hoAvling of a wolf. See Angina. LYCANTHRO'PIA, (from Xevxos, a wolf, and xv- Dpuros, a 7nan). Lycanthropy ; by the Arabians cutu- buth, from an animal which perpetually moves up and down on the surface of stagnant waters; by -Etius, cynanthropy, as well as lycanthropy. It is supposed to be the disorder with which the demoniac, mentioned in scripture, who dwelt among the tombs, was affected. Oribasius informs us, that persons affected with this disease " leave their houses in the night time, in every thing imitate wolves, and wander about the tombs until break of day." Actuarius adds, that " they then return to their homes and their senses." Their looks are said L YC 895 L YM to be pale, their eyes dull, holloAV, fixed, dry, and with- out the moisture of a tear; their tongues dry, their tegs, from the bruises they receive in the night, (and, accord- ing to .Etius, from the bites of dogs,) full of incurable ulcers. It is the melancholia errabunda, erratic melan- choly of Sauvages. Bleeding, blisters, purgative medi- cines, interposing anodynes, with gentle treatment, are the principal means of relief. LY'CHNIS, (from Xvx*os, a torch, because its leaves were usually rolled up as torches). Ly'chnis se'getum ma'jor. See Nic.ellastrum. Ly'chnis sylve'stris. See Antirrhinum, Ocimas- trum, Behen album vulgare, and Saponaria. Ly'chnis visco'sa ru'bra. See Muscipula. Ly'chnis corona'ria Dioscoridis, rose campion, is cultivated in gardens, flowers in June, and its seeds are cathartic. LYCHNOI'DES SE'GETUM, (from lychnis, and ttfos, likeness). See Nigellastrum. LY'CIA. See Cerus Cypri folio. LY'CIUM, (from Lycia). The nandia agiahalid, arbor spinosa, the Indian thorn, probably a species of prunus, grows in the East Indies, is very large, re- sembling the wild pear; fruit bitterish and styptic; the leaves sour and astringent. This last property its in- spissated juice preserves, and is called cate, as it is mistaken for the terra Japonica. Ly'cium bu'xi fo'lliis, pyracantha, box thorn. Celestrus buxifor?nis, or pyracanthus Lin. Sp. PI. 285, grows in hot countries. The rob of the fruit is astrin- gent, but it is often adulterated, or the rob from the berries of periclimenum substituted for it. LYCOCTONUM, (from Xevxos, a wolf, and xletva, to slay, because it was used for the purpose of destroying wolves). See Aconitum. LYCOPE'RDON, (from Asoxa?, a wolf, and -srepfoi, crepitus). Puff ball, supposed to spring from the dung of wolves. Lycope'rdon vulga're, crepitus lupi, bovista, orbi- cularis fungus rotundus 7naximus pulverulentus; dus- ty mushroom, puff ball, lycoperdon bovista Lin. Sp. PI. 1653, is round, or egg shaped, whitish, Avith a short and scarcely any pedicle, growing in pasture grounds. When young they are covered with tubercles on the outside, and pulpy within. By age they become smooth externally, and are filled with a fine light brownish dust. It is a very powerful vegetable styptic Avhen externally applied. Gooch prefers it to the agaric of the oak, and every other fungous substance. It is softer and more absorbent than lint, and, if cut into slices, might answer the purpose of the sponge, recommended by Dr. Kirk- land, after amputation. LYCOPE'RSICON, (from >«»«o«, a wolf, and wit- nxov, a peach, from its exciting a violent degree of lust). Wolf's peach, solanum peruvianum Lin. Sp. PI. 267. It partakes of the poisonous properties of the other solana. LYCOPO'DIUM, (from Xevxos, a wolf, and zrovs, a elaw,) muscus clavatus, terrestris, squamosus, plicaria, cingularia, wolf's claw, club moss ; lycopodium cla- vatum Lin. Sp. PI. 1564, is a fertile moss, destitute of pedicles and capitella, differing from the selago, because its capsules, instead of being scattered in the sinuses of the leaves, are collected into a club; for each scale covers a kidney shaped and bivalve capsule, which loses no part when ripe. It groAvs on heaths and hilly places, flowers in July and August, and is reckoned cooling and astringent. Its pollen is sprinkled with advantage on tender skins, to prevent excoriation. M. Bucholz, of the academy of Erfurth, has lately exa- mined this singular substance, and found that the seeds contained one-sixteenth of a fat oil, of a broAvnish yel- low colour, soluble in alcohol; a portion of true sugar; an insipid, viscid, broAvnish yelloAV extract, leaving a re- siduum of peculiar properties, not explained, butAvhich is said to be a peculiar product of the vegetable king- dom. The yellowish appearance of the seeds is sup- posed to arise from their containing a pigment, and their oil occasions their inflammability and their separation from water. See Plica polonica. LYCO'PUS, (from the same). See Marrubium AqUATICUM. LY'DIUS LA'PIS, (from Lydia). See Magnes. LYGI'SMOS, (from Xvyt^u, to distort). See Lux- atio. LY'GMOS, (from Xv&, to hiccough). See Sin- gultus. , LY'MPHA, quasi nympha, (from w^pt, water). Lymph is a pellucid, insipid, pure liquor in the human machine, and the purer parts of the serosity generally obtain this appellation. The gelatinous parts of this fluid Avere supposed to nourish all the solids, its finer aqueous parts to be circulated through the lymphatic vessels, and, by means of the valves and conglobate glands, again conveyed to the heart. These ideas are,- hoAvever, now exploded; but, in the Boerhaavian school, Ave still hear of lymphatic arteries, which are properly those which will not admit the red globules. They have corresponding veins distinguished by the same ap- pellation. The source of the lymph, Avhich Ave find in the cavities, as the pericardium, the ventricles of the brain, &c. either in the healthy state, or when accumulated in dropsical SAvellings, is uncertain. Dr. Hunter has at- tributed it to exudation through the inorganic pores, as he found his injections, the bile, and other fluids, exude after death. This opinion is, however, untenable, from many vieAvs, but particularly the numerous and dense coats of the vessels; for it is not probable that the pores should be sufficiently large for this purpose, without danger of all the serosity escaping; or that, in each coat, the inorganized pores should so minutely correspond. It is, therefore, with much reason, supposed that the exudation which he found Avas in consequence of the relaxation occasioned by death, and that all the Avatery fluids are either exhaled from the open orifices of ar- teries, or separated by a simpler species of secretion. There is, we think, little doubt of the vessels in a state of health confining the fluids by their tonic power. Indeed, they seem to pass off in a state of halitus. LY'MPHA DU'CTUS, (from lympha, and duco, to carry). Vasa lymphatica. Lymphatic vessels. The lymphatics arise from the cells of the membrana cellu- laris, the cavities of the intestines, of the urine and gall bladders, and of every other viscus, carrying a pellucid liquor towards the receptaculum chyli and thoracic duct, in which they almost exclusively terminate. The coats of these vessels are thin and transparent, much L YM 896 L YM croAvded Avith valves, so as, like the lacteals, to resem- ble, Avhen injected Avith quicksilver, strings of beads. The lymphatics frequently anastomose, and in their way pass through the lymphatic glands, ramifying before they enter a gland, and uniting in their passage from it. Sec Lactea vasa, Ductus thoracicus. The course of the lymph and of the chyle is from the extreme parts of the body towards the centre; and the lymphatics commonly lie close to the large blood vessels of the extremities. All the lacteals, and most of the lymphatics, open into the thoracic duct, which lies upon the spine, and runs up towards the neck, where it commonly opens into the angle betAveen the jugular and subclavian veins of the left side; and thus both the chyle and the lymph are gradually mixed with the blood. The coats of these vessels are thinner and more pel- lucid than those of the blood vessels, but stronger; for they can support the weight of quicksilver, Avhich will rupture the coats of even the arteries. The internal coat is smooth, dense, and highly polished, projecting by little duplicatures into the cavity of the vessel forming the valves. The second coat consists chiefly of muscular fibres, running in every possible direction; but usually in a circular one, surrounding the internal membrane. The outward coat is similar to the pleura, or perito- naeum. The coats of the lacteal and lymphatic vessels have, in common Avith all other parts of the body, arteries and veins for their nourishment, and nerves for their animation: from the blood vessels running through them they are subject to inflammation, and, from their numerous nerves, they are more irritable than any other vessels in the human body. Their valves are two in number, of a semilunar shape; and are so frequently interposed, that three or four pair may be sometimes found in the space of one inch. They are occasionally feAver, and in some parts wholly wanting. The lymphatics, like the lacteals, open into the ca- vities, and draw in the various fluids which these con- tain by a capillary attraction. It is probable, as we have said, that they convey fluids only, or solid substances very minutely divided. That they carry the bony matter we know, from the fact recorded by Mr. Ches- ton, where, in a case of mollities ossium, the thoracic duct was filled with an osseous matter. Bones are not, however, absorbed so rapidly as the frequently quoted experiment, with madder, would lead us to believe; for it is now found, that, though the colouring part of mad- der has a considerable affinity to the phosphat of lime, of which the bones consist, it has greater affinity to the serum of the blood. In such experiments the colour- ing matter is, therefore, only deposited, and again washed away, without any other corresponding change on the earthy salt. The fluids, Avhen once absorbed, are carried, by the action of the vessel, or by the pressure of the adjoining muscles, beyond the first pair of valves; and, by the frequent recurrence of these valves, every action assists the progress of the fluid, since regurgita- tion is prevented. It is by no means certain that all the lymphatics pass into the thoracic duct. Some trunks have been discovered which escape it, and there is rather a probability that lymphatics occasionally ter- minate in veins farther distant from the heart. Lymphatics, as well as lacteals, are not always ex- cited to action: in other words, their extremities are not erected so as to become capillary tubes, a circumstance depending on a variety of causes, of which we can per- ceive with distinctness only general debility, or a suf- ficient supply already in the system. We have had occasion also to suggest, that an elective affinity seems to influence the admission of some fluids, and the rejection of others. Perhaps sedatives may, for a time, paralyze the sensible orifices of the lacteals; stimulants excite them too violently, or astringents contract them too much. This may be deemed conjectural; but some facts might be adduced in favour of each supposition. The lymphatic vessels of the loAver extremities are the superficial, or those more deeply seated. The for- mer lie between the skin and the muscles, and are con- nected with the surface, and the cellular membrane, which lies immediately under it, absorbing fluids from each; one branch of the superficial lymphatics runs upon the top of the foot, another generally under the inner ankle. The branch on the foot runs up on the outside of the tendon of the tibialis anticus, until it rises above the ankle; and running over the shin bone, it divides and forms a plexus, still ascending in the cellular mem- brane to the inside of the knee, from whence it ad- vances up the inside of the thigh under the skin, and, arriving at the groin enters the lymphatic glands. These glands are seven or eight in number, some of which lie in the angle between the thigh and the abdo- men, and others a little below on the fore part of the thigh. Into these upper glands only lymphatic vessels of the genitals enter, so that the venereal bubo, which arises in consequence of an absorption of matter from these organs, is always seated in these; and the lower glands are never affected, except from their vicinity to the glands first diseased. As the upper glands are affected from the genitals, so the lower are usually in- flamed from the absorption of acrid matter in the parts below them. The lymphatic vessels of the genitals having joined those of the thigh, a net Avork is formed, which enters the abdomen under the edge of the tendon of the external oblique muscle, called Poupart's liga- ment: some branches of this plexus embrace the iliac artery. As no considerable branches can be distinguish- ed on the outside of the leg or thigh, it is probable that all the lymphatic vessels of those parts bend toAvards the inside. Upon these superficial vessels, from the foot to the groin, there is scarcely in any instance one gland. Besides the superficial lymphatic vessels which lie above all the muscles, or in the cellular membrane under the skin, there is some seated amongst the muscles, accom- panying the crural artery. Of these the principal trunk can be discovered by cutting down to the posterior tibial artery, near the inner ankle. From this part the vessel passes up with the posterior tibial artery, and is hid amongst the muscles on the back part of the tibia. About the middle of the leg it enters a small gland met with in most subjects, and from hence runs up to the back part of the ham, still lying close to the artery, and in the ham it usually passes through three glands. After it has passed these glands, this single vessel commonly divides into two or three branches, which still accom- pany the crural artery, and pass with it through the perforation in the triceps. Having passed the muscle, they go up with the artery and enter a gland deeper seated than those which appear on the groin, from which they pass into the superficial gland. L Y M 897 L Y M The lymphatics of the lower extremities having noAv •reached the trunk of the body, and passed under Pou- part's ligament, appear upon the sides of the ossa pubis, near the pelvis. Some pass up Avith the iliac artery upon the brim of the pelvis; and others dip into the cavity of the pelvis, and join the internal iliac artery near the sciatic notch. At this place they are joined by the lymphatics from the contents of the pelvis. Be- sides those Avhich sink into the pelvis, on the inside of the external iliac, others keep on the outside of that ar- tery upon the psoas muscle : of these a part goes up to the loins, and passing under the aorta in different branches, from the left side to the right, joins the tho- racic duct. Another part passes under the iliac arteries, and appears upon the os sacrum, making a beautiful net Avork, joining the lymphatics of the right side, and pass- ing under the iliac artery, to form the net work upon the upper part of the right psoas muscle. The lympha- tic vessels of the right side, joined by some from the left, having reached the right lumbar region, appear there in the form of a plexus of large vessels, and pass through several glands. At this part, they receive like- wise large branches under the aorta, from the plexus on the left side of the loins ; and having at last got up as high as the second lumbar vertebra, they all join, and form a single trunk called the thoracic duct: at this part they are joined by the lacteals. See Lactea vasa. Into the thoracic duct the lymph from the other ab- dominal viscera enters. This is brought by a number of vessels, a plexus of AA-hich may be traced from each kidney, lying principally behind the emulgent artery, and opening into large lymphatic vessels near the aorta: these the lymphatics of the glandulae renales generally accompany. The lymphatic vessels of the spleen pass from the concave side of that viscus, along with the splenic ar- tery in the sinuosity of the pancreas, by the lymphatic vessels of which they probably are joined. To the stomach belong tAvo sets of lymphatics, the one running upon its lesser, and the other upon its greater, curvature. The former accompanies the coro- nary artery, and passes through some lymphatic glands which lie by its side. The other set passes from the great curvature of the stomach, through some lymphatic glands that lie close to the arteria gastrica dextra. De- scending by the pylorus, it meets the plexus that accom- panied the coronary artery, and near the lesser curva- ture of the duodenum forms a considerable net work. Into this not only the lymphatics from the spleen en- ter, but likewise those from the gall bladder, together with those of the liver, which are very numerous both hi its convex and on its concave side. Several branches proceed from this net work, some running under the duodenum, and others over it j which all open into the thoracic duct. The lymphatics of the liver, the spleen, and the kid- neys, are generally in two sets; one of which lies upon the surface of the organ, and the other accompanies the large blood vessels in its centre. In the liver, these two sets have been found to communicate with each other ; so that, by injecting mercury into the lymphatic vessels which lie upon its convex surface, Mr. HeAvson hath filled those which accompany the pori bilarii and •ena portae in its centre. Most of the lymphatic vessels VOL. I. which lie upon the convex surface of the liver, run to- Avards its falciform ligament, and pass down by the side of the vena cava ; but some run toAvards the right liga- ment of the liver, where they pass down upon the dia- phragm to reach the thoracic duct. The lymphatics on the concave surface run towards the porta, where they join those which come from the centre of the liver, along Avith its large blood vessels. The lymphatic ves- sels of the stomach enter Avith others into the thoracic duct. All the lymphatics of the viscera, Avith their dif- ferent plexuses, are beautifully figured by Mascagni. The lymphatics of the lungs are in two sets. One set passes on the posterior part of each lobe by its roo'. into the thoracic duct, near the middle of the thorax ; the other from the fore part of each lobe rises toAvards the jugular and subclavian veins. Some of the lympha- tics, on the posterior part of the left lobe, creep under the aorta to the thoracic duct. Those from the anterior part of the left lobe proceed to the angle between the jugular and subclavian vein of the same side, joining the thoracic duct at its termination; while those from the fore part of the right lobe do not communicate with the thoracic duct, but pass into the angle between the right jugular and the right subclavian vein. By the side of each internal jugular vein is a large lymphatic vessel, the trunk of those of one side of the head and neck. Smaller lymphatics are seen near the branches of the external carotid. From various circumstances, it is highly probable that there are lym- phatic vessels on the external parts of the head; and, though none have been discovered, on the brain also. The small lymphatics which accompany the branches of the external carotid artery unite upon the neck, and form a large trunk, which accompanies the internal ju- gular vein, passing through some lymphatic glands, near the termination of this trunk, in the angles betAveen the jugular and subclavian veins. The glandula thyroidaea has many lymphatic vessels, which can sometimes be in- flated by blowing air into the cells of the gland: these vessels pass on each side of the trachea, one part going into the angle of the right subclavian and jugular, and the other joining the thoracic duct upon the left side. Like the leg, each arm hath two sets of lymphatic vessels; one immediately under the integuments, be- longing to the skin and the cellular membrane, con- necting it to the muscles; the other accompanying the large arteries, from the parts deeper seated. The lymphatic vessels, discovered and delineated, are in general only to be considered as the trunks, since every part of the body has probably vessels of this kind; for wheresoever variolous matteris inserted, the lymphatic vessels carry it into the body, as is shown by its inflam- ing the conglobate glands through which these vessels pass. It is by the action of the absorbent system that many noxious materials are introduced into the habit; as the matter of the small pox, the lues venerea, the miasmata of fevers: and it is also by their means that mercury rubbed externally is received into the constitution, and produces similar effects on the interior parts. See For- dyce's Elements, part 1st. Dr. Hunter's Commentaries. Monro's Description of the Human Lacteal Sac and Duct. Hewson's experimental Inquiries into the Lym- phatic System. Sheldon's History of the Absorbent System. Mascagni Historia. L YM 898 L Y M The diseases of the lymphatics are not numerous. They are undoubtedly irritable, and in an inflamed state, at least, acutely sensible; but they never seem to be af- fected with inflammation from any cause but the acri- mony of their contents. In hydrophobia, in lues venerea, and similar complaints, a hard, tender cord may be often traced from the wound previous to the inflammation of the gland. On the other hand, they seem sometimes deficient in irritability; a circumstance on which Scro- fula, vide in verbo, apparently depends. Amongst these disorders, however, Mr. White pro- perly places the depdt laiteux sur la cuisse of Puzos; ischias a spargonosiof Sauvages. Most writers have at- tributed this complaint to a redundancy of milk, and it hence has been often called edema lacteum; by others phlegmatia dolens; but it might be more appropriately denominated ecchymoma lymphatica. Mr. White de- scribes this disorder more accurately than any other writer, and is the first author who escaped from the trammels of the former doctrine. In about twelve or fifteen days after delivery, he observes, the patient is seized with a great pain in the groin of one side, accom- panied with a considerable degree of fever, seldom pre- ceded by a shivering fit and cold rigor,. This part soon becomes affected with swelling and tension, which ex- tend to the labia pudendi of the same side only, and down the inside of the thigh, to the ham, the leg, the foot, and the whole limb: the progress of the SAvelling is so quick, that in a day or two the limb becomes twice the size of the other, and is moved with great difficulty; is hot and exquisitely tender, but without external in- flammation. The pain in the groin is generally pre- ceded by a pain in the small of the back, sometimes by a pain at the bottom of the belly, on the same side; and the parts which suffer the most pain are the groin, the ham, and the back part of the leg, about its middle. The pain indeed extends over the Avhole limb, owing to the sudden distention; but in a day or two it becomes less considerable. It is very hard, smooth, shining, pale, and equable, except where the conglobate glands are situated, which in some cases are knotty and hard, as in the groin, the ham, and about the middle of the leg, at its back part; neither pitting on pressure,nor discharg- ing water when punctured. This disorder generally comes on about the second or third week after delivery; but in one instance it occurred to Mr. White so early as twenty-four hours after delivery, and in another so late as five Aveeks; but each is uncommon. The first parts that begin to mend, both as to pain and swelling, are the groin, and the affected labium ; the thigh next sub- sides, and lastly the leg. The fever, Avhich is appa- rently hectic, in some patients declines in two or three weeks, in others it continues six or eight. It some- times, though rarely, attacks both the extremities. Af- ter the disorder has subsided, it is not uncommon for the sound leg to swell towards evening, and become cedematous; but the groin and thigh of that side are not affected ; the leg is much softer than the other, and pits when pressed. It attacks women of aH ranks, and of different habits, and is not influenced by the discharge of the lochia, suck- ling, the nature and duration of the labour, Or the mode of delivery, but rather attacks the side on which they lay during labour. The healthy and the diseased ; the strong and the weak ; the lean and the corpulent; the sedentary and the active; the young and the middle aged, equally suffer; but it seldom happens after a mis- carriage, nor to a woman more than once, though she has afterwards more children. It occurs at all seasons and situations; but neither attacks the arms, nor other parts of the body; never suppurates, nor proves fatal. The period of the attack, and the elasticity of the swelling, distinguish it from every other disease^ and Mr. White supposes it to arise from the child's head pressing the lymphatic vessels, which arise from one of the lower extremities, against the brim of the pelvis, during a labour pain, so as to stop the progress of the lymph, and produce a rupture Avith a consequent effu- sion. The extravasation in some habits is re-ab- sorbed readily, in others Avith difficulty; and by ly- ing out of the course of its circulation, it will press against the uterus and bladder, and occasion forcing pains, and even suppressions of urine. When the ori- fice made in the ruptured vessel is healed, and the dia- meter of the tube is contracted or closed, the lymph is retained in the lymphatics, distending the glands of the limb and parts around, and the swelling always begins in that part next to which the obstruction is formed. When the obstruction is in part or wholly removed, or the lymph has found a fresh passage, the part next to it is consequently first relieved. This opinion has been op- posed by different authors. Mr. Trye, in his work, published in 1792, considered the disease as owing to an inflammation of the lymphatic gland ; Dr. Ferriar, in the third volume of his Medical Histories (1798), thinks its cause an inflammation of the lymphatics of the side affected. Dr. Hall, in an essay on this disease, which he styles phlegmatia dolens, published in 1800, supposes it to arise from inflammation and an effusion of coagulable lymph. We strongly suspect that the nature of the disease is not understood. The fever is apparently idiopathic, and the swelling seems to be a critical deposition, not of pus or of water, but of coagulable lymph. Were Mr. White's opinion correct, it should always appear within a few days, and the fever should be the conse- quence of obstruction. Were Mr. Trye in the right, the gland should first inflame ; and was Dr. Ferriar's system true, pain should be previously felt in the course of the lymphatics. Dr. Hall seems to approach nearer the fact; but the nature of the fever, and the circum- stances which influence the deposition, are obscure. Milky depositions, as they have been called, are not un- common after delivery, particularly in the peritonaeum in the peritonitis puerperarum, and other parts ; but these are, perhaps, rather depositions of gluten than of milk, or are observable Avhen the milk is checked. In this case the disease is not connected with the suppression of milk; and the only use we can make of the fact is, to show that in such cases the effusion of gluten is not uncommon. If, from fever, such effusion should take place in the tegs, we know that, from its density, it cannot be readily absorbed ; and it is probable, also, that the lymphatics, by the pressure which usually occasions cedematous SAvellings in the latter months, may be Aveakened, so as to be still less equal to the conveyance of the glutinous lymph to the thoracic duct. The cir- cumstances of the delivery, or of the position of the child in utero, may have an effect of determining to one side rather than another, L Y M 899 L Y T According to Mr. White, in the first or inflammatory stage, antiphlogistics are necessary, in the degree Avhich the patient's strength will permit. The bowels should be kept lax, the pains alleviated by opiates internally, by anodyne fomentations, and by the warm and vapour bath; blisters on the upper part of the thigh, and emollient injections inte the vagina, have been found useful; anti- monials, the saline draughts given in the act of efferves- cence, cool acidulated liquors, and cool air, are supposed useful in relieving fever. In the second stage, Avhen the pain abates, the swelling and tension of the parts lessen, though the quickness of the pulse and some de- gree of fever remain, the patient may be allowed a little wine and a fuller diet. A dose or two of calomel, of two grains each, given at proper intervals, have seemed useful in this stage. Fifteen grains of myrrh two or three times a-day, in a neutral draught in the act of effervescence, maybe taken ; or to a saline draught, with myrrh, two grains of the ferrum ammoniacale may be added. The limb may be chafed with warm oil, and bathed at first in water of 82 degrees of Fahrenheit, and afterwards of 76. In the third stage, when no com- plaint remains, except the SAvelling of the limb, and perhaps a general relaxation, the bark, Avith or Avith- out steel, will be necessary, dipping the limb in cold water, or embrocating it with spirit of Avine and cam- phor. A circular calico bandage applied to the limb will also assist in the recovery; and if the swelling is confined to the small of the leg, the bandage may be changed for a straight or laced stocking, or for a half boot. Exercise on horseback, and gentle friction, Avill be of advantage; but walking, or whatever promotes a greater secretion of lymph, will be injurious in every stage of the disease. Mr. Trye endeavours at first to relieve the fever by evacuants, and then, according to his doctrine, attempts to relax the inflamed vessels by fomentations, leeches, and blisters ; to promote absorption by emetics, and in the latter stage by friction with mercurial ointment. Dr. Ferriar applies leeches, with cooling remedies ; and Dr. Hull, like Mr. White, treats the complaint at first as inflammatory, and at last as asthenic. In our hands it has appeared an intractable disease, though relieved at last by the efforts of nature. If the patient is truly such, and the practitioner so unprincipled as to continue medicines which he must know will have little effect, he Avill at last gain the credit of the cure Avhich nature effects. In our hands the fever has yielded to emetics, evacuants, and opiates. The deposition, which soon assumes a chronic form, scarcely yields to any remedies. The Dover's powder, at night, with occasional laxatives, and at last the bark and the squills, have appeared as serviceable .as any of the boasted remedies. See Mauriceau's Traitfe des Maladies des Femmes Grosses, &c. edit. 5, 4to.; Puzos' Memoire sur les De- pots Laiteux, appelles communement Lait Repandu ; Levret's Art d'Accouchement, ch. iii. sect. 7 ; Van Swieten's Commentary on Boerhaave's Aphorism, 1329; M. Raulin's Traite des Maladies des Femmes, en Cou- che; White's Inquiry into the Nature and Cause of that Swelling, in one or both of the loAver Extremities, which sometimes happens to lying-in Women : Trye's Essay on the Swelling of the Extremities of Puerperal Women; Ferriar's Medical Histories, vol. iii.; Hull on the Phlegmatia Dolens; and White's Inquiry, part 2. Lymphatic glands are those bodies through which the lymphatics pass. Their structure has never been de- monstrated ; for while some anatomists suppose them to be cellular, others contend that they are merely masses of convoluted vessels. As we knoAV nothing of the change which the lymph undergoes in these glands, we cannot assist demonstration by theoretical induction. We perceive only that nature anxiously delays the pass- age of the lymph into the blood; as, previous to their entering the gland, the lymphatic vessels are divided into minute branches. This purpose might perhaps be equally answered by convoluted vessels, as by stag- nation in cells, since we find the semen elaborated in the lengthened tubes of which the testis consists. Ye the force of the argument, that some secretion takes place in the cells to animalize this new fluid, is not in- considerable. Since the end is undisputed, Ave need not contend for the means. Let us, however, only add, that in either case, if the contents are viscid, or the irritabi- lity of the vessels preternaturally lessened, stagnation must be the unavoidable consequence. LY'RA, (from Xvpx, a lyre). The inferior surface of that part of the brain called fornix, because its medul- lary lines resemble the strings of the lyre. See Cere- brum. LY'RUS, (from lyra, a lyre; because its leaves are divided like the strings of a lyre). See Arnica Mon- tana. LYSIMA'CHIA. Yelloav loose strife, or avil- loav herb, anothera, lythrum salicaria Lin. Sp. PI. 640, (from Lysimachus, the supposed discoverer,) is a small plant found about the sides of rivers, said, without much reason, to be astringent. A name of a species of the mummularia cassida, and other plants. LY'SSA, (from Xva, to dissolve, a solutione integrita- tis sensuum). The madness of dogs and wolves, or of men who are bit by them. When from dogs, it is called cynolyssa. LY'THRON, (from XvSpov, blood). Dust mixed with sweat; sometimes menstrual blood. Hippo- crates. 5 Y 2 900 MAC ,1? I • or m. In prescriptions it signifies 7nisce, mix ; or manipulus, a handful. In the late British pharma- copoeias it means mensurd, by measure. MACA'NDON, (Indian,) cada palava, a coniferous tree mentioned by Bontius, Unnoticed in modern sys- tems, growing in Malabar. Its fruit resembles the .pine nut, is rather insipid to the taste, the flowers re- sembling those of the honeysuckle. The fruit is roasted, and eaten as a remedy for dysenteries, the cholera mor- bus, and other complaints. Raii Historia. MACAPA'TLI. See Sarsaparilla. MACAXOCOTLI'FERA. The name of a tree in the West Indies, about the size of a plum tree: its fruit is called macaxocotl; is red, oblong, of the size of a walnut, yellow within, sweet, and laxative. Two other species are the atoyaxacotl, and coztieaxocotl, though said to be a species of mirobalans. The other species are atoyaxocotl chichiltic; and chichiaxocotl, which sig- nifies running down with sweat. A decoction of the bark of these trees cures the itch, and its powder heals ulcers ; but the plant does not occur in any botanical system. Raii Historia. MACEDONI'SIUM SE'MEN. See Hipposeli- JfUM. MA'CER, (from the Hebrew term masa). Gre- cian macer. It is brought from Barbary; its thick yelloAV bark and dried root are astringent. Its fruit, called 7nacre, is said to destroy worms. The plant is not known; but the bark so nearly resembles, in ap- pearance and sensible qualities, the simarouba, that they are probably the same. See Simarouba. MACERA'TIO, (from macero, to make soft by water). Maceration, is an infusion or the continued action of water, or any other fluid, on bodies, to lessen their co- hesion, or extract their virtue. See Duratus. MACERO'NA. See Hipposelinum. MA'CHA-MO'NA. A sort of calabash in Africa and America; the pulp of which is agreeable, and serves instead of rennet for curdling milk. It does not occur in any systematic author. MACHjE'RIA. See Persicaria. MA'CHLIS, (quasi achlis, ab a priv. and xXtva, cubo, quod non cubet). See Cervus rangifer. MA'CIA. See Anagallis. MA'CIES, (from maceo, to become lean). Diseases in which the body, or particular parts, are wasted. See Marcqres. MAC MA'CIS,(Ta/n«*£^, cortex aromaticus, aromatic barky Mace, the middle bark, of nutmegs, enveloping their shell, of an oily nature, and of a lively red colour Avhen fresh, growing paler from age. It is dried in the sun upon hurdles, fixed one over another, which gives the appearance of fractured edges, and sprinkled with sea water to prevent its crumbling in carriage. It hath a pleasant aromatic smell, and a warm, pungent, .bitterish taste. Its qualities are similar to those of nutmeg ; but mace is warmer, more bitter, less unctuous, and sits easier on weak stomachs ; yielding, by expression, a more fluid oil, and, in distillation with water, a more subtile volatile one. The essential oil of mace is moderately pungent, very volatile, of a strong aromatic smell, like the mace itself, thin, limpid, and of a pale yellow colour, with a por- tion of thicker and darker coloured oil at the bottom. There are three kinds in the shops, though expressed. from the nutmeg. The oil of mace is often pre- scribed as a carminative and antispasmodic. As such it relieves often in colics, and sometimes in nephritic cases. Externally applied, it sometimes relieves vomit- ing and hiccough. Its internal dose seldom exceeds five or six drops. See Nux moschata. See Lewis's Ma- teria Medica. MACROCE'PHALOS, (from puucpt, long, and xitpxXn, the head,) long headed. Some Indians, and manyof the Asiatics, have, by pressure, given this form to the heads; and what was at first artificial seems to have been continued by inheritance. MACROPI'PER (from fixxpos, long, and rtrepts, pepper). See Piper longum. MACRO'PNUS, (from (*xxpos~, long, and rvea, to breathe). A person who inspires at long intervals. MA'CULA, (from the HebreAV term machala infir- mity). A spot, a blemish ; a cutaneous efflorescence which changes the colour, sometimes the texture, of the cuticle, but seldom conneoted Avith any disorder of the constitution. Ma'cula la'ta. The shingles. See Erysi- pelas. Ma'cule, or Ma'cula matricis; nevus maternusi the spots, or marks, supposed to be impressed by the mother's imagination on the foetus. See Nevus. Ma'cule a'lbe. See Albugo oculi. Ma'cule hepa'tice. Hepatic spots, or efflores- cences proceeding from a dissolution of the blood. M A G 901 MAG Ma'cule oculo'rum. See Cataracta, or Suffu- sio. Ma'cule pestilentes ; spots, or efflorescences, fre- quent in malignant disorders. Ma'cule volatice; fugitive spots, such as are often seen in children. MADARO'SIS; (from fcxfos, bald). A loss of the hairs of the eye lids, from an acrimony of the fluids, from eruptions, exanthemata, or inflammation. See Deplumatio. MADE'LION. See Bdellium. M A'DISIS, (from fcxfos, bald). See Acosmia. MA'DOR, (from the HebreAV term matar, water). Ephidrosis. The sweat which arises during faintness. MADRE'PORA VULGA'RIS, (from t^xfos, smooth, and rupos, a pore). See Corallium album ramosum. M ADRO'TES, (from fixfos, bald). See Acosmia. MjEMA'CYLON, (from (Mttftxa, to desire; from its beauty). See Arbutus. MAGDALEO'NES, MAGDA'LIjE, MAGDA'- LIDES, (from fMcra-a, to knead). Cylindri; masses of plaster, or of other compositions reduced to a cylindri- cal form. MAGELLA'NICA AROMA'TICA A'RBOR. See Winteranus cortex. MAGISTE'RIUM, (from magister, a master). The ancient chemists meant by this term a peculiar and se- cret method of preparing any medicine ; but at present it is applied to powders made by solution and precipita- tion (see Benzoinum, Bismuthum, and Calaminaris lapis), to resins, or resinous extracts, or any white pow- der peculiarly subtile and light. The term generally implies that some of the menstruum remains. At pre- sent we have no general idea, or established character- istic, to distinguish magistery from precipitate. Every magistery is some kind of precipitate; but every preci- pitate is not a magistery. MAGISTRATES (from the same). See Medica- MENTA EXTEMPORANEA. MAGISTRA'NTIA, (from xxt egoxw, magistro, to rule; so called by way of eminence. See Imperatoria. MA'GMA, (from, t*xtro-u, to blend together,) ecpi- e'sma. In a more general sense it is any thick oint- ment that will not melt with the heat of the body, or a poultice that will not easily spread: more strictly the faeces of any ointment after the thinner parts are strained off: Galen limits the term to the faeces of myrobalans. MA'GNA ARTE'RIA. The large artery. See Aorta. MA'GNES. The loadstone. Calamita, lapis Lydius, antiphyson, lapis Heraclius, from Heraclea, a town in Lydia. The term, however, is singular in many respects. Its origin is uncertain, but its application and influence have been peculiarly extensive: various cities have been styled Magnesia, and the Magnetes constituted no inconsiderable nation in Asia. Many of these cities have been mentioned as the origin of the name; but it is not our object to determine the question. The stone itself was long known before it was employed to direct the course of the navigator; and is usually of a dirty black colour, though in this respect it varies, and is sometimes Avhitish, from the mixture of silicious par- ticles in such a proportion as to render it fusible. Whe- ther from its colour, its Aveaker poAvers, or any other cause, this was styled the female magnet, and magnesia. When the white earth, precipitated from salts, similar to the Epsom, was observed, this Avas supposed to resem- ble the female magnet, and, of course, called magnesia, with the distinction from its greater Avhiteness, of alba. When another dark metal, similar to the magnet, was discovered, it had the same appellation; but as it did hot attract iron, some distinction was necessary, and it was called mangnet, manganet, and manganese. The magnet, our present object, is the amorphous, oxidulated iron of Haiiy, iv. 13, often found in Europe, in a ma- trix of magnesian earth, though sometimes in a ferru- ginous sand, or a sulphurated lime. Its obvious quality of attracting or repelling iron is well knoAvn, and in this experiment the north and south poles are attractive, and each repulsive to its own points in other iron or other magnets. Every, the smallest, portion of a mag- net has its tAA'o poles, not verging to the real poles of the world, but to those of the magnetic meridian, which varies sometimes a little to the east, sometimes to the west. The smaller magnets'are more active in propor- tion than the larger. Magnets, like all iron ores, are astringent, but not used in medicine. They have been recommended by ignorant quacks in ruptures, to at- tract the intestine upAvards, and to destroy the lentor of the blood, by separating the particles of iron in it. Sucrr" are the absurdities that deceit will feign and credulity- believe. See Magnetism. Ma'gnes arsenica'lis, a preparation of arsenic', which we omitted under that article, but which we no- ticed under Cancer, vol. i. p. 332, col. 2, q. v. Its name was derived from its supposed power of attracting the morbid poison. Geoffroy adds, that it opens, cleanses, and heals scrofulous ulcers, without the assistance of an ointment of any kind. See Cancer. Ma'gnes epile'psie. See Cinnabaris. MAGNE'SIA,(from magnesia, the female loadstone, magnes). (See Ethel.) Among the alchymists it means the matter of the philosopher's stone, or sulphur; it sometimes signifies melted tin, with which mercury is incorporated, forming into a brittle white mass; sometimes a mixture of silver and mercury, and a very fusile metal, called 7nagnesia philosophorum. But enough of such nonsense. Magne'sia a'lba, was a general term which che- mists formerly gave to all substances Avhich had the power of attracting any principle from the air. Thus an earth which, exposed to the air, yielded vitriol, Avas called magnesia vitriolata. More modern chemists, supposing that it had attracted the nitrous acid, in its preparation, called it magnesia nitri: but, from its colour, it soon obtained its present name, the white magnesia, albus Remanus pulvis, Comitisse Palme pulvis. It was introduced as a medicine in the beginning of the eighteenth century, by count di Palma, at Rome, and continued a very lucrative secret. It is a very white, subtile powder, and now knoAvn to be a peculiar earth, and the basis of the Epsom salt. Magnesia was, as Ave have said, for a long time a lu- crative secret, and it scarcely emerged from the lan- guage and appearance of a quack medicine, at the time it was first prepared by Mr. Glass of Oxford. Mr. Glass took the form of preparing the medicine from Hoffman, M A G 902 M A G and Avas not aware of its nature, or the effect of the ad- dition of the alkali. To Dr. Black Ave are indebted for the discovery of its being a distinct earth. The Oxford preparation Avas light and elegant, though unequal; but the imputation of its being adulterated Avith calcareous earth brought on a dispute between Dr. Glass, the bro- ther of the proprietor, and Mr. Heniy. It is now of little consequence where the truth lay; for it is every where prepared Avith sufficient fidelity. Mr. Henry's process Ave shall add. " Dissolve any quantity of sal catharticum amarum in its own weight of water; filter, and add to it, by de- grees, a filtered solution of pearl ashes, in an equal quantity of water, stirring them gently, until the mixed liquors have acquired the appearance of a complete co- agulum ; then cease adding any more of the alkaline lixi- vium, and immediately throw the mixture into a large vessel of boiling water; keep it boiling for a quarter of an hour, take it out, and put it into a glazed earthen vessel: as soon as the powder hath subsided, and be- fore the water is quite cold, pour it off, and add a fresh quantity of boiling Avater, till- the liquor hath entirely lost its saline taste; next let it be so agitated as to sus- pend the finer parts of the powder, in which state de- cant it into other vessels; and having separated the Ava- ter from the magnesia, by inclination, put it on large chalk stones, until a considerable part of the humidity is absorbed; then wrap it up in sheets of white paper, and dry it before the fire. Pour hot water upon the remaining powder, stir and decant it in its turbid state, and separate the magnesia from the water as before; thus the Avhole, or the most of it, will be reduced to an equal degree of fineness. " The larger the quantity of water into which the precipitated powder is cast, the more speedily and per- fectly will the vitriolated tartar, which is formed by the alkali uniting with the acid of the sal catharticum, be washed off. The neutral salt should be washed off as quick as possible, othenvise, by allowing the mixture to stand for some time, the powder concretes into mi- nute grains, which, when viewed with a microscope, appear to be assemblages of needles diverging from a point. These concretions cannot be re-dissolved by any washing, however long continued. Dr. Black orders four times the quantity of water to that of the solution to throw the coagulum into, but that is far too little. The water should be pure; distilled is the best; but it should be kept until its empyreuma is gone off. Hard or impure water makes magnesia coarse and disagree- able. The chalk stones on which the magnesia is dried should be exposed to a moderate heat, that the moisture may evaporate quickly. Cleanliness should be particu- larly attended to through the whole." Magnesia, when pure, is white, loose, and light, of the specific gravity of 2.330 nearly. It is perfectly in- fusible in the focus of the most powerful mirror, ex- cept Avhen it contains particles of flint, which, if the alkali is impure, sometimes happens. When the vola- tile alkali is employed in the process, no flinty particles are found in it. Magnesia melts, however, Avith borax, and with some of the earths, though more certainly when the earths and alkalis are united. A new manu- factory of china, resembling the seve, is established at Berlin, in Avhich, instead of the kaolin, a magnesian earth, containing flint and an alkali, is the chief ingre- dient. Magnesia is nearly insoluble in Avater, but re- tains a small portion of this fluid Avithin the inter- stices of its particles Avith some obstinacy. When, however, the carbonic acid gas is previously united Avith the Avater, the magnesia dissolves readily. Magnesia contributes to the diffusion and suspension of many resinous substances, and, triturated Avith cam- phor, renders this medicine more miscible with water. It is supposed also to increase the solubility of bark in water, if triturated with it previous to infusion or decoc- tion : but it seems to produce some chemical change in the constituent principles of the medicine, as the colour is not only deeper but more red. Whether it is more active as a medicine than the common decoction has not, Ave believe, been ascertained. As magnesia contains about seven-twelfth parts of fixed air, it should be calcined before it is administered, at least when flatulence abounds. The air, hoAvever, which is expelled by heat, is greedily recovered by ex- posure to the atmosphere, so that it should be kept in a phial carefully closed. The magnesia contracts no acrimony by calcination. Like all absorbents, it corrects acidities in the sto- mach, relieves the heart burn and pain in the stomach, colics and convulsions in children, Avith every other com- plaint arising from acidity. It is preferred to other ab- sorbents, on account of its laxative quality, Avhen united with an acid. If mixed with rhubarb, it is said to pre- vent the rhubarb from leaving a costive habit. If the magnesia does not meet an acid, it is inert, and is some- times supposed to load the stomach as a heavy cold mass. It has been doubted whether it is proper in bilious or putrid fevers, and much idle disquisition has been employed on this subject; for a prudent practition- er will be led, in such cases, to employ medicines of very different qualities. Magnesia can do no good in either disease. See Hoffman's Observationes Physicae Chemicae, lib. iv. Obs. ii.; Black's Observations on the Magnesia Alba, in the Essays Philosophical and Lite- rary of Edinburgh, vol. ii; London Medical Transac- tions, vol. ii. Magne'sia opa'lina ; magnesia rubicunda antimonii. Opaline or ruby coloured magnesia of antimony. In making the hepar antimonii, decrepitated sal ammoniac is sometimes added to the antimony and nitre, and the result is, the opaline magnesia. It is a weaker emetic than the liver of antimony, and may be given in con- siderable doses to horses, to produce sweating. Lemery directs it to be made of equal parts of antimony, nitre, and decrepitated sea salt. Magne'sia vitriola'ta. See Catharticus SAL. MAGNETISMUS. Magnetism, from its effects on the human body, can be scarcely an object of our at- tention ; yet, as folly and fraud have brought it forward in a conspicuous view, it will be necessary to ascertain its real nature, and the advantages which may have cer- tainly been derived from it in medicine. Add to this, that quackery is too fascinating to the human mind to be long Avithout an object, and the exploded artifice of to day may, at a future time, revive in a new form- alter et idem. Magnetism is strictly the power by which an iron ore attracts or repels a piece of iron, according to the point presented, or attracts only a rude mass. The iron ore* M A G 903 MAI or magnet, can communicate this property to a piece of soft malleable iron, so as to make it much more power- ful than any natural magnet. Iron, also, which has long stood in one position, acquires at either end its power of attraction or repulsion. This property is confined to iron, though cobalt and nickel are suspected of having a small degree of magnetism ; and to posses the power of attraction, iron must be in a soft, malleable state. When oxided in a slight degree, the magnetic power is Aveak- ened ; when hardened, or in the state of steel, it receives this poAver in a small proportion. It is equally neces- sary that its structure (may we be permitted to call it organization?) should be entire; for a magnetic wire, twisted round a stick, does not lose its virtue, white it has not been so much bent as to destroy its elasticity ; but, when it can no longer restore its former shape, the magnetism is lost. A smart blow will sometimes de- stroy, or, in turn, give this power. Two important errors on this point must be cor- rected : the one, already noticed, that the magnetic needle, freely suspended, does not lie in the direction of north and south, but a little on the east or west, ac- cording to its " variation." This fact is repeated to add, that a needle only becomes spontaneously mag- netic by lying in the magnetic meridian. Another error is, that the magnetic influence resides in the earth. In fact, it seems to pass over its surface ; for it is much less obvious in caverns than on the earth. The opinion of its cause being one great magnet at the centre of the earth i-j, of course, Avithout foundation." It has been usual to suppose the attraction and repul- sion of magnetic bodies to be OAving to two different antagonizing fluids. This opinion, supported by the au- thority of iEpinus, Coulomb, and Haiiy, should not be rashly rejected. It is, hoAvever, seemingly borroAved from the two electricities ; and, as Ave have found that the electrical phenomena with which we are in this work engaged, might be explained on the supposition of a single fluid, so Ave think the phenomena of magnet- ism equally compatible with one fluid. Some analogy has been observed between magnetism and electricity ; but, if there is any resemblance, magnets are like the electrics per se. Instead of iron being peculiarly at- tractive of the magnetic fluid, it appears to be the only body which resists it. From this resistance the phenomena apparently arise. Electrics per se equally resist the electrical fluid ; but these, if powdered, are changed into conductors. Powdered magnets are still magnetic. Magnetism differs from electricity in being influenced by very different laws. Magnetism attracts large bodies, electricity small ones; magnetic attraction is constant; electrical'variable : the former limited to about two feet, the powers of the latter are unlimited. The magnetic power is also permanent for ages, if not destroyed by an opposite current of a similar nature, as laying two magnets together, Avith the north poles con- tiguous, and is not, or very slightly, affected by mois- ture, water, and oils, nor at all influenced by an electri- cal atmosphere. A magnet in action may be electrified without disturbing that action, which is also equally active in a vacuum. Heat also diminishes the.magnetic poAver, and entirely destroys it when the iron becomes red ; but it is again recovered on cooling. These observations are sufficient to shoAv that, if magnetism has no poAver of its own, little medical effect is to be expected from any fancied analogy to elecricity; and, indeed, magnetism has no analogy to any part of our system, except the small quantity of iron in the blood, which is too much diffused to be influenced by it. In fact, magnetism has no effects but in the promises of the artful, and the delusions of the credulous. Not many years have elapsed since Avhat is called ani- mal magnetism was supposed to cure every disease, and to free the mind from the trammels of the body, the load of earth which confines its active excursions, en- abling it to pervade, at will, through distant regions, unlimited by time or space. This imposition has had a variety of professors in different countries ; and, at one time, seems to have fascinated minds even of a superior order. It affected chiefly the imagination; and the de- lusion was, in general, confined to the female world, and the weaker classes of mankind. An hysteric paroxysm was produced, and the Avanderings of a disturbed ima- gination were received as the dictates of inspiration. In these wanderings, medical questions were proposed and answered ; but all the ansAvers, like those of the ancient oracles, were vague and indecisive. The gesticula- tions of the professors were directed to particular parts, and supposed to remove the complaints of those organs. While the fancy was inflamed, the effects were thought supernatural. When that cooled, the power lost its in- fluence. The professors have published their secret, which is a strange mixture of absurdity and fanaticism. * They are to powerfully excite the attention, to will an end, with views strictly benevolent, moral, and reli- gious. They were not conscious of any means, and this all-powerful influence was to be excited by the volition of the Aveakest, meanest, sometimes the most infamous, of mankind. The bubble is now burst, and the experience of this age will, for a time, prevent its revival. MAGNUM OS ; the third and largest bone of the second i-oav in the wrist. See Carpus. MAGNUS MORBUS. The epilepsy. Hippo-" crates. MAGU'DARIS, (from pxyvfocpis). See Silphium. MAHMOO'DY. See Scamonium. MAHO'GANI. This beautiful wood is procured from the swietenia mahogani Lin. Sp. PI. 548, and the bark resembles, in appearance and qualities, very nearly the Peruvian bark. The trees which produce them are also closely connected by botanical affinities. MAIA'NTHEMUM. See Lilium convallium. MAIDEN-HAIR TREE, brought originally from Japan, by Thunberg, was styled the tree of forty crowns, from its usual price; but it is easily propagated by cuttings, and now common. The appellation was derived from its leaves resembling those of the adiantum, and Linnaeus formed a genus, which he styled ginko; found only in one of his later mantissa. This plant was the ginko biloba. It flowered for the first time in Eng- land in 1796, and the president of the Linnaean society referred it to a new genus, calling it salisburia, with the trivial name of adiantifolia (Linnaean Transactions, iii. 330). It is chiefly cultivated for its beauty and its nuts, Avhich are not produced till the tree is old. They are said by Kempfer to be nutrient and corroborant. MAIL-A'NSCHI. A species of rhamnus, groAving in Malabar; Lawsonia spinosa Lin. Sp. PI. 498. A M AL 904 M A L decoction of its root is commended in gout, and of its leaves in jaundice. MAIL-E'LOU, and MAIL-E'LOU-KA'TOU, are tall evergreen trees groAving in Malabar, which are not found in modern systems. A decoction of the bruised leaves and bark is said to be useful in the after pains, and to promote the lochia. MAJORA'NA, (quod mense Maio fioreat, because it floAvers in May). Marjoram. Majora'na cre'tica, vel Syria'ca. See Marum Syriacum. Majora'na majo'ri fo'lio, amaracus, sampsuchus. Sweet marjoram. By amaracus the ancients meant SAveet marjoram; but by lesser marjoram, the marum. The Egyptians and Syrians call the SAveet marjorum by the name of sampsuchus. It is the origanum majorana Lin. Sp. PI. 825, a low plant, Avith slender, square branched, Avoody stalks; and little, oval, somewhat doAvny, leaves, set in pairs. On the tops grow scaly heads of small Avhitish labiated flowers, Avhose upper lip is erect and cloven, the lower divided into three seg- ments. It is soAvn annually in gardens for culinary and medicinal uses; but the seeds rarely come to perfection in this climate, and are brought from the south of France, Avhere the plant is indigenous. The leaves and tops have a pleasant smell, a Avarm aromatic bitterish taste. Infusions in water have a strong smell, but a weak and unpleasant taste : a tinc- ture made with rectified spirit of" wine hath more taste than smell. In distillation this plant yields its virtues to Avater, and affords an essential oil, in the proportion of § i. from | lxiv. of the leaves slightly dried, though Beaume obtained a much smaller proportion. This oil is hot, not so agreeable as the marjoram, and when care- fully draAvn is of a pale yelloAV colour; though by long keeping it turns reddish, and if distilled Avith too great heat is red at the first. The dose is two drops. The aromatic matter rises almost wholly in distilla- tion, so that an extract possesses very little of the vir- tues of the plant, which is, like the lavender, a warm, stimulating, nervous medicine. The powdered leaves, the essential oil properly diluted, and the distilled wa- ter, are agreeable errhines. In its recent state we are told that it has been successfully applied to scirrhous tumours of the breasts. Majora'na olera'cea, sylve'stris. See Origanum Anglicum. MA'LA, (from a resemblance to 7nalum, apple). The prominent part of the cheek. (Martinius.) See Bucce. Ma'la Assy'ria. See Citreum. Ma'la aura'ntia. See Aurantia Hispalensis. Ma'la au'rea. See Amoris poma, and Aurantia HlSPALIENSIA. Ma'la coto'nea ma'jora, et mino'ra. See Cydo- nia. Ma'la i'nsania ni'gra. See Melongena. Ma'la pu'nica. See Granata mala. MALABA'RICA HE'RBA. See Coru Canarica. Malaba'rica pru'na. The fruit of the eugenia janbos Lin. Sp. PI. 672. The fruit is subacid and salutary, and a mildly astringent conserve is prepared from the flowers. MALABA'THRI O'LEUM See Cinnamomi m MALABATHRI'NUM,(from malabathrum). Oint- ment of malabathrum, compounded of myrrh, spike- nard, malabathrum, and many other aromatic ingre- dients. See Dionysos. MALABA'THRUM, (from Malabar, and betre, a leaf). Into this word the Greeks corrupted the Indian appellation tamalapatrum. See Folium. MA'LAC A RA'DIX. See Sagittaria alexi- PHARMICA. MALA'CIA, (from ftxXxxtov, a ravenous fish). See Pica. MALACOI'DES, (from pxXxxy, a mallow, and eifos a form or likeness,) malva betonice folio, malope malacoides Lin. Sp. PI. 974, a plant similar in appear- ance and qualities to the malloAv. - MALACO'STEON, (from f*.xXxxos, soft, and oxyopx, Jnan- drake). The mandrake wine is made by putting half a pound of the bark of the mandrake to nine gal- lons of Avine. After standing three months the process is complete. MANDUCA'TIO, (from manduco, to chew). See Masticatio. MANDUCATO'RES MUSCULI, (from the same). See Masseter musculus. MA'NGA. (Indian.) Mangas,amba, ambalam,mao, conchifolia, the mango tree, man g if era Indica Lin. Sp. PI. 290, is a native of the East Indies. The fruit is larger than a goose's egg, flattened, shaped like a kid- ney, and of a gold yelloAV colour. It is pickled unripe in the acid milk of the cocoa nut, the kernel filled with garlic, and, in that state, sent to Europe. See Raii Hist. Ma'nga. See Abalam. MANGANESE. Mag7iesiu7n, magnesia nigra, and siderea, manganese oxyde Haiiy iv. 243, is of a black broAvn colour, Avith occasionally a little of the metallic splendour, of a specific gravity from 3.70 to 4.75. Some varieties Avhich stain the fingers are much lighter. It is divisible in rhomboidal prisms of about 100° and 80°, and colours borax of a violet hue Avhen exposed to the blow pipe. It was long supposed to be an ore of iron, and though shown in 1770 by Kaim to contain a pe- culiar metal, it was only completely reduced by Gahn about the year 1774. Manganese attracts oxygen more rapidly than any other body, except phosphorus and the black oxide ; that most commonly employed con- tains sixty parts of the metal and forty of oxygen, fn this variety the oxygen seems in excess, and the excess only is yielded in decomposition; for the white man- ganese retains its oxygen with great obstinacy. It is needless to enlarge on the preparation of man- ganese, as its chief use is in preparing the oxygenated acids and salts. M. Alyon has recommended an oint- ment composed of the black oxide of manganese Avith axunge, in the proportion of one drachm to an ounce, which he recommends in a variety of external diseases, where the oxygen is apparently deficient, but whose boasted merits experience in this country has not sup- ported. In the preparation of oxygen for respiration,' manganese is chiefly used, and it is the principal ingre- dient in Guyton's box to secure from contagion. Those, however, who prepare oxygen gas should recollect the observation of M. Seguin, that some manganese at first yields a portion of azotic gas. MANGARA'TIA. See Zingiber. MA'NGLE. See Guaparaiba. MA'NGOSTAN. Garcinia mangostana Lin. Sp. PI. 635. A tree which has been transplanted from the Molucca islands to Java, and at Batavia is admired as an ornament in gardens. It resembles the citron tree, has a straight trunk, an equal and regular head, and rises from eighteen to twenty feet in height. The mangostan, in the works of modern naturalists, is of the natural order guttifere, as some of the species afford a gummy resin, resembling, in appearance and power, the gutta gamba. The fruit is equally pleasing to the smell and taste. The odour resembles that of the strawberry: the flavour is said to unite the sweetness of the cherry, the orange, and the grape. The mangostans are wholesome, re- freshing, and never produce any inconvenience. Dr. Solander, who Avas at the point of death from a putrid fever at Batavia, found them so refreshing, that he at- tributed his recovery to them. The fruit itself is laxa- tive, the bark styptic and astringent. The decoction of the bark is given in dysenteries, and employed as a gargle in aphthae. The Chinese employ the bark in their black dye. The only other species of the system of nature affords a much more acid and less grateful fruit; and, indeed, it sefems a variety only. To this ge- nus Gaertner has referred the gambogia gutta of Lin- naeus; but on this subject we have already spoken ; and Lamarck has added two other species. MA'NIA, (from fA.xtvofA.xi, to rage,) delirimn mania- cum,paraphrosyne; phrenitis apyreta, heracleius, mad- ness. (See also Melancholia.) This disease re- ceives different appellations, according to its violence, its causes, and attending circumstances. Melancholy is the primary disorder, and madness is supposed, though inaccurately, to be the higher degree. Madness, in all its species, is a chronical disorder, and has been defined, " The perception of objects not existing, or at least not corresponding to the senses," and is consequently a preternatural state of sensation. Dr. Cullen places it in the class neuroses, and order vesariie, defining it an universal insanity. This defini- tion is, hoAvever, very defective, since the chief term is the object of the definition. That of Sauvages is still more exceptionable, as he confines madness to errors of judgment with fury. Those of Linnaeus, Vogel, and Sagar, either define mania by insania, or confine it to fury and boldness. Dr. Battie, who styles it false per- ception, is equally imperfect. It may, perhaps, be more MAN 909 31 A N correctly defined an irregular exertion of the mental pOAvers, particularly those of perception and judgment, without fever, often with great violence. Dr. Cullen distinguishes three species ; the mania 7nentalis, when wholly from the affections of the mind; mania corpo- rea, or inanitoruni, Avhen evidently from a fault in the body; mania obscura, when not preceded by any evi- dent mental affection or disorder of the body. These species are, however, incorrect; but a mere nosological disquisition Avould not have detained us, had not this vieAv of the subject led to erroneous ideas of the disease. Perhaps there is no disorder purely mental. When affections of the mind produce corporeal com- plaints, they first act by injuring the functions of the body ; when the mind also is diseased, bodily changes first appear; and, in the case before us, the most purely mental maniae are found to arise from topical affections of the brain. (See Mens and Mentales.) There isnot.even a sufficient foundation for distinguish- ing those species which arise from atonic gout, re- pelled eruptions, syphilis, &c.; for, though originat- ing from bodily causes, they continue like the appa- rently mental diseases. In short, there is no founda- tion for the subdivision of species in this complaint; since, like many other reputed genera, it is only itself a species. The union of mania with melancholy is, we have said, equally inaccurate; for the melancholic mania is a va- riety only. We shall find melancholy distinguished as a peculiar temperament, marked by languor and inac- tivity in all the functions; and, while it occasionally rises to insanity, even in its last stage, it is clearly dis- tinguishable from other varieties of mania. The phleg- matic, the sanguine, the bilious, as Avell as the melan- cholic temperament, are subject to insanity. Some authors have unnecessarily varied the species from the circumstances or causes of the disease, almost realizing the axiom of the porch, that all fools are mad ; but these are only varieties, and scarcely admit of any difference in the practice. Dr. Battie, Ave have said, considers madness to con- sist in false perception; but this is a partial view ; for the perceptions are often correct, but the reasoning or the judgment are defective ; yet the perception is more frequently in fault than the reasoning. The mind is all alive, but its exertions are irregular ; indeed the mental excitement is so great, that mad persons are often not subject to the effects of cold, nor generally susceptible of the infection of fever. On the contrary, other dis- eases are cured by madness coming on. We remem- ber to have seen a most inveterate asthma immediately relieved by a maniacal paroxysm, and the asthma re- turned Avhen the madness lessened. It has been said, on the contrary, that madness is itself removed by the access of an intermittent; but Ave hesitate in admitting observations made at a time when intermittents were thought highly salutary. M. Pinel, in a late work on insanity, has hazarded a more singular opinion, viz. that the violence of maniacal paroxysms may be only efforts of nature to relieve some latent disease. Though this idea may be, in some mea- sure, countenanced by the facts mentioned respecting asthma, yet its general absurdity is too striking to re- quire our employing a moment in its refutation. The species of mania, according to this author, are less ex- ceptionable. These are melancholia, or delirium, on one subject exclusively ; mania Avithout or with deliri- um ; dementia, or the abolition of the thinking faculty; • and idiotism, or the obliteration of the intellectual facul- ties or affections. The second species only requires a remark. It is defined " a perversion of the active facul- ties, marked by abstract and sanguinary fury, with a blind propensity to acts of violence, without any sensible change in the intellectual functions." There is, how- ever, some doubt, whether this is properly a"species. The instances are, in part, those of violent passions, in support of the axiom ira furor brevis; and, in part, of paroxysms truly delirious. Periodical mania, accord- ing, to M. Pinel, is only a form of madness, and not a distinct species, classed as a variety of the third. The false perception, or false reasoning, which dis- tinguishes mania, sometimes pervades every subject, but very frequently one only. Of the latter Don Quixotte affords an admirable specimen, drawn in a style truly interesting and correct, and supported with the preci- sion which the most minute medical observation could not improve. In Le Sage and Smollet we have pic- tures of the same kind delineated with equal skill, though not equally extended. In general, the subjects on which this kind of insanity is conspicuous, are those less familiar to the patient's general habits of life, and on which he is imperfectly informed. The tradesman is bewildered in his calculations for paying the national debt; and the debauchee in investigating the mysterious ways of Providence, or reconciling the sublime truths of revelation with the shallow views allotted to human reason. As religion is of all subjects the most interest- ing, and least within the powers of the human mind, it is the most common cause of insanity, and of the most obstinate cases of the disease. Insanity seldom attacks at once: its approaches are gradual; and, as suspicion and cunning are the most striking mental symptoms, these are often conspicuous in the earliest stages. In delineating the symptoms, Ave must distinguish between the idiotic insanity, the me- lancholic, and the sanguine; for these are the most striking varieties. We mean not at present to dispute the propriety of distinguishing complete idiotism as a species, but merely to mark that languid state peculiar to leucophlegmatic habits, and approaching Avith slow, undistinguishable steps. The idiotic insanity commences with silence and. re- serve; Avith muttering, inattention to the person who speaks; and a ay-ant of recollection of what has lately passed. The muttering becomes more distinct; and it then appears that some images are presented to the mind different from the objects before the patient. In fact, if '■'•false perception" does not take place, objects do not make their usual impression, or the mind, less im- pressed with the objects around than with its own ideas, suffers the latter only to have any influence. In this state the sleep is usually disturbed, though sometimes sound and uninterrupted; but, when sound, the patient is not refreshed, nor is the mind more steady when awakened. In general, the head appears loaded, and the eyes red j though, in some cases, each symptom is Avanting, but the bowels are always sIoav in their action, and stools are unfrequent; the patient is insensible to the calls of hunger and thirst, to the impressions of cold, but not indifferent to Avorldly objects. On the contrary, distrust MAN 910 MAN and suspicion predominate; and the greatest cunning is exercised to obviate the effects of what the patient supposes most detrimental to his interest. The pulse is often little affected, and the urine copious and pale. Even in this situation opposition will excite to vio- lence, and strength, apparently incompatible with the general weakness will be exerted, to counteract what the patient may dislike. In this case the eyes become quick and fiery, the countenance is animated, while the extremities are cold, the hands tremble, and every function, except what is roused to opposition, appears peculiarly weak. The melancholic madness does not greatly differ ; but the patient, when roused to answer, appears to have lost none of his mental faculties. Often, while his fan- cies prevail, he will reason with acuteness in their sup- port, and his precautions to guard against injury, when he fancies himself a brittle vessel, are ingenious and well conducted. In these circumstances the pulse is languid, the bowels peculiarly torpid, the urine lim- pid, the sleep often heavy, but without relief,, or, when it occurs, the patient is insensible of it, and de- nies, with violence, having slept. The mind, in this kind of madness, rests on one idea, with unusual per- tinacity, and the violence, on contradiction, is peculiar- ly vehement. The distinction between these two varie- ties does not seem to consist so much in the tempera- ment, as in the wandering in the former, and the per- manent ruling idea in the latter. To which we may add, that the first is the disease of a weak, and the lat- ter of a strong mind. Aretaeus describes the melan- cholic mania with singular precision. " Those who are affected with melancholy are sad, dejected, and dull, Avithout apparent cause. They tremble for fear, are destitute of courage, affected with watchings, and fond of solitude. They are prone to anger, changeable in their tempers, and ask a reason for the most trifling and inconsiderable occurrences. They are at some sea- sons so covetous that they will not part with any thing, but soon become silly and prodigal. They are gene- rally costive, sometimes discharge no faeces at all, at other times their excrements are dry, round, and co- vered with a black and bilious humour: they discharge a small quantity of urine, Avhich is acrid and bilious. A large quantity of flatulencies are discharged from their mouths ; and sometimes they vomit a certain acrid hu- mour with the bile. Their countenances become pale, their pulse is sIoav. They are lazy and weak, but discover a preternatural voracity in eating their aliments. When the disorder advances to madness, the patient, when provoked to anger, becomes raging mad. Some wan- der far from home; some cry out in a hideous manner; some shun the sight of men, betake themselves to soli- tude, and only converse with themselves ; others tear and mangle their bodies. In the highest degree of this disorder they perceive red images before their eyes, so that they in a manner think themselves struck by light- ning. They are immoderately inclined to venery, so that they caress publicly, without either dread or shame. But when the disease is in its decline, they become stupid, calm, and mournful; and coming to the know- ledge of their misfortune, they are dejected on account of their calamitous and miserable situation." The sanguine mania greatly differs. It is at first marked by irregularity of spirits, sometimes highly ele- vated, and proportionally depressed; in either case without sufficient reason. This kind of insanity is often the effect of sudden and excessive joy; and madness was more commonly the effect of success in the South Sea year, than of disappointment. An early symptom is aloud and rapid elocution when speaking on common subjects, a feeling of peculiar high health, and boasting declarations of health and spirits. The sleep is very disturbed, and the watchfulness often unremitted. The subjects are as various as the fancy ; each is sud- denly indulged, and as quickly superseded by another. The persons most loved, before, are now detested, and strangers, or the most indifferent people, are sought after with anxiety. The eye appears wild and red, quickly glancing at every object; the face flushed, a tingling in the ears is perceived, and suspicion is alive in apprehension of intended injury; for there is always an enemy in the rear, which is often one of the nearest relations. It is not an uncommon fancy to suppose those around them mad, and their greatest amusement to contrive stratagems in order to secure and confine them. When any object is in vieAV, disappointment does not distress them. The object still remains, and it is to be accomplished on another occasion. The prospect is always cheerful, and success constantly at hand. The pulse, in this case, is often natural, but frequently quick: the tongue is always dry, the skin without the softness of health, the urine generally high coloured. Though Ave may declaim, " what a wonderful piece of work is man !" yet, when we view him in this state, where his boasted reason, instead of assisting, misleads him; when we see him exposed to elemental war, in- sensible of cold, of the comforts of cleanliness, of the dictates of religion, of even common decency ; when we hear him uttering blasphemous execrations, employ- ing the grossest and most obscene language, language abhorred in the lucid moments, when recollection often adds to the horrors of his situation, we may truly ex- claim, " Alas, poor humanity 1" We have sketched only the outline of the picture, the discriminating features of the object. To fill it would require a volume; for, so various, so singular, and so numerous are the eccentricities, Avhen judgment no long- er guides, that it is impossible to detail them. In the general conduct of the human mind, when the balance of judgment or of authority is wanting, the wildest ab- surdities are equally the consequence ; and, within the pale of reason, we observe conduct which almost realizes the stoical maxim already alluded to. Mania often remits, and at times recurs periodically. It has been found to return at the full and new moon, or, at least, to be exasperated at those seasons. Mania is, however, always considered as varied by lucid inter- vals, and in a certain degree is so; but this seems ra- ther a salutary fiction of the law (see Medicina fo- rensis) than the result of medical observation. The violence of the maniacal patient, indeed, often remits, and is exasperated. We know no peculiar constitution predisposed to mania except the melancholic. A tendency to the sanguine variety of this disease is shown by a flighty, irregular, and variable conduct, rising to exuberant spirits from the lovvest depression, and again sinking, MAN 911 MAN from the former, into grief and despondency; to the melancholic, by a fixed attention to one object, from deep thought, never alternating with cheerfulness, and seldom varying its views. The idiotic frenzy appears from a generally variable, trifling temper, Avith little reflection, and less judgment. This kind is, however, unfrequent; nor Avould we condemn every trifling male or female because they are such. Our receptacles must, in that case, be particularly numerous and roomy. A very frequent corporeal remote cause is gout; ei- ther not brought out, repelled, or not properly support- ed. Repelled eruptions, or a check of any usual dis- charge, are by no means uncommon causes. Mania sometimes attends each succeeding pregnancy, and, in turn, the melancholia lactantium, as Ave have said, is cured by pregnancy. An asthmatic fit has, on its re- cession, been succeeded by madness; and a maniacal paroxysm has, in turn, yielded to a spasmodic asthma. The mind is intimately connected, as we have seen, with the genital sy stem ; and the denial of those enjoy- ments which nature claims, is a frequent cause, though ah unsuspected one, of mania; in men chieflyxof the melancholic, in women of the sanguine, kind. Among the mental, remote, causes, or rather the causes originating from mind, Ave may mention disap- pointment, grief, hope long delayed, or destroyed by unexpected reverses, wild extravagant joy from unex- pected prosperity. These produce the corporeal changes, which often induce madness. Mania is undoubtedly constitutional, and propagated from parents to children, sometimes leaving one whole generation unaffected, and appearing again in the next. It is apparently propagated with the form, the features, and complexion, like scrofula; nor is this the only argu- ment in favour of its being a truly corporeal, organic affection. The most striking and constant corporeal change in mania, is fulness of the vessels of the brain; and, though this is less apparent in the wandering, idiotic mania, it very frequently exists. In that wandering, Avhich arises from weakness and inanition, no such fulness occurs; but this cannot be called mania, and in those tempo- rary derangements of intellect, which arise from dele- terious substances taken into the stomach, it is equally absent. These, also, our definition excludes. Yet, when even these are separated from our view, it would be rash to assert that a distention of the vessels of the brain is constantly found in mania. Dissection certainly discovers such distentions in a great variety of instances; but we are informed also, that sometimes a preternatural dryness and hardness of the medullary part, sometimes an undue softness, is found in the contents of the cranium. More frequently tumours, sometimes abscesses at the base of the cere- brum, sometimes exostoses from the cranium, are dis- covered, though the last are more commonly the cause of convulsive paroxysms. The leading symptoms of mania are inconsistency and a disturbance of the usual associations, and these necessarily arise from a Avant of communication between its different parts, or an irre- gular distribution of the nervous power. The want of communication may arise from mechanical obstruction, from a destruction of the organization of some part of the brain, perhaps from a change in the qualities of what we have styled the nervous fluid. The irregular distribution may be owing to increased excitement of one portion of the medullary substance, or to the di- minished power of another. Dissections countenance all these opinions; but unfortunately we have few cases in which the symptoms are connected with the appear- ances on dissection, so as to explain the influence of the organic changes in different circumstances. In gene- ral, we know that the medullary substance, in cases of idiotic insanity, is usually soft and Avatery; in melan- cholic cases, hard and dry; while in the wild, furious mania, some active irritating power is generally disco- verable. Abscesses at the basis of the brain are usu- ally attended with a low muttering delirium. The form of the cranium has been supposed a cause of mania, and it has engaged much of the attention of Pinel. He finds, however, no very striking connection between its form and maniacal affections, except in idiots, where the upper part of the head is shortened, the sides flattened, and the Avhole cranium elongated. In general, the most distinguishing marks of the skulls of maniacs are a flatness of the temporal bones, and a re- tracted occiput. A thickness of the skull is sometimes found on the dissection of maniacs; but this is by no means a peculiar or a constant attendant. Pinel seems not to have observed the softness or dryness of the medullary portion of the brain, mentioned by other au- thors. In his dissections, the fulness of the vessels ap- pears to have chiefly attracted his notice. The prognostic in this disease is usually unfavoura- ble, except when it arises from repelled eruptions, im- perfect gout, or the stoppage of the discharge of a fistula in ano. When it arises from a constitutional organiza- tion, or without any distinct cause, it is seldom cured. The idiotic mania is more frequently intractable than the violent, and the disease from religious impressions very rarely yields to any plan of relief. When from violent and continued grief, from disappointment, par- ticularly disappointed love, the disease is particularly obstinate. If sleep does not relieve; if emetics and purgatives fail of their effect; if convulsions come on, or considerable debility is observed; the complaint will be obstinate, or death soon ensue. The diagnosis is not difficult. The absence of fever clearly distinguishes mania from any disease with which it can be confounded. The cure of mania is simple, or at least art, often dis- appointed, has ceased to interfere with activity. The Avandering delirium from inanition, the singular fancies from swallowing deleterious substances, vanish with increasing strength, the evacuation of the cause, or its continued impression which soon becomes habitual. The varieties of mania which we have mentioned may appear each to require a different plan; but the conduct of receptacles for lunatics is often empirical, and, even when under the direction of a physician, seldom con- ducted Avith scientific vieAvs. We may not improve, but shall endeavour to connect, the scattered limbs found in different authors. In each variety of mania we always find a consider- able determination to the brain; and, even when the disease arises from some organic affection, which seems to interrupt the free communication betAveen its dif- ferent parts, this interruption appears to act as a local obstacle, Avhich excites the action of the vessels around. On this view Avhatever is rational in the MAN 912 31 A X conduct of the cure seems to depend; and the reme- dies Ave shall mention in the order of their importance. E7netics have been generally and principally employ- ed, and the source of their advantages are sufficiently explained in that article. Without any other assist- ance, they have often removed a maniacal paroxysm ; and, when repeated at regular and not very distant in- tervals, they are often highly useful. In general, common emetics from the torpor of the stomach will not produce the evacuation, and antimo- nials are required. To these the vitriolated zinc, with mustard Avhey, must be often added; and the tobacco, the juice of the asarabacca, or groundsel, are often re- quired. The objection made to emetics by those who have never used them, that they determine too poAver- fully to the head, Ave have already considered. See Emetica. Cathartics are, however, chiefly depended on, for reasons Avhich will be sufficiently obvious, and these are particularly useful in melancholic mania. In the sanguine variety the saline are preferable, but they are scarcely sufficiently active in the melancholic; and when the disease arises from the want of the necessary evacuations from the loAver belly, those purgatives which chiefly excite the action of the colon and rectum are most useful. The ancients used hellebore, but they diminished its activity by their mode of preparing it; and we do not find that it possessed peculiar powers, though if the plant they used be, as we have reason to suspect, a species of adonis, it probably combined the qualities of an anodyne with those of a cathartic. What has been remarked respecting the large pro- portion of the vital fluid contained in the extreme ves- sels will sufficiently explain the effects of diapho- retics. Yet we find no striking instances of their utility; and the impatience of maniacs, which leads them to throAv off their clothing, seems to counteract this discharge. In fact, however, the heat is above what has been styled the sweating point, and the dia- phoresis is best secured by moderating its excess. The only remedy of this kind which seems to have been peculiarly useful is. vinegar. It Avas given Avith cam- phor by Dr. Locher of Vienna, but was found equally or more effectual without the camphor. Mr. Pargeter has recommended a camphorated vinegar in this coun- try, but we have not found it peculiarly beneficial. Warm bathing, which is a remedy of this kind, has been highly commended, and is certainly useful when the heat is moderate, not exceeding 96° or 98°. We have not mentioned bleeding, because it is not peculiarly advan- tageous; but when the mania rises to violent delirium it is necessary, and the blood must be draAvn with a decisive boldness, so as to excite deliquium. Bleeding from the jugularveins, and topical bleeding Avith leeches, or the cupping glass, if the quanity drawn is consider- able, will be highly useful; but this, too, is confined to the violent state, when the mania becomes phrenetic. Blisters, with similar views, have been applied; but they are not favourite remedies. Is it that their discharge is more adapted to relieve active inflamma- tion, and less suited to the chronic fulness; or that danger is supposed to arise from their irritation, which has led practitioners to doubt of their utility ? We be- lieve, indeed, that they are not particularly useful, and that the deeper, purulent discharge from a seton is more advantageous. A blister, to be really beneficial, must be applied to the vertex. Dr. Mead speaks of the utility of diuretics, but we know not that modern experience supports their credit, for "we have not had sufficient confidence in this class of remedies to employ them. The diuretic preferred Avas the alkaline salts, and the opinion of obstruction, from lentor, Avas then so common, that we can easily guess the source of the recommendation, and of the good effects attributed to it. Sedatives are most obviously indicated, and the whole tribe has been employed with varied success. Each medicine has had its sanguine advocates, and each has, at different times, succeeded. The refrigerants are chiefly trusted, and the neutral salts, combining this power Avith their purgative effects, are very commonly administered. Nitre is less often employed; but cold, in all its forms, is found peculiarly salutary. The clay cap has yielded to cold affusion of water, or fomenta- tions of the coldest Avater and vinegar; and madmen have been kept under Avater by violence till nearly suf- focated. The maniac, who has escaped from confine- ment, and remained exposed to the greatest cold, has returned in his senses; and those who have been with difficulty saved from droAvning have escaped from the danger and the disease. The sedative antispasmodics are the fcetids, musk, and camphor. The former are comparatively weak ; musk is more powerful, but rarely genuine, and always ex- pensive. Camphor is more active than either, and we have found it, in large doses, a valuable medicine. Less than a scruple at each dose would be, perhaps, useless; and few can bear more than half a drachm. The warm bath seems to have been sometimes successful in this vieAV. The narcotics have been employed in all their variety, particularly by the German and English physicians. Storck used the stramonium; Colin the cicuta and aconite. The ancient hellebore, Ave have said, Avas probably a species of adonis; Willis gave the ex- tracts of cicuta and henbane; Fothergill, of Bath, the henbane only. Lately, the digitalis has been given, in this country, to a considerable extent. These narco- tics have been often useful, and have as often failed, for the disease is generally incurable. Perhaps the digitalis promises most favourably, and the hyosciamus and stramonium appear to be the next in rank. These medicines often act as hypnotics; but the chief of this class, opium, has been commended, and rejected rather from theoretical prejudices than observation. Where opium usually agrees, it is a medicine of con- siderable importance in mania; but it should not be given till the stomach and bowels have been freely emptied, till the vessels of the head have been, in some measure, depleted by active topical bleeding, by blisters, or a seton. In these circumstances, with a large dose of camphor, it is often highly useful, though like other medicines, in an intractable disease, it must occasionally fail. Borax, in a large dose, was used by Dr. Monro to procure sleep. We have observed, that there are cases Avhere the interruption of the balance between the different parts of the brain are owing to diminished activity of one portion of this organ. But these, Ave have said, are feAv and indistinct. Cases of this kind are chiefly the M A N 913 MAN transient Avanderings after being aAvakened from sleep, or the want of recollection after long fevers, or other causes of weakness. Should mania occur, in such situations, a nutritive diet, tonics, with perfect tran- quillity, are the best remedies. The mental regimen, or, as Pinel calls it, the moral treatment, is confessedly of the greatest importance ; and the medical exertions in the most celebrated re- ceptacles arc generally slight, but strictly supported. Tales have been told, that the patients in some of these houses are not suffered to sleep; that the severities have been unusually cruel; that, in the language of Julian, the populous hair has been recruited, designedly, with new colonies; and that derivation to the skin has been kept by the infection of a cuticular disease. Of the truth of these stories we cannot judge; but it is, Ave believe, a fact, that when the mind is restored it is often at the expense of the constitution ; for patients have come to us, from some asyla, Avith their general health and strength completely broken. It is not for us to say- that the regimen and severities were unnecessary, or even to hint that the mind is recovered at too great an ex- pense, by the diminution of the vital power. Yet, when the maniacal fancies are harmless; when the disease seldom rises to violence, and the patient is usu- ally manageable, if relief by common treatment is im- probable, wre cannot say that such severities are advis- able. The violent and continued excitement is, however, alone sufficient to account for the subsequent debility. As Ave have declared that Ave are not of the initiated,' we might decline all farther remarks on the mental regimen; but Ave must add Avhat the experience of others, aided by our own, has taught us, that the maniac is always a coward. With the strength of twenty men he will crouch to an infant, if that infant assumes a haughty and firm tone. A look of confidence will soon have the same effect; and the dread of severities Avhich he has felt, or has reason to expect, will render that look irresistible. With this cowardice, the maniac is cunning, and it is necessary to guard with the utmost care against his artifices; but the great advantage is derived from the prompt and ready obedience which the look ensures. This checks every idle fancy, and stands in the place of the reason and judgment which were once his own. The mind, in this Avay regulated, assumes spontaneously its usual trains, and by steadily persevering in this tract, reason often returns. Thus, in the case alluded to in common life, when the conduct is no longer regulated by judgment or authority, the wildest eccentricities are the consequence. Should a Justus et propositi tenax interfere, the Avhole order is restored with its wonted regularity. If severities should be required, they must be truly such, to prevent the necessity of their repetition ; and the proper waistcoat, made with sleeves to fasten by running strings beyond the fingers, and by these to confine the arms across the body, is often necessary to prevent the maniac from in- juring himself or others. The moral treatment, according to Pinel, is of the greatest importance. It seems to consist in yielding to the more harmless fancies, and firmly correcting the more dangerous ones; at the same time endeavouring to bring back the usual and healthy train of ideas. What numerous cases of insanity has the French revolution produced! vol. i. This command ensures also the punctual obedience in taking the feAv remedies prescribed. These are, we apprehend, chiefly laxatives of the saline kind, nitre, camphor, and opium, with drains from the head by means of a perpetual blister or a seton, remedies chiefly, if not exclusively, useful in lessening the impetus of the fluids to the head, certainly the principal object in the treatment of the disease. The diet should be regulated Avith the same vieAV, and should be mild, light, and not highly nourishing. The drink chiefly Avater. Exercise, when the case will admit of the mind being amused, is highly proper; and cheerful company, Avho possess steadiness sufficient to repress the ruling fancies, and discretion to lead to pro- per subjects, without continuing the conversation so as to fatigue, is often highly salutary. INIusic, too, Avhich steals the mind from its favourite train of thought, and leads on the attention by its peculiarly fascinating powers, to those who are fond of it, contributes greatly to the relief. See Aretaeus, Alex. Trallian, Celsus, Sennertus, Hoff- man, Sydenham, Boerhaave, Beattie, and Arnold on Madness; Muzzelon Melancholy; Cullen's First Lines, vol. iv. p. 144; Pinel on Insanity. MANIGUE'TTA. See Paradisi grana. MA'NIHOT. See Cassada. MANI'BA. See Cassada. MANIO'DES, (from mania, madness). Maniacal. See Ferina. MA'NIPEY. See Jacaranda alba. MANIPU'ERA. See Cassada. MANI'PULUS, (quod manum i7npleat). A hand- ful, des me, dragma, fasciculus; as much as can be contained at once in the hand. MANJAPU'MERAM is a large tree common in the West Indies; nyctanthes arbor tristis Lin. Sp. PI. 8; its floAvers are distilled, and the Avater is used in inflam- mations of the eyes. See Raii Historia. MANJE'LLA KU'A. See Curcuma. MA'NNA,(from the Syriac term mana, a gift; as it is supposed to be the food bestowed by God on the children of Israel). Manna Calabrina, ros Calabrinus, aeromeli, alusar, drosomeli; and when of a rosy colour, nuba. The miraculous food bestowed on the children of Is- rael is said to have been more probably sugar than man- na, as it exuded on the reeds and grass; but it fell also on the stones, and was mouldy and fetid if kept beyond the day, except that day Avas the sabbath. It could therefore be neither, but a miraculous substance, of Avhich Ave can form no idea. The officinal manna has been supposed to be an exudation from the fraxinus ornus Lin. Sp. PI. 1510 ; but on this subject authors speak with indecision and doubt. In fact it is produced from the fraxinus with the rounded leaf: the leaf of the f. ornus is smaller and pointed. Later naturalists have called these species the f. rotundifolia; and a full description of the tree is given in the Memoirs of the Society of Agriculture at Paris (an. 1788, trimestre d'Hyver) by Gaspard Carramone, Avho has examined it on the spot. We shall only tran- scribe from this memoir the distinction between the true species and the common ash. The common ash is found in flat marshy places, par- ticularly near the sea: the ornus, by which he means 6 A M A N 914 M A K the round leaved ash, on the clifts of mountains. The surface of the bark of the former has not the white spots so conspicuous on that of the latter. The leaves of both are decompounded, but the last foliole of the common ash is always larger than the lateral folioles, which is not the case with the true manna tree. In the latter the leaf is unbroken and oval; in the former dentelated, and a long ellipsis. The Calabrians distinguish different sorts of manna; the manna di spontana, which exudes spontaneously; m. forzatella, that which is procured by incision; m. di fronde, which exudes from the leaf; m. di corpo, which proceeds from the body of the tree. Manna flows spontaneously from the 20th of June to the end of July, from twelve at noon to the evening, in the form of a clear fluid. It is collected on the following morning if the night is fair, for otherwise it is washed off by the rain. This, when hard, is the picked manna, or the sorted manna of the shops. About the end of July, when the spontaneous exudation has ceased, in- cisions are made in the body of the tree, when more copious exudations take place, which fall to the ground like masses of wax. This, when dry, becomes reddish or brown, and is full of impurities. What is collected from the leaves is styled grain manna, in little masses, about the size of a millet seed, and is found in the months of July and August. The Calabrians sometimes introduce a straw into the inci- sions, and the manna flows through and around it like stalactites, sometimes in very large pieces. This is very AA'h'ite and pure, called manna in tears. Many other species of the ash afford manna, and it has lately been found in asparagus, by M. Robiquet, Annales d'Chimie, vol. 55. Manna resembles sugar in taste, but greatly differs from it in many other respects. Its sweetness is in a very small degreeowing.to its truly saccharine particles; for it admits only of a partial fermentation, and the product, though slightly vinous, never resembles alcohol (Dupuy-t tren et Thenard, Annales de Chimie, Juillet, 1806). Ardent spirit dissolves a large portion of manna, which is almost wholly deposited in cooling, so as to fill the vessel with the precipitate, and with nitric acid, a large proportion of mucous acid is produced. It is chiefly, therefore, a mucous substance; and these experiments explain why, even in large doses, it does not produce heartburn, or prove in any degree inconvenient during pregnancy. The finer manna of commerce is in oblong, round- ish, single pieces; or in stalks, moderately dry, friable, of a whitish or pale yellowish colour, light, and some- what transparent; internally it is seemingly composed of fine capillary crystals. The inferior kinds are moist, unctuous, brown, mixed with small pieces of wood and other impurities, and in irregular lumps; the manna di corpo before described. The whitest, driest, lightest, purest, the most crystal- line, and that slightly pungent to the taste, is preferred. The manna in flakes is supposed to be the best, but the smaller pieces are as good, if white, or of a pale yellow colour, very light, of a sweet not unpleasing taste, and free from impurities. The fat honey like manna hath either been exposed to moist air, or is damaged by sea water, or a mixture of oily substances. Manna is often adulterated by compositions of coarse sugar, starch, and some purgative medicine, as scam- mony ; but the fraud is discovered by the taste, Aveight, compactness, want of transparency, and its chemical affinities. This concreted juice liquefies in a moist air, dissolves readily in water, and, by the help of heat, in rectified spirit, leaving only the impurities. A great part of the saturated spirituous solution separates on cooling, con- creting into a flaky mass, of a snowy whiteness, and a very grateful sAveetness : the remaining fluid, when in- spissated, is unctuous, dark coloured, and disagreeable. Manna is one of the mildest purgatives, and may be given with great safety to children and pregnant wo- men, to the delicacy of whose frames and situation it is particularly adapted; it is an useful auxiliary to the pur- gative neutral salts, sheathes acrimony, is beneficial in coughs and disorders of the breast, particularly such as are attended with fever and inflammation, and in bilious complaints; but is apt to create flatulencies and cholics, which are prevented by a warm carminative. It purges in doses of from ^ i. to | ij. and this quality is increased by a small addition of cassia. When administered in bili- ous disorders, Geoffroy recommends quickening it with a small proportion of antimonium tartarizatum, to eva- cuate the bilious serum without nauseaor colic. Syden- ham recommends the addition of lemon juice to manna, as a remedy for the gravel, and adds, that the acid ren- ders the manna a quicker purgative, diminishing at the same time the nausea which it sometimes excites, ren- ders it easy on the stomach. In bilious complaints ta- marinds are usefully joined with manna. In the gravel, the hooping cough, and when all possible irritation should be avoided, the manna may be given in milk. Modern practice does not very often employ this medi- cine alone, for the dose is so large as to cloy the sto- mach, and produce nausea. See Raii Historia; Tourne- fort's and Lewis's Mat. Med.; Neumann's Chemistry. Ma'nna thu'ris. See Olibanum. Ma'nna tere'niabin, and trangebin. See Al- hagi. MANNl'FERA A'RBOR, (from 7nanna, and fero, to bear). See Manna. MANSO'RIUS MU'SCULUS, (from mando, to chew). See Masseter musculus. MANTI'LE, (from manus). The name of a band- age. MA'NUS, (from manah, to prepare, Chald.). The hand is divided into the -carpus, metacarpus, and fin- gers. The posterior part is convex, for greater firm- ness, and the internal part concave, for the convenience of grasping. The concave side is called the palm of the hand. Ma'nus De'i. A resolvent plaster described by Le- mery : an appellation also of opium. MANY'L-RARA. A tall tree, growing in the East Indies. Its fruit resembles an olive, and is eaten to pro- mote appetite and digestion. The plant is not included in any system. MAY. See Manga. MARA'NDA. A plant resembling the myrtle, not yet reduced to any genus, growing in the island of Cey- lon : a decoction of the leaves is recommended in the venereal disease. MARA'NTA GALA'NGA. See Galanga. MARASMO'DES. A hectic fever in its last stage. MAR 915 31A R MARA'SMUS, (from fMtpxtva, to render lean,) an atrophy. (See Atrophia.) The species also of hec- tic fever common and fatal to old men. MARATHRI'TES, (from t^xtpov, fennel), See Fceniculum. MARATHROPHY'LLUM, (from fA.xpx6pov, and QvXXov, a leaf). See Peucedanum. MARA'THRUM,(from nxextva, to wither; because its stalk and flower wither in the autumn). See Fceni- culum. MARCASI'TA. (German.) See Pyrites and Bis- Ml'THUM. MA'RCHED. See Lithargyrum. MARCHI'ONIS PULVIS. Marquis's powder, of the Leyden dispensatory, designed as an anti-epilep- tic, consisting of peony roots, misleto, elk's hoof, coral, ivory, &c. MA'RCOR. A preternatural drowsiness. MARCO'RES, (from marceo, to become lean,) the first order of Dr. Cullen's class cachexie, which he de- fines, diseases attended with wasting of the Avhole body. It is similar to the Macies, and Emaciantes, of other authors. MARGARI'TTjE, (from margarita a pearl,) pirle, uniones, pearls, are small morbid excrescences, of a calculous kind, of a bright semi-transparent whiteness, formed on the inside of the shell of the concha marga- ritifera, or mother of pearl fish ; of oysters, muscles, and other shell fish. The finest pearls are brought from the East, inferior ones from the West Indies, and our own shores. The oriental have a more shining sil- ver hue than the occidental, which are someAvhat milky. Those not fit for ornament are called rag and seed pearls, and are employed in medicine. True pearls in the fire become quick lime, and readily dissolve in all acids, except the vitriolic. They resem- ble, therefore, oyster shells, and have no virtue but what is common to these substances. See Lewis's Ma- teria Medica; Neumann's Chemical Works. MARGARI'TA, (a rabbinical term, margalith). See Staphyloma and Albugo oculorum. MARGINA'TUS, (from margo, a margin,) bor- dered, applied to the seeds of plants which have a thin leafy border round them. MARI'NUM, vel MARINUS SAL, (from mare the sea). Sea salt ; esebon; co7nmunis, culinarius, et ci- barius sal; common salt. The salt is not only extracted from the sea water by evaporation, but is also found in extensive strata. (See Gemma sal.) It is composed of the marine acid, and the mineral alkali; dissolves in about thrice its weight of cold water, though, when heated, it scarcely requires less. The solution of this salt, if gently evaporated, affords cubical crystals, which are the common or alimentary salt. A small quantity of the sal catharticum amarum is next produced; but the chief part of this saltremains in what is called the mother water, which is oily, and on that account will not admit of its farther crystallization. Common salt, when dried in the temperature of 80°, contains 38.88 of acid, 53 of soda, and 8.12 of water: by others the acid is said to be 33.3, and the alkali 50. Its specific gravity is 2.120; it decrepitates in the fire, renders Avater colder than before, though, from the ad- dition, it is more difficult to freeze. Common salt is the most generally useful condiment, and the best antiseptic to preserve meat from putrefaction, and butter from ran- cidity. It furnishes a firm and cheap glazing for earthen ware, and is of considerable use in the process of dy- ing. The separation of soda from sea salt is a problem of considerable importance in the arts; and it has been com - pletely solved, if the removal of the duty on salt Avould render it practicable with advantage. This is not the place for disquisitions not connected with medicine; but we may remark, that iron, litharge and lime, in proper cir- cumstances, will effect the decomposition. The lime in the soil of Egypt and Tripoli seems the means by which the soda has been separated in such considerable quan- tities. Acetite of lead will equally effect the separation of the alkali; but it is too dear for commercial purposes. In the animal economy common salt is of general utility. (See Condiments.) It seems to check pu- trefaction ; but is of more service as a general stimu- lant. Animals pine when deprived of it, and few na- tions have been found who have not added this condi- ment to their food. In the animal process the fixed al- kali is seemingly changed to the volatile, and we have suspected that the muriatic acid is changed to the phos- phoric. Chemistry has not yet elucidated this subject, and we offer it chiefly as a conjecture which we could support by inductive reasoning, were this the place for such disquisitions. Beyond its general stimulus Ave do not perceive any salutary action of sea salt in the pro- portion usually taken. In large quantities it is used as an emetic,as a remedy for haemorrhage from the lungs, and in the form of sea water as a laxative and a remedy for scrofula. (See Hemoptysis and AquA marina.) Externally it is used in palsies, and in apparent death from drowning. In these cases, as in almost every other, it seems to act as a simple stimulus only. The sea water, gradually evaporated by the sun's heat, on the rocks, or in circuitous canals made for this purpose, is called bay salt, and is formed into large crys- tals ; it does not liquefy in a moist air, and is more powerfully antiseptic. Spiritus salis marini Glauberi, or the muriatic acid, is made by gradually adding six pounds of vitriolic acid, mixed with five pounds of water to ten pounds of dry sea salt: the acid is then separated by distillation. In this state the acid comes over in a gaseous form, and requires condensation by means of water. As a gas it is elastic and invisible, incapable of supporting animal life or flame, has a pungent smell, and acid taste, and a spe- cific gravity nearly of .002315, about double thatof com- mon air. Water absorbs it copiously and freely; but it is unchanged by the strongest light and heat. Ice ab- sorbs it also, but boiling water admits of no union with it. In the process just described, the acid of vitriol unites with the mineral akali, leaving its acid free, which rises in distillation; and, in the usual form,that of a colourless or a paleyelloAv fluid : itsspecific gravity is 1.196, though the acid of commerce is seldom more than 1.17. The strongest liquid acid is supposed by Mr. Kirwan to contain about an equal part of water. The dryest gas contains a small portion of water, which is only separated by electrical explosions. The specific gravity directed by the college is to that of distilled water, 1.170, to 1000. The muriatic is the Aveakest of the mineral acids,t)ut 6 A3 MAR 916 M A R stronger than any of the vegetable kind : it requires a greater fire to distil it than that of nitre, yet it is more readily dissipated by the action of the air. It has no effect on oxygen gas or inflammables. The muria- tic acid oxidates metals, but requires for all, except iron, a greater or less degree of heat. It combines with all alkalis, earths, and the greater number of metallic oxides. Its composition (see Chemistry) is not yet ascer- tained. The latest experiments are those of M. Brug- natelli, in the sixty-second volume of the Journal de Physique, p. 298. He certainly found the muriatic acid produced, Avhen the galvanic fluid was passed through water, by means of gold, platina, iron, or the black oxide of manganese; but some other metals, particularly silver, produced, in the water, soda. We can connect this only vvith one fact, that Avater, evaporating from iron, pro- duces a positive electricity, and from silver a negative. In these experiments of De Saussure it is, however, clear that the water is decomposed rather than evapo- rated. In Brugnatelli's experiments the positive pole seemed to produce in the decomposition of the water the acid, and the negative the soda. It is chiefly used as a tonic and antiseptic, in the dose of from ten to sixty drops, in Avater, or any other con- venient liquid. In putrid fevers, after having cleansed the primae viae, it supports the strength, and corrects any remaining putrefaction on the contents of the sto- mach and boAvels ; but seems not to carry its antiseptic quality into the general mass, which indeed is seldom in a putrid state. It was Recht's boasted remedy for fevers, which the Prussian government bought at a considerable price. In bilious fevers it has been recom- mended ; but it is not peculiarly useful, and, in gene- ral, its good effects are confined to the parts in imme- diate contact with it. In acidulated v gargles for ulcerated throats it has been strongly recommended, but seems to be in no re- spect superior to the vitriolic acid ; and, diluted with the tincture of benzoe, has been applied, it is said, with success to putrid ulcers. Linnaeus remarks, that, if properly diluted, and ap- plied to chilblains, it radically cures them. If half an ounce of good bay salt is dissolved in four ounces of Avater, and two drachms of the muriatic acid be added, it will form a mixture, of which a tea spoonful, in a glass of water, is said to improve the appetite, and frequently stop vomiting. The muriatic acid, combined with volatile alkalis, produces the officinal sal ammoniac ; Avith fixed vegeta- ble alkali the sal digestivus Sylvii; in modern language, muriated potash. See Chemistry. The acidum muriaticum, combined with calcareous earths, forms a calcareous muriat, which deliquates in the air, and dissolves both in water and in rectified spirit of wine. It is contained in a considerable quan- tity in sea Avater, but remains in the mother water after the crystallization of the muriated soda, and is said to be antiseptic, diuretic, and lithontriptic. The medi- cine, commonly sold under the name of liquid shell, appears to consist only of calcined shells dissolved in marine acid. These combinations are made by mixing the calcareous earth with sal ammoniac, and urging the mixture with a gradual fire, until the volatile alkali of the salt is either dissipated or collected by sublimation Avhen the acid unites Avith the earth. The 7nuriat of lime has lately become a fashionable remedy in scrofula, in scirrhi, and other diseases sup- posed to arise from inspissated lymph. From half ? drachm to half an ounce, diluted Avith Avater, is given. according to circumstances, every day. For the murias ferri, v. Ferrum ; and for the murias barytis, v. Barytes. See Lewis's Materia Medica; Neumann's Chemical Works. MARIPE'NDAM, is a plant in the island of St. Do- mingo. - The distilled Avater from its tops is greatly esteemed in pains in the stomach. The plant has not been properly examined. See Raii Historia. MARI'SCA, a fig. An excrescence about the anus. like a fig. See Condyloma and Hemorrhoides. MARI'SICUM. See Mercurialis fructicosa. MARJORA'NA, (i7iarjorana). See Origanum. MARMARY'GjE, (from fA.x^xipa, resplendeo,) a variety of pseudoblepsis i7naginaria. Sparks or corrusca- tions Avhich seem to flash before the eyes, from a ful- ness of the vessels of the brain. MARMOLA'RIA, (spotted like marble). See Acan- thus. MA'RMOR, (from fA.xpfA.xtpu, to shine). Marble. A calcareous stone, chiefly used for the carbonic acifl gas it contains, employed in preparing the acidulous mineral waters. See Calx. MARMORA'TA AU'RIUM. See Cerumen. MARMO'REUSTA'RTARUS,(from its hardness). See Calculus. MARMORA'CEA VENE'NA. Such poisonous substances as are fatal in doses not exceeding the bulk of a grain of wheat. MAROCO'STINUM. The epithet of.a cathartic extract originally made by Mindererus, in which marum and costus are ingredients, designed for discharging serous humours, but now neglected. See Pharmaco-- poeia Augustana.P///«/<£ marocostina Lemery and Bates. MARO'TTL A tall tree in Malabar, Avith leaves like those of the bay tree, and a fruit which contains an oily kernel. The oil expressed from the kernel is often medicinally used by the natives. (See Raii His- toria.) It has been figured by Reed, in his plants of Malabar, vol. i. pi. 36, but has not been reduced to a place in any system. MARRUBIA'STRUM. See Ballotte. MARRU'BIUM, (from the HebreAV terms mar rob, a bitter juice). Horehound ; mauromarson; which rather means the black sort. It is also a name for the cardiaca, leonurus cardiaca Lin. Sp. PI. 817, and some- other plants. Marru'bium a'lbum ; prasium album. Common white horehound, marrubi/um vulgare Lin. Sp. PI. 816, is a hoary plant, with square stalks, and roundish unwrinkled leaves, set in pairs on long pedicles, from the bosoms of which arise thick clusters of whitish la- biated flowers, in striated cups, whose divisions termi- nate in sharp points or prickles. It is perennial, grows wild in cultivated grounds, and flowers in June. The leaves have a slight aromatic, but not at first an agreeable smell; their taste is bitter, penetrating, dif- fusive, and durable in the mouth : in large doses they M AR 917 MAS prove laxative. This plant is said to be an useful ape- rient and corroborant, in humoral asthmas, pulmonary consumptions, cachexies, menstrual suppressions, scirr- hous affections of the liver, jaundice, and several other chronic disorders. The ancients had an high opinion of its efficacy, particularly in pulmonic and visceral ob- structions ; and, amongst the common people, horehound tea in coughs and asthmas is a common remedy. Dr. Cullen dispu tes its virtues as a pectoral, as well as a de- obstruent, and thinks the authorities of Forrestus, Zacu- tus, Lusitanus, and Chomel, very insufficient. A drachm of the dried leaves in powder, two or three ounces of the expressed juice, or an infusion of half a handful of fresh leaves, are commonly directed as a-dose. See Boici- NENGA. The dry herb gives out its virtues both to water and to spirit. The expressed juice, gently inspissated to an extract, is the best preparation: the dose is from gr. x. to 5 ss. Marru'bium aqva'ticxsm,lycopus Europaus'Lin. Sp. PI. 30, avater horehound, found on the sides of brooks, but inferior in virtue to the white. Marru'bium ni'grum fce'tidum. See Ballotte. Marru'bium \F.RTiciLL\'TVM,marrubiu7nHispanicum Lin. Sp. PI. 816; Galen's mad wort; the base hore- hound. These species are usually neglected. See Lewis's Materia Medica; Neumann's Chemical Works. MARRULLIUM. See Lactuca. MARS DIAPHORE'TICUS. See Ferrum. Mars sacchara'tus, and solu'bilis. See Ferrum. MA'RSAS. See Bonduch Indorum. MARSUPIA'LIS, (from marsupium, because it is shaped like a purse). See Obturator externus and internus, and Gemini. MARTIA'NUM UN'GUENTUM. Martian's sol- dier's ointment. R. Ol. laur. f. Ibiij. foliorum rutae, recent, fttij. ss. majoranae tfe ij- menthae Jfji. salvias, ab- synth. communis, balsamitae maris et basici, aa. lb ss. oleiolivae, Ibxx. cerae flavae Ibiy. vini Malagens, ffeij. m. f. unguentum. This was employed to preserve the limbs of soldiers from the injuries of cold in the camp. Martia'num pomum See Aurantia hispan. MA'RTIS ESSE'NTIA, oleum per deliquium, sal, tinctura, and extractum. See Ferrum. MA'RUM, (from the Hebrew term mar, bitter,) sampsuchus, clinopodium mastichina Gallorum, thimbra Hispanica; Jaca Indica, mastich thyme, or common marum, thymus mastichina Lin. Sp. PI. 827, is a Ioav shrubby plant, with small oblong leaves, pointed at both ends, set in pairs without pedicles ; at the tops of the branches stand Avoolly heads, containing small white labiated flowers, whose upper lip is erect and cloven, the lower divided into three segments: each flower is folloAved by four seeds, inclosed in the cup. It grows spontaneously on dry gravelly grounds in Spain, and in similar soils it bears the ordinary Avinters in England. Its virtues are similar to those of the Syrian marum, but less powerful. Ma'rum Syriacum, vel Creticum, majorana Sy- riaca vel Cretica, marum cortusi, chamadrys incana maritima, marum Germander, or Syrian herb mas- tich, teucrium marum Lin. Sp. PI. 788, is a low shrubby plant, Avith small oval leaves, pointed at each end, and set in pairs without pedicles, of a dilute green colour above, and hoary beneath; in their bosoms ap- pear solitary purple labiated floAvers, each of which is followed by four roundish seeds inclosed in the cup. It is said to be a native of Syria, and does not bear our winter's cold without shelter. The leaves are bitter, pungent, and aromatic to the taste; their smell excites sneezing; and they agree with the canella alba in their virtues. This plant loses but little in drying, gives out its ac- tive matter partially to Avater, but completely to spirit; the Avatery infusions retain the smell, but little of the taste; the tinctures retain more of the taste than the smell. Distilled with Avater, it yields an highly pun- gent, volatile essential oil, stronger than that of scurvy- grass, and of a less perishable pungency; the remaining decoction is bitterish. Rectified spirit carries off only a part of the smell and pungency of the marum. This plant is supposed to possess very active poAvers, and to be an important remedy in cachexy, hysteria, and nerv- ous debility, acting as a warm tonic and a powerful emmenagogue. ' The dose is 5ss- °f the poAvdered leaves given in wine. In the present practice it is chiefly used as a sternutatory, and is one of the ingre- dients of pulvis asari compositus of the London Pharma- copoeia. See Raii Historia; LeAvis's and Bergius' Ma- teria Medica. MA'RVISUM. See Malvasia. MASCHA'LE, (ftxe-x*>*)- See Axilla. M\SCKALl'ST'ER,(fixG-xxXir%p). See Spina. MA'SLACH. A form of opium used by the Turks. MA'SPETA, and MA'SPETUM. See Silphium. MA'SSALIS, and MA'SSARIAM. See Argentum VIVUM. MA'SS^EAD FORNA'CEM. See Candela fu- MALIS. MASSE'TER MU'SCULUS, (from nxe-iroftxt, to eat). Lateralis, manducator 7nansorius. The masse- ter muscle rises on each side from the cheek bone and the interior part of the zygomatic process of the os temporis; and is inserted into the Avhole length of the loAver jaw, particularly the angle. MA'SSOY, a species of bark mentioned by Ray, from a tree hitherto undescribed. It is gratefully fra- grant and heating. MASTICA'TIO, (from mastico, to chew,) manduca- tio; commanducatio. Mastication comminutes the parts of our food, and intimately combines it Avith the saliva and mucus of the mouth. Due mastication is essen- tially necessary to digestion; but it is doubtful whether any portion of our food is absorbed during this process; for every thing which has not passed through the ope- ration of digestion seems to be injurious when mixed with the circulating fluids. V. Digestio. MASTICATO'RIUM, (from mastico, to chew). A masticatory. See Apophlegmatica. MA'STICHE, (from fjuto-o-u, to express). Mastich. See Lentiscus. MA'STICHEN. Odora'tum fu'ndens. See Nux VlRGINIANA. MASTICHI'NA GALLO'RUM, (a dim. of mas- tiche). See Marum. MASTOIDiEUM FORA'MEN. See Styllomas- TOIDEUM FORAMEN. MAT 918 MAT MASTOIDAUS MU'SCULUS, (from t*xr]os, a nip- ple, and etfosforma, the mastoid process, resembling a 7iipple,) sterno masloides, sterno mastoidaus of Dr. Hun- ter, Avho observes that it rises by two distinct portions from the sternum, with that part of the clavicle articulated to the sternum, and is inserted into the mastoid pro- cess. This last portion Albinus considers as a distinct muscle, and calls it clino mastoidaus, but it is not divi- sible from the other without art. Winslow calls this muscle mastoideus anterior,or sterno mastoideus; and the splenius the mastoideus superior. Mastoide'us latera'lis. See Complexus minor. Mastoide'us proce'ssus. See Temporum ossa. MASTOIDY'NIA, (from A«r7'S, a nipple, and ofojv*,, pain). Sore or pained nipples. But more commonly pain in the breast from inflammation. See Inflamma- tio MAMMARUM MULIERUM. MASTURBATIO; manustrapatio, Onanismus, the sin of Onan, from a perverted passage in the Pentateuch. The discharge of semen from a preternatural stimulus; the vice, it is said, of the solitary monk, and, perhaps, of other recluses, to whom more natural enjoyments are denied- It is a habit of the most destructive ten- dency, enervating, in the highest degree, both the body and mind. Nature seems to have fixed a strong mark on those disposed to every unnatural .enjoyment, and however secret their practices may be, so indelible is this mark, that they cannot escape detection from that tact which has been peculiarly distinguished by the term of sensus medicus. In general, the countenance is salloAv, with a peculiar dejection in the look. The voice is hurried and unsteady; the face often covered with dark coloured pustules, hard in the skin, and the whole frame displaying peculiar debility. The dejection, at times, almost amounts to insanity, and every com- plaint appears to threaten instant death. The tremor and apprehension prevent the natural enjoyments, by which they might be otherwise weaned from this de- structive habit; and the whole life is alternated with doubts, apprehensions, and despair. Unfortunately, the practice is never forsaken, at least, notwithstanding every assurance, we have reason to think so. The apprehensions of discovery and the despair ren- der those unfortunate persons the dupes of quacks, and it may be remarked, that every quack bill holds out de- lusive hopes to those who experience the bad effects of such indulgences. Regular practice exhausts the whole tribe of tonics and stimulants with little effect. The Avarm balsams, of which the quack medicines consist, are either rejected from the hands of the physician, or not continued a sufficient time; and even cold bathing, the best remedy, does not fix the imagination so strongly as the solar tincture, or the balm of Gilead. If not too long continued, a prudent marriage may recover the pa- tient ; but it would be unjust, cruel, and impolitic, to condemn a healthy young woman to the shadow of a man. This remedy, however, Ave have often found ef- fectual in cases where the constitution was not wholly exhausted. Tissot on Onanism, and the Appendix to his Disserta- tion on Bilious Diseases; Gruner and Husche Disserta- tiones de Masturbatione. MATALI'STA, MATBALI'STIC. See Jalapa. MA'TER, (from f*xa, to desire). See Dura mater. Ma'ter perla'rum, concha margaritifera, concha mater unionum, concha valvis equalibus, nacre. Mo- ther of pearl. This is the pure pearl like part of the shell in which pearls are found, possessing the an- tacid properties of the pearls themselves. See Mar- garite. MATERIA, (from mater, a mother). Matter; substance. In strictly logical disquisitions, material is in opposition to modal, the one signifying as a cause, a substance, the other a peculiar state; thus a sword in- flicting a wound is a material cause of pain, spasm only modal. To come nearer, a calculus in the gall duct is a material cause, the same effect from violent passion modal only. This is nearly the meaning of Dr. Cullen, when he distinguishes sensation of impression from sensations of consciousness; but this distinction is sel- dom attended to in the undiscriminating, flowery, pages which by courtesy are now styled medical. If we were to refer to works where strict logical discrimina- tion is pursued with rigour, they would be those published during the presidency of Stahl at the univer- sity of Halle. The minute precision of the author's reasoning (Stahl himself) is highly gratifying, while the obscurity of the language and manner would repel every modern reader. Materia Medica. The last article suggests to us a logical inaccuracy in the title, which strictly implies 7naterial substances employed in the cure of diseases. We must, however, extend these views, and, with the spirit of the best authors, follow their example, by con- sidering, under this title, every means of relieving the maladies to which human nature is subject. The field which this inquiry opens to our view is immense. It not only includes a consideration of the properties and use of each of these means, but the mode of investigat- ing these properties, of arranging our copious list of remedies, so as to assist not only our explanations of their virtues, but the choice of our remedies in any given emergency, and to point out the distinctions which, from different circumstances, may guide us in our preference of one to another. Not the least im- portant object in this disquisition is the conduct and merits of the different authors in this department of medicine. The knowledge of medicines must have been coeval with the existence of the human race. Mankind was always subject to diseases and accidents,'and would na- turally seek for remedies. There is consequently no race, however uncultivated, but has its materia medica, and modes of cure, often rash, violent, and injudicious, but sometimes discriminated with precision, and adapt- ed Avith skill. It were to be wished that botanical in- quirers had more often, in their itineraries, preserved these rude modes of treatment as Linnaeus has done in his Flora Laponica. The scattered limbs, however, exist, and will repay the trouble of collecting. The Greeks, who made every thing their own, and often created a fabulous personage, to whom they gave the honour of a discovery, for which they were indebted to their neighbours on the continent of Asisi, attributed the achillea to Achilles, the teucrium to Teucer, and the artemisia to Artemis. Their famous .Es- culapius was probably only an Egyptian title (haskelab), the father of wisdom. The materia medica of Hip- pocrates (for it would be to fill our pages very uselessly to copy all the fables recorded on this subject) was very M A T 919 M A T simple; but even the few remedies which he employed >vere in part rejected by Erasistratus. The empiricism and credulity of Serapion and his followers introduced numerous disgusting and ridiculous remedies; many of Avhich were continued in the foreign pharmacopoeias in the last century, and Vogel even condescends to notice several of them. Themison, the supposed founder of the methodic sect, gibeted in the satires of Juvenal as a most unsuccessful practitioner, recommended medi- cines of activity, as the aloes, the scammony, &c. He first employed leeches, and preferred these and cupping glasses to general bleeding. He seems to have rejected with indignation the ridiculous remedies of the empi- rics; but if we may trust his copyist Coelius Aurelianus, employed some which were scarcely less absurd. The rage for compound medicines seems to have begun with Themison, but it increased with his followers, particu- larly Andromachus and others, down to the era of Galen, to whom the materia medica is greatly indebted for his attentive inquiries into the nature and country of the different medicines, though the real knowledge of their effects was obscured by the numerous ingre- dients of each formula. The authority of Galen, and the use of compound medicines continued, we know, for many centuries ; and we have not long escaped from the trammels of his authority. While, however, the infallibity of Galen remained unquestioned, the Arabians greatly enriched the materia medica by those medicines which their climate, or their connection with India, had introduced to their notice. The purgatives of their predecessors were the mild her- baceous vegetables, or the more acrid drastics; but the Arabians introduced the manna, senna, and myrobolans. They varied also the formulae, and rendered them more agreeable by the addition of syrups; and they were un- doubtedly acquainted with distillation, though they seem to have only employed this process in the prepa- ration of simple Avaters and distilled oils. They added also musk, mace, cloves, Ecc. which are still retain- ed ; the precious stones, leaf gold, and silver, which are noAv neglected. They injured this branch of medicine by their fondness for compounds, in which they exceeded the Greeks; and, by their hieroglyphics, their metaphorical language, their comparison of the stars with diseases, and the metals with remedies, are supposed to have occasioned those wild extravagances Avhich for ages led philosophers in pursuit of the art of making gold, and physicians in that of compounding an universal medicine. Whether this latter conjecture of Boerhaave is well founded or not, the chemical physicians soon succeeded, and the language of Bacon, the earliest of these in the thirteenth century, seems to prove that the torch was lighted from the Arabian flame. Bacon endeavoured only to ward off old age; with Raymond Lully, in the folloAving century, the pursuit of the universal medicine commenced. This pursuit was continued, and the ma- teria medica greatly augmented, by acquisitions from chemical preparations by the Isaacs, Basil Valentine, and many others, down to Paracelsus and Van Hel- mont, the last of whom lived inthebeginningof the 17th century. The absurdities of this sect are inconceivable; but they were succeeded by philosophers and physi- cians, who pursued the same path with more rational views and better success. Sylvius de Je Boe, Tachenius, Quercetanus, Glaser, Schroeder, Lemery, Glauber, and others of the chemical school, the great benefactors of the materia medica, have in succession greatly enriched this science with the chemical remedies which we still employ. During this period the appearance of the lues venerea also added to the materia medica the sarsa, the guaiacum, the china, and some other medicines. The discovery of Harvey, in the beginning of the seventeenth century, gradually turned the attention of practitioners from the active remedies of the chemists to those which were supposed to act mechanically; and mechanical reasoning soon overturned the whole system of medicine, and changed the language which had been hitherto held respecting the operation of remedies. The good sense of Boerhaave led him to retain the re- medies of the chemists while he employed and extend- ed the language of the mechanical physicians, while he studied and enforced the medical observations of Hip- pocrates and his successors. With the downfal of the humoral pathology the ma- teria medica experienced little improvement. Dr. Cul- len, who, like Boerhaave, was a chemist before he had completed his medical system, still retained a predilec- tion for chemical remedies, and for the more active forms. He introduced, it is said by Dr. Fordyce, the emetic tartar ; and he supported, by his recommenda- tion, the corrosive sublimate, not only in lues, but in diseases of the skin : a remedy employed externally for this latter complaint by the Arabians. We mention chiefly these circumstances to speak of a new sect, the introducers of medicines formerly accounted poisonous. Van Swieten, by his adopting the use of the corrosive sublimate from the Russians, seems to have first ex- cited the attention of the physicians of Vienna to the vegetable poisons, the hemlock, the aconite, the bella- donna, the napellus, the phytolacca, lactuca virosa, 8cc.; an impulse followed by the introduction or revival of the digitalis, the arsenic, &c. It is not our present object to appreciate the value of this new step ; for it belongs to the separate articles. In general, however, we may add, that the real merits of the greater number have by no means answered the expectations excited. Our materia medica, as established by the decision of the colleges of London and Edinburgh, is, at present, confined in the number of its articles: but these are well chosen, active, and effectual. Each practitioner will probably add, from his own predilections, some others; but others, we suspect, will not be found ne- cessary. The action of medicines depends on a relation between their properties and the living solid, differing in different parts of the system. This relation is, in general, obscure. It is, however, sometimes, and per- haps more frequently than has been supposed, chemi- cal ; sometimes purely physical; scarcely in any in- stance mechanical. It is occasionally connected Avith the more obvious properties, as the smell and taste of the medicine, but confined in this respect to the vege- table, less strictly to the animal, kingdom. It is some- times connected with the chemical analysis, or with the natural affinities of a plant. Each mode has been em- ployed in investigating the powers of medicines, and to each we must direct our attention; not perhaps as of M A T 920 M A T peculiar importance, for few medicines have been dis- covered in this Avay, but to explain the language and the conduct of authors, and sometimes to correct them. The olfactory organs are peculiarly acute in the brute creation, but of no great importance to us in our in- vestigation of the properties of medicines. The utility of the smell is limited chiefly to vegetables: but feAv animal substances discover their powers by these or- gans, and the insects and the vermes are either without smell, or give faint indications of their qualities in this way. In general, pleasing smells are salutary, and nau- seous or foetid ones injurious. Pleasing and nauseous are, however, relative terms; and to our neighbours on the continent the fumet of tainted venison is highly » gratifying. Authors Avho have investigated the powers of medicine by the smell are Linnaeus and Lorry, each of whom we must notice, as they have considered the subject in very different views ; while former authors, as Boyle, considered effluvia chiefly as philosophers, and contemplated only-the Surprising divisibility of mat- ter; or, as Boerhaave, Venel, and Roux, treated of odour as chemists, and endeavoured to separate or combine it in a more durable form. Linnaeus divides the odours of medicines (Amceni- tates Academicae, iii. 183.) into aromatic, fragrant, ambrosiacal, alliaceous, hircine, stinking, and sickly. The three first are pleasant, the three last dis- agreeable, smells. This enumeration is not perhaps correct, nor the classes distinct; but the Linnaean lan- guage is employed by many respectable physicians of his school, and consequently merits our attention. The aromatic smell is distinguishable in various fa- milies of plants, as the laurels, the umbelliferae, and the labiatae, and is found in every portion of a vegetable, often in every part of the same plant. The iris, the rosemary, and the sage ; lavender, fiowers, and pinks; canella and winter's bark; sassafras wood; laurel berries; cummin and carui seeds; gum benjamin and balsam of capivi, are striking instances of it. They are generally stimulating, not without a suspicion of a narcotic poAver; often induce the calm serenity which we feel from tea, and destroy irritability rather than give strength. The exhalations themselves, from the experiments of Ingen- houz, are chiefly azotic, and, in many constitutions, highly deleterious. The fragrant smell is not very clearly defined. It contains some of the more pungent smells, and seems to be a connecting link between the aromatic and the ambrosiacal. The instances are the floAvers of the lily, the jessamin, the tuberose, some species of pinks, and saffron. They are more actively analeptic than the fra- grant odours, and more certainly antispasmodic. The ambrosiacal smells are very penetrating and ac- tive, when concentrated, as in ambergris and musk, but generally disagreeable. When greatly diffused they are more agreeable. The specifes of geranium, mal- lows, rose, and garlic, styled moschate, are of this kind; the fruits of the pine apple, of some kinds of apples and pears, musk, civet, and burnt animal substances, are instances of this species of odour. They appear to be stimulant, but are strictly sedative, and powerfully antispasmodic. The alliaceous smell is particularly distinguishable in garlic, and its congeneres, in the scordium, asafoetida, and what are styled the Avarm foetid gums. These odours belong to very active stimulants, which poAver- fully excite the vessels of the skin, and increase the discharge not only from these but from every gland in the human body. The hircine smell is that which resembles the odour of the goat; and, in the vegetable kingdom, Ave find it in the herb robert, the orchis, some mushrooms, par- ticularly the phallus impudicus. In general, these fe- tids are sedative, and often deleterious. Stinking smells are exemplified in opium, night- shade, and hemp, which are all narcotics; and the sickly in hellebore, tobacco, colocynth, putrid meat, senna, and rhubarb. All such substances are powerfully emetic, and, if they escape the stomach, are also ca- thartic ; and all are narcotic. M. Lorry has proceeded in a different way, and has considered the smells, which are essential to the medi- cine, and which continue, independent of very minute analysis. These are the camphorated, narcotic, ethe- RIAL, VOLATILE ACID, and ALKALINE. The camphorated is found in the labiated, the compo- site, the terebinthinated, and the aromatic plants, as Avell as in the laurels and myrtles. Its characteristics are, extreme penetrability, a singular volatility, a strong attraction for oily and spirituous menstrua. Though - easily dissipated in the air, yet, when united with resins, in the leaves of plants it is preserved from evaporation, and contributes to their preservation. This principle resists the activity of fire, and the most powerful agents. Even musk and opium will not disguise it: its medical power we have already detailed. See Camphor. The narcotic odour is that virose effluvium which de- stroys the principle of life. It exists in the poppies, the nightshades, the borrage, the cucurbitaceous and umbelliferous plants, with many others; often disguised by the distinguishing principles of the vegetable, and obvious Avhen these are separated by putrefaction or fire. This is the most fixed and adhesive of all smells. It corrects the volatility of the others, and often dis- guises all, except the camphorated. Even in a small proportion it is discoverable among the most fragrant smells, as in the rose, the jessamin, the tuberose, and the violet. These flowers exhale the true narcotic odour, when their aromatic and camphorated smells are dissi- pated. This smell is simple, sometimes concealed under that of aniseseed or garlic, occasionally imitating the smell of radishes, or the offensive odour of bugs. The same odour is found in animal substances. Virgil speaks of the virosa castorea; and animal oils, though rectified by distillation, exhale this narcotic smell. The ethereal odour is volatile, incoercible, and of ex- treme tenuity. It escapes so easily that we can only, re- cognise it for a short time. Art produces its most strik- ing example; but we find it in the pine apple, in melons, some kind of pears and apples, in strawberries, and the greater number of fruits which grow under the burnhfg sun of the torrid zone. It is sometimes discovered on the first appearance of the sceptic process, to which SAveet fruits are exposed. This odour combines with the alka- line, and the narcotic smell of opium giving it a striking volatility, and moderating its narcotic property. It unites also with camphor, "and adds to its sedative and MAT 921 M A T soothing poAvers in a manner well knoAvn to practical physicians. The volatile acid odour is usually combined Avith an aromatic volatile spirit. It is distinguished in lemons, oranges, gooseberries, cherries, &c. combined and dis- guised in many plants, as in the lemon thyme. This odour is in general pleasing and refreshing, and it de- stroys the effects of narcotics. It is often combined with the ethereal smell, as in the aromatic spirit of vinegar, and is destroyed by putrefaction. The volatile alkaline smell is distinguished by a bit- ing acrimony, Avhich irritates the eyes. The horse radish, mustard, scurvy grass, with all the alliaceous vegetables, are examples of this odour, which is in part destroyed by acids. It is generally confined in plants by mucilages and oils, and is very durable, since even putrefaction Avill not wholly separate it. In asafoetida it is combined with the virose odour; and the most fetid smells seem to be combinations of this kind, which lead us to suspect some hepatic combination. The tastes of plants conduct us more certainly to their medical properties; but the similarity of terms may contribute, without care, to confound them with the smells. Our chief guide in this path is Linnaeus himself; but Bergius, assisted by the comprehensive Linnaean lan- guage, has greatly extended our distinctions of taste; though employing terms and comparisons generally known, he scarcely requires an interpreter. Taste has been considered as a cause of the action of medi- cines, or at least as a means of discovering their pro- perties in almost every era of medicine since that of Hippocrates; and,besides Linnaeus, Wedelius, Walther, Hebenstreit, Koenig, and Tauvry, have paid particular attention to it. The two last have, however, confined themselves to mechanical explanations of taste; and, like Willis, have supposed acrid particles needles, oily ones spheres; bitter, salt, acid, and styptic tastes, owing to forked, irregular, polyedral, conical, or hooked par- ticles respectively. Tastes greatly differ; and though, as in smells, we say in general that substances of an agreeable taste are salutary, and those Avhich are unpleasing to the palate injurious, yet the question of pleasantness or its opposite is relative. Pungent tastes are universally pain- ful; but, when diluted, they become agreeable. In fact, as we shall find in the operation of medicines, every thing in excess is stimulant: we only perceive either peculiar properties, or flavours, when the proportion is suitable to the circumstances. Fourcroy divides tastes into those which are highly pungent or painful, as the caustics; those which excite moderate sensation, as the sweets and bitters; such as only affect the stomach, and very slightly, if at all, the palate, as the antimonials; and such as act only through the medium of the nerves. We need not add that this is to extend the subject beyond its proper limits. It is singular, that the people on the coast of Malabar, among whom medicine is in a very rude state, divide their remedies according to taste. Grundler, the Danish missionary who visited that coun- try in the beginning of the last century, has given an ex- tract from the Voya da-satyram, which contains all their medical science, where the remedies are divided into acids, sAveets, bitters, acrids, and astringents. We may just add, that Braun, the son-in-law of Halter, an officer VOL. I. in our service in Indostan, has informed us, that, in the ancient seminary of Benares, no other part of medicine is cultivated except what relates to the virtues of vegeta- bles; and in the Gottingen museum, a valuable hortus siccus of Malabar plants in twelve volumes folio, with their names and properties annexed, Avas some time since preserved. Linnaeus divides the taste of medicines (Amoenitates Academicae, ii. 335) into the saveet and acrid; the fat and styptic; the acid and bitter; the viscid and salt; the watery and dry. The styptic is a compound taste, sometimes consisting of the dry and acid, when it is styled austere; or of the dry and bitter, distinguished by the term acerb. The nauseous taste produces an inverted motion of the oesophagus and stomach. It is a compound, but its ingredients are not easily ascertain- ed. We are informed by Quercetanus, that the medi- cines styled by Hippocrates bitter, acid, and SAveet, arc, by Galen, in conformity to his theory of the humours, called hot and cold, wet and dry. The property of sweetness is conspicuous in the roots of the polypody and liquorice; all ripe fruits; in milk and in honey. The sweets, either saccharine or muci- laginous (vide manna) are, as we have seen, nutritious, chiefly adapted to dry, lean habits, and advanced life. They are also demulcent, and supposed to be expec- torant; but the latter quality rests on a doubtful founda- tion. Medicines distinguished by an acrid taste are heating, irritating, and, in excess, corrosive. In large doses they are the most destructive poisons. Externally, they are rubefacient, sometimes discutient, or occasionally suppurative. By their general stimulus they promote every evacuation, and are sometimes the most active emetics. Their poAvers as cathartics are less conspicu- ous, and they are generally useful in cold, phlegmatic habits. Examples of this kind are the pure alkalis, and the metallic salts; the roots of bryony, pyrethrum, horse radish, and of the alliaceous tribe; the leaves of the soldanella, persicaria, tithymalus and cochlearia; the bark of the elder; the seeds of the mustard; eu- phorbium, gamboge, and cantharides. The fat taste is conspicuous in the almond, cocoa nut, lintseed, and axunge. It is owing to an oil combined with a mucilage, and is lost when they become rancid. They are in general demulcent, and useful Avhen the fibres are stretched, or the mucous membranes abraded. From this last circumstance, they sometimes relieve diarrhoeas, though many of this class are naturally laxative. The contraction of the mouth, which arises from tasting styptics, is sometimes communicated to other parts. Alum is a striking example; but it does not follow that styptic vegetables, as has been supposed, contain an argillaceous sulphat. We find this taste in vitriolated iron and zinc; the roots of tormentil, bis- tort, and quinquefolium; the barks of the tamarisk, the capparis, and the fraxinus; the gall nut; the leaves of the centinodium, the myrtle, and the oak; the flowers of pomegranate, and in red roses; the juice of acacia, catechu, 8cc. These remedies are,in general, astringent; and, as they all contain tanin in a considerable propor- tion, we find the foundation of their properties in the separation of the gelatin. See Astringently. M A T 922 M A T Of the acid taste we require no examples; but if we speak of this as a natural one, Ave must exclude the mi- neral acids, which rather belong to the styptiqs. With this exception, Ave shall find acid substances cooling and sedative, neutralizing in some degree the bile, and de- stroying putrid acrimony in the stomach. They allay thirst, promote a discharge from the kidneys, and often from the skin. They prevent accumulations of fat in the cellular membrane; but do not, as has been said, coagulate the fluids; for they do not reach the circu- lating system with their properties unchanged. The bitter taste is confined to the oily and resinous juices of vegetables, and to the inflammable oxides. It is communicated to all vegetable substances by what is styled by the French chemists their combustion, in consequence of their union with nitric acid. Many of the vitriolated neutrals are also bitter; but in detailing their properties Ave must confine ourselves to the bit- ter vegetables; for there is no reason to suppose that our artificial bitters agree with the natural. We find the pure bitter chiefly in the roots of the gentian, the male fern, and the Avhite dittany; in the bark of the simarouba, the orange and the lemon peel; in the leaves and flowers of the carduus benedictus and the camo- mile; in the Avood of the quassia; in the tops of the cen- taury and hop; in the seeds of the carduus benedictus and mariae; in the juice of the Avild cucumber; in the aloes, the myrrh, and the bile of animals. It is seldom pure, and even in some we have mentioned it is joined Avith a little acrimony; in others with astringency, or acidity. The affinity of the acid with the bitter prin- ciple is very striking, since many plants which in some parts are bitter, in others are acid. We need not add any thing to what we have already said in the article Amara, q. v. except to observe, that some of these men- tioned are actively purgative, a quality which certainly does not belong to the pure bitter. The viscid taste is exemplified in the mallows, lint- seed, and almost all the pure gums, the cartilages and tendons of animals, particularly young animals. All these substances are demulcent and relaxant; conse- quently by sheathing abraded membranes, particu- larly, of the urinary system and bowels, they relieve pain, and often appear to check immoderate discharges. They sometimes appear, when taken in excess, to de- stroy the appetite; and we have suspected them, when swallowed in large quantities, of lessening the urinary discharge. The salt taste is most pure in the muriated soda and the common culinary salt, for all others appear to join different flavours with it. In the vegetable kingdom, Ave find it, though less pure, in the crithmum, the ha- limus and salicornia. In the shell fish and the fuci, the taste appears to be derived exclusively from the sea water. _ See Marinus sal. The watery taste chiefly arises from the excess of the aqueous fluid, diluting every peculiar flavour. The most striking instances are the oleracae, and some of the etiolated plants; and among the roots, the turnip. These substances are slightly nutritious, diluent, and demulcent. They were supposed to be of considerable and extensive use when diseases were attributed to lentor or viscidity of the fluids. The sensation of dryness in the mouth arises very generally from stypticity; but by a dry taste is gene- rally meant that which is produced for instance, by chalk. All the earths in a carbonated state are dry. The insipid woods and barks, the leaves of the ivy, and the dust of of the polypodium, are examples, in the ve- getable kingdom. In the animal, the hart's horn, the crab's claws, the mother of pearl, and coral, are distin- guished by a dry taste. These substances, hoAvever, unless capable of absorbing acids, are of little utility in medicine, but are by no means so injurious as have been supposed. In general, Ave may remark that tastes have a much more pointed and clear connection with the medicinal properties of bodies than smells, and will, in many in- stances, explain, a priori, their virtues. Yet tastes are so infinitely varied by nature, that their composition cannot often be ascertained; and though the expressive language of Bergius conveys ideas peculiarly discrimi- nated and exact, even this, in many instances, fails. A very important distinction of tastes relates to their fugacity or permanence, their immediate impression, or their perception after some interval, their affecting the tip, the middle or back part of the tongue, or the throat. On these subjects our chief assistance is from GreAV and Bergius ; but we have not been able to connect these different sensations with the properties of the bodies. In general, the stimulants are immediately per- ceived to increase the heat chiefly on the fore part of the tongue; the narcotics only act after some time, and on the throat. The impressions of salt substances are generally diffused; of styptics confined to the cheeks and anterior fauces. When the operations of chemistry attracted the at- tention of physicians, it Avas at once supposed that they Avould unravel every secret of nature, and among the rest, the constituent parts of medicines, so as to explain their operation. The members of the French academy laboured very earnestly in this department of .the ma- teria medica: Mr. Boyle and some others of the Eng- lish and German chemists were equally assiduous; but they soon found, that aliments and medicines, the most salutary foods and the rankest poisons, Avere equally re- solvable into acids, oils, and salts, scarcely differing in their properties. In fact, in resolving the compounds of nature, they formed new ones of art, and were not nearer the destined goal. Neumann and Cartheuser did not avholly forsake the former path, but they inter- rogated nature by milder methods, and extracting dif- ferent component parts by the peculiar affinities of water and alcohol, or by their volatility in a gentle heat, taught us what portions of gum, resin, and oil each vege- table contained. But even at a much later period, so rash Avas the analysis, and so powerful the means em- ployed, that we have only of late discovered what is iioav styled the extractive matter, or that portion of the gum and resin combined with the peculiar oil and mucilage of the plant, which renders it equivalent to the vegetable it- self, deprived only of its air, some portion probably of its water, and the woody fibres. When, therefore, in the ve- getable analysis, the proportion of gum and resin with that of the extractive matter is mentioned, the quantity of the two former, or rather of the resin, shows the de- gree of decomposition which in general has taken place; we say in general, for in many plants, particularly in M AT 925 M A T the roots, the resin exists in a separate state. Rhubarb is a striking instance of this kind. Analysis, conducted with care, leads us, however, to form some conjecture of the nature of the vegetable. The expressed juices of the green and watery plants (the oleraceae) are slightly laxative and cooling ; in the language of the Boerhaavians, aperient; of the, cruci- form plants (the tctradynamiae of Linnaeus,) antiscor- butic. Bitter extracts are tonic, often anthelmintic ; oils and mucilages demulcent; essential oils generally stimulant and carminative ; and resins either purgative or diuretic. Whatever opinion, however, be formed of the advantages of analysis in investigating the nature of plants, it has certainly assisted the pharmaceutical treatment of vegetable remedies, and, in the animal kingdom, has been of the greatest utility in showing the fallacy of many boasted remedies, from the identity of their nature, or their insolubility. Even musk and castor we find nearly approaching in their nature to re- sins, and the gluten of vegetables to animal substances. In the mineral kingdom, our obligations to chemistry are too numerous for repetition, and too obvious to de- tain us. We shall only remark, anfong these, the anti- dotes discovered to some of the most active poisons, and the advantages Ave derive from our power of pre- paring artificial mineral waters. The utility of natural history in investigating the properties of medicines is very considerable. To be able to acertain with certainty the identity of any plant is an object of no little importance, as it prevents our disappointment in future trials. Were it not for the assistance of natural history, the greater part of the ex- perience of the ancients Avould have been useless ; and were it not for the aid of Caspar Bauhine, we should wander through their works, like the first travellers in the American forests. All around would be un- knoAvn : Ave could neither appreciate their views, nor follow their examples; yet we have known commenta- tors on the ancient authors, who, supposing they meant some given medicine, were little anxious Avhat it might be. A deep knowledge of botany, however, is unneces- sary. We now know more than 50,000 species, and of these scarcely a hundred are employed in general practice; and of the latter, two-thirds, or even a greater proportion, are useless. Yet the principles of the science should be known, for the reasons just men- tioned ; and, above all, the foundation of the natural orders for the reasons and purposes already assigned. (See Botany.) -One great advantage is, that if a given plant cannot be procured, a similar one may be selected from its natural order; and the author of the little tract on botanical analogy has shown, in a variety of entertaining examples, how the same remedy has been extolled and forgotten; repeatedly, at different periods, and under different names, revived. Observation and experience are, on the whole, 'the safest guides; but here again we are lost in wilder- nesses or fogs. Numerous remedies, recommended as certain, are found to fail: what we have ourselves, at different times, considered to be firmly established as proofs of holy writ, at others Ave have found less sub- stantial than the shadow of a shade. In every step we feel the truth of the Hippocratic axiom " experientia fallax." If those whose education and experience con- tribute to point out the danger of deception, find thai the post hoc is not always equivalent to the propter hoc, how many sources of deception must surround those not accustomed to such observations ? Yet medicines are commended by men of the first character, rank, and abilities, as certain remedies; every newspaper teems Avith affidavits, and we are deemed incredulous indeed if we disbelieve a bishop or a judge. Medical evidence differs greatly from every other: we are obliged to act on the result of reasoning often extremely insufficient; our decisions on the effects of medicines, on the contrary, require the most rigorous examination. If a man as- serts, for instance, that he has been cured of a consump- tion by Godbold's syrup^it implies several positions ex- tremely doubtful. Hoav can he ascertain that the disease Avas a consumption? for in this respect the most judi- cious practitioner is often deceived. But, admitting that it is so, Ave knoAv that vomicae are often com- pletely discharged: Ave knoAV that an ulcer sponta- neously heals, and it is as probable that diet and regi- men may have effected the cure, as a medicine equally inconsiderable in its powers. If then Ave cannot trust to experience, Avhat must be our resource? Though nothing may be certain in the operation of medicines, and our evidence only establish different degrees of pro- bability, yet a rigorous scrutiny in the investigation of every fact respecting this part of the science will greatly facilitate our progress in similar circumstances. Authors on the materia medica abound with assertions respect- ing the properties and use of every medicine, and the most inert is often represented in colours too glaring for even the most active. This partly arises from the Avant of discrimination just mentioned, but more often from an anxiety to display the extent of their OAvn learning; and such are the accumulated recommendations Avhich the student finds, that he thinks his only labour a selection. So frequent are his disappointments, that he at last mis- trusts even the most respectable authorities. Who will cleanse this Augaean stable ? It will require an Hercu- lean hand ; and the little that can be done in a general work like this can scarcely lessen the labour. Wc shall not, however, mispend our time, if we examine shortly the conduct of the best authors on this subject. In this enumeration Ave should have omitted the sys- tems of the astrologers and the signaturists,but that the fancies of the latter still remain. "The former Ave may safely neglect, though not Avholly forgotten by the em- pirical old Avomen of the country, Avho still prefer col- lecting plants at the full or neAV moon. The signaturist prefers plants which resemble the part diseased ; and euphrasia is still used for complaints of the eyes, though its original claim to notice arose from a black spot in its corolla resembling the pupil ; and the pulmonaria is employed in diseases of the lungs, because its form, its texture, and its spotted areolae, afford a distant resem- blance to these organs. Crollius is" the great authority of this sect: but to return to more rational authors. The earliest therapeutical authors were the natural historians ; for to their descriptions of plants were usually added their medical virtues. The herbals, as they may be called, from the time of Theophrastus and Dioscorides to Gerarde, 8cc. are full of extravagant commendations of the most inert vegetables. The latter authors were indeed compilers only; and, if they added 6 B 2 M A T 924 MA T to the bulk of their volumes, were little anxious about their value. They are, in general, careful to tell us in Avhat degree a medicine is hot or cold, to what te t- perament it is best adapted : but to distinguish the dis- eases, or the periods of any disease in which a given plant Avould be most salutary, was often beyond their powers. When botany assumed a more scientific aspect, and distinction as Avell as description Avas its object, our knowledge of the materia medica Avas greatly assisted. The herbalists had accumulated their commendations with little discrimination ; but in the materia medica of Linnaeus we find more accuracy. He first published that of the vegetable kingdom, and aftenvards in the Amoenitates Academicae those of the animal and mi- neral. In each he followed his own system. These treatises were republished by Schreber at Vienna, in 1773, with additions from the Amoenitates and the later works of the northern naturalist. In this volume wc are told whether a medicine is common, rare, or useless; and, in enumerating the qualities, which are those of the greatest importance, the author points out often, by dis- tinguishing marks, how far the boasted powers may be depended on. Tessari, in his republications of Linnaeus's system at Venice under the title of Materia Medica Con- tracta, has carried this plan farther; and in a MS. Avhich was some years since intended for publication, it is still farther extended and more complete. Bergius, an author of the Linnaean school, has described plants according to his master's system, and, in the most precise and point- ed language, conveys very accurate ideas of the sensible qualities of every vegetable remedy. Of the qualities he only mentions the most important; and the practical observations, almost exclusively his OAvn, are few, though important. He apoligizes for not copying for- mer authors by observing, " that those Avho have ex- amined them will soon discover that so many fictions are interspersed Avith what is true, that they cannot be easily separated. Many Avriters on the materia medica, he adds, " have injured this science by trifling fictions and conjectures; by inventing qualities dictated by their prejudices, which they have obtruded on nature. Some have compiled from former authors, inserting their own opinions and their own observations. Many, with too much credulity, have adopted and transcribed the assertions of their predecessors, though of doubtful au- thority and sometimes ridiculous; so that, in more re- cent authors, Ave find the old remnants repeatedly hashed ; blunders again and again copied." We add the Avords of Bergius partly as an apology for ourselves, since from the pages of Motherby we have been obliged to expunge qualities of medicines far more numer- ous than those which the experience of others, or our own, has justified us in retaining. The pharmaceutical and miscellaneous remarks of Bergius are highly valua- ble ; and we regret that the animal and mineral king- dom had not equally shared his attention. Haller, in his description of the plants of Switzer- land, has followed, in the arrangement, his OAvn botani- cal system. As usual, he has annexed to each plant its medical virtues ; and this portion of the work has been republished by Vicat in tAvo small volumes. Haller sel- dom indeed speaks from himself; for he was not a practical physician, and his compilation is not very dis- criminated. The best part of his work relates to the domestic medicine of the Sav'iss mountaineers. Dr Woodville's Medical Botany is of this class ; but in his three volumes he only considers the vegetables in- cluded in the lists of the London and Edinburgh col- leges: In the fourth, some of the plants used in me- dicine, not included in these catalogues, are figured and described. The substance of this Avork is chiefly- taken from the materia medica of Lewis and Cullen; but the plates, which are indeed elegant and accurate, are equally beautiful, and far more numerous in the large and expensive folio of Plenck. Ray, in his history of plants, adds their medical virtues; but Ray,like Haller, Avas no practitioner; and the greatest abilities, the soundest judgment, will not teach that nice medical discrimination, Avithout Avhich compilations are useless. Yet Ray's collections are so extensive, that he merits all the attention, Avhich is not inconsiderable, that he has received. Some other authors have treated of the ma- teria medica as general botanists. The pharmacologia of our OAvn Dale is obsolete, yet it displays judgment and discrimination; for he has avoided the common error of his predecessors, that of collecting every idle obser- vation from the works of his predecessors. Simon Paulli's Quadripartitum, Botanicum, connected, hoAv- ever, but slightly with the botanists, is deservedly ne- glected ; and Zorn's Botanologia Medica, in the Ger- man language, scarcely merits more attention. It is not from forgetfulness that we have omitted no- ticing Murray's Apparatus Medicaminum, in six vo- lumes of unequal bulk. We have separated this Avork from the rest, because it affords the first example of ar- ranging vegetable medicines from their natural orders. We have already spoken of his merit in this respect; and mustnoAv add, that he has collected with great care what the best practitioners who preceded him had taught, and has probably left little for his successors but the labour of discrimination. This part of the task he has greatly neglected; and his work is,on this account, by far less valuable than it might have been. His col- lection, hoAvever, is by no means like that of Vogel, indiscriminate. Gmelin has published the materia medica of the mineral kingdom as a Supplement to Murray's Apparatus, but with still less discrimination, and with very feAv marks of a correct judgment. Many authors on this subject have folloAved a more arbitrary arrangement, though in part botanical. Thus, Simon Paulli has divided his plants as they flourish in either of the four seasons; Vogel, according as the leaves, bark, wood, or roots are employed, again subdi- vided as frequently or seldom employed, or as obsolete, arranging them afterwards alphabetically. The subject is thus broken into so many detached parts, that from the laboured order the greatest confusion arises. Vogel is also a most laborious collector, with little discrimi- nation ; and though a judicious practitioner, seems in this work to have forgotten himself, and to have become a compiler only. It is, however, a manual little inferior in extent of compilation, though of comparatively little bulk, to that of Murray. Another collector who fol- lows, in part, a botanical arrangement, but who does not display a superior discrimination, is Dr. Alston. His chief value arises from his copious compilations from the Greek and Roman authors; but his materials are so inartificially and unpleasingly compacted, that we suspect that he has been seldom read. M A T 925 M A T Herman, in his cynosura of the materia medica, has united the botanical and chemical authors. He arranges his vegetable remedies from the parts employed, and subdivides them according to their chemical analysis. His work is little known in this country, and as a com- pilation from almost forgotten German authors deserv- edly neglected. Geoffroy, who follows a botanical ar- rangement, has been also peculiarly attentive to chemi- cal analysis; and his Materia Medica is equalled by few works on the subject in extent of information or judi- cious discrimination. It is unfortunately little known, though meriting from the student minute attention ; and there are feAv veterans in practice who might not consult it Avith advantage. The Supplement, contain- ing the account of animals by Nobleville and his coad- jutors, is of very inferior merit. Neumann, in his che- mical works, gives us some very judicious and minute analysis of vegetable remedies; but the system of ma- teria medica which rests chiefly as the foundation of its arrangement on the chemical contents of medicines, is that of Cartheuser, which, on this account, merits particular regard, and is, in some other views, a valua- ble and judicious Avork. If these systems are arbitrary in their arrangement, and, with the exception of the apparatus medicaminum giving little assistance to the student, and scarcely illustrating the use of any medicine, by the observations that may have been offered on the preceding or fol- lowing article, still less advantageous must be the alpha- betical order which Lewis has followed in a most ad- mirable work, and Dr. Rutty, in a very inferior one, on the materia medica; an arrangement, if it can be styled one, which Vogel, Geoffroy, and Herman, have in a great degree adopted. The therapeutical Avriters on the materia medica have followed a very different path. Considering medicines as producing certain specific changes in the body, those Avhich produce given changes are arranged under the different and appropriate heads. We thus find not only the principles on which they act, but are able, with very little inconvenience, to compare in given circumstances the advantages and disadvantages of each, or when disappointed in the effects of one, to supply its place with another. In this Avay also the individuals of each class form one separate distinct subject, scarcely, if at all, broken by & consideration of the different qualities of each. In the arbitrary alphabetical arrangement, which, from the nature of this work we are compelled to adopt, we can scarcely avail ourselves of the advantages just stated. We have endeavoured, hoAvever, to combine this plan by enlarging the therapeutical articles, and interweav- ing, in these, the foundation of our choice of individu- als, in different circumstances. It will be obvious, that inpursuing a plan of this kind, authors must differ according to their different objects. Thus Spielman, who connects the chemical and the- rapeutical sects, scarcely employs indications but as the titles of his chapters; while Dr. Cullen, diffuse on the therapeia, is short and often unsatisfactory in the history pf many individuals. In short, this latter work, though vast, bold and comprehensive in its design, is, however, as it has been styled by an able critic, rather the philoso- phy of the materia medica than a detail of the nature and properties of medicines. Crantz' Avorkis short and unsatisfactory in a therapeutical vieAV, though judicious and able in the remarks on different medicines; while Junker, and De Gorter, offer little but a catalogue of medicines arranged according to indications. The latter, though published as that of David, Avas really the Avork of his father, John De Gorter, one of the most judiciouc and intelligent commentators on the aphorisms of Hip- pocrates. The choice of the plans of teaching the ma- teria medica must lie between the arrangement of me- dicines according to their natural orders, or according to their therapeutical qualities." The botanical affinities in the Linnaean orders are not, hoAvever, so strictly me- dical as to render this plan very eligible, and though the arrangement is improved by Murray, it is far from being sufficiently accurate for this purpose. The natu- ral orders of Jussieu, as more numerous, are more natu- ral in a botanical view, but are consequently less usefully therapeutical. The therapeutical plan is, therefore, un- doubtedly preferable, and, Avith it, the former may be more intimately united than by Dr. Cullen, for he has not in- troduced all the natural orders of Linnaeus, though he has grouped some vegetables, in orders strictly natural, not found in the fragments. The orders are not so numerous as to require what Linnaeus calls a method, or a clavis, to connect them ; yet their arrangement is by no means to be neglected, as the therapeutical obser- vations necessary to introduce each are intimately con- nected. Dr. LeAvis has proposed ah arrangement of the materia medica into eleven natural orders, Avhich are not formed exclusively from the properties or the effects. These are acids, absorbent earths, insoluble earths, glutens, oils, astringents, sweets, acrids, aromatics, bitters, and emetics, including cathartics. These orders certainly afford no eligible system of arrangement. Some minuter groups retained in the foreign pharma- copoeia, as the four cold seeds, &c. Ave shall notice under Pharmacia. In Dr. Cullen's system the materia medica is divided into nutrients and medicines: nutrients are food and drink, Avith which condiments are joined. Medicines either act I. on the solids, or II. fluids. The first act either on the simple or the vital solid. Medicines which act on the simple solid are astringen- tia, tonka, emollientia, and erodentia. Those which act on the vital solid are stimulantia, sedativa, including narcotica, refrigerantia, and antispasmodica. Those which act on the fluids are such as either pro- duce a change, or occasion some evacuation. The changes respect the fluidity, comprising attenuantia and inspissantia, or the mixture : when they correct general acrimony, they are styled demulcentia; when particular acrimony, antacida, antalkalina, and antiseptica. The medicines which occasion evacuations are errhina, siala- goga, expectorantia, emetica, cathartica, diuretica, dia- phoretica, and menagoga. In this arrangement Dr. Cullen has forsaken his own system of pathology, since the fluids, in his opinion, are not affected, without previously influencing the moving poAvers. Some other critical remarks might be added, Avere this the place for such disquisitions. To connect this part of the work with what has preceded, and will follow, we shall add what appears to us a more convenient arrangement, and subjoin a list of the ma- teria medica adapted to it, adding the pharmaceutical or Linnaean names, while the more particular refer- ences may be found under each article. M A T 926 MAT It has been usual in these circumstances, Avith Spiel- man and Cullen, to premise the nutrientia; but as this would only extend the clavis, and we have already treated of it at some length under Aliment, q. v. wc shall now omit this class, Avhich consists only of food, drink, and condiments. Medicamenta agunt. I. In Solida viva. x. 1. Motum augent. in ventriculo. Emetica. Intestinis. Cathartica. Vasis extremis. DlAPHORETICA. Renibus. DlURETICA. Bronchiorum glandulis. Expectorantia . Narium glandulis. Errhina. Salivae glandulis. SciALAGOGA. Uteri vasis. 90 Emenagoga. Toto corpore. Stimulantia. Cardiaca. Analeptica. Attrahentia. Discutientia. 2. Motum imminuunt. x Refrigerantia. Resolventia. p Antispasmodica. 3.Tonum imminuunt. Sedantia. Anodyna.* Inirritantia. 4. Tonum augent. Tonica. II. In Fluida. 1. Crasin immutantia. x Attenuantia. |3 Inspissantia. y Alterantia. 2. Acredinem corrigentia, x Demulcentia. /3 Antacida. y Antalkalina. ^Antiseptica. III. In Solida simplicia. x Emollientia. Relaxantia. 0 Erodentia. y ASTRINGENTIA. IV. In Corpora aliena. 1. Venena. Alexiteria. Antidota. 2. Calculum. Lithontriptic a . 3. Vermes. Anthelmintica. The classes of the materia medica are not so numer- ous as to require what is usually styled a methodus; and, if any thing were sacrificed to the parade of system by this means, it Avould be improperly adopted. What- ever may be its merits, it has no disadvantages, for the arrangement is exactly such as if the orders were na- tural and independent; and the clavis limits the inten» tion of the group with peculiar accuracy. The evacu- ants most nearly related follow each other ; and as no evacuation can take place without the excitement of the vessels as muscular organs, so in the following class, stimulantia, Avhere the nervous system is more generally affected, a general action of the vessels of the Avhole system usually accompanies. Of the syno- nyms of Stimulantia the two first, should such medicines exist, act more peculiarly on the nervous system : the two last are topical remedies. The distinction betAveen general and topical medicines usually admitted is, at best, useless, if not injurious; for the most active in- ternal medicines, are often powerful topics. The next division is also connected with some action on the sanguiferous system, which disappears in the second class, the antispasmodics. Resolvents are truly refrigerants, for discutients occur in a subsequent part. The medicines which increase tone are included under tonica, and the astringents are referred to those medi- cines which act on the simple solid. Some certainly act on both, and astringents, as already explained, (see Astringentia,) sometimes appear to be tonics. The medicines which diminish tone, diminish also sensi- bility and excitability; and we have added as synonyms anodyna and inirritantia; those which possess an op- posite quality are commonly associated in idea Avith stimulants. We have admitted, with limitation and reluctance, any action of medicines on the fluids, adopting the ax- iom of the nervous pathologists, that the constitution forms its own fluids. Yet some complaisance is due to many excellent physicians of the Boerhaavian school, and it is at least necessary to point out the medicines which have been employed with these views. The third of the classes of the first division, the alterantia, is vague; yet the action of remedies in scurvy, in what are styled scorbutic eruptions, in lepra, and some other cases, must be collected into one group, and it is not easy to find a more proper place. In the second division Ave clearly perceive the action of demulcents on the throat, the stomach and alimentary canal, the urinary organs, and perhaps the bronchial glands. The antacids and antalkalines are at least useful in the stomach, and some medicines undoubtedly act, chemically, as anti- septics. The medicines which act on the simple solids afford few subjects of remark. If relaxants are any thing more than emollients, they bear the same reference to the sedantia that the astringents do to the tonics; at least they seem to act through the medium of the simple solid. For these and the other reasons assigned, the astringents are referred to this place. The last general division contain classes independent in their operation on each other. Lithontriptics may be only antacids, M A T 927 M A T but they are said, Avith confidence, to dissolve the calcu- lus. Anthelmintics may be only drastic purgatives, but some at least kill Avorms. The observations on the subdivisions of the catalogue must be deferred till that is concluded. It is a common objection to any arrangement, that some medicines possess very different powers, and that their proper places are not easily ascertained. Instances of this kind occur in mercury and steel. Repetition, hoAvever, is unavoidable; and those who seek for the medicine appropriated to any disease in such catalogues, must find them in each list. The more general author on the materia medica, will treat of them under that head where their powers are most conspicuous; and the medicine will again recur, where, from its prepara- tion, or exhibition, peculiar properties are discovered in it. The catalogue, which we shall add, will differ from former ones by the subdivision into groups, which may be styled orders, an attempt first made by Dr. Duncan in his Therapeutics. The plan we have followed is adapted to the therapeutical ideas offered under the dif- ferent articles; and Ave consider this mode of arrange- ment as peculiarly useful at least to the student, since it offers at almost one vieAV a more distinct idea of the poAvers and properties of each medicine than is obtained in the best systems. The catalogue itself can possess no other very peculiar advantages; yet we cannot con- clude this part of the subject Avithout acknowledging our obligation? to the very- excellent syllabus of Dr. George Pearson, Avho lectures on the materia medica with dis- tinguished, and if we can judge from this little work, with the most merited reputation. In our general observations on the materia medica, we mentioned the plan of some authors, and particu- larly of Tessari, of distinguishing the degree of power by slight marks at the end. This idea we have occa- sionally pursued ; and while Ave have folloAved, Avithout any very nice discrimination, the conduct of our pre- decessors in the medicines inserted under each class, Avhen their powers are considerable we have added a note of admiration (!); when dangerous two (!!); when trifling, a semicolon (;); when doubtful, a note of interrogation (?); when the medicine has been in- troduced by fancy, folly, superstition or prejudice, a co- lon (:). These marks are only added to a few, and for the Linnaean appellations and synonyms the reader is referred to the separate articles. I. Emetica. x. Nauseosa. Scillae radix 1 Antimonii praeparationes, refracta dosi. Digitalis purpurea, folia ! Nicotiana! Nux vomica! Colchicum autumnale. /3. Evacuantia. Emetica JVauseosa, auctd dosi. Asarum. Raphanus rusticanus, radix. Sinapi nigrum et album, semen. Bryonia alba. Gratiola officinalis. Veratrum album. Ipecacuanha. ----------- alba; Cathartica drastica. Amara calida dicta. Carduus benedictus. semen. Chamomaelum. flores. Absynthium. folia. Genista, summitates. semen. Zincum vitriolatum et ustum! Cuprum vitriolatum! Platinae praeparationes ? Ammonia; Aqua distillata flammulae Jovis! ------------ranunculi! ---------------------linguae! Emetica epigastrio infricata; Aqua calida, praesertim ope. CATALOGUE. Salis marini, Olei communis. Pulv. sem. sinapeos, Hepatis. Sulphuris, vel putridorum. Motus vertiginosus, vel inusitatus. Associatio. y. Irritantia. Erigerum succus! Hydrargyrus vitriolatus!! Vitrum antimonii! Arsenicum!! II. Cathartica. x. Lenitiva. Sales terrei et neutri. Alum? Selenita? Aquae minerales salinae; Fructus acido dulces; Cerevisia; Vinum; Lac acidulatum; Sapo. Cassia fistularis fructus. Manna. Saccharum impurum; Mel; Fructus siccati; Oleum olivae. ------ricini. Thalictrum. Infusum coffeae; ? Emetica nauseosa. ——— evacuantia-. Balsamum copaibae; Gum asafoetida; Sagapenum; Opoponax; Myrrha; Galbanum; Rosa damascena. folia; Bilis? Infusa aquea animalia vel vege*-v tabilia copiose hausta. Enemata aquosa. Cathartica acria abdomini infricata? Aqua frigida in femora et ventrem cum impetu adacta. /3. Purgativa. Sena, folia. Jalapium. radix! Mechoacanna. radix. Rheum, radix. Aloes succotrini succus inspissatus, Polypodium. radix. Myrobolans fructus. Pulvis antimonialis. Calomelas! Rhamnus catharticus. baccae. Senega, radix! Nitras et phosphas argenti? Peragua. folia. y. Drastica. Gutta gamba. gum. Scammonium gummi resinae. Elaterium! Colocynthis fructus medulla. Convolvulus brasiliensis. MAT 928 M A T Convolvulus soldanella! ---------- turpethum! Gratiola. folia. Alnus nigra! Linum catharticum. folia. Helleborus niger et albus. radix. Genista, semen! Arthanita! Cucumis asininus fructus! Sambucus niger. cortex. Sambucus ebulus cortex interior. Iris nostras succus! Cheledonium radix. Agaricus muscarius. Boletus larycinus. Anagyris fcetida. Croton tiglium! Carthamus tinctorius. semen, flores Buxus. folia. Bryonia alba et dioica! Euphorbiae species omnes! Lycopodium selago. Mercurialis annua. fo Narcotica. Nicotiana. folia! Digitalis purpurea, folia. Lactuca sylvestris. Drastica odoris tetriet saporis amari? III. Diaphoretica. «. Diapnoica. Argenti vivi praeparationes variae. Guaiacum lignum. Sarsaparilla. radix. China, radix. Ulmus. cortex interior. Mezereon. radix. Gestatio. Navigatio. Libratio. Frictio. Aer frigidior. Potiones frigidae. --------acidulae. Applicationes frigidae. Lavatio frigida. /3. Relaxantia. Antimonii praeparationes variae. Ipecacuanha. Scilla. Opium. Acetum Calor mediocris. Solidorum. Balnei. Semicupii. Pediluvii. Fotus. Aeris. Serum lactis. Ex aceto. y. Stimulantia. Calor eximius. Contrayerva. Serpentaria. Infusa calida. Menthae. Macis. Melissae. Calendulas. Salviae. Caryophyllorum. Scordii. Sassafrae. Cinnamomi. Pimento. Zinziberis. Marjoranae. Sinapeos sem. Thymi. Coriandri sem. Serpentariae. Carui sem. Alcohol. Vinum. Cerevisia. Ammonia. IV. Diuretica. a. Diluentia. Aqua. Diaphoretica relaxantia. Acidulae. Fructus acido dulces. Oleraceae. 0. Stimulantia. 1. Salina. Alkali fixum. purum. carbonatum. supercarbonatum. Strontiae solutio ? Magnesia ?; Barytes ? Sales alkalini neutri Acida vegetabilia. Fructus acido dulces. 2. Acria. Alliacea. Scilla. Herbae siliquosae et siliculosse. Juniperi baccae. Apium graveolens. ------petroselinum. Scandex chaerifolium. Daucus sylvestris. semen. Faeniculum. semen. - Stellatae ? Asparagus. Turiones. . Bardana? Arum, radix? Eryngium maritimum ? radix. Persicaria urens herba ? Seneka. radix. y. JVarcotica. Arnica? Dulcamara ? Nicotiana. foliorum ustorum lixi- vium. Lactuca virosa; Digitalis! Genista, summitates. Alkekengi. V. ExPECTORANTIA. u. Demulcentia. Saccharum. Mel. Extract, malvae (pate de guimauve). -------- hordei vegetantis (malt). Amylum. Liquoritia. Succi inspissati fructuum dulcium. Caricae. Uvae passae. Gluten farinae (bran). Gelatina. Icthyocolla. Conserva cynosbatum. Gummi arabicum. ------ tragacanth ae. ------ cerasorum. Lini semen. Mucilago seminis cydonii. Sapo. Expectorantia demulcentia. Oleum expressum olivae. ----------------amygdylarum. ■---------------seminipapaveris. ■ cacao. Tussilago. Petasites. /3. Refrigerantia. Succi spissati ribis nigri et rubri. Conserva lujulae. Pruna gallica et sylvestria. Fructus acido dulces. Limonum succus. Nitrum. Acetum. Vapor aceti cum aqua calida. y. Relaxantia. Aquae vapor. Emetica nauseosa. Ipecacuanha. Opium. Digitalis. Nicotiana ? Hydrogenium. gas? Seneka. radix. fo. Stimulantia- Balsama, q. v. Benzoinum ? MAT 929 MAT Gum ammoniacum! ----myrrhae. ----asa fcetida. -----resin ae foetidae alias ; Umbellatarum semina. Angelica, radix; Hedera terrestris; Hyssopus herba. Marrubium album. Agrimonia? Pulegium. Iris florentina. Enula campana. Siliquosae. Alliaceae ! Scilla ! Colchicum autumnale. Aquae vapor imbutus. Herbis aromaticis. Oleis essentialibus. Alcohole. Oleo vini. .flLther'e. Acido nitroso. Aer aethere, &c. imbutus. Ammonia. Oxygen ? VI. Errhina. x. Mitiora. Primula veris. Iris, radix. Lavendula. flores. Beta, radix, succus. Betonica. folia. Marjorana. Hippocastanum. fructus. Rosmarinus, summitates flores. /3. Acriora. Asarum. Euphorbium. Nicotiana. Helleborus albus. Ptarmica. folia, flores. Iris nostras, radix. Pyrethrum. Marum syriacum. Hydrargyrus vitriolatus. VII. Sialagoga. «. Secretoria. Hydrargyri praeparationos, Acidum nitricum ? /3. Excretoria. Nicotiana. Pyretrum. Piper. Caryophyllus. Angelica. Imperatoria. Stavisagria. semen Zinziber. VOL. I. Mezereum. Mastich e; ? VIII. Emmenagoga. «. Stimulantia. .Oxygenii gas. Exercitatio. Gestatio. Frictio. Electricitas. Alcohol ? Dapes lautae. Calor aeris vaporis vel aquae. Ferrum. Oleum animate. Balsamum peruvianum. Petroleum. Emetica. Hyssopus. Guaiacum. Ammonia. Argentum vivum. Bathonienses aquae. Pathemata excitantia. /3. Irritantia. Cathartica purgantia. Oblectamenta venerea. Rubefacientia. Cantharides. Terebinthina. Rubia. radix ?; Helleborus niger. Electricitatis impetus per pelvim. Cucurbitulae non cruentae. y. Antispasmodica. Camphor. Sabina. Moschus. Castor. Gummi resinae foetidae. Ambragrisea ? .Ether. Pediluvia. Semicupium. 2- Tonica. Cortex peruvianus ? Amara calida. Lavatio frigida. Gestatio. Hilaritas. Tranquilitas. Metalla excepto plumbo. Aquae ferrugineae minerales. IX. Stimulantia. *. Diffusibilia. Calor aeris, aquae, vaporis & solido rum calefactorum. Oxygenii gas respiratum. Valens materia alimentaria ex ani- malibus. Exercitatio. Pathemata excitantia. Acria cuti applicata. Frictio. Ammonia. Hydrargyri praeparationes Aromatica. Caryophylli. Cinnamomum. Balsamita. Ginseng. Melissa. Nardus celtica & indica Macis. Capsicum annuum. Myristica nux. Canella alba. Piper cayennensis. Pimento. Piper album & nigrum. Capsicum. Zinziber. Cubebae. Cortex winteranus. Cardamomum minus. Cassia lignea. Grana paradisi. Aurantium & limon. cortices. Aromaticorum olea essentialia. Bahama. Peruvianum. Gileadense. Copaibae. Canadense. Terebinthinae. • Gum resina styracis. ———^— euphorbii. ---------- benzoe; ----------myrrhae; Scordium. folia. Radices. Galangae. Zedoariae. Calami aromatici. Serpentariae. Ari. Sarsaparillae. Chinae. Contrayervae. Pulsatillas nigricantis. Verticillatae. folia 8c flores. Melissa. Calamintha. Lavendula. Dictamnus creticus. Origanum. Marjorana. Rosmarinus. Marum syriacum. Chamaedrys. Betonica. Mentha sativa & piperitis. Menthastrum. Mentha gentilis Lin. Nepeta. Pulegium. 6 C MAT 930 M A T Hedera terrestris. Hyssopus. Thymus. Serpillum. - Salvia. Satureia. Verticillatarum. olea essentialia. Umbellatae. semina. Anethum. Anisum. Angelica. Xarui. Coriandron. Cuminum. Foeniculum. Pimpinella. Ligusticum. Imperatoria. Seseli montanum. Daucus sylvestris 8c creticus. Umbellatarum gum resin foetidae. Asafoetida; Galbanum; Opoponax; Siliquosae. Sinapi semen. Raphanus rusticanus. radix. Cochlearia hortensis. folia. Alliaria. Lepidium. Eruca. semina. Napus dulcis. semina. . Erysimum. Thlaspi. semen. Nasturtium aquaticum. Cardamine. flores. Alliacea—Spathaceae. Allium. Cepa. Porrum. Coniferae. succi spissati. Terebinthina vulgaris 8c veneta. Thus. Olibanum gum resina Juniperus baccae. Euphorbias. Esula. Lathyrus. Cataputia. Peplus. Tithymalus. Mezereum. Flammula Jo vis. Sedum acre. Ladanum. Liquid ambar. Gum elemi. /J. Topic a. Natron. Sal marinus. Cantharides! Pix Burgundica. Sabina. folia. Anacardium orientale 8c occidentale Moxae urentis flamma. Ranunculus folia, radix. Daphne laureola. Iris palustris. succus. ----radix. Stavisagriae. semen. Persicaria urens. Urtica. folia. Cevadilla. Toxicodendron. Arthanita. radicis succus. Liliaceae. Siliquosae. Kali purum. Ammonia pura. Calx viva. Acida mineralia. Sales metallici. Butyrum antimonii 1 /Era go .Eris ! Cuprum vitriolatum! Hydrargyrus muriatus. Argentum nitratum! Oxyda. Cupri. Hydrargyri. Arsenici! Verberatio. Urticatio. y. Indirecta. , Vinum. Cerevisia. Alcohol! Olea empyreumatica ! JEther ! Oleum alcohol vini. ------dulce gas olefiantis. Papaveris succi. Lollium temulentum. Cocculus indicus. Kaad arboris arabici summitates. Haschich. folia arboris arabici. Hyoscyamus physalodes. Peganum harmala. Agaricus muscarius. Rosmarinus sylvestris. •Vchillaea millefolium. X. Refrigerantia. Sales neutri. -v terrei; ? Acida vegetabilia nativa. ---- fermentatione orta. Fructus acido dulces. Acetosa. Acetosella. Cathartica lenitiva. Emetica nauseosa. Frigus. Materia alimentaria imbecilla. Sanguinis missio. Arteriarum sectione. Venarum sectione. Hirudinum vulneribus. Cucurbitulis cruentis. Aquae frigidae potus. Plumbi praeparationes. Stimulorum abstractio 8c evitatio. XI. Antispasmodica. x. Fetida. Fossilia. Ambragrisea. Suceinum. Petroleum. Bismuthum. Vegetabilia. Ruta. Sabina. Aristolochia; Artemisia; Atriplex olida. Cardiaca. Matricaria. Gummi. Asafoetida. Galbanum- Opoponax. Tacamahac. Camphor. Paeonia. radix. Valeriana, radix. Fuligo ligni. Animalium humores. Castor. Moschus. Zibethum. /3^ Sedantia, q. v. y. "Stimulantia, q. v. fo Emollientia, q. v. e. Demulcentia, q. v. £. Tonica fossilia, q. v. XII. Tonica. x. Amara calida. Cincona. cortex, rubra 8c flava. Angustura. cortex. Swietenia. cortex. Eleutheria. cortex. Aurantium. cortex. Canella alba. Quassia amara. Picrania amara. lignum. Wright. Rhodium lignum. Arnica. Columba. radix. Kursuta. radix. Angelica, radix. Galanga. Zedoaria. Iris. Curcuma. Serpentaria virginiana. Calamus aromaticus. Aristolochia tenuis. Aureliana canadensis. Centaurium minus. Aloes. M A T 931 MAT /3. Amara narcotica. Faba St. Ignatii. Amygdala amara. Lupulus flores. Chamomaelum. flores. Helleborus niger. radix. Hippocastanum fructus. Absynthium Romanum 8c mariti mum ? Santonicum. semen. Abrotanum folia ? Carduus benedictus. semen. Genista, cacumen. Hypericum flos. Tanacetum flos 8c herba. Trifolium paludosum. Marubium herba. Myrrha. y. Fossilia. Alumen. Acida mineralia. Antacida, q. v. Metalla. Ferrum. Zincum. Stannum. Argentum. Arsenicum. Cuprum. Bismuthum. fo Astringentia. Quercus. cortex. Gallae. Fraxinus. cortex. Lignum campechense. Terra Japonica. Gum kino. Sanguis draconis ? Acacia succus. Uva ursi. Viscus quercinus. Myrtus. Plantago. Millefolium. Balaustia. Senticosae. Rosa rubra petala. Tormentilla. radix. Agrimonia. Stellatae. Rubia. radix ? Aparinae ; Galium ; Vaginales oleraceae. Rhaponticum. Bistorta. Rhabarbarum. Hydrolapathum 8c oxylapathum. Rhabarbarum monachorum. Cryptogamia. Felix florida. Trichomanes. Equisetum. Muscus pyxidatus. Fructus. Cydonia. Pruna sylvestria. Sorba. XIII. Sedantia. x. Refrigerantia, q. v. j3. JVarcotica. Solanaceae. Digitalis. Belladonna. Dulcamara. Solanum. Mandragora. Hyoscyamus. Nicotiana. Stramonium. Umbellatae. Conium. Cicuta. Foeniculum aquaticum. GLnanthe crocata. Opium. Passiflora rubra. Aconitum. Flammula Jovis. Lactuca ; ------ virosa ! Taraxacum. Laurocerasus. Laurus. Colchicum ? Nymph aea. Rhododendron. Liquor anodynus Hoffmani. .Ether. Stimulantia indirecta. Antispasmodica fetida. Coffeae baccae empyreumaticae■ Thea. Astringentia? XIV. Attenuantia. x. Diluentia. Aqua. Aquae minerales. /3. Solventia. Alkali. Sales neutri. Sapones. Dulcia ? Diaeta insalubris. XV. Inspissantia. Acida mineralia ? Alcohol ? Astringentia ? Evacuantia HI IV ? Demulcentia. Tonica. ^Siliquosae. XVI. Alterantia. Diaphoretica Diapnoica. Diaeta. XVII. Demulcentia. a. Mucilaginosa. Asperifolie. Consolida major. Cynoglossum. Pulmonaria. Semina. Cucurbitae. Citrulli. Cucumeris. Melonis. Papaveris. Gummi. Icthyocolla. Amylum. Emollientia. /3. Dulcia. Mel. Uvae passae. Ficus. Cynosbatus. Glycirrhiza. XVIII. Antacida. x. Astringentia. Creta. Osteocolla; ? Cancrorum chelae 8c oculi; Cornu cervi ustum ? Corallium rubrum; Ovorum testae. Ostreorum testae. Margaritae : Materia alimentaria valens. /3. Laxantia. Alkali fixum 8c volatile; Sapo. Tonica amara calida. fo Demulcentia. Icthyocolla. Amylum. Gummi. XIX. Antalkalina. Acida vegetabilia. -----mineralia. Acetosa. Acetosella. Fructus acido dulces. Vinum. Diaeta imbecilla. Tonica astringentia. XX. Antiseptica. Acida vegetabilia 8c mineralia. 6 C 2 MAT 932 M A T Diaeta ex vegetabilibus. Fructus acido dulces. Siliquosae herbae 8c radices. Semiflosculosae herbae. Umbellatae; ? Alliaceae. Legumina. Brassica fermentatione acida. Byne. Vinum. Alcohol. Tonica amara calida isf astringentia. Opium ; ? Olea essentialia. ■ empyreumatica ? XXI. Emollientia. x. Oleosa. Oleum olivae. .------seminis papaveris. Spermaceti (adipocere). Cremor 8c butyrum lactis. Palmae oleosae. Cocos butyracea. Butyrum. Axungia 8c sevum animalium. Sapo. Cera. /3. Farino-mucilaginosa, Farina lini. ------cannabis. ------cydoniorum. ------foenugraeci. ------psilli. Amylum. Malva. Althaea. Branca ursina. Melilotus. Saponaria. Liliorum alborum radices. Cepae. Gummi arabicum. -------tragacanthae, 8cc. y. Aquosa. Aqua 8c vapores aquosae. Atriplex. Beta. Bonus Henricus. Spinacea. XXII. Erodentia. x. Azoetica. Sabina. Euphorbia. Gallae. Saccharum ustum. Cevadilla. Ranunculus, folia 8c radix. Tithymelea. Daphne laureola 8c mezereum. Persicaria urens. Flammula Jovis. Toxicodendron. Arum. Arthanita. Cantharides. /3. Solventia. Argentum nitratum. Antimonium muriatum. Cuprum vitriolatum. Hydrargyrus muriatus. Calomelas. JErugo. Arsenicum album. Hydrargyrus nitratus ruber. Calaminaris. Kali purum. -----------cum calce viva. Barytes ? Strontia ? Acida mineralia. -----cum alkali alternata. Unguentum hydrargyri nitrati. ---------Alynois, viz. axungia cum acido nitrico. XXIII. Astringentia. Tonica astringentia ts* fossilia. Externa Farina secalis avenae 8c tritici. Linamentum siccum. Araneorum telae. Lycoperdon. Agaricus chirurgorum. Vitriolum zinci cupri & ferri. Plumbum acetatum. Oleum terebinthinae ? Erodentia ! Frigus. Alcohol. XXIV. AlexiteriA. Emollientia. Emetica evacuantia. Antidota. Arsenici. Kali sulphuratum. Opii. Acetum ? Coffea; Castoreum; Alcohol. Lavatio frigida. Ammonia ? Coffea. Acidi carbonici gazeosi. Lavatio frigida. Ammonia. Aeris nitrosi. Alkalina. Aeris azotici. Alcohol. Oxygenei gas. XXV. LlTHONTRIPTICA Sapo. Kali, praecipue purum. Mel; Calx viva. Amara calida. Uva ursi. XXVI. Anthelmintica. x. Venenata. Dolichos pubes leguminis. Geoffrea. cortex. Spigelia. radix. Sabina. folia. Lonicera marilandica. radix. Ruta. folia. Santonicum. semen. Tanacetum. folia, flores. Mezereum. cortex. Nicotiana. folia, semen. Filix mas. radix. Abrotanum herba. Absynthium. folia. Nux juglans putanem 8c extractum. Epidendrum claviculatum. Anthora radix. Abrotonum foemina. Asclepias curassavica. Annonae muricatae sp. quatior. Jatropha gossipifolia sp. tres. Melia azedurach. Helleborus fcetidus ! Spigelia marilandica. Atropa mandragora. radix. Lobelia, flores. Oleum. Hydrargyrus muriatus mitis. Hydrogenium sulphuratum (gas). Aquae minerales sulphuratae. Aqua Harrogatensis. Aqua calcis. Barytis ? Marina. , Nicotianae fumus. ---------- infusa pro enemate. Stannum. Aurum musivum. Cum hydrargyro. Oleum terebinthinae. Tonica amara calida isf fossilia. Astringentia narcotica. Carica papaya, semen. 0. Evacuantia. Cathartica drastica. Aloes. Emetica ; Vitriolum zinci. M A T 933 M A T From such an arrangement of the materia medica, and this subdivision of the classes, the young student, or the more discriminating inquirer, will, we think, find his labour greatly facilitated, as he will not be obliged to range through a muster roll of names to attain the object of his search. It remains only to explain the foundation of these subdivisions. Emetics, though a class far from numerous, and of simple operation, yet require some distinctions. We do not always require full vomiting, and we some- times Avant this action to produce a very sudden and violent change. It may be supposed that all emetics, in a less dose, will nauseate, or in a more active one give a sudden and violent shock; but ipecacuanha sel- dom produces sickness without vomiting, and squills Avill very seldom occasion a complete action of the sto- mach. Ipecacuanha also acts Avith no more violence in a large than a small dose, and mercurius vitriolatus is severe in its operation even in a small one. Of cathartics and the foundation of the distinctions we have already spoken ; and these lead us to remark another advantage of the subdivisions, a more ready reference to the proper remedies in other parts of the catalogue. Drastic purgatives would be injurious as diuretics in nephritis, and mild ones very inefficient as anthelmintics. There is certainly a very striking, and, in a practical vieAV, a very important, distinction between the relax- ant and the stimulant diaphoretics. If we have been right in our views under this article, the diapnoica equally merit a selection. A view of the remedies in- cluded in the list will, at least, show the propriety of the distinction. It appeared, indeed, so strong, that in the first sketch of this article, made for a very different purpose, twenty-five years since, the alterantia were in- cluded in this class. The stimulant, the diluent, and the narcotic diuretics are equally distinguishable. Perhaps the salina are not properly arranged with the stimulantia; but we were determined by the fact, that nitre, and some of the other neutrals, in large doses, produce pain in making water. They are, however, distinguished ; the strontia and ba- rytes are inserted with doubt and hesitation. The division of the extensive and doubtful class of expectorants is made from the nature of the medi- cines recommended. The first, however, act chiefly on the fauces; the second and third on the fever, except where employed in the form of gas or vesicular va- pour. The fourth contains only the real expectorants; and of the Avhole subdivision there are few strictly such. Some of these are slightly astringent, and should have been separated to have marked them as fre- , quently injurious, or at least only useful in a relaxed state of the glands. Of these the agrimony marked Avith a note of interrogation is the most hurtful; but the whole of the group must be used with caution when in- flammation exists. Dr. Cullen used to distinguish the errhines accord- ing to their effects as irritants and evacuants ; but we found it difficult to follow the idea on an extensive scale ; and the whole, at last, seemed resolvable into their less or greater acrimony. At least this distinction is abundantly sufficient to assist our practice. The division of sialagogues is sufficiently obvious. There is but one certain internal remedy of this kind, mercury. Yet, from the late experiments with the ni- tric acid in syphilis, there is some reason to suspect that it may have a similar power. The experience of others, hoAvever, has scarcely supported the suspicion, and it is consequently inserted with the mark of doubt. In the other list, though almost all the stimulants might haVe been inserted, those usually preferred are only enumerated. In the class of emmenagogues it Avas necessary to distinguish those which stimulate the system in general, from those whose irritation is confined to the uterus, or whose action is of a different kind. The two first orders contain the general and topical stimulants: the two next the antispasmodics and tonics. All the medicines included in this class are employed, and the distinction will be amply explained under the article Menses. The stimulantia have occasioned no little difficulty in the arrangements. The diffusibilia and the topica are chiefly distinguished in the Brunonian works ; but as Ave have rejected the principles, we cannot be expect- ed to adopt their consequences. We could not, hoAv- ever, wholly avoid them. Some stimulants are very ge- neral in their action, others confined to particular parts. Yet they pass into each other by such imperceptible shades, that Ave found it difficult to draw the line, and have passed with sufficient accuracy from the more ge- neral to the more partial stimulants. The topica are those chiefly of topical application. The insertion of the order indirecta appears to lean to the Brunonian doctrines, and we have explained their action to be of a sedative nature, producing an unequal excitement, and, in consequence, an apparent stimulus. Yet a work of this kind must not only contain the author's own opi- nions, but those of others: above all, it is necessary to point out that some of these medicines are employed with success as active stimulants. The refrigerantia are few and simple. The an- tispasmodica, as not connected with general effects, ought perhaps not to have been admitted as a class; but some complaisance is due to former authors, and the first subdivision cannot be referred to any general power. The subdivisions which follow sufficiently show that the power of destroying spasm very commonly de- pends on its cause. Tonics are also with difficulty distinguished in their several subdivisions. The natural arrangement is into bitters joined with astringency, pure bitters, and the more pure astringents. Yet it is not easy in the prac- tice, and Ave have preferred uniting the warm with the purer bitters, and distinguishing them from the narco- tic bitters, for reasons which will be obvious on perusing the article Amara. The subdivision fossilia requires an apology, since it does not point out their peculiar properties ; but we could find no suitable appellation, as they have no sensible operation. The more pure as- tringents follow, which are also tonics. The sedantia are the refrigerantia or narcotica, and this division requires no remark. The attenlantia are merely diluents, or such medicines as enable the serosity to dissolve a larger proportion of the gluten. The dulcia are added on the authority of Dr. Stark, who confined himself to a saccharine diet, and, after some time, experienced all the symptoms of sea scurvy. Yet MAT 934 MAU these experiments must be admitted with hesitation, as his constitution, from a series of Avanton triah, was pre- viously much debilitated. Diaeta insalubris, more strictly unalimentary, is founded on the instances which have occurred of the symptoms of scurvy from such diet; but it is not likely to be employed as a remedy. The remedies included under the inspissantia show that it is highly improbable such a change could be produced by medicines. The remedies for scurvy and the tonics are the only probable means of correcting too great tenuity. The alterantia contain, as already hinted, the dia- phoretica diapnoica; and the only other remedy which we Avere able to introduce is dieta. The subdivisions of the demulcentia and anta- cida are sufficiently obvious, and not very important, perhaps not chemically correct; but affected minute- ness, or extreme accuracy, which Avould multiply trifling subdivisions, is certainly no improvement. The antalkalina and antiseptica admit of no sub- divisions; and those of the emollientia are sufficiently obvious. The erodentia are naturally divided into the azo- etica, which destroy the life of a part, and the solventia, which consume it. Many of the latter act as azoetics; a term borrowed from the excellent syllabus of Dr. G. Pearson : but it is necessary only to point out the medi- cines usually employed with either vieAV. The astringentia are chiefly external remedies; for the internal astringents are enumerated, as already explained, under tonics. The alexiteria, the antidotes, are chiefly those enumerated by authors. The only novelty is the antidote of nitrous air, inserted in conse- quence of a case lately recorded, where death ensued from a person having copiously inhaled the fumes of nitrous acid from a bottle bursting. From the symp- toms it appeared that the oxygen had been separated in the system, and the acid appeared in every excreted fluid. Alkalis, in the first instance copiously taken, wrould probably have succeeded; and the best form would have been that of soap. The lithontriptics and anthelmintics are those usually enumerated. The last class is peculiarly full, as it has been supposed that we have few medicines of this kind, and of uncertain efficacy. The fact is, that diseases are often attributed to Avorms when none exist, or when they are not in the slightest degree injurious. We have thus completed a catalogue of the materia medica On a new plan, more full and complete, we trust, than any yet communicated to the public in ge- neral. Its errors may be numerous; but they have not arisen from Avant of attention, of labour, or observation. Many large works have perhaps cost less pains than tht- compilation of these few pages. Murray Apparatus Medicaminum; Gmelin's Con- tinuation of Murray; Lewis, Cullen, Geoffroy, Linnaeus, .Bergius, Spielman, Vogel, and Cartheuser's Materia Medica; Duncan's New Edinburgh Dispensatory; Dr. G. Pearson's very extensive and valuable Syllabus. Mate'ria mercu'rii sa'lis. See Circulatum. MATERIATU'RA. Intemperature. Castellus. MATHE.T PI'LULjE. Mathew's pill. Starkey Avas its author, but it was sold by MatheAvs for him as an universal medicine. It consisted of the soap of tar- tar, black hellebore, opium, See. . MATLOCK WATERS are found at the place from Avhence they take their name in the county of Derby, Avhere there are a great number of warm springs, which, according to Dr. Short, acquire their heat by passing through a bed of lime, and what he calls croil stone-. The water of the bath, and all the other tepid springs, is exceedingly clear, has no steam except in cold wea- ther, and does not throw up bubbles: it is about, a drachm in the pint lighter than common Avater. A gallon of this water contains about thirty-seven or thirty-eight grains of solid matter, twelve or thirteen grains of Avhich are sea salt, with vitriolated magnesia, the rest calcareous earth, which after calcination, con- tained some particles attracted by the loadstone. This water seems, therefore, to be a light chalybeate of a tepid temperature, containing but a small portion of solid matter, and is used in the diseases for Avhich Bris- tol waters have been recommended ; externally for the gout, rheumatism, and other complaints, where a tepid bath has been found serviceable. It is drunk from one to four or five pints in the day. MATRA'CIUM. See Curcureita. MA'TRES. The two membranes of the brain, the pia and dura mater, supposed to be the origin of all the other membranes. (See Dura mater.) In botany, the artemisia is the 7nater herbarum; in chemistry quicksilver is the 7nater metallorum. MATRICA'LIA, (from 7natrix). Medicines appro- priated to disorders of the uterus. MATRICA'RIA ; parthenium, febrifuga, metrica- ria, from matrix. Common feverfew, featherfew, or febrifuge, 7natricaria parthenium Lin. Sp. PI. 1255. This plant hath firm branched stalks and roughish leaves, each of which is composed of two or three pairs of indented oval segments, set on a middle rib, av ith an odd one at the end, cut into three lobes; the flowers stand on the tops in the form of an umbel, consisting each of a number of short white petals set round a yel- low disk, followed by small striated seeds. It is peren- nial, grows wild in hedges, in cultivated places, and floAvers in June. The leaves and flowers have a strong, not agreeable, smell, with a bitterish taste, both which they communi- cate to water and spirit. On distilling a large quantity of the herb, a yellowish strong scented essential oil is found on the surface of the water: rectified spirit car- ries off but little of its flavour in evaporation. The spi- rituous extract contains a large share of the virtues of the plant, which is esteemed as a warm aperient, carmina- tive, and bitter. It resembles, in sensible qualities and botanical affinities, the camomile, and keeps its virtues for several years. - Its oil is called ol. partheniacum. See Raii Historia; Lewis's Materia Medica; Neu- mann's Chemical Works. MATRISY'LVA. See Asperula and Caprifolium. MATRIX, (from mater, the mother). See Uterus, and Meditullium. MATURA'NTIA, (from maturo, to ripen). See SUPPURANTIA. MAU. See Manga. MAUROMA'RSON. See Marrubium. MAX 935 MAX MAXI'LLA, (from (a.xttxu, to chew,) 7nandibula. The cheek or the jaw. See Bucce. Maxi'lla inferi'or, mela. The lower jaw is situated at the lower part of the face; divided into the chin, sides, and processes. The chin is the anterior middle part; the sides are continued beyond the chin, till the bone, bending upwards,forms the processes. On the middle part of the chin externally there is a transverse ridge, on each side of which the quadrati, or depressores labii inferiores, and the elevatores labii inferiores, hollow out the bone, and are lodged in the furrow. On the in- ternal part of the chin are three protuberances, to the uppermost of which the fraenum linguae is tied. From the middle protuberance the genioglossi arise; and from the lowest the genio hyoidei: below the last the digas- tric muscles are attached to two sinuosities; and at the lower and anterior external part of each side of the maxilla inferior there is a small protuberance, whence the depressor labiorum communis proceeds: and nearer the upper edge is a longitudinal ridge, where the buc- cinator is inserted; inwardly, towards the superior ridge of each side, is a ridge, whence the mylo hyoidei rise. The loAver edge of the chin and sides are smooth, and are called the base of the lower jaw, the extremities of which are named the angles: the outer surface of these angles hath several inequalities where the masseter is inserted, and the inner surface where the pterygoideus internus is attached. The anterior sharp process is called coronoides apo- physis maxilla, round which the temporal muscle is in- serted ; and the posterior process is called condyloid, which is received into the glenoid cavity of the os tem- poris. The upper part, where the teeth are inserted, is called the alveolar process. The foramina are two on each side, one near the root of the processus internally, where a branch of the fifth pair of nerves with an artery and a vein enters; the other, external, at the edge of the chin, Avhere the nerve and the vessels come out. Maxi'lla supe'rior, the upper jaw, is composed of thirteen bones, viz. the ossa nasi, unguis, malarum, maxillaria, palati, spongiosa inferiora, or turbinata infe- riori, and the vomer. The diseases of the maxilla are chiefly those of the si- nuses, and in these worms have been sometimes found; but they are more commonly receptacles of purulent matter. They are sometimes the seat of fistulous ulcers, occasionally of a destructive fungous or cancer, and often of a caries, which happens in some instances after mea- sles or small pox. Matter is let out by draAving the first or second molar tooth, and we recollect, among Gooch's cases, one in which it was discharged by puncturing the cheek. In the Ephemerides Naturae Curiosorum is an instance of a total separation of the lower jaAV which the man survived. See Luxatio and Fractura. MAXILLA'RES Sl'NUS,(from maxilla, the jaw). The maxillary sinuses are lined with a glandular mem- brane, Avhich secretes a mucilage very different from that of the joints. Maxilla'res gla'ndulje. The maxillary glands. Each is placed betAveen the angle of the lower jaw and the os hyoides, and fills up the space between the belly of the digastric muscle and the pterygoideus internus at the angle of the jaw. The anterior edge lies over the muscle called mylo hyoideus, from whence arises its duct, running close under the membrane of the mouth, and by the side of the sublingual. Each opens at an angle, close by the fraenum of the tongue, just behind the incisores. The duct runs from its upper anterior part, on the outside of the genioglossi, and the inside of the sublingual, and opens near the fraenum linguae. MAXILLA'RIA SUPERIO'RA O'SSA. These form the greatest part of the upper jaAV. That long process, which, rising from its superior and anterior part, grows smaller as it proceeds upwards, to make the side-of the nose, is called the nasal process. The alveolar process is that spongy part where the sock- ets for the teeth are formed. The palatine process forms a great part of the basis of the nostrils, and the roof of the mouth. The orbiter process is very irre- gular : from its superior and anterior part, to near the extremity of the nasal process, a ridge proceeds which forms about one third of the outward circumference of the orbit. The bodies of the superior maxillary bones are entirely hollow, and in each is a large sinus, called Antrum highmorianum, q. v. MAXILLA'RIA ARTE'RLE. The maxillary arteries. The external artery, also called the ge- nial and angular artery, is a branch from the ex- ternal carotid. It runs to the basis of the lower jaw, close to the attachment of the masseter, and gives a branch to the maxillary gland. Passing over the lower jaw, it goes upon the buccinator, gives a branch to the lower lip, which anastomoses with that on the other side, and is continued to the upper lip, where it also anastomoses : there they are called labial arteries. The external maxillary then gives off branches to the nose, goes to the inner canthus of the eye, is lost upon the forehead, communicating, in that part, with the temporal artery. The internal maxillary artery is a branch from the external carotid, rising at the origin of the temporal, and distributed to both the jaAvs: it is very much con- voluted, and gives branches to the deep seated parts; one branch runs through the lower jaw, called the in- ferior maxillary artery ; but the main trunk runs up to the foramen, lacerum inferius, at the bottom of the orbit, winds round the antrum, and sinks into the nose behind the upper maxillary bone, and before the ptery- goid process of the os sphenoides, to be lost on the in- side of the nose. MAXILLA'RIS INFE'RIOR NE'RVUS, ramus inferior, is the third branch of the fifth pair of nerves. It passes through the foramen ovale of the os sphenoides, where it gives off several branches to the muscles of the lower jaw, then throws a remarkable branch through the lower jaw to supply the teeth ; which comes out at the anterior part of the channel, and branches upon the lip. From this a capital branch is detached to the tongue, called the lingual, Avhich runs between the two pterygoid muscles, and passes to the top of the tongue, going Avith the duct of the maxillary gland. From this the chorda tympani is derived. Sec Trigemini. Maxilla'ris supe'rior ne'rvus. The upper max- illary nerve is the second branch of the fifth pair. It passes through the foramen rotundum of the os sphe- noides, where it throws off a branch to the palate; but the trunk passes on in the sulcus of the upper 31 ED 936 MED maxillary bone, goes to the upper jaw, and to its antrum. It then comes out below the orbit, and is dif- fused upon the face, particularly upon the nose, the upper lip, and cheek. See Trigemini. MAYS is a kind of Indian wheat. See Cerealia. MEA'TUS, (from meo, to pass,) a duct, passage, or any open canal. The auditory passage is the meatus auditorius; the Eustachian tube meatus a palato adau- rem; the urethra meatus urinarius; the ducts which convey the bile from the gall bladder to the duodenum the meatus cystici. Mea'tus audito'rius exte'rnus is the external pass- age to the ear, beginning at the hollow of the outer ear, and ending at the drum. It was formerly a name for the Eustachian tube. See Auricula. Mea'tus c«'cus. See Tuba Eustachiana. MECAPA'TLI. The American name for one of the species of sarsaparilla. ME'CCHA, Bals. See Balsamum. MECHOACA'NA A'LBA, (from Mechoachan, a province in Mexico, whence it was brought). Rhabar- barum album, convolvulus Americanus, jalapa alba, bryonia alba Peruviana, mechoacan. It is the root of an American species of convolvulus, chiefly brought from a province in Mexico; but its flower has not been so accurately described as to enable us to ascertain strictly to what genus it belongs. In the later works of Linnaeus it has been referred to the genus convolvulus, with the trivial name of mechoacana, but with no pecu- liar precision. It is cut into thin transverse slices, like jalap; but is larger, whiter, and softer. This root was first brought into Europe in 1524, as a mild cathartic, which, having but little taste or smell, was thought not to offend the stomach; but the common jalap hath su- perseded its use. The Phytolacca decandria Lin. Sp. PI. 630, furnishes the Canadian mechoacana. See Raii Historia; Tournefort's Materia Medica. Mechoac'ana ni'gra. A name of the jalap in com- mon use. (See Jalapa.) The Brasilians call it jetecucu. ME'CON, (from wxos, bulk; from the largeness of its head). See Papaver. MECO'NIS and MECO'NIUM, (from f«**«v, the poppy). See Peplion. MECO'NIO, (Syr. e.) (from the same). See Pa- paver ALBUM. MECO'NIUM, (from the same). Opium is the juice flowing from the poppy head through artificial in- cisions ; but meconium is the juice of the whole plant, first bruised, then pressed out. The excrement also con- tained in the intestines of a newly born infant, which has obtained its name from its resemblance to opium. See Infans. MEDE'NA. A species of ulcer. Paracelsus. Mede'na ve'na; the same with medinensis vena. Castellus. MEDIA'NA VE'NA, (from medius, middle). A re- markable vein on the inside of the flexure of the cubit, between the cephalic and basilic veins, called by the Arabians funis brachii. It is frequently opened in bleeding. Media'na cepha'lica, (from the same). See Ce- phalica mediana. MEDIA'NUM, (from the same). See Medias- tinum. MEDIA'NUS, (from the same). See Cervi- cales. MEDIASTI'NA, (from the same). See Inflam- matio MEDIASTINI. MEDIASTI'N^E ARTE'RIiE, (from the same). The arteries of the mediastinum arise from the subcla- vian, and are spread on the mediastinum. Mediasti'nje ve'nje, (from the same). The right vein of the mediastinum comes out from the trunk of the superior vena cava anterior, a little above the azy- gos ; the left from the subclavia. MEDIASTI'NUM, (from the same,) medianum, is the membrane called the pleura, which, after covering the internal surface of the chest, rises from the spine, and is reflected on each side to cover the lungs. This double membrane between each lobe divides the chest into two cavities. It is commonly said, that at the sternum there is a cavity betwixt the laminae of the mediastinum, and that any matter may be discharged, if lodged there, by a perforation through the middle of that bone. This operation, however, if really required, would be very uncertain; for the mediastinum does not commonly terminate along the middle of the inside of the sternum, but from above, all the way down, it in- clines to the left side; so that, if an instrument was thrust through the middle of the sternum, it would pass near an inch on one side of the membrane. The mediastinum contains in its duplicature the heart, the pericardium, the vena cava, and the oeso- phagus. MEDICAMENTA'RIA,(from medicamentum, medi- cine,) pharmacy, is the art of making and preparing medicines, sometimes of preparing poison. Pharmacy hath been distinguished into chemical and galenical. The first consists of those operations in which fire was the chief medium, for the purpose of separating differ- ent ingredients of a compound, or combining different substances into one form; each supposed to differ in qualities from the body which afforded them, or from the substances thus combined. The second consisted in altering the form or texture of simples, so as to ren- der them fit to be taken, or applied, without attempting any change in their qualities; and in uniting them in compositions of various forms, where each simple was supposed to retain its original properties. But these distinctions have been long neglected. The operations in pharmacy may be reduced to these four kinds: 1. Commensuration, or the adjustment of quantities, necessary for the due administration of simple and com- pound medicines, as well as for the formation of those very compounds. 2. Change of form, or texture, often requisite, both for the convenient administering of simples, and forming compounds. The instances in which this is prac- tised are for the reduction of solid cohering bodies to powder, and of those that partake both of solid and fluid into pulp; for converting salts, and other soluble bodies to fluidity; and, in other cases, the restoring them when fluid to their solid state. The several par- ticular operations by which these changes are produced have been styled trituration, calcination, solution, ex- siccation, and crystallization. 3. Extraction or separation, in a general sense, not confined to the making extracts of the gums and resins M E L> 937 MED of vegetables. The different elements of many com- pound bodies having qualities and poAvers, Avhen sepa- rate and pure, which they are incapable of exerting Avhen their force is suppressed by the quantity or coun- teracted by the repugnant qualities of the other compo- nent parts, are by this means obtained, as. acid spirits, testaceous earths, 8cc. 4. Composition is either simple mixture or chemical combination. In the first the different species are in- tended to act, each according to its oaati nature, without producing any mutual change of, or alteration in, each other. But this is the less important kind of composi- tion, as single simples will often answer the end of such composition. The second produces many efficacious remedies, which have no adequate substitutes obtained by other means; as the preparations of quicksilver, antimony, saline substances, 8cc. in which a neAV com- pound is produced, differing in its nature and efficacy from any of its component parts. To execute these several intentions, a variety of me- thods and proper instruments are employed; hence the terms calcination, crystallization, corrosion, depuration, digestion, distillation, expression, exsiccation, fermenta- tion, fusion, incorporation, precipitation, pulverization, solution, sublimation, 8cc. The means of effecting pharmaceutic operations are of two kinds, viz. chemical and mechanical. By che- mical are meant the natural media by which bodies can act on, and produce a change in, each other, not expli- cable from the knoAvn general properties of matter, or laws of motion. By mechanical, artificial instruments. For brevity sake in speaking of these two kinds, the first is called media, the latter instruments. See Phar- macia. M»dica'menta extempora'nea, (from medico, to heal). Magistralia, compositions prescribed by the physician, according to the circumstances of the patient, and made up for this purpose only. A variety of these are found in some Pharmacopoeias, under the title of extemporaneous medicines, and all the compounds of practice chiefly consist of them. These are the re- sources of ignorance and idleness; with these the fashionable practitioner provides himself, and prescribes to the name of a disease, Avith little knowledge of its na- ture or that of the remedy. To discountenance such impositions on a credulous public, avIio contentedly employ every one who calls himself a physician, we have seldom added formulae, and shall not insert any, unless stronger reasons than at present occur to us should be offered. See Formulae. MEDICAMENTO'SUS LA'PIS, (from medica- mentu7n, medicine). The medicinal stone, Avhich con- sists of litharge bote and alum, of each Jfe ss. colcothar of vitriol 2; iij. vinegar $5 ij. m. evaporated to hardness, formerly used in collyria, 8cc. as an astringent. MEDICAME'NTUM, (from medeor, to heal). A medicine has been styled any substance capable of changing the state of the solids and fluids of the human body, so as to prevent the increase of disease,or restore health. This definition is, however, both erroneous and imperfect. Terror will prevent a fit of epilepsy, or *he attack of an intermittent. Sailing will produce a sa- lutary discharge from the stomach, while neither changes the state of the solids or fluids. It is, indeed,by no means clear that any medicine, except those employed in the VOL. I. cure of chronic diseases, produces any considerable change in either; and Ave have found, when we spoke of the arrangement of the articles of the materia medica, that medicines chiefly altered the functions of the body, or the balance of the circulation. The definition seems to have been chiefly intended to distinguish medicines from aliment on the one side, and from poisons on the other. The former Avas supposed to add to the bulk, or to repair the unaA'oidable losses; the latter to destroy life. Aliment, hoAvever, properly regulated, often re- moves diseases and the most virulent poisons in smaller doses are very useful remedies; so true is the canon of Linnaeus, that " medicines differ from poisons, not in their nature, but their doses." Though Ave have treated of the different methods of investigating the power of medicines, it must still be acknoAvledged that we OAve our knoAvledge of the most powerful remedies to chance, or to the pursuit of ob- jects very different from the.results which have been experienced. Chemistry, it is said, has elaborated many remedies, but discovered none. Yet in the pursuit of the imaginary elixir, to prolong life to an indefinite term, some medicines have been discovered, though among these we can neither reckon mercury nor anti- mony, whose powers were elicited by chance. A happy boldness, or a random experiment, has often added es- sentially to our stock; but inductive reasoning has only- contributed to correct the hasty views of the indiscreet, or to regulate the eagerness of the too sanguine experi- mentalist. Mudern practice employs few remedies. Yet, as we have more than once shown, simplicity of prescription is the delusive meteor that has sometimes led us astray. (See Combination of medicines.) In general, how- ever, we agree with an author, whose name has escaped us, that long formulae are proofs of either ignorance or deceit. It has been doubted whether there are any specific medicines. As usual, the question requires only to be explained to approach at least to a decision. If it be meant whether a specific stimulus exists, the position must be granted. If, then, there be such, the medicine which possesses this stimulus is, to a certain degree, a specific; but if it be meant whether any medicine can cure a disease by such peculiar inherent poAvers as are neither warranted by its general properties, or our knowledge of the nature of the complaint, Ave must hesitate in our answer. The number of supposed spe- cifics, by a more careful investigation, have not been found peculiarly poAverful in the disease to which they were supposed to be exclusively adapted; and we have only left on the list the Peruvian bark and mercury in intermittents and the lues veherea. The former, how- ever, has now lost this proportion of its credit, since other tonics, particularly the arsenic, is found of equal or superior efficacy. The pretensions of mercury to the character of a specific we have lately investigated (see Lues); and when Ave consider the history of the numerous individuals supposed to belong to this class, we are disposed to conclude, that, as usual, ignorance is the parent of our admiration. Had we any medicine of efficacy to compare with mercury we should discover its relations, and, of course, the cause of its general utility. We have made some steps in this inquiry in the article just quoted. 6 D itt E D 938 M E D Universal medicines are now only seen in the columns of a neAVspaper, or a quack bill. The num- berless inconsistent qualities attributed to a patent medicine would almost fix it in this rank; but its real utility is soon seen, if we trace the leading diseases for which it is recommended; and we then find it a com- mon medicine decorated with a pompous title, if it be not an inefficient compound, whose sole merit lies in its name, in its extravagant recommendations, and the credulity and folly of those Avhose abilities, if exerted, would soon point out the fallacy. See Quacks and Quack medicines. The various distinctions of medicines into general and topical, curative, palliative, or preservative, are suffi- ciently obvious, though little attended to at present, as the same medicine is now often used with each view. The bark, for instance, is a palliative in restraining the colliquative sweats in hectics, a preservative during the progress of a highly putrid epidemic, and a curative in intermittents. MEDICI'NA, (from medeor, to heal). Medicine. The history of the science which is the chief object of our work, must necessarily detain us for some time; yet, to avoid an article of an extremely disproportioned length, we have broken'it in a manner already explained, and shall, in the references at the end, collect the scattered limbs, so as to form one whole. At present, we must examine the history and the progress of medi- cine ; and if, for ages, we find reason to lament its slow advance towards improvement, if we sometimes find it Stationary, and occasionally even retrugittde, the causes will furnish abundant proof of the imbecility of our boasted reason, of the vast extent of science, of the limited powers of human intellect. It would be idle to trace at length the probable origin of medicine, or determine whether it be the result of ran- dom experiment, of imitation from observing the instinct of brutes, or of divine inspiration. Disease is the lot of humanity ; and remedies, or at least attempts to relieve, must be coeval with disordered functions. The obvious means of procuring relief was to expose the patient in the streets, and to obtain, if possible, the advantage of greater sagacity, or more extensive experience; and when either a natural sagacity and opportunities of observation were combined with a ready recollection, they constituted the physician of rude ages, as they often constitute one at the present moment. Priests, as possessing greater leisure and more frequent oppor- tunities of observation, were probably the first medical practitioners, and the most successful physicians were soon deified. Superstition gradually mixed in the scene, and dreams in the temples of the gods, or incantations and amulets, soon corrupted the few lights Avhich expe- rience had suggested. Yet however superstition or design may have corrupted the fountains, the stream was preserved with tolerable purity by the means of the f temples; for these were the receptacles of the earliest records, the histories of cases recorded by the patients, and from the temples of iEsculapius Hippocrates is sup- posed to have drawn his best observations. We owe only to a sarcasm of a later era one of the remedies of the sacred fane, viz. the fat of pork in consumptive cases; and, of all animal foods, this is perhaps the least injurious in such cases, To the Egyptians medicine, with every other science, is said to be chiefly indebted; and we are told, Avith a triumphant confidence, of their Thoth,who was probably only an allegorical personage, and of Isis, perhaps only a regal title. Horus the son of Isis, the Apollo of the Greeks, was seemingly a real person; but of his acqui- sitions in medicine we know nothing except from the claims of his adopting parents; who have mixed them too copiously with fable to enable us to discriminate their true value. The real knowledge of the Egyptians in medicine it is not easy to appreciate; for, as we have remarked, (see Chirurgia,) Prosper Alpinus wrote in a period Avhen the later improvements had been carried to Egypt. Blumenbach has, however, shown, that the process of embalming Avas hastily and rudely conducted; and we cannot attribute any scientific knowledge of medicine to those who confined the management of each disorder to a single family, a single disease to one practitioner, and limited, by law, the use of medicine to' a definite period of the complaint. It is said we are indebted to them for the use of clysters; but it is more certain that they excelled in prognostics, which must be the result of careful observation. This talent Galen, Avhile he highly commends, attributes to astrology. Their remedies were chiefly diaetetic, if we except, perhaps, the nepenthe. The medical knowledge of the Chinese, the Israelites, and the Brachmans, need not detain us. Among each it was inconsiderable; and the chief merits of the first seem to have consisted in punctures with needles; of the second in distinctions between clean and unclean beasts; and of the third in botanical knowledge. The early Grecian medicine was chiefly chirurgical; and though we hear of internal remedies, yet we have no clue to guide us respecting their nature, as the asser- tions of some authors nearer the period of theirintro- duction are contradicted by others. Amidst the darkness of the fabulous ages we must acknowledge that the baths of Hecate, Circe, and Medea, seem to show some knowledge of the powers of vegetables externally em- ployed; and the tale of the poisened shirt of Deianiria equally implies the knowledge of deleterious plants, even if some of the circumstances in Medea's story should be wholly fabulous. The events of the Trojan war, which called for the interposition of art, were chiefly, if not exclusively, external injuries; and there is a very slight foundation for supposing, from the language of Homer, that inter- nal medicines were at any time exhibited. Nepenthe was almost the only instance, for the moly Avas an amulet. If the temples of Philostratus were at a sub- sequent period crowded with votaries, who sought his aid in consumptions, dropsies, intermittents, and dis- eases of the eyes, we must rather attribute the removal of the complaints to the arts of the priests or the cre- dulity of the votaries, than to the interference of the deceased hero, who is not represented as having pos- sessed any medicinal powers. AEsculapius, who accom- panied the Argonauts, is not mentioned in the Iliad, so that he probably died in the interval; but his fame was preserved in his temples, where the artifices of the priests in choosing a healthy spot shaded with trees,and combining various species of amusement, contributed perhaps more to the patient's recovery than their me- dicines. The Asc'lepiada seem never, before the time of ME D 939 MED Hippocrates, to have practised beyond the confines of their temples; but they had various schools, of which the Coan and the Gnidian were the chief. Their ana- tomical knowledge, of which they boasted, was rude and incorrect; their practice we can scarcely judge of from the different application of their terms. We should suppose them to have employed drastic pur- gatives, since they used the elaterium and the grana Gnidia. Yet we learn from Dioscorides how much the ancient elaterium differed from ours, and the xoxot, or grana Gnidia may, as the word implies, have been only pills. The Coan and Gnidian schools were, however, the chief rivals, and the Gnidian sentences, the compilation of Euryphon, of an age somewhat anterior to that of Hippocrates, is severely criticised by the latter. He complains of the little attention which the Gnidian school paid to the observation of diseases; of the severity of their remedies; their unreasonably increasing the numberof diseases, and the little attention they in- culcated respecting diet. The only distinguished au- thor of this school known to us is Ctesias, and, from his works, some fragments are preserved. Of the Rhodian and Italian schools, established by the descendants or priests of .Esculapius, we have few remains : of the existence of the latter we find only some imperfect hints in Galen. The former .was more distinguished, but its remaining vestiges are few. The medals bear a branch of Balaustines; but this mark is rather referable to the arts than to medicine, as the plant was then almost exclusively used in dying. The fame of these schools and of the philosophers, for medicine seems hitherto to have been cultivated only as a branch of philosophy, was soon eclipsed by Hippocrates, who seems to have been the first to whom the appellation of physician, in its modern acceptation, is due. He first separated it from philosophy, gave it the form of a distinct science, and personally observed the progress of diseases, as well as the effects of reme- dies ; on this account he is styled the inventor of the medicina clinica. Yet perhaps the philosophers who preceded him must not be wholly omitted. We are re- minded of Pythagoras by the Climacterics, by the Cri- tical days, and his recommendation of the vinegar of squills, in deafness; of his scholar Alcmaon, who first described the eye; of Empedocles, who, before any other anatomist, dissected with accuracy the ear; and of Timaeus Locrus, who taught that the nervous system was the basis of the whole body, on which the nutritious substance was gradually extended. Democritus was rather a philosopher and a chemist than a physician, and might have ranked with credit in each class were the various hints of his labours collected. Of Hippocrates it is difficult to speak with impar- tiality in a manner that will satisfy his warm admirers, or those who reject every thing which is not of a mo- dern aera. If we look at him as a physician, when me- dicine had scarcely escaped from the trammels of su- perstition, the refinements of philosophy, or the dictates of antiquated tradition, our admiration will rise almost to enthusiasm ; for we shall perceive sound judgment, accuracy of reasoning, and acuteness of observation, superior to his aera, or the state of science at that period. But to study and admire Hippocrates at this time is very different. Science has opened newer and more extensive view s; diseases are distinguished with greater accuracy; and the remedies, as they are more numerous, may be more appropriately adapted to the circumstances. If we find a striking description in Hippocrates, we admire it as a mark of superior genius, and wonder how the same event could have happened both in Greece and England. Yet strip the fact of the disguise of system, and it will be found that patient ob- servation would alone have taught it. He fills, however, so vast a space in the medical scene, that some further notice of him and his doctrines will be necessary. Hippocrates was born in the first year of the 80th Olympiad, 460 years before the birth of Christ, and was descended from a line of physicians, inheriting the in- structions of his father and grandfather, themselves descendants from the Asctepiadae, while his mother traced her origin from the Heraclidae. He died at La- rissa, it is said, at the age of ninety. He first practised physic at Thasus, afterwards at Abdera, and at last in Thessaly; but his chief residence was at Cos, whence the Coan school became for a long time the successful rival of the Gnidian. All that has been added to these few events is doubtful.' That his instructors were He- rodicus (or Prodicus) and Democritus, rests only on the attention which he has paid to the gymnastic art, as Well as to anatomy ; and the philosophy of Hippocrates is more nearly allied to the tenets of Heraclitus than of the Abderite. As Hippocrates was a great traveller, he might have attended the lessons of Prodicus in Athens, where he chiefly taught, and might there have been acquainted with his brother Gorgias, Avhom he afterwards attended in his medical capacity in Thessaly, Avhen worn down with old age; but we have no records of his having ever practised at Athens. The other tales either to his honour or discredit are too idle to detain us. Had he violated or burnt a temple, Greece could have afforded him no asylum. Had he been greatly instrumental in relieving those affected with the plague at Athens, Thucydides could not have stated that medicine was of no advantage in that epidemic. The oration of Thessalus the son of Hippo- crates on the subject of the honours decreed to him, must be spurious; for at that time the sage was but thirty-one years old. The request of Artaxerxes, Avhich he is said to have refused, is also wholly inconsistent with the crime supposed to have driven him from Cos. The tale of his being sent to Democritus by the inha- bitants of Abdera seems only one of the many sneers the stupidity of the Abderites scattered in ancient his- tory ; and Reland has shown, that the imputed letter was written by Epictetus. The time of his death is equally uncertain. Under the name of Hippocrates we have received works of very different value. Those of his prede- cessors and successors are confounded with his, partly from his having appropriated some of their remarks, in part from the high character he had acquired; and from several of his descendants having retained his name. The chief cause, however, of the many spurious works attributed to him, is the avarice of the collectors of Ptolemy, who, when he founded the library of Alexandria, endeavoured to obtain, at the most ex- travagant rates, the works of every author of reputa- tion. Every thing under the name of Hippocrates was eagerly received, and it was thought of little importance whether they proceeded from the first, second, or third 6D2 MED 940 M E D of that name: the reports were not sifted Avith minute discrimination. To distinguish the real works of Hip- pocrates has been consequently a problem of no little difficulty. At the expiration of 500 years, this task was attempted by Galen, who, to an intimate knowledge of what the successors of Hippocrates hadAvritten, pos- sessed a discriminating genius, and a critical discern- ment of the style and manner of the Coan sage, which peculiarly fitted him for the task. Mercurialis, a man of the most extensive erudition, Haller, a physician of vast information, capable of the most incredible labour, and Gruner, possessed of all the indefatigable diligence of his nation, have laboured in the same field. They have assumed, as a principle, that Hippocrates was a man of singular abilities, extensive information, consummate candour, and modesty. By these tests they have tried every imputed work. Though perhaps the principles might not be readily conceded, yet, as they will certainly point out to our attention the most valuable works, we shall give the result of their la- bours. The undisputed works of Hippocrates are said to be the first and third book of the Epidemics ; two books of the Pr^notiones (a different Avork from the Prae- notiones Coacae, published by Elzevir in 1660, by Duretus at Paris, and with commentaries by Hollerius at Leyden, which is very certainly spurious), containing the Prognostics, and the second book of the Prorrhetica; De Diata in Acutis, in opposition to the Gnidian sen- tences ; the Aphorismi; De Aere, Aquis et Locis ; De Natura Hominis; De Humoribus Purgandis; De Ali- mento; De Articulis; De Fracturis; De Capitis Vulneri- bus; De Officina Medici; De Locis in Homine. This is nearly the enumeration of Haller ; but Galen and Haller seem to have admitted tracts among the Hippocratic Avorks, with too great facility. Gruner, who like Hal- ler considered brevity, gravity, and the absence of theo- retical reasonings to be the true test of the genuine writings of Hippocrates, differs in the application. He admits the oath, but rejects the treatise, De JVatura Hominis, De Locis in Homine, De Humoribus, De Ali- mento, et De Articulis. Whether the oath be admitted or rejected, is of little importance; since it must be con- sidered rather as an object of curiosity than of utility. The first of these rejected works was admitted, with hesitation, by Galen and Mercurialis, as containing many passages very distant from the manner and doc- trines of Hippocrates; but it was retained, as containing some facts of importance. The second, though ad- mitted by Galen and Caelius, and though it agrees, in general, with the practice of Hippocrates, has been suspected on account of some passages of a very differ- ent description. Haller only asserts that it 7nay be his Avork; and Mercurialis, who ascribes it to Hippocrates, thinks that he did not live to complete it. Gruner and Mercurialis reject the tract He Humo- ribus, but add, that it merits attention. It has been in- deed commended in every age, and illustrated with commentaries by Galen, Duretus, and Gunzius. The tract on Aliment, on the contrary, imitates only the terseness of Hippocrates, but betrays the author to be of a later aera, by the doctrines respecting the arteries and veins. The book on the Joints is evidently the Avork of Hippocrates, or, at least, of the author of the tract De Fractures, and universally admitted. It contains also an account of the luxation of the thigh, Avhich the history of medicine uniformly attributes to Hippocrates, by recording a controversy betAveen him and Ctesias on this subject. Yet even the undisputed Avorks of Hippocrates must be received with some hesitation. The criteria by which they are decided are, we have said, not infallible ; for they assume a degree of uniform excellence, which perhaps few have possessed. The tract De Aere, Aquis et Locis, shows the author to have been an European; and various passages even in the most genuine works, may be ad- duced to prove that interpolations have crept in. Where then can Ave draw the line ? or need the line be draAvn ? We have enlarged on this part of the subject to add the only conclusion Avhich can be admitted, that the undisputed works of Hippocrates show rather the state of medicine in the earliest eras than form what may- be styled the system of an individual. They are there- fore objects of curiosity, rather than use ; for the most important facts are scattered in a variety of modern Avorks, and Avithin the reach of the greater number of readers. Yet the writings of Hippocrates merit atten- tion. Where the title of doctor is assumed merely as a claim to receive the fee of a physician, it is of little im- portance whether the practitioner can read: the world is contented to take his talents on trust; but the man who claims the rank of a regular, Avell instructed, phy- sician, should not be ignorant of the language of Hippo- crates, or of the state of physic at the earliest period of recorded observations. He will derive no little satis- faction from the polished terseness of the Hippocratic language, from the candid relation of facts, whether favourable or otherwise, from the firm undeviating in- tegrity, which seems to have regulated the conduct of this father of medicine. We have been led also to this inquiry from other views. Various are the authors who have treated of Hippocrates and his system, Avithout knoAving that, in the same volume, works most umvorthy of any author of credit were confounded under his name. Each has been quoted with the same indiscriminate complacency, and it may be easily conceived what a motley mixture must be the result. Having thus pointed out where his real sentiments may be found, we shall very shortly point out what they apparently Avere. The tenet of Hippocrates, that a knoA\dedge of nature is the first principle in medicine, has been quoted Avith great zeal, to prove that he who saw this position in so strong a light must have been acquainted Avith the structure and the functions of the body. Yet even this axiom seems not to have been suggested by Hippocrates, as it occurs in one of his doubtful works. That nature preserves health and -cures diseases is a tenet more obvious, and must have often occurred in a practice so inert as that of the Coan sage. His anatomical knoAv- ledge was inconsiderable. In his work on the bones, one of doubtful authority, he describes the spine as con- sisting of tAventy vertebrae only. The error is indeed corrected towards the end, but apparently by another hand. The vesiculae seminales are expressly described as a series of vesicles on each side of the bladder. This fact has been quoted to show that he dissected human bodies; but the tract, in which the observation occurs, is pronounced to be spurious, even by Galen. That Hip- pocrates was acquainted with the circulation of the 31 E D 941 MED blood, as some authors have contended, no longer re- quires'a single remark. Tnough his genuine account of the structure of the genital organs is confessedly incorrect, yet his ideas that the male and female semen are mixed in conception, that the sex is determined by the most powerful, and that, if the semen escapes from the female, impregnation is prevented, arc principles still supported by many physiologists, and are, on the whole, highly probable. The reciprocal action of the warm and cold spirit, in promoting the growth of the fcetus, is wholly imaginary. The soul, he supposes, is drawn in Avith the air; not with air as such, but as a vehicle of water and fire, and communicated through the vessels of the placenta to the foetus. His theory of the cause of labour pains, from the exertions of the fcetus, in consequence of the want of nourishment, though long supposed to be true, Avill scarcely bear the test of rigorous examination; and indeed every supposed cause of labour supervening at the end cf the ninth month appears to be equivocal. The reason which he assigns for the life of a fcetus of seven months, while one of eight is generally dead, ap- pears to be too refined, and in part imaginary. It has been said, that a woman, accused of adultery, because her child Avas like neither supposed parent, Avas ac- quitted on Hippocrates suggesting, that a picture, Avhich resembled it, might have been in her bed chamber, which, on examination was found to be true. The story is told, however, by an obscure writer, Hieronymus; and Galen, Avho relates it as the tale of a former age, does not attribute the decision to Hippocrates. To engage, however, in any extensive enquiry respect- ing the physiological doctrines of the Coan sage would be idle, since much was fancy and more probably con- jecture ; but above all, on account of the latitude of expression which he employs. Thus vevpov signifies not only nerve, but ligament and tendon ; QXi-^/ not only a vein, but an artery, or an excretory duct; and xtfcA means not only blood, but any Avatery fluid; and the nervous fluid the air inspired, Avhich mixes ulti- mately with all the fluids of the body. It is more clear, that he supposed the existence of four fluids in the body, blood, phlegm, yellow and black bile. Their common source fie supposed to be the stomach, but each had also its peculiar origin, viz. blood from the heart, phlegm from the head, yellow bile from the gall duct, and black bile from the spleen. The last organ, in his opinion, attracts not only the black bile, but Avater also, which it conveys to the urina- ry organs or to the belly. This doctrine of the four humours has been the foundation of the system of Galen, and still infects the theory of medicine. See Temperamenta. The Hippocratic pathology might be offered in a neat compacted system, were the book DeFlatibus cer- tainly Avritten by the father of medicine. It is, however, generally and deservedly removed to a later aera ; yet Galen employs the flatus when mixed with the bile, as the cause of fever. The cause of epilepsy, as assigned by Hippocrates, is so recondite, and so totally at variance Avith what anatomy teaches, that it Avould be useless labour to enlarge on it. Yet this, and some other of this author's disquisitions, sIioav with Avhat eagerness he endeavoured to transfer his observations on the ap- pearances found in the dissection of brutes to the human system. We may here remark Avhat an cxamir nation of the Avorks of Hippocrates for this purpose has suggested, that the boasted to Getov is introduced hastily and abruptly, greatly resembling an interpolation. In other parts of our Avork we have folloAved the herd of authors, and attributed it to a fixed systematic opinion. As Hipprocates speaks of the rising and setting of the dog star, of the pleiades, 8cc. it has been supposed that he attributes diseases to their influence. If, how- ever, his works be examined, it will appear that, in such places, he only endeavours to fix the seasons with greater accuracy. It is evident, indeed, that he examines the influence of different seasons, the prevailing Avinds, the situation of marshes and mountains, Avith great precision, and pays peculiar attention to the age, mode of life, constitution, and diet of his patient. The histories or daily progress of diseases he has described with great accuracy and perspicuity; nor are his re- marks, though not strictly applicable in our climate, and in constitutions so totally differing by a very oppo- site mode of life, wholly useless at present. Observa- tion seems to have suggested Avhat have been styled critical days; nor, though he hints at a supposed har- mony of numbers, is there any real evidence that the doctrine was suggested by it. His observations on the pulse are few and indistinct; on the urine, numerous and minute; on the excretions eitherfrom the lungs, from the stomach, or bowels, peculiarly distinct and pointed ; on the appearance of the features and the state of the body, full and discriminated. Yet, with all these aids, he stills considers the prognosis in acute diseases as uncertain.' The practice of Hippocrates must be divided into his diaetetic, his surgical, and his medical system. The chief diaetetic Avork under his name is attributed by the critics to Polybius, his son in law; but there is much reason to think, that the rules are derived from the sage himself. In general, in this work, as in other parts of his Avritings, he commends moderation, and a quantity of aliment in proportion to the exercise used. In some of the tracts attributed to him he speaks of the compa- rative utility and effects of horses, asses, foxes, and hedge hogs flesh. Where excess has been indulged, he mentions the advantages of vomits, purgatives, clysters, frictions, baths, 8cc. When persons Avere seized with acute diseases, he employed low diet, and forbad exercise : Ave find it injurious at this moment. His practical rules are sound and judicious ; yet, per- verted by fashionable systems, they have been found most fatal. Acute diseases are, he thinks, cured by nature, and the physician must look on and attend: those which have a fair proper crisis we must not disturb. What ought to be discharged must be dis- charged at the most convenient outlets, and at those where the tendency to evacuation is perceived; but concocted fluids only must be attacked by medicines, not crude ones, unless they are turgid. It is impossible to convey more sound and judicious practice in fewer Avords, yet it has been mistaken so much, that evacua- tions have been forbid in the beginning of diseases, and volumes have been Avritten to explain the meaning of turgid matter, or rather to conceal it. The real meaning of the rules, examined in their literal sense, or in com- parison with the other passages of his undisputed Avorks, is this: What must be discharged will be properly MED 942 31 E D evacuated by the most convenient outlets. We are not, for instance, to urge purgatives when there is a ten- dency to perspiration, or sudorifics when expectoration is necessary. Concocted fluids are only to be evacuated, not crude ones, unless they are turgid. This is the fatal sentence ; for the term concocted has been applied to the state of the fluids only after a long continuance of fever, and it has been supposed that fever must continue before evacuations are attempted. Whatever be the meaning, however, the interpretation must be limited by the term turgid, which in fact means only full. Thus a fullness of the epigastrum, of the abdomen in general, bilious vomitings and diarrhoeas, redness of the eyes, and a heaviness of the head, are distinctly noted as marks of turgescence. These are the cases in which modern practice employs evacuations, and these are the symp- toms which, even with Hippocratic rigour, would be truly found to indicate, them. Yet to wait for con- coction has been the fatal rule, which has kept febrile patients in bed with closed windows and curtains, with fire in the dog days, the addition of blankets, and the most heating medicines for many weeks. At the mo- ment of our commencing practice his plan was not wholly exploded. A rule, less liable to be mistaken, was, that diseases from repletion must be cured by evacuation; and the contrary. Rest is equally the remedy for labour, and labour for indolence; and, in general, medicine consists in adding or taking away, according to the nature of the cause. Every attempt, however, to change a continued habit must be gradual, for every excess is dangerous. If evacuations cannot safely take place from the most convenient parts, a revulsion must, according to Hippo- crates, be attempted, and the nearest emunctories should be preferred ; for the discharge, he adds, is not salutary from its quantity, but from its freedom and the ease Avith which it is borne. When, however, it is the object to weaken, the discharge must be excessive. If the practitioner should not at once succeed, he should not hastily change his plans, but consider Avhether any thing has been omitted, or, for a time, rest to see what nature will point out. When the patient appears to yield to the disease, he forbids further attempts ; but those, he remarks, with an oracular uncertainty, who are not re- lieved by medicine are relieved by iron; those who yield not to iron are cured by fire; and those on whom fire makes no impression are incurable. The milder laxatives of the " divine old man" were the juice of the herb mercurialis, cabbage, the leaves of elder, or a decoction of beet root with salt and honey ; various kinds of milk, either boiled or in the form of whey. These in larger quantities were sometimes em- ployed to produce vomiting. As assistants to these, he employed clysters and suppositories; and, when more active drastics were necessary, the hellebore, not, how- ever, without the precaution of premising the most cooling diet. He was anxious also that whatever might prevent hiccup and convulsions should be ready, and assisted their quick operation by clysters. To the white hellebore he usually joined the sesamoid; to the black, the peplium, supposed to be a species of esula, or the portuiaca, though by some authors thought to be the papaver spumeum of Dioscorides. We might fill pages with conjectures respecting the present names of these plants, but must leave the question at last in uncertainty. Hippocrates certainly considers what he styles the Avhite poppy to be a pur- gative, and Pliny refers a kind of poppy to the genus tithymalus. The peplium seems, from other parts of Hippocrates's works, to be a carminative, and the cum- min or the anise seeds appear to be occasionally sub- stituted for it. Other purgatives, recommended by the Coan sage, are the grana Gnidia, the colocynth, the thapsia, the cyclamen, with the flowers and scales of copper, though the last are chiefly employed externally. Scammony and elaterium he commends for pessaries ; but the latter was also given internally, as he advises the milk of a woman or a she goat which have taken elaterium, as a purgative for children. It has been .suspected that, in this passage, elaterium is inserted instead of veratrum, which goats greedily devour, and which acts on them as a cathartic. It is singular, how- ever, that the particular purgatives, especially the dras- tics, are mentioned only in the tract De Morbis Mulie- rum, which is supposed to be from the school of Gnidus, and older than Hippocrates, since no mention is made of aloes, which was brought from India through Egypt in his time. The head, according to Hippocrates, was particularly evacuated by the grana Gnidia, hippophae, a thorny shrub which discharged a bitter milky juice; the stone magnesia, which is undoubtedly the load stone; and the tetragonum, supposed by Galen to be antimony, but by modern botanists to be the juice of one of the fir tribe, several of which are purgative. In general, Hip- pocrates used purgatives in chronic diseases; but he certainly employed them in acute ones more freely than the greater number of the more modern practitioners. The diuretics prescribed by Hippocrates were the leek, onion, mercurialis, wild parsley, Sec. with wine and honey largely diluted, sometimes the warm bath. Can- tharides, however, he orders in dropsies; and five, with the head, feet, and wings taken off, to expel the secun- dines and bring on the catamenia. It is not certain, however, that so many Avere always swallowed: in drop- sies he gave three only. To purge the lungs a singular method was employed. If there was reason to suppose that an abscess had formed, after a peripneumony, a decoction of different acrimonious plants, with honey, 8cc. was directed to be poured into the trachea, the passage to which was opened by drawing out the tongue. Galen, however, has long since informed us, that the whole process was taken from the Gnidian school. The uterus was stimulated by the most active pessa- ries, clysters, and injections, or by partial vapour baths (incessus) composed of the same ingredients. He at- tributed much to perspiration; but produced it chiefly by warm diluting liquors, by bathing, and covering the patient with Avarm cloaks. His ptisans, decoctions of barley of different richness, are often mentioned. He drew blood by venesection, and by scarifications more or less deep, chiefly near the head; yet he did not repeat the evacuations frequently, lest, by intercepting the. current of blood to the head, apoplexy, convulsions, or inflammations might be induced. When the voice was affected, he divided the vein of the right arm; in pleurisy and peripneumony, the internal vein of the side affected : some directions are subjoined, respecting a division of the veins under the tongue, or in the hands MED 943 M E D In inflammationsof the chest, he sometimes bled till the patient fainted. He bled topically with cupping glass- es, and sometimes directs the necessary size. The lancet, he observes, should not be too pointed, that a free passage may be afforded to the more viscid fluids. When he wished to alter the crasis of the more fluid, or of the more solid parts, he chiefly employed diet; and he is consequently copious in describing the powers of particular diets as cooling or heating, diluting or drying, as laxative or constipative. A large share of the tract De Victu Acutorum is employed on this subject, where the ptisans again frequently occur. To check excess of motion, he seems to have very rarely used opium. In what he styles strangulations of the uterus, he advises to vrvarixov [A,t)xaviov, the soporific meconium: the ores mxavoe seems to be the papaver spumeuin, the peplium, perhaps the wild purslain. He recommends the mandragora in a dose below that, which produces delirium, and thinks it useful in the violent paroxysms to which those affected with melan- cholia are sometimes subject. The juice of the man- dragora, and the wild cucurbit diluted with milk, is to be injected into the anus to relieve prolapsus, or bleeding piles, and into the vagina to evacuate the vessels of the uterus. But to cure quartans he mixed the mandragora with hyoscyamus, silphium (probably asafoetida,) and trefoil, giving them together in wine. To correct rigidity he employed baths, fumigations, and gargles. Oils, impregnated with different flowers, sometimes with aromatics, were also freely ordered ; cataplasms and ointments, sometimes stiffened with wax, but scarcely in any instance consolidated into what may be now called a plaster, were frequently employed. The oils were generally rubbed in after exercise, and thence called acopa, relievers of fatigue. It was an idle fancy of the alchemists that Hippocrates was an expe- rienced chemist. The surgery of Hippocrates is scattered through a great number of tracts, but this part of the subject has been anticipated in the history of surgery. (SeeCHiRUR- gia.) Yet, on recurring to that article with a more cir- cumspect eye, we perceive omissions which we shall now endeavour to supply. A minute attention, which seems to have prevailed in the Gnidian school, to the form of bandages, he rejects as rather curious than useful. The patient, he remarks, requires assistance, not ornament; and whatever does not contribute to his ease or his relief, he thinks unde- serving of attention. He penetrated bones with an instrument not unlike the modern trephine, and even the ribs, to evacuate water collected in the chest. The management of fractures, though the instruments were somewhat rude, seems, on the whole, judicious: no plasters were applied till after the aera of Paulus Egineta. The eye, in inflammations, was scarified by the friction of the rough Milesian wool. We have enlarged on this subject because we have not found the Coan system fully and impartially stated; and because the practice of Hippocrates, like an over- ruling genius, has continued to lead us, by imperceptible threads, even to the present sera. Subsequent to his time his descendants and disciples continued in the same line, and for many ages little improvement was made in practice, and but few innovations occurred in physiology. For the latter we are indebted to Plato, whose fancies on this subject are amusing, and, but that we have little room for amusement only, might for some time detain us. The names of Hippocrates' successors, and we could add scarcely any thing to the catalogue, would not be interesting; but we were some- what surprised among them to find the elder and younger Dionysius. We could easily conceive that the elder, as was reported, delighted in Avitnessing the most painful surgical operations; but the idle dissipated cha- racter of the younger forbad us to expect from him any mental exertion. It is suggested, however, that the barbers and perfumers shops, for he Avas as conde- scending and familiar as our fifth Henry when prince of Wales, were called \xTpe)x, and that it might there- fore be truly said that his time was employed ev )xrpeiots, but not in medical disquisitions. From the time of Hippocrates to that of Ptolemy Philadelphus few were the medical practitioners, and these rather distinguished for fancy and refinement than any improvement in the art. Diodes, already noticed in the history of surgery, rescues this period from total insignificance. Yet, even at this time, when authors contended that no blood naturally entered the arteries, and the arterial vibrations were attributed to a pulsific conatus, the pUlse was attended to and employed among other prognostics. The fame, hoAvever, of the medical practitioners was eclipsed by that of Aristotle, who flourished at this time; a man to whom every branch of natural science was highly indebted, who alone united the most comprehensive views, the acutest genius, and the most unremitting diligence, and who has only been disregarded by those Avho have not talents to appreciate his labours. His two books on medicine are unfortunately lost; his anatomy, in the works which remain, is not on the whole correct, and his physiology somewhat fanciful. These.Ayere, however, the faults of his aera, not his own. Whatever were the errors of his physiology, and philosophy, both were adopted in gene- ral by Galen, and more exclusively by the Arabians; so that their effects were most extensive. The va'st knowledge which Aristotle possessed in the three king- doms of nature is sufficiently understood; to his in- structions Ave are indebted for what Theophrastus has collected, and perhaps for the fatal knowledge which Thrasyas is said to have possessed of the deleterious qualities of vegetables. The other physicians of this aera do not merit the slightest notice. The prominent objects which next offer themselves to our attention are Herophilus and Erasistratus, the great founders of the Alexandrian school, at least the powerful supporters of its credit. Erasistratus we have styled the elder, but the chronology of this very early period is uncertain. Erasistratus was a physician of some eminence, but he applied to anatomy at a very late period of his lifevand with great candour recanted, in consequence of his discoveries, some of his early opi- nions. He certainly apprpached very near the secret of the circulation, but could not understand the use of a double heart. He supposed digestion to be performed by attrition, and violently opposed the humoral patho- logy of his predecessors. His own system rested on the idea of the arteries containing only a spirit, and that diseases, particularly fevers and inflammations, arose from their admitting blood. He was apprehensive of bleeding, test the blood should find a Avay from the MED 944 M E D veins to the arteries; of purging, because Pythagoras had forbidden it. He reduced his patients by abstinence, or by violent exercise: venesection he supplied by ligatures; purgatives by slight emetics, or by clysters. He recommended simple medicines, and violently re- probated the complicated formulae of that aera. The school of Smyrna, in which Erasistratus taught, Avas undoubtedly famous; but there is reason to doubt Avhether the medals which remain, supposed by Mead to have been struck in honour or commemoration of this seminary, had really such an object. The figure of .Esculapius, Avhich they bear, is so common on medals Avhere there is not the slightest suspicion of their being intended to commemorate physicians, that the image carries no conviction. The names added seem to be those of magistrates or priests; indeed these offices were sometimes united, and should the name of a physician occur, it rather belonged to him in his official than his medical capacity. Herophilus, though chiefly distinguished as an anato- mist, was, however, according to Galen, acquainted with the whole science of medicine. He, as well as Erasistratus, was accused of dissecting criminals alive; nor can we at this time deny what Celsus has expressly asserted, and Tertullian confirmed, notwithstanding the silence or the evasions of Pliny. He certainly firsftaw the lacteals in goats, and gave his name to many parts of the human body, which he first described. We are informed by Plutarch that he considered the function of respiration to be performed by tAvo systoles and two diastoles, but his account is far from being intelligible. Every complaint, he thought, was OAving to humidity. In pleurisy, one portion of the lungs Avas only, in his opinion, affected; in peripneumony the whole viscus. He was peculiarly minute in his prognostics from the pulse, and appears to have illustrated it by a geometrical construction; but Pliny, to whom we are indebted for the account, seems to think that the full explanation had not reached even his era. He chiefly depended on vegetable medicines and used hellebore freely. When the whole system was in confusion, he thought the dis- ease Avould escape. He Avas also fond of gymnastic exercises, and is quoted by Eustathius in his notes on Homer, unless with some able critics Ave read Herodicus, the first patron of gymnastic exercises, for Herophilus. The followers of Herophilus Avere numerous, and their names are preserved ; but they are spoken of with little respect by Galen, as arrogant and loquacious; and it is singular that not a single one has been celebrated for his anatomical acquisitions. The indifference to anatomy seemingly arose from the gradually increasing influence of a new sect, Avhose origin has been traced to Acron of Agrigentum, the rival of Empedocles, and the cotemporary (probably) of Hippocrates, I mean the Empirical. Its real author, however, according to Galen, was Philinus of Cos, the pupil of Herophilus; though Serapion, on the authority of Celsus, has been considered as the first and chief of this sect. Herophilus himself may have dic- tated this schism, by lessening the authority of Hip- pocrates, whose anatomical descriptions were found by Herophilus to be seldom consonant with the human structure. It appears, however, more probable that the new sect arose from the superstitious dread of the Grecians, Avho thought themselves polluted by the touch of a dead body, for Herophilus dissected in Egypt; and this I conjecture to have been the .case, since the first mark of disaffection expressed by Philinus Avas the aversion to anatomical dissections ; nor can I find, afier a very minute enquiry, that he proceeded farther in his heresy. He wrote also some tracts on plants, and com- mentaries on Hippocrates; butvery little is knoAvnof him. Serapion of Alexandria, first openly contended that all dogmata in medicine were useless or injurious. The result of casual information, when pursued in practice, they called imitation; frequent imitation an experimen- tal habit; and they formed rules, more or less general, according to each. When they transferred Avhat they had observed respecting one disease to another, they called it epilogismus; and the result of their OAvn ob- servation, autopsia; that of others, history : the two last with analogy (epilogismus) they styled the tripod of medicine. This is the equivocal triplex sermo which Ga- len accuses Serapion of preferring to the ancient dogmata. Of the empirical practice Coelius Aurelianus has given some specimens: castor, cicuta or opium, and henbane, were the chief remedies. In the account of epilepsy the reader will find almost the whole of the materia medica of the empirics; but they usually premised bleeding, vomiting with veratrum album, and purging with black hellebore and scammony. The followers of Serapion have not been distinguished in the annals of medicine; and one of the last, whose name merits our regard, Heraclides of Tarentum, devi- ated, we suspect, from his predecessors, since he com- mented on all the works of Plippocrates, and is praised by Galen. His tracts on internal affections and on diet were also commended ; but, in general, the empirics were attentive to diaetetics and to surgery. Celsus praises their ordering moderate and frequent potions in fevers, though he disapproves of their management of quartans. Galen describes an antidote of Heraclides, which consisted of the juices of cicuta and henbane, of each four drachms; of castor, white pepper, costus, myrrh, and opium, of each a drachm. These were mixed in two glasses of wine, and evaporated in the sun till the whole Avasof the consistence of an electuary, and the quantity of a horse bean given Avith tAvo glasses of Avine in all cases of bites from poisonous animals, in pains, and in strangulated uterus. We have arrived far beyond the period Avhen Celsus tells us that medicine was divided into three branches, diaetetics, pharmaceutics, and surgery, yet Ave have seen the same authors treating of each; and though the proportion of their attention has been varied according to their fancies and opinions, yet the same author has seldom wholly neglected either. The language of Cel- sus seems therefore to have been mistaken, and in Tres partes deducta seems to mean the particular attention paid to each branch; for surgical knowledge often exert- ed in the moment of necessity, and diaetetics, Avhich re- quire domestic attention, could form no part of the systems of the priests. Some, however, were particularly famous for branches of the science, Avhich they had particularly cultivated, and we know that lithotomy, for instance, was practised by exclusive operators. The empirics, we have indeed remarked, were pecu- liarly attentive to diet; but there is no evidence of any real separation, except in the case of the operation for the stone. On attentively examining this subject, we M E D 945 MED ■find traces of compounders of medicines (pharmacope- ias) distinct from the practitioners. Theoplirastus, for in- stance, distinguished the Pharmacopola Thrasyas from his pupil Alexias, who Avas acquainted Avith the Avhole art of medicine. The same author asserts that Eu- demus of Chio Avas accustomed to prepare tAventy doses of hellebore in one morning; and it appears, from the subsequent sentence, that the pharmacopolae kept open stalls, not unlike, probably, the stages of modern moun- tebanks. The herbalists were a still inferior class, sub- servient to the pharmacopolae. The successors of He- raclides are not of sufficient importance to detain us, for much remains to fill up the picture. Greece Avas now become subservient to the superior genius of Rome, and Ave must there look for the pro- gressive steps of medical improvement. Rome, formed by the rude tribes of ferocious banditti, wanted for many ages little more than those chirurgical aids which their mode of life rendered indispensable. Epidemic fevers, however, were at times violent and fatal, from the Pontine marshes, which were at no great distance from this capital of the world. Yet, for nearly 600 years, they were said to be Avithout medical aid, and their only resources to have apparently been blind empiricism, superstitious charms, or religious cere- monies. Temples seem to have been erected to Fe- bris, and their most destructive enemy, thus raised to the rank of a goddess, was Avorshipped. In various parts of the city subordinate deities of the same kind Avere in- troduced ; and no less than three goddesses, Intercidona, Pilumna, and Deverra, were propitiated by offerings to confine Sylvanus, who Avas supposed to be inimical to Avomen in child bed. In the year 321 ab urbe condita, a temple was erected to Apollo for the health and safety of the Roman people ; and in 470 .Esculapius, or rather his emblem, a snake, was brought to Rome by a solemn embassy, sent for the purpose to Epidaurus. The snake took refuge in an island in the Tiber, and there the temple of the god Avas erected. This fact is of con- siderable importance in the history of medicine, since it proves that the Avorship of .Esculapius was continued in Greece in that era, and consequently that traces of the records from which, as a sacred fountain, Hippo- crates dreAv a great part of his observations, were still preserved. Some of the votive tablets hung up in this new temple are preserved by Gruter, and of a date so late as the age of the Antonines; but these are in Greek, and seem to have oAved their origin to the grati- tude or superstition of some Greeks who at that time resided in the city. It indeed appears singular, that, while Rome Avas so little distant from Naples, a Greek city, who traced their original to the Rhodians, among whom .Escu- lapius was Avorshipped, they should have had no traces of medicine; especially as the Pythagorean philosophy Avas brought from thence, or from the farther provinces, styled Magna Graecia, to the Roman kings. The tes- timony of Pliny, however, is positive ; nor is it repelled by Dionysius of Halicarnassus, who remarks, in two distinct epidemics, viz. of the years of 282 and 401 ab urbe condita, that the disease was so violent, as to baffle the skill of the physicians; for such would be the lan- guage, whatever the medical aid might have been. The stern patriotism of Marcus Cato seems to have pre- vented the increasing influence of the Grecian physic; VOL. I. and, from authority, or complaisance, Pliny fixed the period of 600 (strictly 535) years, during which no physicians Avere to be found in Rome. It must be obvious, as we have already insinuated, that this could not be strictly true; for some resources, cither ridiculous or superstitious, must have been sought for Avhen dis- ease occurred. The diaetetic system, the virtues of cabbage, adopted from the school of Pythagoras, and the superstitious attachment to the Asclepiadae, could not have sufficed ; but Ave find little to substitute in their place. The Roman records fail us, and the authority of Cato is supreme. We mean not, in this account, to allude to a law said to be introduced by Cato, prohibit- ing the Grecian practice ; for at the time of the arrival of Archagathus from Greece, he Avas but fifteen years old; but, as we have remarked, to his influence in prevent- ing the increase of the prevailing fashion. The fame of Archagathus quickly faded; for, though at first styled Vulnerarius, he was soon stigmatized by the appellation Carnifex. Of the practice of Cato, Avho Avished to su- persede the Grecian system, Ave have hints from Pliny, Plutarch, and his OAvn remaining works. He did not enjoin abstinence, but alloAved his patients to eat vege- tables (Pliny says cabbage, exclusively), ducks, pigeons. or hares. In fractures and dislocations, his remedy Avas a charm, consisting of hard Avords, Avithout a meaning. The English reader may find some amusement on this subject in the memoirs of Martinus Scriblerus. The bad success of the severer practice of Archa- gathus soon rendered his successors more gentle in their operations ; but that some remains of the active Greek surgery continued to prevail Ave learn from Plutarch, Avho informs us, that, when C. Marius suffered the ex- tirpation of the varices of one leg without a groan, he declined the attempt on the other, saying, that the advantages did not compensate for the sufferings. Numerous works have been Avritten to prove, that physicians at Rome were slaves, liberti, or foreigners. The opponents of this opinion have been equally voluminous. We must, as usual, give the result of our inquiry without engaging in the controversy. It seems clear that the greater number of practitioners Avere of the description mentioned, but it is equally certain that many Avere of a superior character. Archagathus him- self Avas received at first with great ardour, and a house purchased for him; nor, on the decline of his credit, was he apparently deprived of it. He Avas also raised to the rank of a Roman citizen; and the Aquilian laAv declares, that, if any physician neglects a slave after any opera- tion, he shall be pronounced guilty of a crime. By the same law, an action will lie against a physician, who, by the unskilful use of the knife or of medicine, shall kill a slave; and Ulpian decides, that amidAvife, in the same circumstances, shall be pronounced equally guilty. These regulations must relate to free men, and the Aquilian law is confessedly anterior to the age of the Caesars, for all physicians were by Julius Caesar raised to the rank of Roman citizens. Varro is also explicit on this subject, when he discusses the question for what farms it is preferable to have artificers, amongwhich he reckons medical assistants, occasionally hired, and to what kinds it is better to have slaves attached. In the time of Cato, also, the Phoenicians had been driven from Sicily by the Romans, and the Macedonians from Greece. The Grecians had therefore recovered a great 6E M ED 946 MED share of their former liberty. As their language Avas fashionable, their manners pleasing, their demeanour obliging, perhaps approaching to servility (Juvenal), it is not surprising that they should flock to Rome, nor that they should be favourably received. Medicine obtained no inconsiderable advantages from the legacy of Attalus Philometor, the last king of Per- gamus, Avho left the Romans his heir. We are told by Galen that the Pergameni Avere the rivals of the Egyptians in collecting books; and Philometor was peculiarly attached to gardening, and the examination of the poAvers of poisonous plants. It has been said that this study was rendered subservient to the most cruel purposes, but of Philometor's cruelty Ave have no evi- dence. We know that he wrote some tracts on agri- culture, Avhich Pliny and Varro have praised; that he engaged in metallurgic experiments, and in modelling with Avax: Galen describes also, with commendation, some medicines invented by him. To the patronage and to the assistance, probably, of Philometor, we are indebted for the Avorks of JVica7ider, particularly the Theriaca and Alexipharmica. His collection of reme- dies, the prognostics translated from Hippocrates, and a work in verse, De Re Rustica, highly commended by Cicero, are lost. A long fragment of the last is pre- served by Athenaeus, which shows that it contained many observations relative to medicine. The poems which remain were highly valued by ancient authors, as we find from the numerous commentaries on them; and Avhatever may be said of Attalus' more philosophical or patriotic pursuits, it is still probable that experiments on co7idemned criminals furnished Nicander Avith many facts. The history of medicine describes Thrasyas as attentive to poisonous plants, and perhaps their anti- dotes, fable speaks of Dcianira, Hecate, Circe, and Me- dea, butanimal poisons Avere first considered scientifically by Nicander. The king of Pontus, about the same period, engaged in a similar investigation; and to his experi- ments in pursuit of antidotes we owe the famous medi- cine, which bears his name, Mithridate. The receipt, with many others, Avas taken from the cabinet of Mi- thridates, by Pompey, Avho directed his freed man Le- naeus to translate them. The original formula however of this famous alexipharmic consisted only of two dried nuts, as many figs, twenty leaves of rue, and a grain of salt. To this remedy Ave shall, hoAvever, return. The pursuit of this subject has draAvn us from our chronological clue ; for, previous to the conquest of Pontus, Asclepiades flourished. He was not a Roman, but born in Prusia, a city of Bithynia. He was by pro- fession a rhetorician, an Epicurean, and the friend of Cicero. If we may trust the report of Pliny, Ascle- piades came to Rome without any knowledge of medi- cine; and, failing in his attempts as a rhetorician, he with little preparation professed himself a physician. He was the first of this profession Avho gained general esteem in the capital of the world, and whose name has reached posterity. Pliny gives a long account of the artifices by which he attained his reputation, but they are such only as every fashionable physician employs, viz. pleasing the patient, and avoiding every thing that can give uneasiness, till nature curesr or yields to the disease. He curtailed the rigorous abstinence of the Greek physicians,gave wine occasionally, recommended friction, gestation, baths, he. vide Balneum, pro- fessing to cure Avith speed, Avith safety, and Avithout inconvenience. He declared that he deserved no credit, if he was himself umvell; and, fortunately for the credit of his system, he died in extreme old age, in conse- quence of a fall over the stairs. Asclepiades was the founder of a neAV sect styled the Methodic ; for his philosophy was.that of Democritus as reformed by Epicurus, and his physiology rested on corpuscles, flowing through invisible pores. The doctrine of Hippocrates, respecting the intelligence of nature, and her influence in curing diseases, he rejected with contempt. He denied even the poAver of at- traction in the magnet. The soul he considered only as the united action of all the senses; and the intellect, or the power by Avhich we understand what is secret or concealed, consisted, according to Asclepiades, in a reso- lution of the ideas, attained by the sensible images for- merly collected. Every thing happened, in his opiniony from necessity, and nothing Avithout a cause; nor was nature any thing but the body, or its motions, and, in- stead of assisting, usually injurious. Thus the Epicurean system of Asclepiades verged towards Stoicism. His ana- tomical knowledge was very imperfect, or he Avould not have thought that the urine passed from the intestines into the bladder through pores. Digestion was, in his opinion, unnecessary; and he supposed that the food was carried into the blood, and there attenuated till it was adapted to the pores of the vessels which conveyed 'it as nourishment. Hunger Avas induced by the relaxa^ tion of the larger, and thirst by that of the smaller pores. The faeces Avere not, he thought, excrementi- tious, as some insects fed on them. His pathology Avas of a similar complexion. Inflam- mation Avas OAving to obstruction either from the mag- nitude, the figure, the multitude, or the rapid motion of the atoms; pain to obstruction from particles of a large size, and the absence of the smaller ones'. Faintings, dropsies, and hectics, arose from the too great size of the pores; and dropsies, in particular, he thought might be OAving to t.he transudation of the flesh, which then became water. Quotidians Avere owing, in his opinion, to the obstruction of the larger particles, tertians of the less, and quartans of the least. He denied the existence of critical days. This system he adorned with all the art of his former profession, and his practice was no less captivating. He rejected vomits and purgatives; admitted of bleeding, but with numerous limitations ; and substituted, forpur- gatives, the most acrid clysters. Obstructions Avere, he thought, best removed by wine, by friction, gestation, and bathing. He plumed himself on having first directed frictions, and is minute in his directions for their management; yet, so far as we can collect from his disciples, he added little to Avhat Hippocrates had, in a few words, directed. He sometimes, however, ordered medicines, though chiefly external applications, and occasionally scarifications. Thus was this famous revolution in medicine effected, not from superior judgment, more extensive observa- tion, or experience, but from ignorance of what former practitioners had taught, and indolence, which rendered him umvilling to learn. It was easier to Construct a fanciful romance than to study by the midnight lamp, and some late systematics have thought the sune. The Avhole Avas rendered fashionable by his eloquence, MED 947 MED and the comparative pleasantness of his medical di- rections. We must not, hoAvever, suppose, as has been too com- mon with medical historians, that Asclepiades had no prototype or rival. Celsus expressly remarks, that he borrowed from Clcophantus, a physician of a former era; and Pliny observes that the use of wine, as directed by Asclepiades, was borrowed from the same author, whose period is uncertain, though we approach it by finding that his scholar Mnemon flourished in the time of Ptolemy Euergetes. One sarcasm of his rivals has been mentioned, where he is referred to the butchers and cooks, as able to give him correcter physiological views than he possessed. Cicero also, the friend of Asclepiades, highly praisesCrateras,and bitterly laments the death of Alexion. We may likewise mention, though it might more properly occur in another place, that Crateras the herbalist, highly commended by Pliny and Dioscorides was probably the first who dreAv figures of plants. He lived, however, in the time of Mithridates, and must be distinguished from a physician of the same name, the cotemporary of Hippocrates ; nor is it too late to add, that many Asclepiades flourished in subsequent eras, whose Avorks and opinions, without great care, may be confounded with those of the Bithynian. The sect of Asclepiades seems not to have been at once established. Alexander Philalethes, his scholar, taught in Asia; and Artorius, the physician of Augustus, who perished at sea, Ab. U. C. 722, Avas also a folloAver of this celebrated innovator. Artorius has been con- founded Avith Antonius Musa; but he had been dead ten years, when the latter succeeded in the cure of the emperor, after his former physician had failed. Who that physician was is not certainly known. If we trust the emendation of P. Harduin, he was called Camellius; and this name occurs not only on inscriptions preserved by Gruter,but on medals. What the disease of Augustus was we are not informed ; probably a debilitated sys- tem, Avhich A. Musa cured by cold bathing, cold drinks, and lettuces, which Camelius' scruples had for- bidden. The gratitude of Augustus was unbounded. His pecuniary rewards Avere immense: hejwas allowed to wear the ring; and immunities Avere not only granted to him, but to all Avho exercised the same art. Sue- tonius adds, that his statue, made of brass, was placed next that of Esculapius. We have no reason to sup- pose that Musa Avas a follower of Asclepiades ; for he is spoken of by Galen as intimately acquainted with the Avhole science of medicine. Whether it arose from the slow progress of the plans of Asclepiades, or from the alterations and improve- ments of The7niso7i, that the latter has been considered as the founder of the methodic sect, is uncertain. Such, however, is the general language of medical history, and Ave must folloAV her steps. Themison has been highly commended by his cotemporaries and successors, and his name was long synonymous Avith that of an able phy- sician. Yet we cannot but recollect the line of Juvenal: Quot The7nison agros autumno occiderat uno. Asclepiades chiefly considered the causes of diseases : Themison thought it only necessary to connect them by some common symptom, and divided diseases into the stricta, laxa, and mixta. By these terms we must not understand, with the generality of authors, constricted and relaxed fibres, or a mixture of both, but diseases attended Avith impeded or increased secretions, or too great discharges from one part, and too little from an- other. TTiese principles afforded a path for physicians, and hence the sect (from peOofos, via) Avas styled the methodic. In the first case he directs evacuants, in the second restringents, and in the third to oppose, by either class of remedies, the most dangerous disease. Such was the system he taught in advanced age ; but the methodic doctrine had not yet been polished with care, so that Ave shall speak of Themison as an individual only in this place. . Themison neglected the precepts of Asclepiades in many respects, particularly in giving aloes and scam- mony, in alloAving cold water after bleeding, and in not observing the due periods for giving nourishment, ex- citing evacuations, or bleeding. It is remarkable that in the writings of the methodic sect Ave find the first traces of bleeding with leeches ; and Coelius Aurelianus re- lates a singular fact of Themison, that, having been bit by a mad animal, or possibly remaining too long Avith a friend labouring under an hydrophobia, he contracted the same disease. He cured himself; but, Avhen he at- tempted to explain the method, he relapsed. This must have been a high degree of hypochondriasis. He was the author of many works, from which Coelius Aurelianus has preserved short extracts ; but we can select nothing very important, except his praises of plantago, a plant supposed to be discovered by himself. The system of Themison seems to have had no very violent opponent, or defendant: so far as we can col- lect, the opinions of physicians vibrated betAveen the pores of Asclepiades,aiid the stricture or laxityof Themi- son, and practitioners seem to have reasoned Avith some freedom, though with no striking marks of genius or ability. A work intilled Problemata Medica, ascribed to Cassius, Avho seems to have lived about the end of the reign of Augustus, and the beginning of that of Tibe- rius, displays some marks of judgment and discrimina- tion ; but in his reasoning he seems to lean rather to the opinions of Asclepiades than Themison. We must not, however, conceal that the problems have been attri- buted to a later author, who is by no means a servile follower of the Rhetorician's doctrines. His practice, as we learn from Celsus, Avas far from irrational, and he freely gave cold water in fevers. Galen and Scribonius Largus mention a remedy of Cassius, called col ice, as useful in colic pains. It consisted of carmin uives, spices, opium, and saffron. This receipt Cassius left, apparently, to his servant Atimetus, whom he bequeath- ed to Tiberius, and from him Scribonius received it. Celsus Avas another distinguished practitioner of the methodic sect, who brought, or greatly contributed to bring, physicians back to the patient study and obser- vation recommended by Hippocrates. He seems to have been a cotemporary of Cassius ; and his language alone would place him in the Augustan age. Some late critics have reduced him to that of Trajan. Pliny, however, who dedicates his Avork to Vespasian Titus, in his sixth consulship, A. U. 830, quotes passages of Celsus, Avhich Ave still find in'his writings; but Trajan only began to reign twenty years aftenvards. Pliny also observes, that Julius Graecinus, respecting vine- yards, transcribed the directionsof Celsus ; but J. Grae- cinus was murdered by Caligula, according to Tacitus, M E D 918 M E D and Caligula Avas himself killed in A. U. 783. Celsus tells us that Themison, in advanced lfe, had deviated from the precepts of Asclepiades, and Pliny, that The- mison was the pupil of Asclepiades, Avho* lived in the time of Pompey. Celsus, indeed, speaks of The- mison as still alive, and consequently he must have himself flourished in the latter years of Augustus. Cel- sus is said to have been a Roman, or perhaps a Veronese; but though he speaks occasionally of his oavii observa- tions, he was not a regular medical practitioner. Pliny never mentions him in this light; and, when he enu- merates the physicians of Rome, the name of Celsus is not included. Celsus in his medical works has chiefly followed Hippocrates, particularly in his Histories of Diseases and Prognostics, except in relation to critical days; but he is not, as has been supposed, the servile commentator of the Coan sage; for he quotes numerous authors of a later era, and seems to have given a brief abstract of the best systems, in a connected view, though evidently of the methodic sect, and the echo of Themison in Avhat relates to the cure of fevers. He is, indeed, rather an epi- tome of his predecessor's maxims,than himself an object of historical research ; and Ave shall leave him with re- marking, that those Avho Avish to study the opinions and practice of the ancient physicians will find both ele- gantly, as well as correctly, detailed in Celsus. We should scarcely have mentioned JEmilius Macer, a physician of this era, who is said to have written on plants, on breeding birds, and on theriaca,but to remark that his works are lost, and that the poem on the Vir- tues of Plants, ascribed to him, is the production of an obscure monk of the middle ages, or, as has been said, of the physician Odo. Of Servilius Democrates we should also have scarcely spoken, since his era is un- certain, and the subject is too uninteresting to induce us to engage in the disquisition, but that the more laboured composition of the Mithridate and Theriaca is profess- edly taken from his Avorks by Galen. They were de- tailed in Greek iambics. Of an uncertain age also is Philo, Avhose name is preserved in the Philonium, a preparation described, according to Galen, in elegiac verses. In this prescription the corrector of opium is the euphorbium, as in the theriaca it is the squill. He seems to speak of himself as of the family of Asclepi- ades ; but his age, we have said, is doubtful. Scribonius Largus, of whom we have incidentally spoken, Avas of an era posterior to that of Celsus, though not so late as has been suspected from his style; a pecu- liarity satisfactorily explained, by supposing that he Avrote in Greek, and that his work was translated by an inferior author. His tract on the composition of me- dicines contains many choice receipts, collected from different sources, chiefly private collections, and empi- rical traditions, which are not found to countenance the encomia with Avhich they are introduced. Scribonius highly commends his preceptor, Apuleius Celsus, whose antidote against the hydrophobia he has preserved. Another pharmaceutist of that era was Philenides or Philonides, who wrote, according to Dioscorides, on white hellebore; but the chief author in this department of medicine was Andromachus, perhaps the first who Avas dignified with the title of archiater, though the ho- nour of priority has been contested in favour of Demo- crates. The title has been equally the subject of con- troversy, and it has been disputed whether it meant the principal, or the emperor's physician. Galen, indeed, ex- pressly observes, that such Avere his talents, not only in the medical but in the literary departments, that he AA*as appointed xgxilv T*'v "ixTpav. He was the author of the theriaca, still known by his name, whose utility con- sisted not only in resisting the poAver of all poisons, but in giving calmness and hilarity, as Avellas removing the: effects of fatigue. In this preparation the troches of vipers Avere designed to be the alexipharmie, and the opium the cordial, ingredient. This remedy, for more than one thousand five hundred years, enjoyed the highest reputation, and Avas prepared by kings and no- blemen Avith the most accurate attention. The receipt in Greek verse is preserved by Galen. Andromachus has left no other memorial; but the Avorks of his son are often quoted by Galen, though neglected by later authors, as he is not explicit respecting the preparation of his compositions, or the times of most successfully employing them. Numerous are the collectors of formulae in this pe- riod. Among these are the younger Asclepiades, called, probably for the sake of distinction, tpxpfAMxeav; Cha- ricles, highly commended by Tacitus, and Menecrates, perhaps of an earlier era, who first endeavoured to abolish the medical characters of Aveights and measures, as liable to be mistaken by transcribers, and to substi- tute words. The improvement, hoAvever desirable, Avas soon overlooked, and Galen complains that the characters were again employed. There is much reason to suppose, that, from the time of Celsus, physicians again returned to the more cer- tain road of observation and sound reason ; but either the rage of innovation, or the desire of distinction, ex- cited another sectarist, who, like Asclepiades in a for- mer, and Paracelsus in a later, era, attempted to over- turn all that his predecessors had collected. This man was Thcssalus Trallian us, Avho boastingly styled himself, on his tomb, Iatronice. His father was of the loAvest rank, and Thessalus himself Avithout the advantages of education. This is the account, ipdeed, of Galen, who, on every occasion, eagerly censures him; but Ave have the evidence of Pliny to convict him of the most dis- gusting arrogance, and the most consummate igno- rance. He gained access to his superiors by flattery, and a subserviency to their pleasures; nor did he pro- fess himself a physician till he had disgraced himself by every species of infamy in their service. His system differed, however, very little from that of Asclepiades and Themison. If, in their opinion, health consisted in the pores being adapted to the fluid, and disease in their being unsuitable, Thessalus thought the same. But in the mode of relief he aimed at changing the state of the solids rather than the fluids. He also was the first who in fever ordered three days abstinence and rest, from which physicians were afterwards called diatritarii. His peculiar pathological opinions intro- duced a singular language, which has not been pro- perly explained, viz. metasyncrysis and metasyncritical remedies. In the language of the methodic sect, svyxptvesBxt is opposed to foxxpivesix), the former mean- ing to mix and unite, the latter to separate. Merxsvt- xpive7)6xt, therefore, means the separation of bodies previously united. Coelius Aurelianus uses the Avords recorporate and recorporatio. The chief, works of M E D 949 MED Thessalus, quoted by Coelius Aurelianus, relate to diet; but Galen mentions his name on a subject of surgery, which leads us to suppose that he wrote some chirur- gical tracts. Among those who recommended themselves by the novelty of their fancies rather than their improvements, we may mention Crinas, of Marseilles, who only al- lowed food Avhen the horoscope of the patient permit- ted; a system sarcastically hinted at by Juvenal; and Charmis, from the same city, Avho, with less discrimina- tion and more eagerness than A. Musa, allowed only of cold baths and cold drinks. Authors of a superior character, in this era, were Rufus Ephesius, Avho Avas perhaps the first medical lexicographer, and Avho wrote De Nominibus Partium, and Erotian, whose Lexicon Hippocraticum is still a work of great value. Rufus, who is placed by some historians in the time of Trajan, wrote many other works, particularly one on the affec- tions of the bladder. His poem, in hexameter verse, on plants, is wholly lost, unless, as has been suspected, the lines on the plants consecrated to the gods, added by Aldus to his edition of Dioscorides, and preserved in the Greek bibliotheca, be a part of it, as Fabricius suspects. In this era also, from the age of Nero to that of Trajan, Dioscorides and Pliny lived. The vast Avorkof the latter has furnished many parts of this history, and the materia medica is indebted to each author for the most important aid. We have mentioned them more particularly in another place. From the Preface to Arius it is probable that he was himself a practitioner of medicine, though to no great extent; and, from the predilection he seems to feel for the sect of Asclepiades, if Ave may guess froni^ his almost exclusively quoting his folloAvers, he Avas probably a Methodic. It will be obvious, from this history, that the doc- trine of the Methodics had, at no period, a very general currency, and about this time the Asclepiades were di- vided into many subordinate sects. One of these, the ErisYNTHETics, endeavoured to reconcile the various discordant opinions of different authors; and another, the Eclectics, to°select from each system what was most probable. The chief of the first was Leonides of Alexandria, whose Avorks are lost, and from the quota- tions which remain in other authors, it is not easy to ascertain his peculiar opinions. The chief of the eclec- tics was Archigcnes of Apamca, a most excellent author, highly commended by Haller in all the different de- partments of medicine. He Avas a scholar of Agathinus, one of the chiefs of the Episynthetics. Another sect into which the Methodics divided, and which was at last absorbed in, or absorbed, them, the pneumatic, merits more particular notice. The chief of this sect Avas Athenaus of Attalia, a man whose system, according to Galen, Avas polished Avith greater skill than that of any of his cotemporaries. The philo- sophy of the Pneumatics Avas derived from the Porch, since they allowed Chrysippus to be their great proto- type. Athenaeus supposed that fire, air, water, and earth were not really elements, but that their qualities, heat, cold, dry, and moist, merited this title. FolloAving the Stoics, he introduces a fifth principle, viz. a spirit go- verning and directing every thing, and occasionally, when ofL-nded, inducing diseases. From this new principle they Avere styled Pneumatics. Agathinus, already mentioned among the Episynthetics, was in a subsequent period a Pneumatic, in consequence of his attending Athenaeus. He explained, it appears, at some length, the principles of his sect, in a tract on Discoveries since the time of Themison. He Avrote also on the pulse. Herodotus, Archigenes, and other physi- cians of character, Avere followers and pupils of Athe- naeus; but the fame of each Avas eclipsed by that of Are- taeus. It is singular that he never mentions Galen, nor is mentioned by him; and, at the same time, the quo- tations of .Etius from Archigenes bear a considerable resemblance to the observations of Aretaeus on the same subjects. Was the Attic dialect of Archigenes more agreeable to the Roman ear than the Ionic of Aretaeus? or were they one and the same, differing only by a change of dialect? We must, for Avant of further in- formation, leave this subject in its former obscurity. The language of Aretaeus is distinguished by a lu- minous terseness, \vhich impresses the idea with con- siderable force. He can scarcely be styled a Methodic, and indeed bears few marks of that sect, and particu- larly differed from them in investigating the causes of diseases by anatomical dissections. The nerves, he supposed, did not run from their origin to their ter- mination in straight lines, but crossed each other in the form of an X, passing in this way to different sides; and he thus explains the disease felt on the side oppo- site to that where the head Avas injured. His practice Avas that of the most judicious of the ancient physicians, and he Avas particularly fond of exciting vomiting by Avhite hellebore. This operation, he remarked, relieves the breathing, changes Avhat was of a bad colour to a good one, and restores plumpness to those who Avere emaciated. He used the most active purgatives, bled frequently and freely from different parts, though he argues very forcibly against the refinement of some prac- titioners, who prefer small veins, which are the branches only of those from which blood is usually taken. He employed arteriotomy, cupping glasses, and leeches; but preferred curing acute diseases by diet. He gave wine more freely than former physicians allowed, and employed opiates with little reserve. He Avas pecu- liarly partial to castor, as a nervous and antispasmodic medicine, thinking it also an assistant of digestion. He recommended asses', mares', sheeps', and women's milk, used frictions and the actual cautery, and advised the operation of lithotomy. In short, practitioners of any age will derive from Aretaeus the most sagacious and useful medical observations. His practice is active, enlightened, and discriminated. Aretaeus is, by some authors, referred to the age of Nero. His era is, in- deed, uncertain; but the Ionic dialect was not Avholly disused even in the time of Hadrian. An author of this era, and of the Methodic sect, Avhose works are lost, was Soranus of Ephesus; and we have reason to regret it, because Galen, who loses no opportunity of criticizing the Methodics, speaks respect- fully of Soranus. They were translated in a barbarous style by Coelius Aurelianus, an African; but even in this dress they have reached us in an imperfect state. Yet from Coelius Ave have the only systematic and con- nected vieAV of the Methodic doctrine; for by Soranus only it was brought to a perfect state. As the cycles of the Methodics are often mentioned in medical works, we shall add a short description of the meaning. MED 950 MED The cycles were periods supposed to consist of three days each, or combinations of three, and during these the same plans Avere continued ; but at the end of each cycle the exertions were increased, so as at last to rise to the most active measures. The resumptive cycle consisted of common foods: the metasyncritic of a more acrid and stimulating diet, Avith frictions, baths, rubefacients, sternutatories, 8cc. The cyclus vomitorius Avas distinguished into two, as the vomits accompanied the sparer diet of the first, or the more stimulating diet of the second. Each cycle consisted of four diatriti, though sometimes prolonged to sixteen days; the addi- tional diatrition containing four days. We have already observed, that in all the Avanderings of the fancy, the natural good sense of physicians occa- sionally brought them back to the safer road of patient thinking, and accurate observation, Avhich so much dis- tinguished the Hippocratic school, the real (A.edofos of the healing art: but Ave have now to notice the revolution Which for ages gave a stability to the science of medi- cine, and fixed an oracle, who for more than one thou- sand five hundred years dictated to the world, and whose decisions were listened to with the most im- plicit deference. We allude to Claudius Galenus, of Pergamus. Galen lived in the second century of the Christian era, and was born during the reign of Severus. He studied at Alexandria, but chiefly practised at Rome, and was the physician of the amiable and benevolent Mar- cus Aurelius, one of the feAv emperors who added lustre to the purple. Galen was distinguished in his earliest years, for a lively fancy and uncommon ingenuity. He attained all the learning of that era, and was soon dis- gusted with the prevailing systems of medicine. He professed, indeed, to select from each what Avas most valuable; but has almost exclusively confined himself to commenting on and illustrating the Avorks of Hippo- crates, which he thinks succeeding physicians had either misunderstood or misrepresented. Yet he seems to have taken the qualities of the four elements from Athenaeus; and though Hippocrates mentions, some- what equivocally, the Spirit, he apparently borrows the vital, animal, and natural spirit from the Pneumatics. Galen wrote very diffusely on every part of medicine; but he added only dress and ornament to the system of Hippocrates. In fact, minute distinctions, refined spe- culations, and abstract reasoning are the Avhole for which the medical world is indebted to him. They did not lead Galen himself from the path of truth; but they had the most fatal influencexm his successors, Avho specu- lated when they should have observed, and reasoned when they should have acted. The doctrine of con- coction, the most fatal idea which ever occurred, was completely established in the school of Galen. The splendour of Galen's fame dazzled his cotempora- ries and successors, so that we find few Avho afterwards dared to think beyond his circle. Quintus Serenus Sanionicus Avrote, in Latin verse, on medicine in the following century; but whether that Avas the work of the father or the son is still doubtful; nor does its real merit call on us to enlarge on it. Alexander Aphro- di.iaus, who wrote a treatise on fevers, and a Avork in- titled Interdicta Medica, and Problematica Physica, scarcely deserves more attention. Oribasius has been stvled the ape of Galen. The tAventy-fourth and twenty-fifth books contain, indeed, an abridgment of Galen's anatomy; but Ave find a description of the sa- livary glands, Avhich, if knoAvn to the Pergamenian, has never reached us in any of his Avorks. Oribasius, who lived till near the latter end of the fourth cNmtury, was the physician of Julian, and his collections were com- pleted about the year 360. It is not, however, true that he collected from Galen only; for even in his first fifteen books, the only ones we possess, except the ana- tomical ones, other authors are mentioned, and we find numerous quotations from preceding physicians. Ori- basius was not only a physician, but high in the confi- dence of the emperor Julian, Avho appointed him the Quaestor of Constantinople; and though in the suc- ceeding reign he was for a time disgraced, and even banished, his real merits were too considerable to admit of the continuance of his exile. His anatomy, we have observed, was copied from Galen; but the remaining books of his medical collec- tions, amounting, it is said, in the Avhole to seventy-two, besides his quotations from authors noAV lost, contain some practical remarks of importance. His recom- mendation of scarifications, instead of cupping, is not, we think^ one of these ; for ligatures, bathing the legs, and the application of stimulants previous to the use of the lancet or needle, answered the same purpose as the rarefaction or exhaustion of the air. Oribasius first described the singular madness styled AvxxvSpunx, in which the patients avoid the society of mankind, haunting the most desolate places, andAvound- ing themselves Avith stones, 8cc. Some critical disqui- sitions have been employed to determine whether they " open" the tombs, or only " dwell" among them. The question is of little importance, though, as it is con- fessedly the disease mentioned in the New Testament, if we recollect rightly, the possessed are there said to " come out of the tombs exceeding fierce;" and the tombs of the pagans were generally open to receive the oblations to the manes of the deceased. As we have pronounced the question to be a trifling one, we shall not enlarge on it. Oribasius wrote four books also on diseases, and several others, Avhich were chiefly abridg- ments of Galen. Some receipts, quoted by .Etius, seem to be his oavii; but the commentaries on the aphorisms of Hippocrates, attributed to him, are of a much later era. Excepting the collections, the nine books of his synopsis, addressed to the younger Eusta- chius, and four, De Euporistis, to Eunapius, are the only works which remain of this author, Avho certainly merits more attention than he has received. About the same era JVemesius, bishop of Emesa, abridged the physiology of Galen, intitled Natura Ho- minis. Vindicianus, the archiater of Valentinian, ad- dressed to that emperor his Carmen Epistolare; and Theodore Priscian, the disciple of Vindicianus, and archiater to the second Valentinian, wrote his four books De Curatione Morborum. The last Avork has been attributed to Q. Octavius Horatianus, the disciple of Priscian, and under his name the treatise is annexed to the Strasburg edition of Albucasis' Surgery. Seve- ral authors of this century, Avhose Avorks are still ex- tant, merit little more than the mention of their names. The chief is Marcellus F.77ipiricus, Avho wrote De Medicamentis Empiricis; Plinius Valerianus, Avhose work De Re Medica is referred by Gunziusto Siberius; Vegelius Renatus, a different person from the Tactitian; MED 951 31 ED and Celius Aurelianus, already noticed, the last medi- cal author Avho Avrote in Latin. After the lapse of nearly one hundred years, in which scarcely the name of a physician is recorded, we meet with JEtius of Amida, of avIiqsc sixteen books (iv tetra- biblia) but eight have yet been published in Greek, though we possess the Latin version of the Avhole. He is chiefly distinguished as an original writer, by his chi- rurgical operations, and in this line his practice seems to have been extensive. In medicine he recommends purlbtures in dropsies ; but the observations on these subjects are taken from Archigenes and Leonides. His remarks on cauteries, both actual and potential, are more peculiarly his OAvn. He advises them freely in many complaints, and directs numerous drains to be made. To keep these open by tents seems to have been the improvement of a subsequent era; for in many places where caustics are recommended by .Etius, tents could not be used. Setons are only mentioned 800 years afterwards. From Leonides he also describes the dra- cunculi, by modern authors called \hevene medinenses, an appellation given by the Arabians. .Etius, who had studied at Alexandria, introduced much of the Egyptian pharmacy, and Avas particularly fond of external appli- cations. He introduced also charms and amulets, so common in the same country; and, though a Christian, and an officer of the emperor's household, seems not to have been exempt from credulity. Many boasted and high priced remedies he has taught us to prepare; but adds no opinion of their utility, though of other medicines, and indeed generally of those truly valuable, his encomia are usually warm. Palladius of Alexandria Avas but a few years later than .Etius, and his Synopsis of Fevers, as well as his Commentaries on different parts of Hippocrates, are still extant. He differs, however, little from the system of Galen, and merits no particular notice. Alexa7ider Trallian, so called from his native place, Tralles, a city in Lydia, Avas nearly of the same era, and a writer more original than any that have occurred to us since the days of Galen. He limits his observations to the signs of diseases and their remedies; and though he shows too great confidence in the efficacy of some apparently trifling medicines, and is particularly fond of amulets; yet, in many parts of his work, he displays great judgment, and extensive experience. His obser- vations on bleeding in syncope are valuable, and those on the use of emetics, particularly of purgatives in fe- vers, highly useful. He is apparently the first au- thor who mentions rhubarb; but he certainly means the Rhapontic, as he speaks of it only as an astringent. The white hellebore had at this period been neglected, and even Alexander speaks slightingly of it: nor was it again recommended till Asclepiades, more than fifty years afterwards, employed it with success. Alexan- der Avas by no means a servile follower of Galen. On the contrary, he frequently differs from him, and in some instances, particularly the treatment of hectics, boldly pronounces him wrong.. Though Christianity was now established, and the physicians lately mentioned were Christians, yet the next author was the first monk who wrote on, and proba- bly practised, medicine. We shall call him Theophilus, though, from his sanctity or his talents, he was also called Philotheus and Philaretus. There is, hoAvever, a singular confusion arising from the name of Theo- philus, which was given to a cotemporary of Alexan- der, called by him Jacobus Psychrestus,or Psychochres- tus. The latter Avas by birth an Alexandrian, archiater to Leo the Thracian, and a count of the empire. If they were, therefore, the same, he must have become a monk in his latter years, a circumstance by no means uncom- mon. Jacobus Psychrestus left apparently behind him no medical work, though Theophilus, who by some histo- rians is placed in the beginning of the seventh cen- tury, and certainly a different person, is the author of five books De Fabrica, in the collection of Celsus Cras- sus, and a tract De Urinis, the first work professedly on the subject, in Henry Stephens' Principes. His scholar, Stephen of Athens, Avas the author of a Com- mentary on some part of Galen's works. Paulus of JEgina is the last author that claims our particular attention. He flourished near the end of the seventh century, and was the first physician who, by his particular notice of female diseases, appears to have paid very particular attention to them : indeed he seems to have practised midAvifery. In medicine he does not merit any great regard; but his surgical observations are valuable, and often new. What relates to lithotomy- and herniae are the most important parts; but the observa- tions on aneurisms are sometimes new, and generally valuable. Some Byzantine physicians, dimly seen through the obscurity of the darker ages, we may shortly mention. Aronus, who lived near the end of the tenth century, by the command of Constantine Porphyrogenetus, wrote an Epitome of Medicine, chiefly taken from .Etius, Alexander, and Paulus; and near a hundred and fifty years afterwards, Symeon Lethius, who held some office in the palace of Antiochus, wrote a Syntigma de Ciba- rioruin Pacultate, in which he copied chiefly the work of Psillus, who Avas his cotemporary. Both treatises still remain, but are of little value. Demetrius Pepa- gomenus, near the end of the thirteenth century, Avas a distinguished author on haAvking; but he was the phy- sician of Michaeelis Palaeologus, and left also a Treatise on Gout. Somewhat later lived Myrepsus, the author of the Antidotarium; and the scene closes with John, the son of Zachariah, honoured with the title of Actua- rius, nearly ansAvering to Avhat we mean by physician in ordinary, in the court of Andronicus Palaeologus. His six bookson the Methodos Medendi,and his Treatise De Urinis, have been commended by some practical authors; and the latter was thought, by H. Stephens, worthy of a place, in his valuable work, among the Principes Artis Medicae. All his works are in a great measure compilations from his predecessors, but there are some original observations respecting the palpita- tion of the heart, in Avhich Actuarius seems first to have recommended bleeding and purging. He is also the only Greek physician who speaks of the milder purgatives, as senna, manna, cassia, and myrobolans. The pods of the senna were then only employed, and it was brought from Syria under the name of a fruit. These medicines were professedly borroAved from the Arabians, Avhom he calls barbarians. He mentions sugar, also, and Avhat seems to have been distilled water of roses, derived from the same source. Indeed MED 952 MED distillation appears to have been known prior to the era of Actuarius, which was probably about the end of the eleventh century. We have greatly regretted, in this long career of the Grecian medicine, that no author has connected the re- volutions of this science with those of the Grecian phi- losophy. We perceive, in every step, how greatly they would illustrate each other; and, but for the extent to Avhich our article would be thus drawn, we should have enlarged a little on the connection. We have, in this part of our history, traced, with anxious care, the suc- cession of the different sects, the influence of prevailing opinions, their alternate fashion or decline, and while these, with some neglected portions of the history, have detained us, Ave have certainly omitted, not without de- sign, what may be found in every common author. We ought not to conceal that the history of medicine has not hitherto been that of a science. We have seen the scattered limbs: we wished to see them connected, so as to form an entire body; and of this connection Ave have endeavoured to give the outline. While we have less anxiously detailed the medical opinions of philosophers, we must not omit some ob- servations of Dr. Friend, Avhose history is chiefly filled with discussions on different portions of ancient medi- cine. He remarks, that the historian Procopius Avas probably a physician, from his minute and scientific de- scription of wounds, and of the plague. He adds, too, that the professional character of St. Luke is obvious, not only from his more polished language, but from his expressions relating to diseases. The curiosity of the subject has led us to pursue it, and Ave certainly find, in the relations of the cures effected by the miraculous power of our Saviour, the elegant terseness of Aretaeus. When science declined in the west it again rose in the east. In pursuance of the plan just mentioned, we have not omitted to notice the gradual steps by Avhich me- dical knowledge gradually approached its former cradle, seeking, in its decline, the protection it had received in its commencement. In the later ages of Grecian medi- cine we perceive a strong predilection for an education at Alexandria, and Ave have already traced its progress in Asia, as we catch transitory glances of its occasional appearance. Alexandria, once the receptacle of the fa- mous library, burnt by accident during Caesar's attack, received, in return, by the bounty of Anthony, the fa- mous collection of Mithridates, already mentioned as a legacy to the Roman people; and even at the com- mencement of the ninth century its professors were highly celebrated. Other circumstances favoured the progress of medicine in the east. When Valerian was conquered by Sapor, the king of the Persians, and car- ried captive to his new city, Grandisapora, he was fol- lowed by many Greek physicians. So early as the sixth century a medical school was founded in that city, and an hospital established in it. Hospitals were, indeed, not unknown in the latter ages of the Roman empire, and seem to have been first established before the reign of Justinian Its school was highly celebrated, and much frequented by the Arabian physicians, even at the time of Mahomet; but Persia was conquered by the Saracens in the year 460, and medicine was scattered by their means through the wide extent of their tributary regions, even to the confines of Spain. Previous, how- ever, to the conquest of Valens, Sapor had married the daughter of the emperor Aurelian, and probably the medical knoAvledge of Greece had already attracted the attention of the Persians. They left, indeed, no traces of their acquisitions; for the earliest eastern medical authors were Syrians. Aaron, the presbyter first collected what he called the Pandects of Medicine, from the Greek, about the time of Mahomet, A. C. 622, which Avere only translated into Arabic by Masergawaihus, in 683. Near a century afterwards we find Alexander, the se- cond caliph of the house of Abbas, requiring the assist- ance of Bactishua, who resided at Grandisapora; so that this city still retained its character for the acquisition of medical science, and the family of Bactishua continued famous for many succeeding generations. To them the eastern nations were indebted for many translations of the Grecian authors into Syriac and Arabic. All these translations, and even Honaim's, were very imperfectly executed, though the latter, disgusted by the treatment of Mesue, had retired tAvo years to the Grecian islands, where he had cultivated his. knoAvledge of their language. Indeed, on all occasions the Ara- bians take the liberty of altering the arrangement, and often the sense, of the Greek authors, so that they can scarcely be recognised in their neAV forms. The names of plants are also so much changed, that many are, at present, unknoAvn. Mesue Avas the first author, after Aaron, Avho wrote on medicine. He also is styled a Syrian, as he proba- bly Avrote in the Syriac language, and Avas apparently educated under one of the descendants of .Bactishua. Yet, when we compare his works which now remain Avith the criticisms of Haly Abbas, Ave are obliged to remove him to a later date, or admit, with the best his- torians, that there Avere two or more of that name, of very different periods. Serapion seems to have been next in succession to Mesue, and was probably the first medical author Avho Avrote in Arabic. Historians have differed also about his era, and the knot, as usual, has been cut, by suppos- ing that there were other authors of this name; for Serapion is only a Patronymic; but Haly Abbas, who wrote near his time, quotes his works as they have been handed doAvn, and places him between Mesue and Rhazes. In other respects he merits little attention. Rhazes, the great luminary of the Arabians, flourish- ed about the middle of the tenth century. To him it is supposed that we are indebted for the first descrip- tion of the small pox; and, in fact, he is- the first au- thor on this subject Avhich has reached us, though we are informed that it was publicly described by a preced- ing physician, Amrou. The two great works of Rhazes are the Continent, and the ten books styled Almanzor, addressed to Mansor, king of the Corassini. The first appears rather a common place book, in which facts and observations are obscurely noticed for his OAvn recollec- tion. The second is a full and complete vieAV of medi- cal science, taken almost exclusively from the Greek physicians. Rhazes, hoAvever, was the first author who spoke professedly of the diseases of children, and he first described the spina ventosa. The Arabians are said to have been the earliest physicians Avho applied che- mistry to medicine, and chemical remedies have been at- tributed to Avicenna. We were therefore anxious to MED 953 M E D point out the fearly traces of this connection in the Greek authors; and Rhazes certainly, in many instances, spoke of chemical preparations. Haly Abbas, or Haly, the son of Abbas, we have al- ready mentioned. His only Avork is styled Almaleki, or the Whole Book of Medicine. One half of this work is theoretical, and the other practical. Haly, hoAvever, is chiefly valuable for his remarks and criti- cisms on Mesue, Serapion, and Rhazes. Liberal in his censures on others, he has added nothing from himself to .the stock. Avice7ina is the most celebrated author of the Ara- bians. He flourished early in the eleventh century, and Avas born at Bockara, in Chorasan. He was the last of the Arabian authors of medicine; for his successors Avere born in Spain, where the Saracens Avere then triumphant, and little communication seems to have been held between the eastern and western empire. Avicenna has, however, little of his own : he was merely a compiler, though his chief wark, his Canon, Avas for centuries commented on, and the syllabus or founda- tion of the lectures in every university. Of Albucasis, undoubtedly the same author Avho is sometimes styled Alzaharavi, we have already spoken in the history of surgery. It is, therefore, only necessary to mention him, as it preserves the connection Avith the Arabian authors, and to add, that he flourished near the end of the eleventh century. Avenzoar, or the son of Zohr, was an Arabian of the western empire, born at Sevil, in Spain, apparently about the beginning of the twelfth century. He lived to the very advanced age of a hundred and thirty-five, and continued his practice to the last, from Avhich he has been called Experimentator. The term probably implies the experienced; for he deserves not the title of empiric, Avhich, in the opinion of some authors, this term im- plies. He treats of medicine in a rational, often in a dogmatic, manner, and seems first to have described the inflammation of the mediastinum, and of the peri- cardium, as well as the dropsy and empyema of the pe- ricardium. It is a singular remark, that he cannot fol- low Galen's advice in giving asses' milk in consumptive cases, as it is unlawful for the Saracens to drink the milk or eat the flesh of this animal, and that he, there- fore, substituted goat's milk. It is only, however, to the stricter sects of Mahometans that the ass is an abo- mination; but this circumstance may account for the use of goat's milk. He first recommended the bezoar, and seems to have been particularly expert as a surgeon. From some parts of his Avorks Ave should even suspect that he had dissected dead bodies. In his time, surgery, pharmacy, and medicine, seem to have been practised by different persons, and neither Avenzoar nor Averhoes quotes the Arabian physicians of the east. The little connection between the Arabians of the east and west seems to have been owing to a political, or rather a re- ligious, dissention respecting the true caliph. Averhoes was also a Spaniard, who flourished early in the thirteenth certury; but rather distinguished for his Commentary on Aristotle than for his medical Avritings. His Compendium Medicinae, hoAvever, in seven books, has been highly commended by some authors. Mose Ben Maimon, a scholar and a cotemporary of Averhoes, was born at Corduba; and, though a Jew, Avas archiater of Saladin, the sultan of Egypt. He Avas VOL. I. the author of a Treatise on Regimen, addressed to the sultan of Babylon, and of Aphorisms, according to the Doctrines of Hippocrates and Galen. The Avorks of some other Arabian authors are extant, particularly of Abenguefit, Bulcasen, Jesu Haly, Cama- nusali, 8cc.; but Ave cannot find that they contain any- thing peculiarly interesting to the progress of the science. Indeed, during its cultivation in the east, we find little added to the stock. The Arabians certainly introduced many neAV medicines, made some additional progress in medical chemistry, and mitigated the seve- rity of the Grecian practice. The new diseases, Avhich they described, are feAv. The small pox Avas a native of the east, and the others were in no respect highly important. They seem, therefore, to have cherished, and but slightly to have animated, the spark. The Arabian Avriters refine, indeed, with great fancy, and distinguish with the most minute precision; but their metaphorical and ornamented language they have Avisely left to their poets. Perhaps, from the example of their Grecian masters, they are often concise, and generally reason with correctness and precision. Thus Avhile medicine Avas declining in Greece it was kept alive in Arabia; but it seems scarcely to have sur- vived the thirteenth century in either. This was the period of its downfal. Europe and Asia were obscured by the cloud of ignorance, and the arts of Avar or poetiy Avere alone cultivated. European genius began first to penetrate the obscurity; but in this cloud of bar- barity we for a long time catch but a feAv imperfect rays. As Ave found medical science stealing by almost imperceptible steps from Greece to Asia, so we shall here perceive, that, from the western extremity of the extensive empire of the Saracens, it gradually ex- panded to different parts of Europe. It is too much the fashion to refer the spread of knowledge to the Cru- sades. The human mind wants not such a poAverful mo- mentum : the gradual expansion of its OAvn poAvers will solve the problem. The short distance from Spain to Italy, and the constant intercourse, even at this time, gradually introduced the medical knoAvledge of the Arabians to the latter country. It has been supposed that Latin, Hebrew, and Arabic professors of medicine were settled at Salernum in the seventh century. This opi- nion has, however, no well founded support; but it must have attained some credit, as a school, before 802, Avhen Charlemagne founded a college there. It will be obvious, hoAvever, that, at this period, medicine could have gained little from the Arabian authors, since they were then imperfectly knoAvn even in the east; so that if, in reality, Salernum was so early a school of medi- cine, it must have gleaned the .little knowledge it pos- sessed from the later Grecians and the Byzantine au- thors. We are consequently ready to" deny this early antiquity of Salernum as a seminary of medicine, and the more willingly, as its first author, Constantine the Carthaginian, flourished only at the end of the eleventh century. He did not collect all the accumulating science of this establishment of Charles the Great, but is expressly said to have resided, for a long period of his life, in Babylon and Bagdat. He was appointed secretary to Robert Guiscard, duke of Apulia, about the middle of the eleventh-century; and there is much reason to believe that Salernum was established as a medical school about that time. Its appellation, Civitas 6F MED 954 M ED Hippocratica, shows that it Avas considered to be a scion of the Grecian stock; and, hoAvever barbarous the Latin style of the African may appear, it is said that he was intimately acquainted with Greek. He was afterwards a monk of Mount Cassino, thence called Cassinus, and dedicated his work, Breviarium dictum Viaticum, to its abbot, Desiderius, raised afterwards to the purple by the name of Victor the Third. Several other Avorks, parti- cularly the Antidotarium, and the Loci Communes, Avere Avritten by him ; but the substance is copied from the Greek and Arabian authors : the latter is apparently a servile translation of the work of Haly Abbas, though professedly an original, and, as he remarked, greatly Avanted. The Schola Salertina, a Treatise on Diet and Medicine, in leonine verses, Avas probably composed very early in the twelfth century, and was for a long period highly celebrated. It is said to have been writ- ten by John of Milan, and was dedicated to the duke of Normandy, son of the conqueror. Salernum perhaps justly boasts of its priority as a medical seminary, and the school of Montpelier is the next, the foundation of which Astruc, in his_ memoirs on this subject, refers to 1150. That of Paris was founded, according to Naudaeus, by papal authority, in 1220, and the school of Bologna in the following century. To this chronological series there is but one objection, that JEgidius, whose Latin hexameters on the Virtues of Medicines, the Urine, and Pulse, written towards the close of the twelfth century, is somewhat severe in his reflections on those who were educated at Montpelier; a circumstance which must have arisen, if the dates are admitted, from personal opposition, as the character of the school could not have been, at so early a period, ascertained. Few, however, were the physicians of character edu- cated in these seminaries. One road to fame and for- tune was obstructed; for the chief physicians of kings and princes were Jews; nor was the intolerance of the Spaniards so rigid as to reject this nation when their own lives and healths were in danger. The emperor Frederick II. attempted to restore the study of anatomy. In his Treatise on Hawking he introduced several va- luable remarks on comparative anatomy, and instituted public dissections and demonstrations. Fifty years after this attempt, his laudable career was checked, in 1300, by a bull of pope Boniface, who forbade the dissection and preparation of the human body. To this edict Mundinus alludes, when he declines a demonstration of the internal parts of the ear; because it is necessary to separate the bones by boiling, which a propter peccatum dimittere co7isuevi." Mundinus was an anatomist and a physician of considerable celebrity: indeed, so great was his credit, that any observations on the structure of the body, which did not coincide with his, were sup- posed to relate to lusus naturae. Arnold of Villanova and Peter Julian the Spaniard (aftenvards pope John XXI.) were both celebrated for their knowledge of medicine, about the end of the thirteenth century. The former has been chiefly com- mended for his chemical knowledge; but, though none of his works remain, it is certain that he was not less famous as a practical physician. The latter was the au- thor of several works, both physiological and practical; but all are copied from the Arabian or the Greek authors. Gordonus, a Scotchman, Avas professor at Montpelier early in the fourteenth century, and his system of the practice of medicine, entitled Lilium Medicum, con- tains some remedies not yet Avholly forgotten. These are the troches, which still bear his name, and the pul- vis ad guttetam. Petrus de Apono, an author of the same era, was one of the first professors in the univer- sity of Padua, then recently established. His chief cre- dit was derived from his chemical remedies, of which very few Avere invented by himself. He practised at Bologna, and attained a high degree of reputation, with a handsome fortune. Apono commenced a supplement to Mesue, which Francis of Piedmont, in the service of Robert, king of Naples, continued. Another physician in the service of Robert Avas Jo- annes Sylvaticus, styled Pandectarius, from his Pan- dects, or Medical Vocabulary. He was a Mantuan by birth, and educated in the school of Salernum; but his Pandects are written in so singular a style that they contribute little to their professed object, the explana- tion of the Greek and Arabian authors, and actually re- quire a dictionary to explain them. JVichol, Nicolus de Falconius, a Florentine, was nearly a century later, and must be distinguished from Ni- cholaus, a Florentine also, but of a later date, a cele- brated patron of science. He appears to have been a physician of no common genius and learning; but his most distinguished work is his Sermones Medicinales, published at Venice, in four volumes, folio. The last author we shall mention is Valescus de Tarenta, who has given a compendious view of the doctrines of the Arabians, and of the physicians of the middle ages. He' lived in the fifteenth century, and is one of the few au- thors who give opinions of their own. He appears to have been an able and experienced physician. During this obscurity, Greece still retained her former treasures, and could boast of a few physicians to whom they were not unknown, and by Avhom they Avere not neglected. A Avarlike race, whose martial spirit Avas aided by enthusiasm, burst at once from its fastnesses, and soon overwhelmed the Roman empire in the east. The Turkish emperor, Amurath, in the year 1430, took by storm Thessalonica, from whence Theodore Gaza, a man of considerable learning, escaped, with some of his literary treasures to Italy. When Constantinople was taken, a few years afterwards, and the Byzantine kingdom wholly overturned, many others followed his example. All were Avarmly received by Lorenzo de Medicis, and the manuscripts, thus rescued from obli- vion, soon disseminated the stores of Grecian poetry, history, philosophy, and medicine. The human mind was roused from its lethargy by many other events in this century. The invention of printing facilitated the communication of knowledge. Colon and De Gama discovered, or facilitated, the access to either India, from whence the materia medica gained new acquisi- tions. The Scurvy, first observed in Germany, in 1482; the Sudor Anglicanus, first noticed about the same time, followed by the Lues Venerea, and the Morbus Pete- chialis in Italy, equally animated the spirit of enquiry to prevent or relieve the effects of such afflicting scourges. During this era Fracastorius and Massa were the chief luminaries of the Italian schools; Sylvius and Fernelius of the Paris; Lommius, the excellent author of the Observationes Medicinales, was a disciple of Fernelius, and practised at Brussels. All these authors Avere Avarm MED 955 MED admirers of the Hippocratic medicine, and with equal zeal and perseverance endeavoured to revive it. Botal- lus, a Piedmontese of this era, a disciple of Fernelius, archiater to Charles IX. and Henry II. of France, chiefly distinguished himself by his recommendation of profuse bleeding. In this practice he might have found examples both in the medical authors of Greece and Arabia; but evacuations, so indiscriminate and profuse, must be often injurious. The fatal effects of his plans are even yet felt; for, in France, venesection, almost forgotten in England, is still freely and copiously prac- tised. Duretus, N. Piso, and Hollerius, were also French physicians, but with more correct views, under the guidance of Hippocrates, whom they admired and illustrated. De Gorris (Gorraus) and Fasius of Dijon were equally able illustrators of the ancients in the Definitiones Medica et Oeconomia Hippocratis; but the most striking features in the history of this era are the attention paid to prognostics, and the publication of select observations and consultations. For the latter we are indebted to Forestus and C. Piso. As we approach nearer our own times, we shall pass more hastily on; and, as we have explained in distinct articles the prevailing systems of medicine, we shall connect only the historical links, except where we find any important fact omitted or misrepresented. The extravagant and erring spirit which we have in this history so often found expatiating beyond the sphere of sober investigation and patient observation, seems again to wander in the 17th century. In its commencement, indeed, Bellonius and Riverius still pursued the system of Hippocrates ; and though Sennertus endeavoured to unite the doctrines of the Coan school with the more judicious parts of the chemical system which then began to prevail, it Avas reserved for Van Helmont to inundate the whole science with the 'mysticism of the alchemical doctrines and language. Paracelsus, who first introduced chemistry into medicine, was an ig- norant boaster, the Jatronice of modern eras, professing to cure all diseases by chemical remedies. He burnt, in solemn state, the works of the ancients, as no longer necessary; and, in possession of the universal medicine to secure immortality, died himself in an hospital at the age of forty-seven. He lived near the middle of the 16th century, but then appeared like a single transitory meteor, so that we reserved any notice of his extrava- gancies till we could combine the Avhole of the chemical sect. Van Helmont, the next in succession, was a man of superior talents, distinguished by sagacity and judg- ment, Avhich might have been more advantageously directed, but which still render his works, collected by his son, not unworthy the attention of the modern phy- sician. He is considered as the first discoverer of factitious air, to which he gave the name of gas; but Rey had published, somewhat earlier, essays on the cause of the increase of weight in lead when calcined. His son was more mystical than the father, but acute and ingenious, and the friend of Leibnitz. He was suc- ceeded as a chemical pathologist by Sylvius de la Boe, Avhose doctrines of alkalis, acids, and effervescence, even to our OAvn time, disgraced the science. The prevalence of the chemical system, in the school of Leyden, pro- bably led Boerhaave to select some portion of Sylvius' doctrine to fill up his eclectic system; and Hoffman, amidst more judicious and scientific views, returns often Avith a partial fondness to acids, alkalis, and acrimony. In our own times the chemical doctrines infected Willis and the Avhole tribe of Boerhaavians; nor are we, at this moment, exempted from the mania, under the more fashionable names of oxygenation and deoxy- genation. This century was, however, distinguished by exertions more honourable for science. It Avas the era of the discovery of the circulation of the blood, a subject already noticed, and of the dissections of animals, to ascertain many important points of physiology. In both Harvey was a distinguished and active philosopher; and, while the circulation was decried or opposed by ignorance or prejudice, his other labours were warmly received. Spigelius, Sanctorius, Asellius, Pecquet, the two Bartholines, and Rolfincius, equally promoted phy- siology, or disseminated the discoveries of others, ob- tained by their dissections, assisted by the newly dis- covered art of injections, and the use of lenses; for microscopes, in the complex sense now affixed to the term, were the invention of the following century. Another distinguishing and honourable feature of this century was the institution of medical and philosophical societies. Our own Royal Society was the first of these, and it was followed by the Academy of Sciences at Paris in 1667, established by the judicious and penetrating Colbert. The Academia Naturae Curiosorum was at first a private society, and its origin is traced from 1652; but it was established, some years afterwards, by the au- thority of the emperor Leopold, and then styled Aca- demia Caesareo-Leopoldina. Its publications were con- tinued, under various titles, till within these few years. It will fill but a small space to pursue this subject. The Royal Society at Berlin was founded in 1700 by the advice of Leibnitz, and first published its transactions (Miscellanea Berolinensia) in 1710; the Petersburgh Academy in 1724, which first published its " Commen- tarii" in 1726; the Bologna Society, founded by Marsi- gli, first published its " Commentaries" in 1731. The Breslaw collection, afterwards called Commercium Noricum, was published from 1717 to 1731, under the former title; and from that time to 1745, under the direction of Dr. Trew, distinguished by the latter. The Royal Society of Norway began to publish their trans- actions in 1771; of Denmark, in 1745 ; and the Royal Academy of Sweden in 1739: the Royal Society at Upsal in 1720; of Bazil in 1751; of Gottingen in 1752; and of Montpelier in 1766. Within the years 1771 and 1792 we have seen philosophical societies established in Hesse, Philadelphia, Brussels, Boston, Ireland, Padua, Edinburgh, Calcutta, and New York. These have admitted into their plan medicine as a branch of natural philosophy, and several medical improvements of importance have been published in their successive volumes. Establishments more closely connected with medicine are also numerous. The first work of this kind was Thomas Bartholine's Cista Medica Hafniensis, in 1662; and a similar one appeared in 1679, at Paris, entitled New Discoveries in every part of Medicine by Nicholas de Blegny. The Zodiacus Medico Gallicus, in Latin, by Bonnet, succeeded in the following year at Geneva; and in the same year, the lexicographer Blanchard published, in Holland, Collectanea Physico- Medico. The Recueil Periodique d'Observations de Medicine appeared at Paris in 1754, and was continued MED 956 M ED under the title of Journal de Medecine; but this col- lection Avas preceded by the Medical Essays of Edin- burgh, which were begun in 1733, and continued to 1742. These were succeeded by three volumes on a more extensive plan, entitled Essays and Observations. Physical and Literary, and by the Medical Commenta- ries of Dr. Duncan. Two volumes of a collection entitled Acta Medicorum Suecicorum have appeared, which are not, however, exclusively medical, and two volumes of collections of a medical society at Copenhagen. The Royal Medical Society at Paris published their first volume at Paris in 1779, and continued their volumes, at irregular intervals, till the year 1788. Four societies have collected medical observations in London; the college who published their first volume in 1768, and their third in 1785 ; a society who published " Medical Observations and Enquiries" in six volumes, from 1757 to 1784; another society, to whom we are indebted for " Medical Communications," of which two volumes have appeared, commencing in 1784, and concluded in 1790; the Medical Society, Avhose memoirs are still continued, and have extended to six volumes; and an- other society, whose collected labours are entitled Trans- actions for the Improvement of Medical and Chirurgical Knowledge, in two volumes, appeared in 1793 and 1800. A collection also, entitled Medical Facts, has been continued in numerous volumes; and medical journals in a profusion which baffles our enumeration. The conclusion of the 17th century was distin- guished by some of the brightest luminaries which have illustrated this science; Sydenham, Morton, Baglivi, and Boerhaave, though the fame of the latter was chiefly conspicuous in the next century. Of Sydenham and Morton we need not speak, for their merits are suffi- ciently known; and the Boerhaavian system we have explained in a separate article. In treating, however, of this venerable and highly respected eclectic, we have mentioned a philosophical sect, whose tenets we have not explained. In fact, the sect fell so nearly within each century, that it was not easy to fix accurately its precise era. The application of mathematics to astro- nomy by Kepler, and to the laws of motion, as Avell as to the system of the Avorld, by Newton, led to the opinion that its powers were irresistible, that it might unfold every secret of nature. Borelli, at the end of the 17th century, applied this science where it properly admitted of application to the motions of animals, and showed the advantages and disadvantages derived in these motions from the origin and insertion of the muscles. His scholar, Bellini, in the beginning of the following century, Avent farther, and, from mathematical data, endeavoured to explain many functions of the human body. Keil, a philosopher and a mathematician, rather than a physiologist, calculated from imaginary data the power of each organ, and gave the stomach, for instance, a force of compression which must so over- come the resistance as to destroy its organization; and Pitcairn, with his followers, calculated the ratio of medicines in proportion to that of the consitution. In the principles of medicine of this last author, and in some of the early volumes of the Edinburgh Medical Essays, this phrensy is carried to a most ridiculous height, indeed so far as to undermine its OAvn best security; for, if such were truths, mathematics had no certain foundation. From the chemists and the mathe- maticians, as wc have seen, Boerhaave drcAv his theory; but his practice was founded on the sound observations of the Coan sage, and his most respected followers. The fatal doctrine of concoction held its ground, and Avas supported in all its rigour. Thus fever Avas not to be checked, but encouraged : most destructive delusion ! millions have been the victims to this fancy. While Boerhaave held the reins of empire, and ruled with a sway almost as absolute as that of Galen, two rivals arose vvho overturned his apparently Avell esta- blished dominion. Hoffman and Stahl were rival pro- fessors at Halle, yet without acrimony, and without, at least, open opposition. Hoffman was a voluminous writer, but not the founder of a sect; for he does not always reason with consistency, nor are his arguments directed to any definite system. He Avanders from the mechanical to the chemical doctrines ; but, in the midst of these, directs the reader's attention to the exertions of the vital powers, in changing the direction and the balance of the circulation. Stahl, with scarcely less industry, but with acuteness and talents eminently superior, aimed at changing the Avhole of the science. He acknowledged, with Van Helmont, a ruling poAver, guarding the constitution against disease, and repairing every defect which might occur; but, with this superin- tendance, he considered the human system as a living and an irritable machine, susceptible of various and ir- regular motions, and consequently of topical congestions. This is the meaning of " spasm," of " tonic motion," and similar expressions; nor can we avoid the suspicion,, that, when Hoffman speaks of spasm, he means Avhat Stahl styles his tonic motion, for each is attended with topical congestions. Whatever becomes of this idea, it is evident that the germ of this new doctrine gradually expanded. Even Boerhaave, in his later years, did not reject the consideration of a nervous fluid, though con- sistently with his humoral pathology he considered it as "inactive;" and Gaubius his successor treats at some length of the diseases of the vital solid. Indeed the heresy began in his own family ; for his nephew, KauAV Boerhaave, Avho practised Avith credit at Petersburgh, considered the influence of the nervous system in his work entitled Impetum faciens Hippocrati dictum. Hal- ler, though chiefly of the mechanical sect, and who is entitled to our gratitude for his industry, rather than his genius, assisted this new revolution by his experiments on irritability; and Dr Cullen at last constructed, on this ground, a system highly ingenious, though, like many first efforts, sometimes too refined, perhaps occa- sionally incorrect. See Boerhaavian and Cullenian Systems. On the same foundation Dr. Brown has still farther refined; but, while the Boerhaavians made the human body wholly material, he considers it as wholly spiritual, created only by heat, motion, and other sti- muli. See Brunonian System. Of living physicians, as of surgeons, it is not " our hint to speak;" nor, indeed, in the present era, have we any revolution to describe, or any marked improvement to praise. When, in the history of surgery (see Chirurgia), we pointed out the objects of the surgeon, we discriminated those of the physician. We there engaged also in a,slight disquisition on the talents and acquisitions necessary to the surgeon. This calls on us for a similar explanation; yet, as coming " nearer to our own business and bosoms," it is a task we Avould MED 957 m i: d wish to decline. Necessity, hoAvever, imperiously de- mands it; and the consciousness of holding the mirror up to what appears to us the character of an accom- plished physician, will be our best shield against the censure wc must consequently encounter. It Avould appear superfluous to say, that a physician should be at least acquainted Avith the ancient languages, did Ave not daily see pretenders to that character with- out even a knowledge of their OAvn. The observations of Hippocrates and his followers should be read in their OAvn language; and Ave Avould engage to promise a classical scholar the highest literary entertainment from the simple elegance of the Coan sage, the polished elo- quence of Galen, and the expressive terseness of Are- taeus. Among the Latins his prospects are less allur- ing; and the Augustan elegance of Celsus must atone for the barbarisms of Coelius. Yet in more modern times Lommius, Read, Friend, Heberden, and Baker, Avill compensate for Stahl and Brown; and the sterling sense of Halter, Gaubius, and Burserius, will instruct, if their language should for a moment disgust. The modern languages are equally necessary, at least the French and the German. It is indeed to be regretted, that vernacular tongues are so much employed ; for no position is more truly unfounded than that what deserves to be translated has already appeared in an English dress. The Italian is perhaps less necessary ; yet Sar- cone, Ave believe, still retains his original garb, and dif- ferent modern writers of that country seem to merit more attention than they appear to have received. If, as has been supposed, the practice of medicine requires the active exertion of the intellectual poAvers Avith their full energy, it will at once be obvious, that every method by which the physician's views are early contracted must be injurious. For this reason, to spend the first period of his life in an apothecary's shop has appeared a plan of the worst tendency, for this is the time in which he must endeavour to attain an intimate acquaintance with the classics, a competent knowledge of mathematics and of natural philosophy. Man, the most glorious work of the Creator within our limited observation, is not indeed regulated by the laws of matter and motion; but each must be often taken into our vieAvs, in reflecting on the deviations from health and the means of restoring it; and, so intimately is every part of nature's works connected, that we cannot draAV the line where the vital powers begin, and those of matter and motion end. Mathematics are highly ne- cessary to enable the student to follow the mechanical philosopher, and to understand the mechanical physi- cian ; for it is highly disgraceful in the modern physi- cian not to be acquainted with the principles of every sect, or unable to comprehend their mode of reasoning. Without mathematics, Haller, Hamberger, Bellini, Van Swieten, and Sauvages, will be often unintelligible. The utility of mathematics is not confined, hoAvever, to their aids in pursuing other objects. They accustom the mind to clos'e, abstract investigations; give a habit of connected and accurate reasoning, of connecting con- sequences with premises by their strict relations, rather than by loose analogy. In these vieAvs we have often reason to regret the neglect into Avhich the mathema- tics have lately fallen. Natural philosophy is highly necessary, independent of its connection with matter and motion. We are advancing rapidly into those branches, Avliere, as in the human body, Ave see effects Avithout being able to com- prehend causes ; Ave mean in the sciences of electricity and galvanism, and have reascn to suppose that the discoveries in these will, at no great distance, materially illustrate the functions of the human system. It is dis- graceful not to be intimately acquainted Avith each, and in the acquisition of either matliematics are useful, if not necessary. The great supports of this position are the papers of Columb and Van Swinden. Another assistant in acquiring this habit of close reasoning is logic, a science essentially useful, though, in conse- quence of its abuse, too much neglected. When pro- perly regulated, it gives the distinctions so necessary to the clear enunciation of a proposition, and the conduct of the reasoning either in support or in opposition; and it leads the mind, by easy steps, to detect the fallacy of a too unlimited statement, of an unsuspected subterfuge. or of inconsequential reasoning. Were logic more generally studied, many bulky volumes Avould neither have tired our patience, nor disgusted our judgment. Fatal as its neglect has been in every science, it has not been more severely felt than in medicine. Of chemistry Ave need not now speak: it is acknow- ledged to be an essential part of the physician's educa- tion ; nor should any science which is supposed orna- mental in a gentleman be omitted. Geography, for instance, may appear far from a necessary branch of medical knowledge; but it would be disgraceful to speak of the ipecacuanha as a production of Russia, or the cortex peruvianus of the arctic circle. A knoAvledge of botany is highly necessary, especially an intimate acquaintance with the natural families, as it will often enable a physician to apply his indigenous species of plants to useful purposes where the exotic is Avanting. AH these are, or should be, preparatory sciences, for medicine itself is a study Avhich will fill all the time usually allowed for its attainment. Where then can this varied knowledge be acquired? not behind the counter ; not in dispensing the prescriptions of others; not in staring at diseases, without information, or without principles. In this way, the student either attains no knoAvledge or crude imperfect ideas, which he can scarcely ever correct; or, if correction is in his poAver, it will require more trouble than the acquisition of juster notions. This kind of education also narroAvs the mind in another vieAV. We look Avith some partiality to our earliest instructor ; our first ideas stick to us with peculiar force, so that it is of consequence Avhere thev are acquired. Those who are accustomed only to a narroAv circle cannot easily expand their ideas beyond it, as the native of SAvitzerland thinks his valley scarcely- less than the whole world. We do not indeed contend, that able and enlightened physicians have not, at times, escaped frOm the shop ; or, on the other hand, that the deepest and most profound philosophers have been the best practitioners. Exceptions prove a general rule; but some distinctions are requisite in the full discussion of this question, Avhich Ave shall soon consider. We have, in different parts of this Avork, hinted that a physician should be, from his earliest years, educated Avith the vieAV to his future profession. If the best parts of his life have been directed to other pursuits, he will seldom acquire that extent of information, and readiness of application, Avhich the practice of his profession MED 958 MED requires. In the most advanced period of his life, Avhat he may have seen at his first entrance into the study may happen to be applicable, though, through the whole interval, it has been never necessary. It must not be supposed, that the most splendid abilities or the deepest knowledge are always requisite. Many diseases are obvious in their causes, appearances, and treatment; but, on the other side, many serious complaints assume, at first, a common form, and it requires no little sagaci- ty to trace them in their bud; no little knowledge to obviate the fatal consequences. Were it always possible to say whether a disease was common, great abilities or extensive knoAvledge might not be necessary; and we thus find physicians, with little real skill, but Avith policy and address, pass through life Avith credit, some- times Avith the highest applause. It is not, hoAvever, enough to possess knowledge, but the mind should be ready and actiye in its application. It is often necessary to adopt at once a plan, and to pursue it Avith active decision : it is necessary to weigh contending difficulties, and at once to seize the path where the fewest or the least important appear, or where the inconveniences are counterbalanced by the advantages. This rapidity of decision, the result of great and extensive knowledge, as Avell as readiness of resource, is often equally the off- spring of ignorance. No difficulty can be experienced by those who are unable to anticipate danger; and doubt, the consequence of different plans contending for superior eligibility, can scarcely be felt by those who have none. Physicians are called on, in general, to act Avith this prompt decision ; and to hesitate is usually accounted a mark of ignorance. A man must have merited the confidence of the world before he can re- quire time for consideration, and his reputation be firm- ly established before he can own himself at a loss. Readiness of resource is partly owing to habit and long experience ; but it may be easily aequired by a ready arrangement of ideas, and clear distinct views. The able and experienced physician, who can at once comprehend the ohject to be attained, will, at the same moment, perceive the various methods by which it may be effected, and he has only to choose the most con- venient and the best adapted to the habit or idiosyncra- cy of his patient. In his progress new views will gene- rally open, and the soundest judgment is shown in steer- ing between the opposite extremes of varying the plan according to the variety of symptoms, or obstinately persisting in it, notwithstanding every change of ap- pearance. The first is pleasing to common observers, as it shows diligent attention; but it is a proof of weak- ness and indecision. The last, perhaps the most venial error, is the effect of too great confidence ; and, unless accompanied with extensive knowledge which dictated the first opinion, and an acute sagacity in discerning the effects of the medicines, is scarcely less injurious. It has been supposed, that extensive reading rather impedes by overloading the mind, than assists by giving information. Reading, however, with judgment and discrimination will produce no such effect. The mind should be so regulated that each new fact may be com- bined with the former stock, or, if, in opposition, re- served for subsequent mature reflection. It will then come in aid, to limit, to confirm, or to invalidate pre- conceived opinions. If reading and practice proceed, pari passu, the advantages will be still more considerable. Each new observation may be soon brought to its pro- per test, and its value consequently justly .appreciated. Facts in medicine have lately accumulated so rapidly, that we are oppressed by the load rather than informed by the substance. To discriminate between the true and the false, the important and the trifling ones, is no easy task. To say that any author states as a fact what he does not know to be true must appear harsh, perhaps unjustifiable; but the internal evidence often shows, that the case cannot have existed as the writer (we should have said the author) describes. When Ave find the symptoms loosely detailed, the necessary con- nections omitted, the effects of medicines imperfectly or inconsistently described, Ave may rest assured that it is the manufacture 'of the closet. When we find violent complaints cured by. the most inert remedies, we may be equally certain that the violence of the symptoms are magnified, or the real effects of the medicines disguised; and, as has been often hinted, when an inventor describes his plan as infallible, sus-'11 picion should open all her eyes to detect the fallacy;' ">? yet many such deceptions occur with no culpable in.-' * tention. A young sanguine practitioner seems to think every case the same, and always finds wonderful benefit from his plans. When he reviews them with a calmer, more experienced eye, he doubts whether they have been so successful as he supposed, or indeed whether they have succeeded at all. This is not indeed a singu- lar case: it is the unavoidable progress of the mind from youth to age, from confidence to doubt, from hesi- tation to scepticism. The mind of the physician should, in the most ardu- ous and difficult circumstances, be unruffled. Doubt and hesitation should never be seen in his countenance, or in unsteady, vacillating councils. In the midst of uncertainty he should be calm. In the most adverse events, Avhile he may express his surprise, he should never appear without his resources, nor until the case be wholly desperate should he suffer those around him to despair. For doubt and apprehension of the event there may be a more early foundation, and suspicions' may be cautiously suggested that, should any given re- medy fail, the danger would be increased. In emergencies, friendly and affectionate anxiety may suggest additional advice, or a remedy of a doubtful quality and uncertain effects, the boasted panacea of some fashionable quack, recommended by an archbi- shop, a judge, or any other old woman; for, in such circumstances, each appellation is synonymous. No physician,' whatever may be his character, is justified in refusing professional assistance, when required; nor, to his coadjutor, in this respect, ought he to withhold whatever his former experience with the patient has taught him. If he gains from his assistant, the patient has the advantage; it is his fault if the patient suffers. In every consultation it should be known Avhether the first or the second has the implicit confidence of the patient and his friends; and the conduct should be suitable. In the administration of a quack remedy more caution is necessary. It should be known whether it is a mere name without effect, or whether it has any decided positive power. If the former, it maybe indulged; nor is it a great sacrifice, in case of a fortunate event, that the medicine has the credit, if, in contrary circum- MED 959 M E D stances, the friends of the patient feel satisfied that every thing which art could devise has been attempted. This doctrine we know will not be popular among physicians; but they ought to recollect, that to cure their patient is their first object; to gain fame, a secondary one. If indulged with their favourite remedy, they will agree to combine other means; confidence Avill be supported, hopes raised, the spirits cheered ; and, in case of a sinister event, the candour and liberality of the practitioner will secure general esteem. Yet he would merit the severest censure, if, indulging such fancies and prejudices, he omitted, for a moment, the efforts Avhich he yet retained. The conduct we re- commend is only justifiable where the case is desperate, or the boasted panacea inert. In some circumstances, however, the remedy is active, and the ingredients Avell known. The physician must then decide whether it is adapted to the complaint, or whether its effects may not be too powerful. When he has stated, fully and impartially, his opinion, the friends or the patient must determine. We think, that he is not justified in leaving, as has happened,- the patient to his fate. It is rather his duty to look on, to watch, to regulate, or correct any errors. He may yet save the devoted victim from destruction, from fall- ing a sacrifice to prejudices either his own or his mista- ken friends. There is yet another situation in which an active quack medicine may be allowed. In continued chronic complaints the patient is often weary of his physician, and willing to try the recommendation of some in- terested adviser. He has, for instance, been using a ^mercurial alterative, and wishes to try Spilsbury's drops. They are no other. Why then may he not be indulged ? Low indeed must be the credit of his physician, if he should suffer by adding one to the many boasted cures performed by this medicine, which is only the hydrargyrus muriatus in small doses, apreparation of mercury generally employed. Yet we must repeat, that, in every such instance, the physician is inex- cusable if he do not guard the patient against any pro- bable inconvenience that may result from the supposed qualities of the secret remedy, and suggest the best methods of preventing them. These few remarks we have suggested as a kind of supplement to the very liberal and judicious observations of Dr. Gregory in his most valuable lectures on the " Duties and Qualifications of a Physician," and to this work we would refer the young practitioner for his more general conduct. Had we room, we might enlarge a little on the policy of medicine. Hoffman has left us a dissertation entitled Medicus Politicus, though its object is different; but the art in this age is greatly improved, and an amusing treatise, copied from life, might be easily written. Our object is however to make the practice of medicine re- spectable, not contemptible. It was a question suggested respecting surgery, whether it had been improved in later periods. The same question has been agitated respecting medicine, and perhaps it may, in this part of our article, merit a short notice. The argument, that medicine has not im- proved, has been supported by the most inconclusive reasoning; viz. that Ave still resort to the older authors, and that diseases are still mortal as before. To engage in an extensive discussion is inadmissible, but, as in the article referred to, we may adduce a few instances. In the conduct of fevers, is it no improvement that the rigorous abstinence of the early days, enjoined by the ancient physicians, is, at least, abridged or softened? that the great heat, the close rooms, the warm stimu- lating medicines, and the sudorific regimen of the modern Galenists, are wholly abolished ? It may be asked, whether either plan is justly or advantageously super- seded ; and we hazard little in replying, that the re- coveries under the later mode of treatment exceed those under the former three times told. Death, from a fever, is now comparatively rare : formerly, recovery was equally so; and many, whom we remember among the recoveries, lingered out the remaining period of life without the slightest enjoyment of an hour's perfect health. In internal inflammations the constitution is equally preservedbythe rejection of the indiscriminate bleedings- so often and so copiously employed; nor is the excita- bility exhausted by the numerous blisters applied, under the mistaken idea of derivation. In childbed how is the strength preserved, and inconveniences avoided, by the cool regimen, by the discharges from the boAvels, and the early application of the child to the breast ? How is the strength and health of the child augmented by copious and frequent ablutions ? In dysenteries, what pains are saved by the free use of cooling laxatives; in scirrhous livers, how long is the life comfortably pre- served by the free use of mercury ? The paper would fail before we could enumerate the advantages of modern improvements in the practice of medicine. Let us take up the subject more generally. Abstruse disquisitions respecting the causes of disease, and the operation of remedies, are now seldom indulged. Our indications are more clearly pointed, and the means usually better chosen and more direct; less depending on pathological ' enquiries, and more closely connected with the changes to be produced. Dr. Friend was supposed to be master of all the medical science of every aera; and yet, if any modern physician, who had for some years escaped from his early studies, were to read his Reflections on the Practice of the Ancients, they would suppose them- selves engaging in a new and most intricate science; so disguised and involved are the most common observa- tions and directions. This was, in fact, our OAvn case. We had intended to have closed this article Avith a sketch of a medical library, but we feared to terrify the indolent practitioner, or to repress the timid. Yet per- haps we may find an occasion to resume this subject under a later article, Studium Medicine. At the conclusion hoAvever of so long a work reasons of ne- cessity must at last decide. Le Clerc Histoire de la Medecine ; Friend's History of Physic; Blumenbach's Historia Medicinae Literaria; Schultze Historia Medicinae; Conringii Introductio ; Halleri Bibliotheca Medicina Practica. See Chirurgia ; Botany; Materia medica; Ohstetricatio ; Medicinv forensis et poli- TICA. Medicina forensis et politica. Medicine has for ages been the guide of the police and of justice, without ostensibly mingling in their contests. When Acron of Agrigentum is said to have kindled fires to . M E D 960 M E D promote the circulation of air in order to check the plague of Athens, or Numa constructed seAvers to keep the imperial city from the noisome stench of impurities, they acted as able politicians and judicious philosophers; and an early work of Hippocrates on a kindred subject should have particularly fixed the attention of phy- sicians. Many similar regulations are indeed the result of good sense, reduced to practice by an active mind and Avell directed vieAA's; but many years elapsed before regulations of this kind were digested by a regular scientific publication, professedly on the subject. The Criminal Constitution of Carolina was the earliest work in which the rudiments of forensic medicine Avere developed, and the first edition of this work appeared in the beginning of the 16th century. The origin of political medicine in modern times may be dated about forty years later, and its first publication by Joach. Struppe, at Frankfort, appeared in 1573. His work in quarto contains the necessary precepts for preventing the air from contamination by filth, by injurious occu- pations, and by sepulture in the midst of cities. He adds regulations respecting the occupations of millers, bakers, butchers, 8cc, on the proper instructions neces- sary for midwives, on the establishment of infirmaries, on the propriety of visiting the shops of apothecaries, and of guarding against the arts of quacks. In the same year, he published his Anchor of the Hunger, Thirst, and the Health of Mankind ; in which he parti- cularly treats of the substances Avhich may occasionally supply bread, and the means of preserving meat from putrefaction. At the end of the same century, Fortu- natus Fidelis of Sicily published his Avork on the depart- ment of forensic medicine, De Relationibus Medicorum; and, under the name of Reinesius, his Scholalctorum Medica. The subject was still further pursued by Paul Zacchias, principal physician to the pope, who publish- ed his Quaestones Medico-Legales in 1621, See. in nine volumes, quarto, at Rome. About the end of the same century Paul A-mman, a native of Breslaw, and a pro- fessor at Leipsic, published the Medicina Critica seu Decisora, as well as the Irenicum Numae Pompiliicum Hippocrate; and, in the same century, G. Welsck of Leipsic published his Rationale Vulnerum Lethalium Judicum. We may just add, as objects of curiosity, that this author first described the purple miliary fever of childbed Avomen, as a new disease, in 1655 ; and, about the same time, a German clergyman first de- scribed the method of recovering persons apparently drowned. To pursue the history through the 18th century would be useless, and almost impracticable. We en- gaged in it chiefly from curiosity, and need only add, that the minor works on this subject are collected by J. C. Traugott Schlegel, published in six small volumes at Longosalissa; but we must remark, that of this city and some others Ave have found it impossible to discover the vernacular name. The obscure towns in Germany have not found a place in any Latin or geographical dictionary to which we have access. To account for the numerous German and French publications on this subject, we must observe that the laws of these countries are much more minute in their distinctions respecting crimes than the criminal code of this kingdom. This may be one reason why the sub- ject has been so much neglected, that it has not formed any portion of a course of lectures ; and very lately only has a professor of forensic medicine been established in a British university. To treat of this branch of medi- cine, therefore, Avith all the subtility of a German laAvyer, will be unnecessary, and we must confine ourselves to the outline of those topics, Avhich must be the subject of inquiry in an English court of justice. We must first consider forensic medicine as it is a branch of medical investigation, and next as it is con- nected Avith the conduct of the surgeon. Mania is one of the most frequent subjects of forensic inquiry, in Avhich the physician is called on to decide; and, to the disgrace of science,- Ave find the most opposite opinions adduced by practitioners of eminence. Much depends on the period during Avhich the physician sees the supposed lunatic, and more on a few necessary distinctions, Avhich we fear are sometimes designedly neglected. It is possible for an interested relation to fix on a day when the patient is calm and rational, an hour Avhen he is usually collected, to intro- duce the physician Avho pronounces him sane. Another, in different circumstances, might pronounce him mad. It is necessary, therefore, to guard against such decep- tions, to visit him frequently at different times, and at the most unsuspected hours. If this is refused, a col- lusion Avill be evident. We remember seeing a man, who was confined for a crime and defended on the plea of idiotic insanity. We visited him frequently, while unsuspecting any such examination, and found the plea strictly true. Yet, when called into court for the purpose of acquittal, Avhen cleaned and dressed, roused also perhaps by the novel appearance of the scene, his- look assumed a meaning, and he Avas almost rational. In the general relations of life, a man may be thought- less, ridiculous, and extravagant, yet these errors will not be sufficient to fix the charge of insanity, which consists either in false perceptions or erroneous rea- soning, on objects distinguished in their true colours. Many individuals of this kind require guardians for their property as much as persons really insane; but the law entrusts no practitioner with such discretionary power. The difficulty arises when this wild absurd conduct is attended with no such inconsistencies as lead to the sus- picion, that the perceptions or the reason are affected. This situation is a question of prudence, rather than of jurisprudence, or medicine. The reflecting physician will not fix, unnecessarily, the stigma of insanity on a whole race; nor will he expose a family to ruin by a too great delicacy. In this difficulty, he will rather take the opportunity of a calmer moment to induce the patient to adopt such plans as may prevent the ruin of the family, and may properly make use of the alternative as an argument, in case of refusal. But this, as we have said, is not a medical question. There is another doubtful state, m which the phy- sician is often called on to decide, viz. when from disease, from general weakness, or any constitutional cause, the mind is so much enfeebled as to render it uncertain whether the patient can judge of the proper disposition of his affairs. This too is a question of dis- cretion, for the afflicted person may be taught to ansAver common questions readily, or may be awed by some interested attendant. In this case, if the physician, MED 961 M ED when alone with his patient, talks to him of his affairs, suggests, for the sake of a reply only, some objections to his arrangements, he will soon find whether the testator has judged properly, or only repeats a lesson. The circumstances themselves often suggest doubts; and Avhen an infirm old man disinherits obedient or near relations, for the sake of those connected Avith him only by accident, the presumption is, that his mind is not sound. We have said, in the article Mania, that by a fiction of the law every mania, we have been informed, js sup- posed to be relieved by occasional lucid intervals, and that if the act of a madman is reasonable and proper, it is a proof that the interval was a lucid one. Thus in the case, which has just been considered, whatever be the apparent state of the patient's mind, if his will be judicious and proper, .there is no reason why the phy- sician should not pronounce him in a sound state. Yet, in criminal cases, the law is not equally indulgent, nor has it always, perhaps, been equally humane. Lucid intervals, in cases of murder, are not allowed, and the man who has been proved to be mad on the Monday and Wednesday is not allowed to be sane on the inter- vening day ; yet decisions have occurred of a different kind ; and an art in planning, a coolness in executing, a deliberation in the conduct, have been supposed to con- stitute soundness of mind. On these grounds lord Ferrers and Mr. Oliver were executed. Yet, if the motive is at any time connected with the hallucination, the subsequent action should certainly be considered as a part. In later trials the opinions have leant more on the side of humanity. The question of confirmed insanity must be decided by a comparison of the patient's state with the pathog- nomonic symptoms. Yet there are many sources of doubt, and often room for hesitation. In many in- stances the mind wanders, at first, on one subject only; and, when the madman has any point to gain, he will, Avith great success, counterfeit a calm reasonable state. Each point must be carefully guarded ; yet the expe- rienced physician will not be easily baffled. A wildness of the eye, a tension of the skin of the temples, a dry furred tongue, often a hurried pulse, will explain the real state. The madman is also a coward, and we have drawn from this a good pathognomonic symptom. If threatened with some vehemence with any punishment, hoAvever wild and impracticable, he will shrink and tremble, forgetting all his art, or returning to his ori- ginal deviation of mind. Returning sanity is another point of doubtful dis- tinction ; nor do we see that it is possible to lay down any rules, except the absence of the pathognomonics of the disease. Yet Ave have often witnessed the return of persons from the appropriate receptacles, Avith a wildness of the eyes, a quickness of utterance, rapid unsteady motions, which showed corporeal disease, though the mind Avas calm. Such persons should not be pronounced secure ; and," though confinement may not be necessary, the most pointed caution should be continued. Dissembled insanity might more properly belong to another head, morbi simulati; but we may more easily speak of it in this place. An experienced practitioner will soon detect the absurdities Avhich assume the form of insanity; for, though incoherencies, wildness, and VOL. I. obscenity, may be imitated, the hurried look, the rapid pulse, the dry tongue, and the sleepless nights, cannot be assumed. Above all, the coAvardice, the apprehen- sion of punishment, the influence of threats, are seldom to be discovered. A French author details the symp- toms of madness, for the purpose of this distinction, so elegantly as to induce us to copy the picture. " Thus to neglect what most deserves attention, and to value what is least deserving of it; to rejoice or weep without an adequate reason ; to despise what is terrible, and to fear what is ridiculous; to admire trifles, and to reject what is excellent; to love the dbjects of hate, and to hate those of love; to hope Avithout an object, and to despair while in security; to be pleased with things which excite no agreeable sensations in others, and to fly from what every one would anxiously seek ; to be timid with those who demand no deference, and bold to those whom they ought to respect; such are the infallible marks of a wandering mind." In either of these cases, an excellent criterion may be found by inducing the supposed lunatic or the pre- tended convalescent to write. If engaged in a corre- spondence particularly respecting his OAvn affairs, he will soon betray insanity, should it remain. In the servile war, the slaves Avho opposed the spears of their former masters yielded, when they saw them armed Avith whips; so the most furious maniac -will often submit on presenting him a pair of handcuffs, which will only irritate the counterfeit. Morbi simulate Dissembled'diseases sometimes claim attention in a court of justice, but perhaps more frequently in an infirmary. The latter is, as usual, the school. Insanity, of Avhich Ave have already treated, is the most frequent, and, next to it, are the different nervous and spasmodic complaints. We must not, hoAv- ever, always accuse the patient. The timid girl Avill have the catchings and the gesticulations of chorea more frequent on the access of a stranger; and the disease, to the attendants apparently cured, will appear to return. On the contrary, these and some other diseases will occasionally seem to lessen on the approach of the phy- sician. The wanderings of delirium will cease, and the wildness of the eye be converted, to an expression of meaning. These are circumstances which must be kept in vieAV, as tending to explain the opposite course. The diseases counterfeited are catalepsy (commonly styled ecstacy) and convulsions. Some patients possess even a command of the features, and others, it is said, of the pulse; but, in general, an unchanged expression of countenance and an unaltered pulse Avill explain the deceit. Boerhaave is reported to have cured real fits by threatening, ea qua pollebat gravitate, to burn the next patient seized, Avith a hot iron. To heat a poker with the same gravity has cured pretended ones, espe- cially if they felt the heat approaching. Plunging the suspected patient in cold water is still more effectual, and it will not injure if the disease be real. Dashing cold water in the face, unsuspectedly, will succeed ; but, as the bathing requires preparation, it will not be necessary, in case of deception, to proceed to extremities. Pains in the limbs, which sometimes happen Avithout fever, is a fertile source of deception, and blisters will often have little effect in detecting the fallacy. We have not, however, found patients of sufficient constancy to endure a few smart electrical shocks; and the 6 G MED 962 M E D galvanic, if the skin is punctured, will be probably still more effectual. In cases where fever must necessarily attend, the detection is easy. No one can counterfeit the febrile symptoms enumerated under Febris ; though by topical stimulants inflammation and fever may be brought on. In the time of Galen, tumours were produced in the kneeby the semen thapsi; and Zacchaeus, in his numer- ous quartos, has copied many tales of this kind. We have seen abcesses produced by inserting splinters under the skin, continued ulcers by stimulating dressings, and even haemoptoe occasionally returning by artificially exciting cough. Yet while we awaken suspicion, we would not silence the feelings of humanity. We have seen cases where no deception could exist,' where no motive could be found for fallacy, that appeared at the first sight fictitious. We have known the urine retained six weeks Avithout any remarkable vicarious discharge : we have known a nail of no inconsiderable size, such an one as fastens the hoops of small barrels, retained in the throat till it formed an abscess : yet in each case no deception could exist. The mendicant Avith his ulcers counterfeits both deafness and dumbness; but these deceptions are best detected by the beadle, or by a little address. " How long have you been dumb, my good friend?" says a passenger, with the most insidious humanity.—" Three Aveeks, sir," replied the incautious deceiver. Impotentia. This disease rarely requires the in- terposition of a physician in a court of justice. The complainants, who are commonly females, can relate their grievances in terms sufficiently guarded and clear. The causes and cure we have already considered, and we see but one circumstance in Avhich it requires our attention in this place. The extirpation of the tes- ticles is an operation obviously designed to prevent ge- neration. But in the human species, as we have seen, they are originally seated in the abdomen, and fall through the rings of the muscles into the scrotum. If they do not appear in the scrotum it is no evidence of their absence, and it has been said that their influence on the genital powers are more conspicuous while they remain in their original seat. It is at least certain that this influence is not less, so fallacious is the logical maxim, when applied to medicine, De non apparenti- bus et non existentibus eadem est ratio. If they did not exist, or were not evolved, the beard, the graver tone of voice, and every mark of virility would be absent. If they had been extirpated, the cicatrix would remain. It has been said that one, three, and even four, testes have been discovered. One has certainly been lost by accident, has decayed, or been extirpated, Avithout in- juring the generative power: sometimes the other has enlarged, but more often continued of the same size, with little apparent diminution of the powers. The stories of three and four testes we cannot disprove ; but there is much reason to suppose that many of these have arisen from an enlargement of one or each epidydimis. They at least furnish no grounds for a legal process. From what has been said under the article Impo- tentia, q. v., the physician will be sufficiently di- rected in his judgment; nor need we enlarge with the dis- gusting indecency with which the old authors expatiate on this subject, nor on the public display of the active powers in the venereal act, Avhich some of the canons enjoined. The original authors seem plainly to hint that this indecency was only the prelude, like the mo- dern actions for crim. con. to a divorce, and designed as a justification of the most licentious conduct; for divorces, they add, were less frequent since such exhi- bitions were abolished. This practice began, it is said, early in the thirteenth century, and ended about a hun- dred and fifty years afterwards. Poisons. This frequent cause of violent and pre- mature death is often the subject of inquiry in courts of judicature, and the physician is usually called on vfor his opinion. Science has been often disgraced by the crude, the injudicious, and often the opposite, opinions offered on these occasions; nor has humanity had less cause to regret the sacrifice of lives on the most vague and inconclusive evidence. Poisons may be accidental or designed. We-shall begin with the latter. The marks that poison has been administered are the sudden appearance of extraordinary and unsuspected symptoms, as uneasiness, nausea, an acute pain in the stomach, palpitations, faintings, disagreeable and fetid eructations, vomiting of blood, and bile, hiccough, sud- den debility, smallness and inequality of the pulse, cold and clammy sAveats, coldness of the extremities, pale- ness, livid nails, general cedematous SAvellings, windy distention of the abdomen, sudden relief with an equally rapid return of pains, blackness and swelling of the lips, burning thirst, loss of voice, a livid counte- nance, vertigo, convulsions, rolling and starting eyes, loss of sight, with a dilated pupil, lethargy, suppression of urine, a fetid smell of the whole body, purple erup- tionsj livid gangrenous spots, and an alienation of mind. All these symptoms are undoubtedly equivocal, and oc- casionally attend other diseases. They are marks of poi- son only when they come on suddenly, Avithout any known cause; when the food, if unsuspected as the vehicle, sudden cold, violent affections of mind, or de- leterious vapours, cannot be accused; for these will in- duce many of the symptoms, though seldom in so con- siderable a degree as arises from poison. If the patient be not a suicide, and still retains his senses, he can explain the taste of the food, or medicine, which has induced these symptoms, so as to direct the future inquiries. When no satisfactory explanation can be obtained we must depend on the evidence collected on dissection. Poisons, so far as they are the object of our present inquiry, are violent, inflammatory, stimu- lants, or sedatives. The pungent stimulants betray themselves by the taste, the pain in swallowing, and the inflammation of the fauces; and they must be treated under the head of accidental poison, as they cannot be given without suspicion. The chief substance. to be considered here is arsenic, which is nearly tasteless, and violent in its action, even in trifling doses. Its poAver is shown by violent inflammation and gangrene in the stomach; and it is discovered by calcining the contents of the stomach with the black flux, when the smell of garlic will betray even such an impregnation as will not often be fatal. Some of the saline mercurials show no very decided action on the tongue or fauces, and will produce similar effects. These may be discovered by adding ammonia, and heating the whole in a close vessel, when the mercury will be so far revived as to Avhiten copper on rubbing. In this way mercury can be often discovered in those quack medicines where its MED 963 MED existence is utterly denied; for the ammonia contri- butes to precipitate the mercury, reduced in part to its metallic state, and enables it to appear on the copper. The suspected substance, if arsenical, heated between plates of copper, will give a Avhitish tinge to the part of the plates in contact with it. Independent of these trials, when the stimulant poisons have been the cause of death, the abdomen is greatly inflated, becomes ra- pidly putrid, dark spots appear on the body, erosion, inflammation, and gangrene, are found in the fauces and stomach, the blood is black and collected in the veins ; above all, the villous coat of the stomach is destroyed. One other discriminating appearance, on dissection, is mentioned by a respectable author on jurisprudence. If, after a body has been long buried, should gangrened spots be found in the stomach, surrounded by a reddish circle, these were effects of changes during life. Should the colour of the Avhole be uniform, the putrefaction took place after death. There are other poisons Avhich kill by a partial stimu- lus. The chief of these is cantharides; but their pecu- liar action on the bladder will point out the cause. The violent inflammation, the rapidity Avith which it hastens to gangrene, will at once betray the crime, and, at the same time, point out the culprit. No such can escape. The colocynth, the elaterium, and the tithymali, be- tray themselves by their taste, as well as by their local action, and can neither escape the detection of the per- son himself who is the subject of the crime, nor the attendant physician. The narcotic poisons like the others, produce A'omit- ing; but the faintness which is the effect of the vomit- ing in the former cases is the apparent cause of it in the present. The rapidly sinking strength, the dilated pupil, convulsions, stupor, sleep, vertigo, swellingveins, and cold extremities, point out the cause. Fortunately there are feAv such substances that do not betray them- selves by their taste; but there are such, though Ave shall not point them out; nor shall we mention any poi- son that can be secretly administered. It is incumbent, hoAvever, on the practitioner to be cautious in these in- stances respecting his decisions; for no chemical ana- lysis will assist him, and his only guide will be the dis- charge of substances Avhich the powers of the stomach cannot change. He must compare with anxious atten- tion the appearance of the symptoms after the supposed cause; trace with diligent circumspection every other cir- cumstance that might have produced the effect; examine with care the patient's usual habits, his predispositions, his complaints, and at last remember that every medi- cal conclusion is doubtful. Should he then be positive when the life of a human creature is at stake ? One trial has been falsely considered to be decisive, viz. the effects of what might remain of the supposed fatal beverage on animals. This will hold true of the stimu- lant poisons; but by no means of the narcotic. The most innocent substances of this kind are occasionally fatal to animals ; the narcotics, most injurious to man, are to many animals innocuous; and the human fluids changed by putrefaction are themselves poisonous. Accidental poisons are received in the food, or are hastily swalloAved by mistake instead of a medicine, before the taste betrays their nature. The former are chiefly copper,arsenic,and lead ; the latter, nitre, cam- phor, ammonia, or the mineral acids. Copper is greatly dreaded, and has frequently been accused Avith little reason. Copper culinary vessels, bell metal mortars, and all the various means by Avhich this metal can be introduced to the system, have re- ceived an indiscriminate sentence of banishment. In- juries have undoubtedly arisen from them, and Ave would earnestly join in deprecating their use. When, hoAvever, avc have said this in the Avay of caution, Ave may be allowed to add, that the dangers have been greatly magnified. The taste of copper is so peculiar that it can scarcely be disguised, and it will not gcnerally fail to give the alarm in doses far distant from dangerous ones. Hunger, or eagerness to taste a luxurious dish, may however, hastily impel us, and such vessels should be avoided. The effects are chiefly on the stomach, and the quantity taken must be considerable to endanger life. Arsenic has been swalloAved accidentally Avhen join- ed with any SAveet substance to poison flies, or Avith other substances to destroy rats. The effects are so marked and discriminating as not for a moment to mislead, and they have been sufficiently detailed. It has been supposed that this metal may be accidentally introduced into the system when employed in fining Avine ; but for this purpose it is noAV wholly disused in this kingdom. Lead has been accused of producing the Poitou colic Avhen united Avith cyder, either as this metal is pre- sented to it in the instruments employed in pressing the apples, or as added to correct the acidity of either Avine or cyder. We cannot deny that in each instance it has produced the effect, since it is the peculiar con- sequence of SAvalloAving any saturnine preparation. But these are by no means the constant, or indeed the most frequent causes of the disease. Another source is said to be the glazing of the common earthen vessels, since lead is used in the process, and in such vessels pickles are usually kept. Lead is not, however, always the substance employed, or it is not dissolved by the acetous acid. We have kept vinegar in such vessels for many days in a Avarm place, without its discovering the presence of lead on the addition of the most deli- cate tests. The alarm, therefore, we think unfounded. In these circumstances caution is almost as necessary as in the former, where the life of an individual is at stake. The credit of a house, the character of a professional man, are involved; and the feelings of those whose want of caution may have occasioned the mistake may be so ex- cessive as to endanger their lives. Though their negli- gence may merit punishment, yet that punishment may be too severe. Ignorant druggists have sold camphor and nitre in- stead of neutral salts; and by mistaking the vials, the aqua ammoniae, some mineral acid, or other stimulating substance, has been SAvallowed. The eagerness to escape from the taste of a disagreeable medicine hastens the act of deglutition, and the error is sometimes not discovered till the whole has been swalloAved. The medical treatment is not our object in this place. The only connection this subject has Avith medical jurispru- dence, is to ascertain the cause of death Avhen such sub- stances prove fatal. If taken as a medicine, the effects of the poison must be compared with the symptoms of the disease; and should the latter be highly dangerous, the feelings of the mistaken attendant may perhaps be MED 964 M E D relieved by the humanity of the physician's declaration, in which, if he offers truth in her fairest and most fa- vourable hue, he will do no injury to any individual. The symptoms Avhich distinguish camphorswallowed in large doses are, giddiness, vertigo,delirium, and con- vulsions. Nitre produces, with the common symptoms of narcotic poisons, bloody discharges from the bowels and the urinary organs. The mineral acids and ammonia do not greatly differ in their effects, which are those of violent stimuli, rapidly exhausting irritability. Inflam- mation in the mouth, or fauces, with a burning heat at the scrobiculus cordis, are followed by vomiting, by the sense of a heavy load in the stomach, and a consequent diminution of all its poAvers. From these symptoms, the remains of the medicine, and the report of the pa- tient's feelings when it was swallowed, if he is able to report them, the nature of the deleterious draught may be ascertained. The case of the suicide is deplorable ; yet he often repents before the termination of the scene, and can lead us to form a judgment of the treatment necessary. The physician's testimony may be called for, and no rule of morality can, we think, be Violated by soften- ing the most offensive circumstances. The feelings of the relatives may be essentially hurt by marks of dis- grace to the body, which we believe never once deterred a determined suicide. Apparent death has been the subject of much discussion, and premature interment the object of universal apprehension. Numerous are the tales told on this subject, many of which are exaggerated, and the greater number probably false. It is, indeed, possible that a person not yet dead may be interred; but it is highly improbable that any one should, in such a situa- tion, recover their senses and recollection ; for before these returned they must be suffocated by the want of air. The complaints, in which such apparent dissolu- tion is most common, are the spasmi and comata of Dr. Cullen, drunkenness, excessive evacuations, narcotic poisons, strangulation, drowning, breathing deleterious gases, excessive cold, sudden and violent terror, and violent passions. The want of motion, or feeling, of respiration and pulsation in the arteries, are neither singly nor in con- junction signs of death. The motion of the carotids, in the greater number of instances, continues longest, and their state should be most carefully examined. The experiment proposed by M. Bruhier is, to draAv.down the lower jaw, and if it approaches spontaneously the upper jaw, he thinks it a conclusive sign of some life remaining; but this may happen from the elasticity of the ligaments and other causes. It is certainly an equi- vocal proof. The eyes furnish the most certain signs, independent of putrefaction. If their transparency is lost, the eyeball sunk and wrinkled, and the pupil di- lated so as not to contract by the strongest light, resus- citation is no longer in our power. The sunk features, in the eyes of experience, are a proof almost equally sa- tisfactory ; but putrefaction furnishes the only unequi- vocal symptom. Yet this we cannot always wait for. If any legal question depends on the state of the inter- nal parts, dissection must be attempted at an earlier stage, since putrefaction changes every appearance by which we are enabled to decide. In cases of the slight- est doubt, it is recommended to commence the dissec- tion in the parts less essential to life, that if the stimu- lus of the wound excite the action of the remaining powers no considerable injury may ensue. Violent death is apparently ascertained wiihout difficulty ; and when the cause proceeds so far as to de- stroy the organization of a part essential to life, little hesitation can be felt. Haemorrhages, and the appear- ance of contusions, are often fallacious. The former certainly take place from a variety of causes independ- ent of violence, and the latter may arise from petechia:, or similar causes. We can scarcely, however, conceive a question to come before a court of judicature, where the difficulty would arise Avhether death was occasioned by a putrid fever or by bloAvs ; and we think the deci- sion ofthe father of forensic medicine, Zacchias, decisive in this respect. In case of violence, he observes, there is an extravasation under the skin : the lividness from other causes only discolours the surface by a change in the skin itself. We know that Stoll in two cases dis- covered a considerable extravasation under petechiae ; but these instances are rare, and the danger of mistake very trifling. On the other hand, considerable extra- vasations may take place internally, without the surface being affected, as where the bruise consisted of a large heavy weight, which gave a considerable shock without making an impression on any particular part. This cause of death may, however, be discovered by dissec- tion ; though, undoubtedly, bruises after death may, be- fore the blood has coagulated, occasion similar appear- ances. This source of error must be carefully investi- gated in the particular cases. One very important subject of inquiry arises, how- ever, out of these discussions. If a man, in an acci- dental or premeditated struggle with another, by any extraordinary exertion, break a blood vessel and die, though the struggle occasioned the death, yet it is deemed accidental. If this struggle be a pugilistic con- test, where personal animosity is unsuspected, and the person thrown dies on the spot, a doubt will arise hoW far his antagonist was the cause of his death. Again, if, in the violence and heat of a quarrel, a person strike an- other with an inconsiderable Aveapon, and death follows as much from the passion as the bloAv, the doubt will be increased. In each instance, the physician and surgeon are called on to decide; and we knoAv no cases in which such contradictory evidence has been given. The prin- ciples on Avhich the decision should rest appear to be these. When, from prior complaints, any weakness or predisposition to disease, hereditary or otherwise, can be discovered; Avhen the violence is such that, in a sound healthy body, it Avould not probably produce any dangerous effect, the blow or the fall should not be ac- cused. If a man, subject to a spitting of blood, in a strug- gle should break a blood vessel; if a person with a full florid complexion, and a short neck, Avhose parent had died of apoplexy, and perhaps about the same age,should fall down dead in a trifling contest, Avhere the exertion was inconsiderable, we should certainly not convict his antagonist of any thing but imprudence and misfortune. When any contest has taken place, independent of personal animosity, and some slight injury has been seemingly received, the subsequent conduct of the pa- tient should have great influence on the judgment of the practitioner. If he has received injury in his side or head, and, instead of a cautious mode of diet, should M E D 965 M E D indulge in every irregularity, the pleurisy or phrenitis that might ensue should not, in justice, be attributed to the antagonist; nor, when the proper distinction is made, Avill the law, we believe, condemn him. This is not, however, the place to discuss a legal question, but to point out the foundation for the physician's opinion. The case is somewhat different when an abscess has folloAved external injury, independent of any irregu- larity of the patient's conduct. The physician must then decidedly attribute death to the consequences at least of the accident; and the legal distinctions will regulate the degree of criminality, and, of course, the punishment. We have for some time been trenching on the pro- vince of the surgeon; but to introduce those parts of our subject which are more peculiarly his object, Ave must offer some remarks on the dissection of bodies, Avith a view to discover the disease which has proved fatal, or the nature of the Avound, in complicated cases, Avhich has been destructive. Dissections are opposed on many grounds. We shall notice only the objections Avhich urge that by this means we discover effects rather than causes, and that complaints may have occured either in the minuter parts, which cannot be detected, or in the nervous sys- tem, which are not cognizable by our senses. Un- doubtedly we more often observe effects rather than causes; but the objection will only apply Avhen the anatomist, from ignorance, cannot detect the difference; or, from haste, will not Avait to examine. The source of great error has been the partial examination of the part apparently most affected. We remember the dis- section of a person supposed to be starved. The sto- mach was empty and full of wind, but not contracted. Some doubt remained; for the mesentery had not been examined, in which the conglobate glands were after- wards discovered in an enlarged and scirrhous state. Many similar instances might be adduced; and we may here add, that, in general, every cavity of the body ■> should be examined with care, particularly the head. Complaints also may undoubtedly occur in parts of the body which even an exact anatomist may not think of examining; but these, we believe, will seldom prove fatal: nor, except from deleterious gases, is there any probability that the nervous system will be so much af- fected as to produce death, without leaving evident cor- poreal traces. In medical jurisprudence, however, dissection is ab- solutely necessary, as the law requires the best evi- dence that can be procured, and various cases may be stated in Avhich it is essential. A man, for instance, is found dead in a close apartment, in which charcoal has been burning, or which is in part consumed. The cause will appear evident: but dissection may disco- ver traces of poison Or of blows ; and the fire may have been lighted to prevent suspicion. When the dissection is determined on for the disco- very of the cause of death, it should be attempted early, before putrefaction can have changed the appearance of the parts, and with as little motion as possible, that the relative situation of the viscera be not disturbed. The Avhole body, particularly the head, sternum, and abdo- men, should be cautiously examined by gentle pressure. All the natural openings should be carefully sounded, and each part opened in succession, beginning with that Avhich is most probably injured. The order of the examination is of more consequence than has been sup- posed. If, for instance, in the dissection of the body of a new born infant, to ascertain the cause of its death, the heart and lungs be first opened, the copious dis- charge of blood Avill drain the large vessels, which will be found empty, and a strong suspicion will conse- quently arise that the child died of an haemorrhage, by neglecting the ligature on the funis. So, in examining a wound and its direction, every thing must be avoided which can disturb the relative situation of the parts; for to establish the cause of death it is necessary that the direction of the instrument should be accurately as- certained. In ruptures of internal vessels this caution is of less importance; yet, Avhen there is any suspicion of the cause, it should be traced Avith as little disturb- ance of thd relative situation of the parts as circum- stances will permit. The mode of examination is knoAvn to every sur- geon ; but it is highly necessary that he should be ac- quainted Avith the natural bulk and colour of the parts, and Avith the changes which fermentation, inflammation, and putrefaction will successively, at different periods* produce. The swelled abdomen and livid spots on the side may give suspicion of poison; but they are the effect of a separation of air, and the necessary changes in consequence of a warm season. If an inconsiderable wound, from its place or its direction, proves fatal only after some time, the previous inflammation will close it so that it shall appear too inconsiderable to be the cause of death. Rape. The ancient authors on forensic medicine are full on this subject, and unnecessarily minute and inde- cent. The examination and marks of violence will alone determine the judgment of the practitioner; and for this purpose the English laAv has wisely determined that the complaint should be immediately made, since the injury can then only be best ascertained. The existence of the membrane closing the entrance of the vagina, deified under the name of Hymen by the ancients, has occasioned some controversy. The moderns have wisely cut the knot, and admitted, that though it is a sign of virginity, yet its absence is no proof of violation, since it may be destroyed in a variety of Avays without suspi- cion of impropriety. An observation of Buffon, which we believe to be correct, will explain some of the ap- parent contradictions on this subject. He observes that this membrane is seldom found in young children, or in girls long previous to puberty. It is at that early period folded in Avrinkles, and expands, as the custos horti, only near the age of Avomanhood. It is certain that its existence has been denied by anatomists of eminence, who, in order to " make assurance double sure," in such a doubtful point, have sought it in girls from four to ten years of age. The marks of violence, and the evidence of the young woman, according to our laws, alone decide, ana* these require no further medical dis- crimination than we have stated. The swelling of the neck, which the " hesternum monile" can no longer surround, the blackness under the eye, the sullied whiteness of the cornea, must be referred to the list of old women's stories, which sounder science spunis at. Suspectf.d pregnancy. On this subject a surgeon is often consulted, and we have already stated in dif- ferent articles the foundation of the distinction. (See M E D 966 MED Conceptio, Gener itio, and Ascites.) We shall here, hoAvever, give a general connected vieAV of the sub- ject. If a Avoman, Avho has been previously regular and in good health, at once complains of obstruction, Avithout any avcII founded cause, as cold, fright, &c. suspicion must be kept alive, and active medicines aA-oided. The complaints Avhich arise from pregnancy, though of a similar nature from those OAving to suppression, yet greatly differ. In the first Aveeks the pregnant Avoman feels no inconvenience, and then only from sickness, and chiefly in the morning. In the intervals of sick- ness the spirits are free, and in the evening the appe- tite is also good; while, from obstruction, vomiting is an uncommon symptom, the languor comes on more slowly, and the symptoms are by no means worse in the morning. In the former case the complexion is clear, in the latter pale and dark : in the former the eyes often lively, in the latter uniformly dull. Not many weeks elapse before the breasts swell, and a pink or brown areola appears round the nipple. The former state of the breasts may hot be known, and the areola in many women is naturally dark. Yet in a thin woman it Avill be at once seen, if the breasts are disproportion- ally full; and even in a more lusty one their firm- ness will betray an increased bulk, while in suppressed menses the breasts are much extenuated. The areola in a pregnant woman is also unusually extensive. After the fourth month the swelling arises above the pelvis in, the form of a round, circumscribed ball, and the sick- ness usually goes off, while the spirits become pecu- liarly free and cheerful. At this period the state of the os tincae may be discovered by the finger, and will at once preclude all hesitation. See Pr-iesentatio. We have not mentioned the sensation of motion in the uterus, because we proceed on the supposition of concealment. The same cause may prevent our knoAV- ing the state of the menstrual discharge: but the A'o- miting, the tumour of the breasts, the darker areola, cannot be concealed, and the tumour of the abdomen at the subsequent period will be decisive. At this time, also, and often more early, a slight pressure will produce a flow of serum or milk from the nipple. Hebenstreit indeed observes, that many women, not pregnant, can bring on a discharge of milk at will; but we have no reason to think that moderate pressure, independent oMong continued irritation, or suction, can produce it in this climate. Medical authors, kind to the fair sex, have been anxious to point out the fallacy of all these proofs ; and we shall so far join with them in-urging the practitioner not to hasten the decison. Certainty is at no great dis- tance, and it is prudent not to endanger driving the woman to despair. This may occasion the Avorst of crimes ; and, if though guilty, she escape, she may live to repent, and repair to society the injury Avhich her former errors have occasioned. It sometimes happens that women pretend to be with child, either to impose a fictitious offspring on a cre- dulous companion, or to avoid punishment. The deter- mination is in this case more easy; but should it be pru- dent to delay the decision, a most unremitted vigilance is necessary. Suspected delivery very often claims the attention of the surgeon. The signs, hoAvever, though singly equi- vocal, are, together, certain. The very considerable re- laxation of the Aagina, the laxity of the teguments of the abdomen, the want of the fourchette, the thin membrane Avhich unites the labia below, the peculiar SAvelling of the breasts, the extended areola, milk pec u- liarly thin and serous, with the unequivocal smell of the lochia just going off, will decide. Exceptions may be made to all these as well as to the signs of pregnancy; but the experienced eye cannot be deceived. Retarded or premature delivery. Nothing can be conceived more ridiculous than the discussions of me* dical jurisconsults on this subject. The ancients con- tended that every animal had a fixed period of gesta- tion except the human female ; but this is by no means true: and the moderns have tortured their invention to explain Avhy delivery should be retarded. We need not enlarge on the subject; for our laws speak plainly that if a Avoman lies in Avithin eleven months after the death or the possibility of the access of the husband, the child shall still be his; and the axiom pater est quern nuptia demonstrant, be uncontroverted. It is not our business to oppose the law, but to explain it, though Ave may still remark that it is peculiarly complaisant or indulgent. On the other hand, the law, we believe, recognizes only a living child of seven months to be legitimate, if former access can be denied: a circum- stance which can seldom happen. Abortion. This is a subject which, by our laws, can scarcely be considered as an object of medical juris- prudence ; for no statute is in force to punish the means of procuring it. The civil law made many unscientific, and even ridiculous distinctions on this point, resting on the period when it was supposed the fcetus began to live. We have hoav reason to think that life com- mences from the moment of impregnation. There is, hoAvever, a nice distinction in the English laAvs, Avhich can never be applied Avithout the most rash, unwar- rantable decision of the physician or surgeon. If, says Dr. Burn, Avhom we quote, by a medicine given the child is killed in the Avomb, " it is great misprision, but no murder;" "but if the child be born alive and dieth of the potion, or other cause, this is murder." The opinion, Ave say, is inapplicable: for where is the physician Avho will decide that a weakly child might not have been so Avithout the potion ? and the vague clause distinguished by italics must make the whole " Avords of sound signifying nothing." There is, how- ever, another view Avhich we must take of the subject. An author of the purest morality, the most extensive benevolence, and the soundest religion, Dr. Percival, has dropped a hint, that it may not be unlawful to pro- cure abortion where the size of the pelvis is not adapted for the birth of a living child. This is a latitude which we cannot sanction. A more recent-(we believe a more recent) proposal of a celebrated accoucheur, who sug- gests in such circumstances, the propriety and advantage of bringing on labour at the end of the seventh month, is greatly preferable. In this case, though the attempt is peculiarly difficult, and can only succeed in the most experienced hands, the health of the mother is less en- dangered, and the child may be preserved ; nor, on the whole, does humanity so strongly revolt at the attempt. Yet, as Ave have said, the Avhole should only be under the conduct of a man who unites resolution with dis- cretion, and judgment Avith humanity. m e d 967 M E D Infanticide. We know not when we have found greater difficulty in speaking on any subject than on the present. The weight of arguments seem often to bear hard on those who are the objects of the greatest com- passion ; on unhappy women, deluded to their ruin, struggling with remorse, with the apprehension of dis- grace, acting from a momentary phrenzy in self defence, often inconsistently and improperly subjected to suspi- cion from circumstances wholly beyond their power, and to conviction from the fortuitious occurrence of events not within their calculation. On this subject particularly, and indeed in every branch of medical ju- risprudence, we strongly advise the practitioner to be cautious. He may reason as a physiologist, but he should act as a man of feeling and reflection, who knows that no medical conclusion is certain, and that the life of a perhaps innocent individual may be sacri- ficed to his hasty oracular decision, perhaps to his inadvertency. The punishment of a crime, says Bec- caria, cannot be strictly called just or necessaiy, while the law has not employed the best possible means of preventing it. The law is indeed silent; but modern refinement, the precision of outrageous virtue, which admits not of the penitence of a sinner, urges the unhappy culprit to the worst of crimes. In such circumstances the woman, from the causes already stated, is alone, her mind agitated, her resolu- tion weak, herself spiritless and indecisive. The labour is perhaps rapid, the child born during fainting or con- vulsions, and lost from want of that attention which no law enforces, and which the apprehension of disgrace prevents her calling for. A state of this kind may be ascertained by subsequent faintings, peculiar debility, a low fluttering pulse, paleness, and subsequent oedema. Should these symptoms not occur, let us not yet decide without hesitation; for other circumstances should be also considered. The first question must be, Avas the life of the child so perfectly established as to be probably continued after its birth ? This is answered by its appearance, and the perfect, the complete development of its organs. It may be again asked, was it not dead before delivery ? According to Alberti, if dead previous to delivery, the limbs are flexible, the skin wrinkled or soft, the colour yellow or livid, the abdomen sunk, with marks of com- mencing putrefaction, particularly about the navel, and the umbilical cord empty, yellow, livid, and apparently dissolved. The appearance of the cord is, hoAvever, equivocal; for the access of the air -will, in a short time, produce the same changes. Indeed, all these appear- ances are the result of putrefaction, and the child may have died only a very short time previous to its birth; nor are authorities Avanting to show that, while the access of the external air is prevented, putrefaction does not soon take place. (Heister, Alberti, and Hebenstreit.) The marks of apparent violence on the body are by no means decisive; but we have already, when speaking of con- tusions, laid down the best diagnostics on this point. If an infant has breathed, it is supposed to have lived; but how many weakly infants are born alive, without breathing for many minutes; and Iioav often, on the other hand, after a hard labour, does the child breathe once or twice, and then die ? That the child may breathe before the delivery is complete, and die before it is fully born, is a fancy within the verge of possibility only, but too improbable to induce us to enlarge on it. A child, indeed, wholly perfect, may be strangled in its birth by the twisting of the umbilical cord round its neck; and it has been doubted Avhether, in this case, it is suffocated or dies apoplectic. It is probable that death is rather the consequence of the stoppage of the circulation through the cord itself; but this is of little moment as the mark remains. May not this mark, however, be the effect of violence? It certainly may be so; and the famous experiment of the lungs sinking in water is adduced to determine the doubt. In a child that has not breathed, the lungs occupy the upper part of the chest, so as to leave the heart and pericardium exposed to view. But Avhen the lungs are- distended by respiration they fill the chest, and become specifically lighter thanAvatcr. The English courts do not admit this experiment as evidence, and Ave are unwilling to disturb their decisions. We shall, there- fore, add a feAv words on it as philosophers rather than as forensic physicians. Heister observes, that the experiment is indecisive, because scirrhi in the lungs Avill make them specifically heavier than Avater; but Avho would be so weak as not to examine whether the experiment Avas tried on a morbid or a sound part; for the morbid lungs even of an adult will sink in water ? He adds, that he has seen a child Avho had breathed twenty hours, Avhose lungs sunk in Avater; but he here speaks of the Avhole viscus, not of any particular portion, on Avhich the experiment ought to be made. Again, it is contended that Avhen putrefaction has taken place, the lungs of a child Avho has never breathed will sAvim. This fact is positively denied by at least equal authority; and, in reality, the lungs are scarcely susceptible of putrefaction, even Avhen it has taken place in a considerable degree in the other parts of the body. If there were, hoAvever, any ambiguity, it may be at once removed by a slight at- tention. The air, separated by putrefaction, may be observed in the Avater passing along the divisions of the lobules, while air within them is invisible. It is certainly possible that the mother, in attempting to revive a still born child, may endeavour to inflate the lungs by her oavu breath. Anatomists of eminence have differed on the possibility of success; and we own that it appears to us impracticable, since the force of the expiration must be sufficiently great to expand the thorax, and the nostrils must be at the same time closed. Humanity will, however, take this source,of expanded lungs into consideration when the life of an individual is at stake. The colour of the lungs, which is of a bright red pre- vious to inspiration, their situation in the thorax, and the situation of the liver and stomach, as Avell as the shape of the diaphragm, will afford more decisive proofs (Sabatier Memoirs de 1'Academie Royale des Sciences); but we Avill not accumulate what may be adduced to criminate. Suppose it, however, ascertained that an infant is born alive, does it folloAV that the mother has been its murderer? The English laAV allows the concealment of pregnancy, and the want of provision for the infant, to be presumptive proofs of her guilt; though this has been most Avisely and humanely put out of view by constituting it a distinct crime, with its appropriate punishment. But if children die soon after birth, Avhen MED 968 M E D the most anxious attention is exerted to preserve them, is it not probable that, in circumstances like those Ave speak of, the fatal event will be more common? Is it not rather surprising that any should live? The dangers that attend this first state of existence are numerous, and the neglects which may prove fatal are equally so. It is not our present business to point out these; and, indeed, we have through the whole discussion purposely avoided giving information that may be abused. The foreign authors on forensic medicine seem to aim at assisting criminal intentions, by industriously pointing out the means of their execution. Wounds. The surgeon is often called to decide on the degree of injury sustained by these, and on the cause of death which folloAvs them. When not mortal, and mutilation only is the consequence, the recom- pense Avhich the law awards is proportioned to the in- jury sustained. The English laAv, hoAvever, makes the lying in wait, to maim, a capital offence, and Avith great propriety, as the lurking assassin is far more dangerous than an open enemy; and when it was alleged in a criminal's defence that the design Avas to kill, not to maim, the objection was overruled, on the principle that Q7nne majus continet in se 7ni7ius. It is not easy to kill without, maiming. Wounds are fatal either in consequence of the effu- sion of blood, or the destruction of the organization of some part essential to life. It is not here our business to enter into the legal distinctions in this very compli- cated subject; but to point out to the surgeon, for his observation, the various circumstances on which these distinctions are founded. The divisions of the civilians, and of the older forensic physicians, into wounds mortal or indifferent, necessarily or absolutely mortal, Etc. we shall not enlarge on, as they are not applicable to the system of English jurisprudence. Wounds may, hoAV- ever, be fatal by accident, as a bone at some part of the skull may be penetrated, if peculiarly thin, by a slight blow; a part essential to life may be in a preternatural situation, as a blow on the groin, which would do.no injury, may bring on a fatal inflammation in case of a previous hernia; or a fever, which a slight blow has occasioned, may excite an indolent vomica to suppura- tion. In all these instances, the English law inquires quo animo the injury Avas inflicted. Again, a trifling wound may become fatal during the prevalence of a malignant epidemic, in a constitution deeply tainted with scurvy, syphilis, &c. or in one of great nerv(ous irritability, by inducing tetanus, or its lesser degree, a locked jaAV. A state of pregnancy, infancy, or old age, will also render trifling injuries dangerous or fatal. The event is equally influenced by obstinacy or cow- ardice, which prevents the treatment necessary to pre- serve life; by intemperance, violent passions, or de- spair; by neglecting the proper precautions enjoined ; the want of necessary assistance, its delay in inclement seasons, or the unskilful ness of the practitioner. It was a truly judicious remark of a judge in a late cause, that he could not try the skill of a surgeon; and we would here add, that in every case where the opinion of a professional man is called on the conductof another, he should reflect that his judgment is enlightened by the subsequent circumstances. In the situation in Avhich the first practitioner was at the early era of the acci- dent or complaint, the question must be, could he Avith propriety have acted differently? If that question is ansAvered in the affirmative, another Avill arise; and should a man, himself liable to error, be forward in criminating a brother? Wounds of the brain are seldom mortal, except the base, the cerebellum, or the spinal marrow at its com- menpement are injured. A large portion of either hemisphere has been evacuated without injury, and even Avithout the slightest (apparent) diminution of the faculties. Depressions of the skull are much more dangerous; and compression, from a fractured skull or extravasated fluids, as well as that torpid inflammation Avhich concussion, after some time, brings on (vide Concussio and Cerebri compressio), are almost equally fatal. It is not the present object to point out the symptoms of each; but we must add the strongest injunctions in case of apparent compression, to examine with the strictest anxiety, the part affected, in order to the application of the trepan. This is often very difficult to ascertain. Wounds of the nerves are not always dangerous; but if a nerve is partly wounded it may bring on a fatal tetanus, when, from its situation, the nerve cannot be divided. Bohnius remarks, that wounds of a nervous plexus are usually mortal, and bruises on a nervous part, particularly where its nerves are connected with the vital organs, are generally dangerous. Michaelis men- tions bruises on the pit of the stomach, in the English pugilistic combats, as frequent causes of death; and in- deed, all .wounds of the stomach and intestines are highly dangerous, though many miraculous stories are related in which the patients were cured. Wounds of the liver, spleen, kidneys, bladder, and uterus, are also usually fatal, from the access of the air or the internal haemorrhages. In experiments made on animals each Ls carefully avoided; but, with every precaution, the Caesarian section is usually mortal. Injuries in the vital organs, and indeed all wounds of the larger vessels, must necessarily be fatal. The stop- page of respiration, from any cause, must also soon ter- minate in death. A question sometimes occurs, whether the person may not have been suspended or drowned after life had been extinguished ? This question can only be ansAvered satisfactorily by dissection. Indeed, when life is destroyed by suffocation, the mark of the injury is conspicuous in a much greater degree than by common suspension; and, in cases of droAvning, the pale livid colour of the face, with froth round the mouth, may determine the question ; but each sign is equivocal. In either case, however, the venous system, particularly of the vena cava, and of the head, is greatly distended; and in strangulation the pulmonary artery is unusually full. \Vhether death has proceeded from deleterious vapours, in which the body has been confined, to avoid the suspicion of former violence, is not so easily dis- covered. The application of galvanism Avould, how- ever, show the extraordinary diminution of irritability, which is usually the effect of such vapours; and, in each case, other marks of violence, and the injury of organs essential to life, will-give strong suspicions, which dis- section will confirm. To pursue, with forensic physicians, the wounds of every different part, would extend this article beyond its proper limits; nor indeed could we add any thing which a knowledge of anatomy and physiology will MED 969 M E D not supply. We must not suppose our readers ignorant of either. Shocks and bruises. In the article respecting concus- sion we have shown how shocks impair the irritability of the vessels, and produce chronic inflammation in the brain or liver, which after some time is often the cause of death. Each cause here mentioned will also produce internal effusions, generally from a rupture of arteries, Avhich may be fatal. A late instance has occurred, in Avhich the radial artery was broken through its whole substance, by the shock only of a fall from a horse; and Pilatre de Rozier, the victim of aeronautic folly, fell on his feet, and died immediately from the shock, which was found to produce internal effusions. Blows with a stick, without inflicting any wound, will occasion, inter- nal, and sometimes neighbouring accumulations; and military punishments, when not fatal from gangrene, are sometimes so from abscesses forming below the bruised part. (Hamilton's Regimental Surgeon.) It is necessary, therefore, in forensic medicine, to look be- yond the immediate injury, and examine the effects of what may arise from the shock or its consequences. In three instances Ave have heard from practitioners of credit decided testimonies that the blows were not the causes of death, because no mortal appearance attended the wounds. It was unlucky for the cause of justice that they were so ignorant; but humanity might smile through her tears, and charitably hope that the escape would prove a warning. Hanging and drow7iing. We can scarcely separate the forensic from the more strictly medicinal considera- tion of these subjects, and must therefore refer to Strangulatio and Suspensio. Medicina politica. Medical interposition, ac- cording to our laAvs, is seldom necessary in questions of police. Yet there are many cases \vhere an intelligent physician might afford satisfactory information. Per- haps the neglect has arisen from that dogmatism Avhich is the effect of ignorance, or of imperfect science, as in the instance mentioned by Dr. Percival, Avhere two physicians contradicted each other respecting the dan- gers from a copper Avork. One swore positively it was dangerous ; because copper ores usually contained ar- senic ; the other had ascertained, by experiment, that the ore in question contained none. In the article Aer we showed that weather, and a state of atmosphere apparently the most insalubrious, were sometimes found healthy; and that neither rea- soning a priori, nor experiment with the eudiometer, would always point out situations Avhere the, health can be preserved. The vicinity of marshes certainly ren- ders situations unAvholesome; but this is liablffco ex- ceptions. If the prevailing winds bloAv from a marsh to a toAvn, at the season when the marsh is covered with water, little danger arises from it; but if the wind passes over it Avhen in a moist state, diseases often fol- low. Dilution of the miasma, Ave have said, is the Gest security, and, therefore, at a certain distance its power is lessened or destroyed; but unfortunately this distance is not ascertained, nor is it certain that every marsh produces deleterious vapours. Those covered with salt water at each returning tide, or even at each spring, are not always dangerous. We cannot as- certain the innocence of any other kind, except of those very generally covered with water or herbage. Stag- VOL. I. nant water has indeed been accused ; but we suspect without reason : it certainly is not eminently injurious, and, from the " green mantling," known to exhale oxy- genous gas, it may probably be salutary. Towns, it may be said, cannot be removed; Taut if unhealthy they -will be gradually forsaken. A house may be removed to a healthier spot; but the more tem- porary situation of a camp or a barrack Avhich may be chosen should be fixed with peculiar care. The re- ports of army surgeons frequently point out the fatal effects of inattention to this important circumstance; and it has been said that barracks have been heedlessly erected in spots peculiarly unhealthy; nor should Ave be surprised to find the same carelessness respecting health that we have found of expenditure. A medical to- pography should be published of every district, com- prehending the particulars of its situation, its prevailing winds, usual temperature, and reigning diseases. This plan, Avhich has been adopted in France, Avould truly merit the attention of the legislature ; and it might easily have been appended to the agricultural surveys, Avere we as attentive to the lives and health of mankind as of the shape or breed of cattle. Nuisances often claim the attention of courts of jus- tice, and physicians are sometimes called on to de- cide. Their object is, however, to determine only what manufactures are injurious to health. A brick- kiln, a lime-kiln, a pottery, and an iron-foundry. are unpleasant neighbours ; but can we say either is unwholesome ? Smelting-houses for lead, and, in ge- neral, for copper; dye-houses and tan-yards, erected so near the water as to corrupt the stream, are certainly injurious. The manufacture of the mineral acids, the oxygenation of the muriatic acid for bleaching, the singeing of velvets, currying of leather, are processes always offensive, and generally injurious ; for the work- men are usually pale and weak, subject to nervous dis- eases, and seldom long-lived. Yet it is said, that the improved methods of burning the smoke prevent much of the inconvenience. The process of making candles is offensive, but apparently not unwholesome. It has been admitted into towns, but with reluctance; and the ma- nufacture is discouraged in populous cities Avhen com- plained of. The business of the dyer or the butcher is certainly not injurious to the health of those Avho prac- tise or who live near either, nor can we recollect, in a large populous and trading town, any peculiar com- plaint that could be traced to their quarters. The breath and the dung of the cows have been thought sa- lutary; but should they be so, the vicinity of pigs is cer- tainly otherwise, and these should not be fed in popu- lous cities. Were the police to interfere in buildings, one cir- cumstance should be indispensable, viz. that every house should have a free ventilation from the front to the back part: the smallest court behind would be suffi- cient, if not shut up by houses rising gradually higher on a hill. We have found no circumstance so injurious to the general health of a family as a situation where free ventilation is impeded. The foreign authors on the medicina politica arc full of numerous disquisitions, in which the law of this coun- try speaks positively, and requires no medical aid. One of these points is the age proper for marriage ; others are cohabitation, the Caesarian operation, punishments 6 II ME D 970 MED during pregnancy, 8cc One of these subjects calls, we think, for medical interposition, viz. the danger of pro- pagating the most dreadful diseases, as mania, scrofula, phthisis, 8tc. Yet Ave see not how physicians can inter- fere ; for the child sometimes partakes of that parent's constitution, which is perfectly sound. Must that child, or such children, then, be deprived of existence be- cause the life of others may be short or suffering ? Hu- manity, reason, and religion, will at once forbid. A stronger case is, where a woman, from deformity, can- not have a living child. Must her marriage be pre- vented ? Neither law nor religion will decide in the affirmative, though the child and the mother may be sacrificed ; and such is the circumstance lately men- tioned, where the civilians have thought the procuring abortion justifiable. This, for numerous reasons, we must oppose, though we think bringing on labour at the seventh month a humane and judicious expedient: the impossibility of the woman's bearing a living child should, however, be first ascertained without any doubt. When the testimony of a physician is called for in a court of justice, his evidence should be clear, divested of technical language, and in modest, decent terms. He is sworn to tell the truth, the whole truth, and nothing but the truth; yet we have spoken of giving truth in her fairest garb, of softening what is harsh, and leaning to the side of humanity. We must explain. It is not our design to recommend prevarication, much less con- cealment ; yet in the most decided cases there must be doubts, there must be views, which will carry with them alleviations. It is neither prevarication nor con- cealment to give each their full force; to point out how far they may bear on circumstances the most appa- rently positive. It has been said that it is better ten criminals should escape than one innocent person suf- fer by insufficient evidence. Yet criminals are con- fessedly punished for the sake of example ; and the frequency of escapes, we fear, encourages new attempts. The maxim, therefore, though humane and benevolent, has been carried to an extreme; yet, as involving some intricate disquisitions, not applicable to medical evi- dence, we can only add, that as the extreme of justice is the extreme of injury, so excess of humanity may be the excess of cruelty. We have now finished a subject, new in our lan- guage, and in which, though we have anxiously avoid- ed error, we may have often committed it. The extent of our article is comparatively short, for we have endea- voured to compress volumes into pages; and as Eng- lish forensic disquisitions on medical subjects must re- late to English laws, many bulky inquiries were foreign to our purpose. Yet, in our references at the end, we have pointed out the sources of a more general and a more extensive inquiry. If these appear numerous, the reader will feel more sensibly the obligation we have endeavoured to confer, viz. contracting our article by the omission of numerous references in our progress. To the candor of the more enlightened and experienced readers we now trust it, with a consciousness of having meant well; of having Nothing extenuated, Nor set down aught in malice. See Paullus Zacchias Quaestiones Medico legates, 3 vols. fol. Norinberg; Michaelis Valentini Pandectae Medico legates, 4to. Frankfort; Zittman Medicina Fo- rensis, 4to. Frankfort; Alberti Systema Jurisprudentiae Medico legalis, 6 vols. 4to.; Richter Decisiones Medi- co Forenses; Teichmeyer Institutiones Medicinae legalis (Fazellii edit.), Jenae, 4to.; Hebenstreit An- thropologia Forensis, 8vo.; Ludwig Institutiones Me- dicinae Forensis; Fazellii Elementa Medicinae Foren- sis; Collect Opusculorum ad Medicinam Forensem Spectantium, a Schlegel, 6 vols. 12mo. Lipsiae ; Me- decine Legate et Police Medicate de Mahon, Paris, 3 vols. 8vo.; Percival's Medical Jurisprudence; Medical Jurisprudence on Madness by J. Johnstone, M. D. Medicina statica. During the prevalence of the mechanical systems, Avhen pondere mensura et numero Deus omnia fecit was the conduct held out to our imitation, the body was constantly Aveighed, and the salubrity of food Avas estimated by its perspirability. This plan, pursued at some length by Sanctorius, was soon found to give unsatisfactory results; for the vale- tudinarian, in his statical chair, though the balance Avas carefully preserved, lost his strength and spirits; and he saAV, with surprise, that he was " truly found Avant- ing." Many circumstances were not taken into the account, which would greatly alter the result; but these Ave need not stay to enumerate, as the folly has had its day, and is now forgotten. Sanctorii Medicina Statica, and Keil's Aphorisms. Medici'na tristi'tijE. See Crocus. MEDICINA'LES DIES, are those days in fevers which are neither critical nor indicatory, and on which it is supposed proper to administer powerful remedies. MEDINE'NSIS VE'NA, (from Medina, where it was frequent). Medena vena. A worm ; called vena, before it was known to be an animal. See Dracun- culus. MEDITU'LLIUM, (from medium, the middle). See Diploe. When it signifies the pith of vegetables it is called also cardia, cor, encardium, medulla, matrix. MEDIUM, (from Media, its native soil). See Cer- vicaria. Me'dium te'stjE. See Bregma. MEDIUS DIGITUS. See Digitus. MEDU'LLA, quia in medio ossis. Marrow; ax- ungia de mumia. In anatomy it hath various significa- tions. The white substance of the brain is called me- dulla, or the medullary part, to distinguish it from the brown or cortical. The continuation of the brain in the spine is distinguished by the epithet spinalis; but me- dulla strictly means marrow in the bones. If the marrow be viewed through a microscope, it seems^mass of small globules united like those in the roe oflPherring. The distinction betAveen medulla and succus medullaris is useless, for the marrow in the liv- ing body is ahvays fluid. The membrana medullae not only, lines the internal surface of the bones, but divides the vesicles, or membranous bags, containing the mar- row; these very fine minute vessels from Avhich the mar- row is secreted are dispersed on these membranes, and are branches from the artery, Avhich enters the bone by its appropriate aperture. The use of the marrow is said to be rendering the bones flexible, for it was with little reason supposed they would soon otherwise become brittle, as happens in syphilitic and scorbutic habits., where it is apparently separated in too small a quantity, too quickly absorbed, or diseased. The membrana MED 971 MEL medullas is furnished with a nerve Avhich enters with the artery, and with an accompanying vein. The small vessels Avhich secrete the marrow are more than usually diminished by advancing age; and we thus find the marrow bloody in the earlier periods, oily in the middle stages of life, and Avatery in old age. The marrow is never sensible but in a diseased state, and is usually absorbed with the rest of the fat in drop- sies. In the foetus the bones contain albumen chiefly; and in birds the proportion of marrow is inconsiderable, for the cavities chiefly contain air. Marrow of animals is prescribed in some compositions, but it has no supe- rior efficacy to other fats. Medu'lla c'assi.e. The pulp of the cassia fistularis. See also Meditullium. Medu'lla oblonga'ta is a continuation of the me- dullary substance of the cerebrum and cerabellum, passing downwards, and a little backwards to the fora- men magnum occipitale, where it assumes the name of medulla spinalis. It is rather of a depressed pyriform figure though called oblong; rising by two crura from the cerebrum, and tAvo peduncles from the cerebellum : the enlargement formed from the union of these is called pons varolii, or tuberculu7n annulare, behind which is a stricture upon the medulla oblongata, fol- lowed by an enlargement, on each side, styled corpora pyra7nidalia. From the medulla oblongata arises the medulla spinalis, and all the nerves which pass from the head, except the first and second pairs. (See Nervi.) Death is the immediate consequence of an injury on the medullary part. See Cerebrum. Medu'lla spina'lis ; cerebrum elongatum; JEon; is the continuation of the medulla oblongata, from the fora- men magnum occipitale,.through the vertebrae of the neck, back, and loins. It is of different sizes; in the neck flat and broad; in the back, small; in the loins, large; and at last it becomes a bundle of nerves, which have the name of cauda equi7ia, because when taken out, and extended in water, they resemble a horse's tail, and as the medulla passes out of the fora- men magnum, its external membrane the dura mater is united to the ligamentous lining of the bony cavity, but this connection does not extend beyond the first verte- bra. The cineritious matter in the medulla spinalis is within the medullary. A singular circumstance, of importance in explaining the phenomena of many diseases is, that the spinal marrow, though apparently one cord, is divided into two, easily separated, but united by a cineritious sub- stance : it is therefore, double, but, from the mode of union, single only; and Ave thus see how, in the more important organs, an injury in one part of the j^rroAv is attended with a diminution of the power om^in the organ, and can explain the reason of the irreparable consequences of a distortion, or exostosis of the bony canal. The fasciculi of nervous fibrils are sent off from each portion of this double cord, anteriorly and poste- riorly, passing through separate foramina of the sheath. The posterior nerves form a ganglion, and then unite with the anterior. Each fasciculus is attended by the external lamina of the dura mater, the internal is gra- dually lost, and the angle left by each in its first divarication is filled by a fine ligament, which appears to support the nerves on the front, and behind, in their passage. This denticulated ligament seems through the whole cord to distinguish the anterior and posterior bundles, and, near the cauda equina, has been considered as itself nervous, since it there loses its denser structure as having less to support. The tunica arachnoides is more distinct from the pia mater in the spinal marroAV than in the brain, though it adheres more closely to this membrane at the bottom than above. It is apparently suspended by the denticulated ligament, and passes Avith the dura mater, along the nervous fibrils sent off. The spinal arteries arise from the vertebral within the foramen magnum, Avhich again passing through the occipital hole divide into two other branches, Avhich run to the posterior portion of the medulla. Each runs through the respective grooves formed by the division of the cord. They divide, and again unite and anasto- mose occasionally, with the vertebral, the intercostal, the lumbar, and sacral arteries. We thus see that the effects of a slight change in the capacity of the bony canal, by interrupting the course of the blood, and, in part the nervous influence, may be gradually obviated by the efforts of nature alone. The medullary veins terminate in the vertebral, and in different sinuses, which have a free communication, apparently serving, as in the head, to keep the arteries full, and to prevent the fatal effects of temporary pressure. See Cerebrum. MEGALOSPLA'NCHNOS, (from fieyxs, great, and orxxlx^ov, a bowel). A person affected with an en- largement of any viscus. MEGRIM. See Cephalalgia. MEIBO'MII GLA'NDULjE. See Ciliares gla*- DULJE. * MEL, MELI, (from fceXt, honey). Honey; aero- mili, acoitus. Aristaeus, a pupil of Chiron, is said to have first gathered this sweet vegetable juice, col- lected by the bee from the flowers of various plants, and deposited in the cells of its comb. The little animal which furnishes this rich juice is the apis mel- lifica, Lin., and the honey which separates without expression contains a less proportion of wax, and is of a thick consistence, a whitish colour inclined to yel- low, a granulated appearance, an agreeable smell, and pleasant taste; both the colour and flavour differ in some degree, according to the plants which the bees prefer; but that wrought by young bees, and permitted to run from the comb Avithout heat or pressure, is called virgin honey. The honey of old bees, pressed from the wax, is yellow. Honey produced where the air is clear and hot is better than that where the air is variable and cold. Where the bee hives are fixed, aromatic plants, particularly thyme, lavender, violets, primroses, baum, sage, and borage, should abound. Honey seems to be merely collected from the flowers, and not elaborated by the internal economy of the insect, for it derives, apparently from its source, many qualities not peculiarly its own. New honey to many proves disagreeably and powerfully laxative; and it sometimes, particularly in America, proves poi- sonous. Boston (American) Transactions. Each incon- venience is often removed by age, but more certainly by boiling. The animal which collects it is an ex- clusive inhabitant of the old continent, imported by America, Avhere the natives call it the white mens' fly. Honey contains a large portion of a purely sac- charine matter, mixed with an acid partly uncom- bined, though concealed by the sugar. With this, 6 112 MEL 972 MEL hoAvever, there is certainly a proportion of mucilage, since oxalic acid is the result of its treatment with the nitric. If M. Seguin's late experiments are correct, honey must also contain albumen, since substances which are susceptible of fermentation without yeast, seem, in his opinion, to OAve it to their albumen. When deprived of it they lose this property; and Avhen it is again added in the form of the white of an egg, they regain it. Yeast certainly contains albumen, but M. Seguin has lately shown so much fancy in his experiments on gelatine, with which intermittents he thinks may be cured, be- cause the bark appeared to contain this substance, that we distrust his present conclusions. Honey is highly nutritious, though when long conti- nued as a diet, is said to occasion a dissolution of the blood. As a medicine it is supposed to be aperient, anti- septic, and expectorant: but it is perhaps only slightly laxative, and a pleasing demulcent. It seems to possess some stimulus, since it is forbidden where heat and in- flammation are considerable. _ If given in a large quan- tity it has been said to relieve asthma, and dissolve a calculus in the bladder (see Calculus) ; but there is much reason to doubt its efficacy in these complaints. It is only a sugar with a larger proportion of mucilage, for its acid is inconsiderable in quantity, and highly Aro- latile. Mel ae'rium. See Manna. Mel despuma'tum. Clarified honey. Liquefy the honey in a water bath, separating the scum as it arises. On continuing the heat, a considera- ble quantity of an aqueous fluid, impregnated with the finest smell of the honey arises : the inspissated resi- duum dissolves in water and in spirit. If treated Avith moist clay, as practised by sugar bakers for purifying sugar from its treacle, the unctuous parts of the honey may be separated, and its saccharine matter obtained in the form of a solid, saline, white concrete. Oxymel simplex. Simple Oxymel. Take of clari- fied h°ney, two pounds; of distilled vinegar, a pint. Boil them in a glass vessel, with a gentle fire, to the consistence of a syrup. Pharm. Lond. 1788. Cera'tum me'llis, (from cera, wax, and mel, honey). Cerate of honey. R. Olei olivae; mellis despumati aa ffo ss. Cerae flavae. Emplastri lithargyri aa. | iv. m. Melt the oil, wax, and plaster together, and afterward add the honey. This cerate is said to be well calculated for scrofulous ulcers, as it is slightly stimulant. Mel bora'cis. Honey of borax, consisting of an ounce of honey to a drachm of borax, is applied to the mouth in cases of aphthae. In every instance where heney is thus employed, it should not be new, and it should be ascertained pre- vious to its use whether honey commonly disagrees with the bowels. Of many compositions honey forms the basis, as the mel scilla, oxymel scille. See Scilla. Mel Rosa. See Rosa. Oxymel Colchici. See Colchicum. Mel hydrargyri, and Mel JEgyptiacum. See -Egyptiacum UNGUENTUM. MELiE'NA, MELAI'NA, (from n-eXxs, black). A disease in which the discharges are black, attributed to black bite. See Morbus. Mel^'na no'sos. See Morbus kigers MELAMPO'DIUM. See Helleborus niger. MELAMPY'RUM, (from AtsA*?, black, and zrvpos, wheat, because it resembles >» he-it,) triticumvaccinum, crateogonum, purple coav avhsat, melampyrum arvense Lin. Sp. PI. 842, because it is very grateful to black cattle. Its effects resemble those of darnel, and arc narcotic, until custom has rendered it habitual. It is found among corn in many countries, particularly Friesland and Flanders. A Avild species is called sa- tureia lutea sylvestris. Melampyrum sylvatiewn Lin. Sp. PI. 843. See Raii Historia. MELANAGO'GA, (from t*.eXxs, black, and xyu, to expel). Medicines Avhich purge off black matter sup- posed formerly to be bile. MELANCHOLIA, (from (A,eXxivx, black, and x°*i, bile). Melancholy; delirium melancholicum, eroto- mania, panophobia, athymia. Dr. Cullen places it as a genus in the class neuroses, order vesania, and de- fines it, a partial insanity, without dyspepsia. (Vide mania.) Melancholy and hypochondriasis are so nearly allied, that the distinction is difficult. Dyspepsy is, however, a commonly attendant symptom of the latter; but absent in the former. Of this Dr. Cullen distinguishes eight varieties, arising from the objects of false conceptions. 1st, from being fearful of the dangerous state of the consti- tution ; or, 2dly, from a false conception of their more prosperous situation ; 3dly, from violent love, without the irritation of lust; 4thly, a superstitious fear of a future state; 5thly, a dislike of motion, and all the offices of life ; 6thly, Avith inquietude and restless- ness ; 7thly, with a Aveariness of life; 8thly, from a man's false conception of the nature of his own species, fancying himself a dog, a horse, or some other animal. Melancholy, however, is in general the beginning or a less degree of madness, and the highest degree of hypochondriasis. Each passes gradually into the other; and they all often, at last, terminate in alienation of mind. See Mania. MELANOPI'PER, (from n.eXxtvx, black, and piper, pepper). See Piper nigrum. MELA'NTHIUM,and MELASPE'RMIUM,(from (A.eXxs, and trrejtftx,semen, seed). See Nigella Ro- MANA. ■•.'■. '..* . -. , MELA^tCVRiA, (from f«A«5, black). See Atra- MENTUM S(5T04l,VM-J '*■•*. ME'LAS, b-£acx. ' An. epithet applied to the colour of the skin," fu\d/ to $§Ome -particular medicines, as calomelas. A' species qfjeprosy of a dark black colour has the same app^atiqil^* see.ALPHus. MEm 'SMAyifiom uctig?,- black). See Sugillatio. MEO/ZZO,. KSee 'S^ctfjuiruM. ME'LCA, (from xjieX'fb, m milk). « Milk well sea, soned with boif^ng*dio£ vinegar',,to separate by rest the curd from the Tyhtfo. ^onstamine de Agricultural lib. xviii. !; '-V v'■ V " MELEGE'TA. See Paradisi grana. MELEI'OS. See Alumen. ME'LICA. See Milium indicum. MELICERI'OLA. A small meliceris. MELICE'RIS, (from t^Xt, honey, and kh^cs, wax)* Mellifavium, is an efc^sted tumour, whose contents resemble honey and wax:.. It differs fjpm the atheroma by its evident fluctuation, and from'4he steatoma bv - ., "•» * MEL 973 MEL its firmness. It may be extirpated, or opened and dis- solved, by exciting suppuration. See N^vus. MELICRA'TOX, (from fA.eXt, honey, and xepxwvpt, to mix). See Hydromeli. MELIGEI'ON, (from ueXt, honey,) a foetid oily hu- mour of the consistence of honey, discharged from ulcers Avhen complicated Avith a caries of the subjacent bone. Blanchard. MELILO'TUS, (from fA.eXt, honey, and Xu]os, the lotus,) lotus sylvestris, sertula compana, trifolium cabal- iinu7n, corona regia, common melilot, trifolium meli- lotus officinalis Lin. Sp. PI. 1078, is a plant Avith smooth, oval, striated leaves, standing three together on slender pedicles, and round, striated, branched stalks, termi- nated by long spikes of papilionaceous flowers dropping downward, folloAved by short, thick, wrinkled pods, containing each one or two roundish seeds. It is an- nual, or biennial, and floAvers in hedges and cornfields the greatest part of the summer. Melilot is emollient, and supposed to be anodyne, participating of the virtue of camomile. Its taste is un- pleasant, somewhat acrid and salt, but not bitter; when fresh it hath little smell, but in drying acquires a strong aromatic though disagreeable odour. The distilled water of melilot, though of little smell, remarkably heightens that of other substances. It formerly gave name to a plaster, to which its juice imparted a green colour; but it is noAV seldom used. Melilo'tus major. See Lotus urbana. MELIPHY'LLON, (from t*.eXt, honey, and QvXXov, a leaf,) baum or balm. See Melissa. MELI'SSA, (from tteXte-c-x, because bees are fond of it,) apiastrum, erotion, mellifolium; citrago, citraria, and cedronella, from its colour; melissa officinalis Lin. Sp. PI. 827, is a well knoAvn plant in our gardens: the stalks are square; the leaves are oblong, pointed, dark green, somewhat hairy, and set in pairs, in the bosoms of which • arise pale, reddish, labiated floAvers, standing several together, on one pedicle, with the upper lip roundish, erect, and cloven, and the lower divided into three segments. It is perennial, a native of mountainous places in the northern parts of Europe, and flowers in our gardens in June. Baum is one of the mildest cordials and corroborants: with a pleasant smell, resembling that of the lemon, and a weak aromatic taste, which it loses ki a great degree by drying; a slight roughness discoverable in the fresh herb, becomes more sensible when dry; the young shoots are stronger than the full grown stems. Infusions of the leaves, in water, smell agreeably of the herb, but have not much taste, though, when inspis- sated, that of the extract is bitterish and austag| In- fusions of baum do not, like other aromatics, offend the head. Cold infusions in water, or spirit are far better than the cohobated distilled water, and are the best pre- parations. It used to be considered as an efficacious nervous medicine in hypochondriasis and melancholia, as well as an emmenagogue. At .present it is only given in infusion asa'^ralliefli^dihHMit in fevers, some- times acidulated Avith temoh"j\n<^. * . On distilling thv, or the HebreAv term meni, a month). The menses in women, and the bleeding piles in men. The plural also of Menstruum, q. v. ME'NSTRUUM, (from the same). A fluid body capable of reducing a given solid to the same state, and thus diffusing the latter through every part of the former; called a menstruum, because the chemists first assisted its action by a moderate fire for a philosophical month ; synonymous with solvent. See Solutio. MENSURA. The variety of measures employed by different nations renders medical directions often obscure, and occasionally fallacious. The word mensura is sometimes employed absolutely to denote a given bulk, and the measure occasionally contains one, some- times two, quarts, and the quadrans mensurae is either six or twelve ounces. The great diversity in this respect has induced the London college to order every thing by weight; for a pint of the purest alcohol is very different from even a pint of water, and much more so from a pint of the vitriolic acid. In general, the pint is supposed to be equivalent to a pound; but, in medicinal directions, it is estimated at twelve ounces : the French pint is double, and the Scotch pint equal to tAvo quarts. The cantharus of the Swedes equals five pints. In smaller quantities, the tea spoonful is estimated as equal to a drachm, but few tea spoons hold more than forty drops. A dessert spoon holds somewhat more than than two drachms, called, in prescriptions, cochleare medium, and the table spoon about half an ounce. The modern French weights and measures are greatly 6 I 2 MEN 980 M E N changed, and have produced no little confusion in me- dicine, chemistry, and even in common life. We shall detail the principles of their neAV system under the article Pondera, on Avhich that of their measures de-. pends; so that avc shall in this place only explain the terms. The fundamental measure, the litre, filled with distilled Avater, is equivalent to the Paris pint, somewhat more than tAvo English pints, and, in weight, is nearly equal to the kilogram, two pounds. The semilitrum (demilitre) is equal to somewhat more than a pint; the decilitrum to about three ounces, and a drachm, equal in weight to the hectogram: the double and the half of the decilitrum are easily estimated. The litre contains fifty cubic inches, and consequently the centilitrum half a cubic inch ; and the double cen- tilitrum one cubic inch? or nearly five drachms, about a large table spoonful. MENTA'GRA, (from mentu7n, the chin, and xypx, a disease,) impetigo. An obstinate tetter, which ap- peared in Italy during the reign of Claudius Caesar, be- ginning upon the chin, extending itself bver the face, and descending to the neck, breast, and hands. A cau- tery Avas applied to some convenient part, so deep as to penetrate to the bone. We sometimes find a disease of less virulence which seems to merit this appellation. It affects the bulbs of the hair on the chin, resembling, in its nature and treat- ment, the tinea capitis. MENTA'LES, (from 7nens, the mind). Alienation of the judgment, in Avhich the functions of the mind are disturbed. Nosologists have formed a class of diseases under this title, and in an arrangement from symptoms it may probably be admitted. It is, however, necessary to remark, that, though the mind be affected, a laesion of any function, which alone constitutes disease, can only be recognized by the practical physician ; and we have found changes, in appearance most purely mental, arise from a material cause. Our idea of the duration of time, for instance, is, as we shall see, produced by opium; a fit of apparent insanity will be relieved by discharging a very moderate quantity of bile. See Mania. ME'NTHA, mint ; hedyosmos, from its sweet smell; is a perennial herb with square stalks, serrat- ed leaves set in pairs, and spikes of monopetalous floAvers, each cut into four sections, and followed by four seeds inclosed in the cup. The species are nume- rous, but not hitherto described with sufficient accuracy. See Linnaean Transactions, vol. v. for an account of the British species by Dr. Smith. Me'ntha AquA'TicA, Lin. Sp. PI. 805, sisymbrium sylvestre, 7nentha rotundifolia palustris. Red water mint. Its leaves are somewhat oily, and set on pedicles; the stamina long, standing out from the flowers. Me'ntha cata'ria ; nepeta cattaria, mentha felina, herbafelis,calamintha palustris,nepetella, nepeta cataria Lin. Sp. PI. 796,for cats are so delighted with the smell that they roll on it, and destroy the plant unless defended till it has acquired some strength. It is an hoary plant Avith square stalks; the leaves heart shaped, acuminated, serrated, and set in pairs on oblong pedicles; the floAvers Avhitish, labiated, standing on spikes at the top of the branches. The upper lip is divided into two, and the loAver into three, sections. It groAvs Avild in hedges and on dry banks, and flowers in June; is moderately aro- matic, of a strong smell, resembling a mixture of mint and pennyroyal, and participates of their virtues. Water dissolves their active matter; but rectified spirit extracts it more completely. Distilled with Avater, they yield a yellow essential oil, not quite so agreeable as the herb, though resembling it in smell: the remain- ing decoction is bitter and subastringent. See Raii Historia Plantarum; Cullen, Lewis, and Tournefort's Materia Medica. Me'ntha corYmbi'fera mi'nor. See Ageratum. Me'ntha crispa, Lin. Sp. PI. 805, agrees in its gene- ral virtues with the Mentha spicata, q. v. Me'ntha hirsuta, var. fo Smith, in the Linnaean Transactions, v. 196 ; probably a variety of the mentha sativa. See Flora Britannica. Me'ntha palu'stris fo'lio oblo'ngo, mentastrum hirsutum, auricularia; hairy avater mint, or earwort, has long hairy leaves, without pedicles, and broad spikei of flowers. All the watermints grow in marshes and on the banks of rivers, and flower towards the end of summer; their smell is less agreeable than that of spear mint, their taste more bitter and pungent: the second sort resem- bles the pennyroyal. They yield much less essential oil than the spear mint, and their virtues, though similar, are greatly inferior. The hairy water mint is supposed to be auricularia, planta Zeylanica, or earwort, celebrated by Marloe for the cure of deafness. Me'ntha piperi'tis. Pepper mint. Mentha pipe- rita Lin. Sp. PI. 805; hath acuminated leaves on very short pedicles, and the floAvers set in short thick spikes or heads: it is a native of this kingdom, and its natural soil is a watery one"; but in any other it does not degenerate. Pepper mint hath a more penetrating smell, with a stronger and warmer taste than the other mints. In the mouth it feels at first hot, afterwards cold, and some- what nitrous. From its stomachic, antispasmodic, and carminative qualities, it is of great use in flatulent complaints, hysteric depressions, nausea, and other dyspeptic symptoms; often producing immediate re* lief by diffusing a gloAving warmth through the Avhole system. Its qualities are with great probability ascribed to the camphor, which the experiments of Gaubius have proved to be largely contained in it, and it is seldom injurious from its stimulus. It readily and strongly impregnates either Avater or spirit by infusion: in distillation with water it gives over a large quantity of essential oil, of a pale greenish yellow colour, groAving darker coloured by age, and possessing a great degree of the smell and pungency of the herb. As much of this oil as can be suspended in rectified spirit of wine is sold under the name of the essence of pepper mint. The decoction Avhich remains after distillation, like that of the other mints, is bitterish and subastringent. For the Avater, spirit, and oil, see Mentha spicata. Me'ntha pule'gium. See Pulegium. Me'ntha spica'ta ; 7nentha sativa Lin. Sp. PI. 805, mentha vulgaris, hart mint, and common spear mint, hath oblong, narrow pointed leaves, joined close to the stalk, and small purplish flowers, MEN 981 MER standing on long spikes on the top. Though a native of warmer climes, it is common in our gardens, and flowers in June and July. The smell of mint is agreeably aromatic, and the taste bitterish and moderately warm ; it is carminative and stomachic, particularly useful in relieving vomit- ings and weakness of the stomach. An infusion of mint in water is said to prevent the coagulation of milk in stomachs where acidity prevails; and in general this herb nearly resembles the pepper mint, though perhaps less efficacious as an antispasmodic, and more injurious as a stimulant. In vomitings from inflammation in the stomach it is injurious. The juice expressed from the leaves retains the bit- terness and astringency, but not the aroma of the mint, Avhich, however, is not lost by keeping, drying, or a moderate degree of heat. In five or six hours cold water extracts the more agreeable and active parts of the mint; a longer maceration extracts the grosser and less agreeable portions. Hot water more quickly extracts its virtees, but boiling dissipates the aroma. Infusions and tinctures contain the whole virtue of the mint; the oil and the distilled water only the aroma. Mint Avater should be distilled from the fresh heib, and it is improved by adding some dried mint. In distillation with water an essential oil rises, which is of a pale yellowish colour, changing by age to a red- dish hue: about an ounce is procured from ten pounds of mint, Avhich for this purpose should be gathered when the flower is expanding. The oil is not, however, an agreeable preparation. Dry mint yields to spirit of wine, either Avith or Avithout heat, all its virtue, without its disagreeable parts. Spirit takes up very little in distillation. An extract made with spirit possesses the concentrated vir- tues of a large portion of dried leaves. Fifteen grains of the resinous extract obtained from either the com- mon mint or pepper mint, by means of spirit of wine, is said to be equivalent to six drachms of the dried herb. The spirituous tincture mixes with watery liquors Avithout precipitation; but spirituous liquors impregnat- ed with its pure volatile parts by distillation turn milky on the admixture of water. A conserve made in the usual way is an excellent vehicle for other medicines, in diseases of the stomach. Tincture of mint is made by adding to a pint of mint Avater half an ounce of the dried leaves of mint: after standing four hours in a warm place, it must be strained. The distilled Avater contains as much of the volatile part of the herb as it can retain; but by infusion it takes up as much of the extractive matter as pure water. Thus any of the simple distilled waters may be much improved, and, Avhen required, the Avaters distilled from one vegetable may be the menstruum for a dif- ferent one. The college of physicians order from the mentha sativa, and mentha piperitis, a water and a spirit, Avhich are directed to be made as folloAvs. Take of spear mint or pepper mint dried, one pound and a half, water suffi- cient to prevent an empyreuma; and to the same quan- tity of the herb they order one gallon of spirit, with water sufficient to prevent an empyreuma. In each process they draAV off a gallon. The essential oils of each are obtained by distillation.. See Oleum. MENTHA'STRUM. See Mentha aquatica. ME'NTULA, (from the HebreAV term matah, a staff)- See Penis. Me'ntula ala'ta. See Penna. MENTULA'GRA, (from mentula, and xypx). A disorder of the penis, induced by a contraction of the erectorcs musculi. ME'NTUM, (ab eminendo, from its sticking out). The chin is the anterior protuberance Avhich terminates the lower part of the face; the under part of the chin is termed its basis, distinguished from the throat by a transverse fold, extending from ear to ear; in the mid- dle of the chin a dimple is usually found. MENYA'NTHES TRIFOLIA'TA, et PALU'S- TRIS. See Trifolium paludosum. MEPHI'TIS, (from the Syriac term mephuhith, a blast). A poisonous exhalation, or Avhat the miners call a damp. It Avas formerly applied to any air, not respirable, especially if attended Avith an offensive smell. Modern chemistry is more accurate; and what was Avith little discrimination called mephitic is now hydro- gen, nitrogen, or carbonic acid gas. MERCURIA'LIS, (from mercurius, quicksilver). Mercurial, or a preparation of mercury. But in obsolete authors, the atra bilis is also called the mercurial humour ; and the diseases from this source have the same appellation. In botany it is the name for lapathum unctuosum folio triangulo, bli- thum, chenopodium, bonus Henricus Lin. Sp. PI. 318, all good, English mercury, a plant Avith triangular leaves, covered underneath with a whitish unctuous meal: its stalks are striated holloAV, partly erect and partly procumbent, bearing on the tops spikes of small imperfect floAvers, each of Avhich is folloAved by a small black seed, inclosed in the cup; perennial, groAvs in waste grounds, and floAvers in August. The leaves are mucilaginous, a little subsaline, and used"as emol- lients in clysters and fomentations. The young shoots are eaten in spring as a gentle laxative and diuretic. See Raii Historia. Mercuria'lis a'qua. See Beya. Mercuria'lis fru'cticosa inca'na testicula'ta ; 7narisicum, thelygonon, 7nercurialis tomentosa Lin. Sp. PI. 1465. Children's mercury, is a garden plant, and used in Barbary against some female diseases. Mercuria'lis mas, mercurialis testiculata, spicata, and famina. French mercury. It is the mercuri- alis annua Lin. Sp. PI. 1465, var. x. and p, hath smooth glossy leaves, and branched stalks. Each va- riety is annual, and grows wild in shady uncultivated grounds. The leaves have no remarkable smell, and very little taste; they are slightly mucilaginous, but seldom used. Mercuria'lis mucila'go. See Argentum vi- vum. Mercuria'lis ; cynocrambe, canina brassica, persi- caria siliquosa, mercurialis montana, wild mercury, dog's mercury, mercurialis perennis Lin. Sp. PI. 1465, is one of the poisonous plants found in Great Britain. The root is creeping, light coloured, and fibrous; the stalk erect, green, juicy, and unbranched. The leaves are oval, serrated, pointed at the extremity, placed in pairs opposite each other. The floAvers groAv at the tops of the stalks in thin slender spikes from the alas of the leaves, of a light green colour, and are male and female. The furrows of the germen receive a barren MER 982 MEB filament, terminated with a gland, marked with two dark coloured spots. It flowers early in the spring ; is found in woods, shady places, and the banks of ditches; distinguished from the French mercury by be- ing perennial, larger, with rough leaves, and the stalks not branched. In early spring it may be eaten with safety, dressed like spinach; but its acrimony is soon evolved, and it produces nausea, vomiting, and afterwards comatose symptoms. These ill effects are removed like those of poisonous mushrooms. See Amanita- and Vene- num. Wilmer's Observations on Poisonous Vegetables. MERCU'RIUS. Quick or living silver; from its great fluidity. See Argentum vivum. Mercu'rius alcalisa'tus. Alcalisated mercury; hydrargyrus cum creta; Quicksilver with chalk ; JEthiops albus. R. Hydrargyri puri § iij. cretae pp. 5 v., rub them together until the globules disappear. Ph. Lond. 1788. Mercu'rius calcina'tus; mercurius precipitatus per se. Calcined quicksilver, hydrargyrus calcina- tus. This preparation is directed to be prepared by exposing a pound of quicksilver in a flat bottomed glass cucurbit to a heat of about 600 degrees, in a sand bath, till it becomes a red powder. By agitation, or by triture, similar effects are produced on the mercury, and in much less time. This has lately been a fashionable preparation, but is scarcely, if at all, supe- rior to calomel, though the prejudices of the moment have occasionally given it the-preference with ourselves and others. Mercu'rius cinnabari'nus. See Cinnabar fac- titia. Mercu'rius corrosivus sublimatus. See Mer- curius CORROSIVUS ALBUS. Mercu'rius coralli'nus, arcanum coralli7ium. This was designed to render the mercurius nitratus ru- ber a more mild internal medicine; but as no consi- derable advantage was obtained by the process, it has been rejected. Mercu'rius corrosi'vus a'lbus. The white cor- rosive mercury; mercurius corrosivus sublimatus, gas siccum sublimatum, albi, aquila alba, sublimatum, hydrargyrus muriatus, muriated quicksilver. The modes of preparing this medicine are various; but the college of London direct quicksilver and vitri- olic acid two pounds of each, dried sea salt three pounds and a half: the quicksilver is to be mixed with the acid in a glass vessel, and boiled in a sand heat till the matter is dried; which is added, Avhen cold, to the sea salt, in a glass 'vessel. The whole is sublimed in a glass cucurbit, with a heat gradually raised, and the sublimed matter separated from the scoriae. Pharm. Lond. 1788. The greatest part of this preparation used in England is brought from Holland and Venice ; and, as has been suspected, adulterated with arsenic. Dr. Lewis gives the following method of detecting the fraud: " Take any quantity _of the suspected white corrosive mercury, powder it in a glass mortar, and mix it well with twice its weight of black flux (see Calcinatio,) and a little filings of iron ; put the mixture into a crucible capable of holding four or five times as much; give a gradual fire until the ebullition ceases, then hastily increase it to a white heat: if no fumes of a garlic smell be per- ceived during the process, and if the particles of iron retain their form, without any of them being melted, we may be sure that the mixture contains no arsenic." Neumann denies the possibility of this preparation be- ing adulterated with arsenic, and observes, that, instead of their subliming together, the arsenic will attract the marine acid to itself, and the mercury will be revived, instead of sublimed in the form of this preparation. Sublimated mercury is peculiarly adapted to those cases in which the slow continued action of the metal is required, particularly in eruptions, in glandular indura- tions, and some similar complaints. ' In lues it often fails, after having first appeared to succeed. It was given by Van Swieten in lues, dissolved in corn spirit; and in this form it sits most easily on the stomach; but the watery solution is not inconvenient in this respect. A small proportion of crude sal ammoniac in the solu- tion prevents the precipitation. It may be given also in pills mixed with the crumb of bread, and the dose, at first, should not exceed one fourth of a grain. See Argentum vivum. Mercu'rius du'lcis sublima'tus ; dulcified mer- cury sublimate, calomelas; and when the sublima- tion hath been ten or twelve times repeated, panacea mercu7-ii. It is the mercurius corrosivus albus, dulcified by the addition of crude mercury. The London college directs the proportion of nine ounces of purified quicksilver to twelve ounces of the muriated quicksilver : rub them, itis added, together till the globules disappear, and sub- lime ; in the same manner repeat the sublimation four times; afterwards rub the matter into the finest pow- der, and wash it by pouring on boiling distilled water. Ph. London. 1788. In the Augustan Dispensatory one sublimation only is required. See Argentum Vivum. The marks of sufficient dulcification are, its being perfectly insipid to the taste, and indissoluble by lohg boiling in water. If the water hath taken up any part of the mercury, it may be discovered by dropping into the liquor an alkaline solution, which will precipitate the mercury it may contain. If the dulcified mercury turns black on being mixed with lime water, or volatile alkali, it is duly prepared. We have already mentioned Mr. Scheele's prepara-* tion of calomel in the humid way, and explained its principles. We shall now add the process at length, translated from the Stockholm Transactions. " Half a pound of quicksilver and the same quantity of nitrous acid are to be put into a small vessel with a long neck, the mouth of which is to be covered with paper. The vessel is then to be placed in a warm sand bath; and after a few hours, when the acid affords no signs of its acting any longer on the quick- silver, the fire is to be increased to such a degree that the solution may nearly boil. This heat is to be con- tinued for three or four hours, taking care to move the vessel from time to time, and at last the solution is to be suffered to boil gently for about a quarter of an hour. In the mean while we are to dissolve four ounces and a half of fine common salt in six or eight pints of water. This solution is to be poured boiling into a glass vessel, in which the above mentioned solu- tion of quicksilver is to be mixed with it, gradually, MER 983 MER and in a boiling state also, taking care to keep the mixture in constant motion. When the precipitate is settled, the clear liquor is to be drained from it, after which it is to be repeatedly washed with hot water till it ceases to impart any taste to the water. The preci- pitate obtained by this method is to be filtered, and afterwards dried by a gentle heat. This is the hydrar- gyrus muriatus mitis of the London Pharmacopoeia, only that they order four ounces of sea salt, instead of four ounces and a half. " It might be supposed, that Avhen the nitrous acid ceases to effervesce with the mercury, it is saturated with it; but this is far from being the case: the acid, when the heat is increased, being still able to dissolve a quantity of it; with this difference, however, that the quicksilver at the beginning of the process is calcined by the acid, but afterwards is dissolved by it in a me- tallic form. In proof of this we may observe, that not only more elastic vapour arises, but also, that by adding either fixed or volatile caustic alkali we obtain a black precipitate; whereas, when the solution contains only calcined quicksilver, the precipitate becomes yellow by such an addition. If this black precipitate is gently distilled, it rises in the form of quicksilver, leaving a yellow powder, which is in fact that part of the mer- cury which, in the beginning of the operation, was cal- cined by the nitrous acid. " The boiling of the solution for about a quarter of an hour is necessary, in order to keep the hydrargyrus nitratus in a dissolved state, it being much disposed to crystallize. In general, some of the mercury remains undissolved; but it is always better to take too much than too little of it, because the more metallic substance the solution contains, the more hydrargyrus muriatus mitis will be obtained. " It is necessary to pour the mercurial solution into the solution of salt by little at a time, and cautiously, so that no part of the undissolved quicksilver may pass along with it. Two ounces of common salt are suffi- cient to precipitate all the mercury; but then it may easily happen that some superfluous mercurius corro- sivus attaches itself to this precipitate, which the water alone is incapable of separating completely. This is un- doubtedly the reason why mercurius precipitatus albus is always corrosive. I have found that common salt possesses the same quantity as sal ammoniac, viz. that of dissolving a greater quantity of mercurius corrosivus. I therefore employ four ounces and a half of common salt, in order to get the mercurius corrosivus entirely separated." Of all the preparations of mercury, calomel is the most frequently used; and all the virtues attributed to mercury this preparation apparently possesses. The dose is from gr. i. to 9 i. according to the intention; but five or eight grains are rarely exceeded. We have said, that probably calomel might supply every other preparation ; but that accident, or the rou- tine of practice, easily becoming a habit, sometimes fixed a preference for other forms, without their possessing any real superiority. In glandular complaints calomel seems to be preferred ; but small doses of the muriated mercury are often equally efficacious. In cutaneous complaints, it is often used in combination with the antimony, though from the preparation employed, the sulphur auratum, its virtues, as a mercurial, are greatly diminished. In the early preparation of Dr. James's powder (see James), calomel fonned a portion; and it has been lately fashionable to add it to the antimonial, in the early periods of fevers, to secure a discharge from the bowels as soon as possible. The exhibition of calo- mel with camphor and opium, in the early stages of pleurisy, as recommended by Dr. Lysons, we think a more doubtful practice; and on this account we are unable to speak of its effects from experience. If, how- ever, it is found to supersede the necessity of frequent bleeding, as has been asserted, it will undoubtedly be useful; but we do not find that the plan has been suffi- ciently followed to enable us to decide on its efficacy or eligibility. In the confluent small pox calomel has been given to assist or bring on the salutary salivation; but in this disease it has been dangerous from its in- flammatory stimulus, nor is there sufficient time to pro- duce the necessary evacuation. Rubbed upon the in- side of the lips, it has produced similar effects to those which are occasioned by taking it internally, particu- larly in the lues venerea: in cases of chancres also, used by itself, or in the following form, it is highly ad- vantageous. R. Ceratilapid. calamin. 5ss. calomelanospp. 3 i- ni. Mercu'rius duplica'tus philoso'phicus. See Rebis. Mercu'rius eme'ticus fla'vus. Hydrargyrus vi- triolatus, turpethum minerale; vitriolated mercury, and turbeth mineral. Take of purified quicksilver, vitriolic acid, of each a pound ; mix in a glass vessel, and heat them by degrees, until they unite into a Avhite mass, which is to be per- fectly dried with a strong fire. This matter, on the affusion of a large quantity of hot distilled water, im- mediately becomes a yellow powder. Rub the powder carefully with this water in a glass mortar; after it has subsided, pour off the water; and, adding more distilled water several times, wash the matter till it becomes in- sipid. Pharm. Lond. 1788. To edulcorate it more quickly and effectually, the water intended to be used in its ablution is impregnated with a determined proportion of fixed alkaline salt; and by this means the quantity of the preparation will be increased, and its strength more equal. The yellow emetic mercury is a powerful vomit; and, like other mercurials, Avill excite salivation : in robust habits it hath been used in cutaneous disorders and glandular obstructions. As an emetic, it hath been given to eight or ten grains; but in this dose it operates violently, and is only employed when the shock of vo- miting is required to be considerable. It is thus some- times useful in palsies, and more certainly in amaurosis. Half a grain or a grain, given every night, is said to have produced the best effects in the most inveterate cases of the venereal disease, in obstinate rheumatisms, and ulcers that were difficult of cure. It is a powerful medicine, but yet does not appear to excel the other less violent mercurials, except in particular instances, where considerable and rapid effects are necessary, and where the constitution is robust. It is a favourable me- dicine with some active practitioners, particularly Dr. Maryatt, in dropsies. See Maryatt's Art of Healing. Mercu'rius prjecipita'tus ruber. Hydrargyrus nitratus ruber. Pharm. Lond. 1788. Red precipi- tate. The London college directs us to take of MER 984 MES purified quicksilver and nitrous acid each a pound; muriatic.acid,one drachm by weight; to mix in a glass vessel, and dissolve the quicksilver in a sand bath; then to raise the fire till the matter is formed into red crys- tals. Pharm. Lond. 1788. As soon as it hath acquired the sparkling red colour it should be immediately re- moved from the fire, or it will soon lose it again. This preparation is sometimes mixed with minium and vermilion, but then the peculiar brilliancy is de- stroyed. If only^ minium is added, it may be detected by giving a SAveetish taste to vinegar. If laid also on a very hot iron, the mercury will evaporate, leaving the lead behind. The red nitrated quicksilver is only used externally as an escharotic; and if finely powdered and mixed with the unguentum resinae flavae, in the proportion of one or two scruples to an ounce, it is an excellent digestive for foul ill conditioned ulcers, bringing on a proper purulent discharge, instead of a thin sanies. Unguentum hydrargyri nitrati. See Trachoma. Cera'tum hydra'rgyri nitra'ti. Cerate of ni- trated quicksilver. R. Unguenti hydrarg. nitrati; cerati spermatis ceti aa. 5ij. m. It is sometimes ap- plied to scrofulous and phagedenic ulcers. Mercu'rius precipitatus a'lbus. Calx hydrar- gyri alba. White calx of quicksilver. The Lon- don college directs the following process : take of mu- riated quicksilver, sal ammoniac, water of kali, each half a pound; dissolve first the sal ammoniac, after- wards the muriated quicksilver in distilled Avater, and add the water of kali; wash the precipitated poAvder until it becomes insipid. Ph. Lond. 1788. Great care is required test more of the fixed alkali be added than is necessary, for the precipitate will then be yellow. This preparation is almost constantly con- fined to external uses. Half a drachm or two scruples of it, added to an ounce of pomatum, is used as an elegant cure for ,the itch; the same quantity may be dissolved in two ounces of a thick decoction of lintseed, as a liniment for curing chancres when situated on the glans penis, or on the inside of the prepuce; a rag being dipped in it is applied to the glans, and the pre- puce may be drawn over it. This precipitate is adulterated with starch, and with white lead. The first is discovered by its becoming glutinous on being dissolved in a small quantity of water; the second by adding one third of its weight of alkaline salt; heating the mixture in a crucible till no fumes arise. If the residuum does not melt in water, it is adulterated. Mercu'rius precipita'tus du'lcis. Ph. Lond. 1-721. See Hydrargyrus muriatus mitis. Mercu'rius prjecipita'tus per se. Mercu'rius calcinatus. * Mercu'rius sacchara'tus. Sugared mercury. A preparation designed to give the mercury in a liquid form. Equal quantities of brown sugar candy and mer- cury are triturated till the globules disappear, adding a feAv drops of the oil of juniper. Mercu'rius xi'tm, angelicas, Algarothi pulvis. The mercury of life ; the precipitate formed by di- luting butter of antimony Avith water. This powder Avhen edulcorated is a calx of antimony, always nearly of the same strength, and therefore some- times preferred to the glass in preparing tartarised antimony. ME'RGEN, (from the Arabic term morgan). See Corallium. MERLU'CIUS, (quasi maris lucius, the sea pike). See Asellus marinus. MERYOPHY'LLON. See Millefolium. MEROCE'LE, (from t-upos, the thigh, and xijXi), a rupture). See Hernia femoralis. ME'ROS, (from i*.etpa, to divide). See Femur. ME'SANG DE VA'CCA. See Bezoar bovinus. MESAR^E'ON, neTxpxtov, (from f*.e (A-eo-ui srtXos ; because it has a cap or crown in the middle). The med- lar. Mespilus germanica Lin. Sp. PI. 684. The com- mon medlar is about the size of an apple tree; leaves strong and sharp pointed; floAvers in May, and the fruit ripens in September. In Germany these trees are wild ; with us cultivated. The fruit hath an austere astringent taste, which is lost when kept so long as to appear rotten; and it is then cooling and slightly as- tringent. Me'spilus A'piifolio. See Spina alba. METACA'RPIUS, (from metacarpus). A small fleshy muscle, situated obliquely between the large in- ternal angular or transverse ligament of the carpus and the whole-inside of the fourth metacarpal bone; fixed by a tendon to the os orbiculare, and to the neighbour- ing part of the large ligamentof the carpus : at its other end to the outer edge of the fourth metacarpal bone. METACA'RPION, METACA'RPUS, (from ^7*, after, and xxpros, the wrist,) that part of the hand si- tuated betAveen the wrist and the fingers. The ancients called the carpus brachiale, and the metacarpus/2oaf bra- chiale. It forms on the inside the palm, and on its out- side the back of the hand, but the first phalanx of the thumb is not apart of the metacarpus. The metacar- pal bones support the fingers. Each bone of the meta- carpus is long and flatted at the ends. The anterior surface of each body is concave, Avith a sharp ridge in the middle to separate the interosseous muscles. The ends next the arm have a hollow, for the articulations of the carpus; and those next the fingers are dis- tinguished by protuberances for fixing the ligaments that unite these bones. A rough ring is observable round their heads, where the capsular ligaments that unite them to the fingers are fixed. These bones are united to the carpus and to each other by surfaces al- most plain, as little motion is required; and, in those of the foetus, each end is usually cartilaginous. The hollow of the hand is formed by the concavity of the fore part of these bones, and, from the minute mo- tion of which they are susceptible, they form a secure basis for the action of the fingers. METACINE'MA, (from f«7<*, and xtvea, to remove). A removal of the pupil of the eye from its proper situa- tion. METACO'NDYLI, (from pel*, and xovfvXos, a knuckle). The last joints of the fingers next the nails. META'LLA, (from the Hebrew term metil, a hard substance). Metals, or metallic substances, are distinguished by their splendour, their opacity, their fusibility, specific gravity, conducting power, hardness, elasticity, malleability, ductility, tenacity, and com- bustibility. From their hardness and elasticity, they are M E T 986 MEU adapted for the construction of different instruments employed by surgeons; and these properties fit them for discovering solid bodies by the vibrations they con- vey to the hand, as a stone in the bladder, or a bullet under the muscles. Their splendour is connected with their opacity, for all metals are impervious to light; and the green rays, which seem to pass through the thinnest gold leaf, are seemingly OAving to light transmitted through an accidental fracture. All metals are fusible; and mercury even retains its fluidity in our greatest colds. The specific gravity of the lightest metal, arsenic, is more than five times greater than water, and much more considerable than the densest stone, which is not suspected to be metallic. The metals are the best conductors of electricity, and it has been supposed that the electrical fluid is conveyed through our system more readily by the small propor- tion of iron Avhich the blood contains. This is, however, improbable, as the electrical shock folloAvs more closely the course of the nerves than of the arteries. Metallic substances are also called perfect pr imper- fect. The first are not permanently altered by the greatest heat of our furnaces ; white the second, when exposed to a strong heat, with the access of free air, are changed by .a process similar to burning, and in some instances Avith an actual flame, into an earthy sub- stance called calx, which is heavier than the metal from Avhich it Avas produced, though its specific gravity is less. This arises from the union of vital air, Avhich converts some metals into acids. If the calx of a metal be exposed to a strong heat in a closed vessel, Avith some inflammable matter, styled a flux, it recovers its metallic state. This is called reduction, or reviving of the metal. All metals are imperfect, except gold, silver, and platina. The imperfect metals are, mercury, lead, copper, iron, tin ; and the semimetals, bismuth, nickel, arsenic, cobalt, zinc, antimony, manganese, molybdae- na, tellurium, titanium, chronium, columbium, osmi- um, iridium, and uranite, Avith some others whose nature is not yet accurately ascertained. As the appella- tions arsenic, antimony, manganese, wolfram, and mo- lybdaena, are given to the ores, the term of regulus is often employed to distinguish the metal, though modern chemists often use the terms indiscriminately. The heaviest metal is gold, then follow platina, mer- cury, lead, silver, copper, iron, and tin. The most malleable also is gold, followed by silver, copper, tin, iron, lead, platina, zinc, bismuth, antimony. The force of cohesion is greatest in gold, next in iron, silver, brass, and copper, successively : tin is far below copper, and lead still less cohesive. The order of fusibility is the folloAving, tin, bismuth, lead, zinc, antimony, silver, copper, cobalt, nickel, gold, iron,manganese, and platina. Different proportions of tin and lead are still more fusible; and, if bismuth be added, this property is increased. Five parts of tin, three of bismuth, and two of lead, become soft in boiling water. This last pro- perty renders such metallic mixtures highly useful as injections for anatomical preparations. All the metals dissolve in acids. See Affinity; and in these solutions the metal is in a state of calx. —Neumann, Chaptal, Fourcroy, and Thompson's Chemistry. -METALLU'RGIA, (from fulxXXov, a metal, and ffyov, work). Metallurgy ; the chemical doctrines of m-.-tals, particularly respecting their separation, depu- ration, and preparation. METAPE'DIUM, (from pul*, and ms, the foot). See Metatarsus. METAPHRE'NON, (from /tt}«, and tyms, the dia- phragm). See Dorsum. M ETA'STASIS, (from f*.eTXTiftift,i, to transfer,) di- adexis, diadoche, a translation of a disease from one part to another. The term is limited to a change of deter- mination, for when matter or water passes through the cellular membrane, it is not called a metastasis. METASY'NCRISIS, (from perx, and e-vyxpha, to mix together). The word generally implies a change in any given part. Asclepiades. See Medicina (His- tory). METATA'RSIUS, (from fu1«, and rapnt, the tar- sus of the foot). A fleshy mass lying under the sole of the foot, fixed by one end to the fore part of the great tuberosity of the os calcis, and terminating in a short tendon, inserted in the tuberosity and posterior part of the loAver side of the fifth bone of the metatarsus. It moves the last bone of the metatarsus, and draAvs the fourth bone along Avith it, contracting the sole of the foot. METATA'RSUS, (from perx, and Txps-es, the tar- sus,) planta, planum, vestigium, mctapedium, is com- posed of five bones, similar to those of the metacarpus, but, in general, thicker and stronger ; their round ends not so broad, and less in proportion to their bases. Their bodies are also sharper above, and flatter on the sides, with the inferior ridge inclined more to the out- side, and larger tubercles at the lower part of the round head. ME'TELLA NUX. See Nux vomica. METEORI'SMUS, (from mleupos, a vapour). See Tympanites. METEO'ROS, (from perx, and xtpu, to elevate). Elevated, suspended, erect, sublime, tumid; pains af- j fecting the peritonaeum, or the superficial parts of the body, opposed to more deep seated ones. Galen. METHEMERI'NOS, (from uerx, and mu^*, a day). See Quotidiana febris. METO'PIUM, an oil, or an ointment described by Dioscorides, named from the plant which produces galbanum: sometimes it means the oil of bitter almonds. See Amygdalae. METO'PON or METO'PUM, (from y.erx, and »*, oculus). See Frontis os. METO'SIS. An amaurosis, from an excess of short- sightedness. ME'TRA, (from wr^p, a mother). See Uterus. METRE'NCHYTA, (from wpx, the uterus, and *VX,v<», to pour into). Injections for the uterus. METRE'NCHYTES, (from the same). A womb syringe. METRI'TIS, (from ftylpx, the womb). Inflammatio uteri, q. V. METROCE'LIDES, (from fA-yrvp, a mother, and #»?A/s, a mole). See Njevus. METROPROPTO'SIS, (from wrpx, the womb, and zs-portrla, to fall down). See Procidentia uteri. METRORRHAGIA, (from f*.tf}px, the womb, and pyywfA.1, to break-out). See Menorrhagia. ME'U, ME'UM, (from petov, less,) on account of its diminutive size. Spignel, baud, or vauld MIA 987 MIL money. Athamanta 7neum Lin. Sp. PI. 353. Fenicu- lum Alpinum, is a perennial plant, whose leaves are much smaller, and seeds broader, than those of fennel. The root resembles that of fennel, but is of a more agreeable though fetid smell, and a more pungent taste. Me'um alphi'num Germa'nicum. German or mountain spignel, 7nutellina, phellandrium mutcllina Lin. Sp. PI. 366. It possesses only the virtues of the common sort. Me'um latifo'lium adulteri'num, seseli perenne folio glauco breviori, feniculum sylvestre, ferula folio breviori, saxifraga montana 7ninor, bastard spignel, seseli 7>w7itanum Lin. Sp. PI. 372, grows on dry hills, and flowers in June. The root is drying and pungent. MEXICA'NUM BALS'AMUM, (from Mexico, of Avhich it is a production). See Peruvianum balsa- mum. MEXICANA'VA. See Botrys Mexicana. MEZE'REUM, an indigenous appellation. See Laureola fcemina. MIA'SMA, (from ptxim, to pollute). Miasmata have lately claimed the attention of pathologists, as they are the causes of some of the most fatal fevers to Avhich mankind are subject. In the more strict patho- logical investigations of modern authors they are dis- tinguished from contagion, which is confined to the effluvia from the human body, when subject to disease; yet this contagion, when it does not proceed immediate-' ly from the body, but has been for some time confined in clothes, is sometimes styled mias7na. Another kind of miasma as already noticed, (see Contagion,) is pu- trid vegetable matter, and indeed every thing of this kind which appears in the form of air. Miasma, then, strictly speaking, is an aerial fluid, combined with atmo- spheric air, and not dangerous except the air be loaded Avith it; for diffusion, as avc have seen, renders it harm- less. It is not always discoverable by the smell, and scarcely ever by the nicest eudiometrical tests : it is not therefore hydrogen or azote, though there is great rea- son to suppose that it is a modification of these; for, from marshes hydrogen generally arises, and, from the human body, the chief injurious exhalation is azote. Hydrogen and azote also destroy irritability, or induce sudden debility, effects generally found from the mias- mata which produce fever. As Ave know not the nature of miasmata, therefore, we cannot discover their cor- rector. Diffusion, however, renders them harmless, and it is sufficient for us that free air will prevent their de- leterious effects. What the variety of miasmata may be we cannot say. Each infectious disease has its own, diffused round the person Avhich it has attacked, and liable to convey the disease at different distances, according to the nature of the complaint, or to the predisposition of the object exposed to it. This part of the inquiry rather belongs to contagion, and to the particular disease. A patient in the small pox seems to diffuse an infectious atmosphere to the distance of from ten to fourteen feet: measles and scarlatina are less active in this respect, and even the plague seems not to be infectious, except from fomites, but from actual contact. The miasmata of marshes, those only whose effects we can more distinctly- perceive, produce intermittents, and remittents of the Avorst kind. They produce also dysentery and the epidemic catarrh, of Avhich the in- fection is usually conveyed by the air. The bilious fever of America Ave have supposed to be the natural autum- nal remittent, and therefore may be referrible to the same source; nor can Ave avoid concluding that every endemic disease must have its origin in the peculiar exhalations of the country. The putrid vegetable matter which has been accused as the cause of many fevers may be truly such, for Ave know that many parts of vegetables produce azote. Yet their effects in this respect have not been traced with accuracy. " Continued fevers are chiefly referrible to contagion: but the causes of intermittents in some constitutions seem to produce fevers of the more con- tinued form ; and the miasmata of marshes, Avhen they have excited their peculiar fever, may certainly, through the medium of the human body, produce continued fevers. Human effluvia confined, independent of a morbid state, become undoubtedly the cause of fevers the most continued in their form, and are then truly miasmata. MI'CA, (from f-ixpos, S7nall). A morsel, a crumb, a grain; also a foliated semi-transparent stone, formerly, and at present in the Russian navy, used as glass. It is of the magnesian genus, but not used in medicine. See Haiiy, iii. 208. Thompson's Chemistry, iii. 462. Mi'ca thu'ris. See Olibanum. Mi'ca pa'nis, the soft part of bread; employed in preparing mild cataplasms, by soaking slices of neAv bread in water until they become perfectly soft, and" then pressing out the superfluous Avater, beating the bread up with a^poon, and stirring into it a small quan- tity of lintseed meal. It is used also in its dry state, as a convenient mass for pills. MI'CRO-LEU'CO-NYMPHjE'A, (from ptxpos, small, Afvxss, white, and vvp/pxtx, the water lily,) nym- phaa, morsus rana, frog bit, hydrocharis morsus ra- na Lin. Sp. PI. 1466, groAvs in muddy waters, and floAvers in July. It is said to resemble in virtues the leuco-nymphaea. Mi'cro-nymphje'a, ((A.txpes, and wptpxtx). A variety /S of, and in every respect resembling, the above. It is less than the nymphaea; grows in ditches, and is said to possess the same virtues. MI'CROS. See Digitus. MID'WIFERY. See Obstetricatio. MIGRA'NA. A corruption of Hemicrania. See Cephalalgia. MILIA'RES GLA'NDULiE, (from their resem- blance to millet seeds). See Sebaceae glandule. MILIA'RIA, MILIA'RIS FE'BRIS, (from the pustules resembling millet seed). The miliary fe- ver, by the Germans Friesel, placed by Dr. Cullen in the class Pyrexia, and order Exa7ithemata; defined " a synochus attended with restlessness, frequent sigh- ing, a fetid SAveat, and prickling of the skin; red, small, distinct spots, on an uncertain day of the disease, break out copiously over the whole skin, except the face, Avhose tops discover, after a day or two, very small white pustules, continuing but a short time." This fever is now generally supposed to be symptomatic only, because it never appears contagious or epidemic. It sometimes attends febrile affections, as Avell those of an inflammatory as of a putrid nature, but it seldom occurs in any, unless a hot regimen and sweat precede. MIL 988 31 I L The French and German authors, hoAvever, still con- sider it as an idiopathic disease, and we have twice seen it when the regimen could not be accused as the cause, though it must be allowed to have been often the crea- ture of art, since, after the disuse of the hot regimen, its appearance has been rare. When the pustules are white it is called purpura alba, Avhen red, purpura rubra. It is almost exclusively confined to child-bed women, though it sometimes appears during the sweat- ing regimen in rheumatism. This disorder is denominated simple when none but^miliary pustules accompany the red ones, which, when appearing alone, are called a rash. If we speak of it as an idiopathic disease, we must employ the lan- guage of those who have described it as such. They say that it is peculiar to some constitutions, who experience the disease repeatedly in their lives, and pe- culiarly affects the Tender, the weak, and the irritable; preceded by sighing, great lowness, oppression on the praecordia, and ushered in by shivering, followed by heat and a pricking sensation of the skin; nor does the anxiety and lowness cease till the eruption is completed. Unlike other exanthemata, the eruption does not con- clude the disease, for successive crops often appear, preceded and attended with the same symptoms. Ac- cording to circumstances, the fever sometimes rises to phrenitis, and sometimes sinks into a typhus. The pustules, first apparently filled with serum, afterwards with a Avhitish fluid, at last dry, and scale off in branny crusts. It is not, we have observed, contagious or epidemic; the eruptions have no regular periods of appearance or duration; and though the origin and source of the dis- ease are said to be at no distant period and country, yet traces of it are discoverable even in Hippocrates. All these circumstances strongly militate against its being an idiopathic disease, and the only connection which has been discovered, if it be really a discovery, between the different states of constitution subject to miliary fever is, that it more often attends those subject to considerable haemorrhages. Such discharges certainly occasion great irritability; and the disease is not con- nected Avith mere debility, since it is not peculiarly attendant on typhus. On the other hand, the appear- ance of the urine is peculiarly pale, and the smell of the perspiration is acid; but the former is an almost constant attendant on fevers in their commencement, and the latter is peculiar to the perspiration of child-bed women. The accidental symptoms of miliaria are remission and exacerbation of the fever, but at no regular periods. The sleep is disturbed, often interrupted; tremor, sub- sultus, and even convulsions, come on. Occasionally, the pulse sinks, the eruptions assume a purple hue, clammy sweats and death follow. The directions for the cure of this fever have been strangely and without reason embarrassed. If it is symptomatic of a too hot regimen, Ave shall find little other regulation than with caution to lessen it. If idiopathic, similar plans should be followed, and according to the principles laid down in the articles Diaphoretica and Morbi Cutanei, Ave should conduct the perspiration steadily and slowly. Cool instead of cold drinks should be employed, the cooling neutrals freely given, and the bowels kept free by the mildest laxatives. The nervous symptoms are best relieved by camphor, which the stomach usually bears with ease, and should the strength sink, a little wine may be cautiously allowed, or ether added to the cam- phorated draughts. In general, hoAvever, cool free air is the greatest cordial. Even Fischer, after the expe- rience of sixty years, advises us not to be too anxious to force on the discharge from the skin; and Ave have seen that cool air is the most effectual diapnoic. See Diaphoretica. When the pustules assume a purple hue, which in this country is an occurrence peculiarly rare, the bark and port wine, in quantities proportioned to the violence of the symptoms, are necessary, and when the debility is considerable, bark, independent of putrescency, has been given. This may be requisite, but we have never found it so, and there is always danger that bark may occasion a stricture on the skin and check the salutary diapnoe. When inflammatory, phrenitic, or pneumonic symptoms come on, they must be treated according to the rules laid doAvn under the proper heads, urging, however, the general evacuations with caution, and trusting rather to the topical ones. Blisters are never useful, except in such cases of topical congestions. See Hoffman and Sir David Hamilton's Treatise on the Miliary Fever. Sydenham Miliaris nova Febris, Schedula Monitoria; Fischer et Febre Miliari; Allium de Miliaria. De Haen Ratio Medendi; Colin de Mi- liaria. Cullen's First Lines, edit. 4. vol. ii. Milia'ris Nau'tica, and Purpura'ta, species of Typhus : the former is called by Huxham febris nau- tica pestilentialis. MILIA'RIUM, (ptXtxptov). See Alembicus. MILIO'LUM. A small tumour in the eye lids, of the size of a millet seed. MILITA'RIS AlZOI'DES. See Aloides. MILITA'RIS HE'RBA, (from 7niles, a soldier,) from its efficacy in curing fresh wounds. See Mille- folium. MI'LIUM, (from mille, a thousand, because of its numerous seeds). Millet, cenchros, panicum Italicum and miliaceum, Lin. Sp. PI. 83 and 86, hath large, broad, grass like, somewhat hairy leaves, encompassing the stalk of three or four feet in height, bearing on the top a large pendent panicle, composed of many slender stalks, with many small glumes, including small, white, hard, shining grains. It grows plentifully in Poland; is sown in April, reaped in August or September, and is used as food. See Aliment. Mi'lium I'ndicum, sorgo, sorghum, melica, Holcus, Holcus sorghum Lin. Sp. PI. 1484. Indian millet is sown in Spain, Italy, and other warm countries. In Turkey they feed their hogs and poultry with it; but in the human body it induces constipation. Mi'lium arundina'ceum, Coix lachryma Jobi, Lin. Sp. PI. 1378; the lithospermum. MILLEFOLIUM, (from 7nille, a thousand, and fo- liu7n, a leaf). Le7itibularia; supercilium and lumbus Veneris, 7nyriophyllon, chiliophyllon, common yarrow; mill foil, Achillea millefolium Lin. Sp. PI. 1267, is a plant Avith rough stiff leaves, divided into small seg- ments, set in pairs, along a middle rib, like feathers; the little flowers stand thick together in the form of an umbel on the top of the stiff stalk, and consist each of several whitish or purpleish petala, set round a loose disk of the same colour, followed by small crooked seeds. MIN 989 MIN It is perennial, groAvs plentifully on sandy commons, and flowers almost all the summer. The leaves and flowers are considered to be mild corroborants, and antispasmodics ; their sensible quali- t'us promise some activity, for they have a weak but agreeable aromatic smell, a slightly bitter, rough, and pungent taste: the leaves are most bitter, the flowers have most smell, and the young roots a glowing warm taste like that of contrayerva, but the smell is greatly diminished by drying. By the Greek physicians this plant was esteemed a vulnerary and styptic, generally employed internally as an astringent in all haemorr- hages. Stahl and Hoffman used it in bleeding from the lungs and nose, too copious Aoav of the menses, and bleeding piles. Stahl considered it not only as an - astringent, but a powerful tonic, antispasmodic, and se- dative; it is now neglected, and the leaves and flowers only are appropriated to medical purposes, if it should be employed. Both Avater and spirit extract the virtue of the leaves and flowers; but water the astringency, and spirit the aroma, in the greatest degree. If the flowers are dis- tilled Avith water they yield an essential oil; and if the plant is gathered from a rich soil, the oil will appear of a blue colour ; if otherwise it Avill be green. A strong decoction of the root and leaves is said to have cured a dysentery. See Raii Historia; Lewis's Materia Medica. Millefolium aqua'ticum. See Myriophyllon.^ MILLEGRA'NA MAJOR, (from mille and gra- num, grain). See Herniaria. MILLEMO'RBIA, (from mille, and morbus, a dis- ease). See SCROPHULARIA MAJOR. MILLE'PEDES, (from mille, and pedes, feet). See Aselli. MILPHO'SIS, (fA,tX0aris). A Greek primitive. A Baldness of the eye brows : sometimes an increase of the flesh in the corner of the eyes. MILZADE'LLA, (from milza, Span, the spleen, from its virtues in diseases of the spleen). See Lamium Maculatum. MIMO'SA NILO'TICA, seu jEgyptiaca. See Acacia. Mimo'sa Japo'nica Ca'techu. See Terra Japonica. MINE/A. See Anime. MINERA'LIA, (from mina, a mine of metals). Minerals. The mineral kingdom furnishes numerous and very valuable remedies, first introduced by the che- mical physicians, and, for a long time disregarded by the Boerhaavian school. They were supposed by the latter to be unalterable in the stomach by the digestive poAvers, and consequently incapable of producing any change in the circulating fluids, the source, in their opinion, of all diseases. Dr. Cullen first clearly pointed out, that many medicines, particularly opium and arse- nic, produced considerable changes, though thrown up with an apparently undiminished bulk, and that therefore they acted on the stomach as a nervous organ, sympa- thetically connected with the rest of the system. Since that time, the opinions of the chemical sect have been revived with more distinct and more rational views, and copper, arsenic, barytes, with some other medicines of considerable power, introduced into the materia me- dica. In the views of the natural historian the study of mineralogy has been attended Avith greater difficulty. In the system of Linnaeus, Avho was very imperfectly ac- quainted with minerals, the form alone Avas considered as the basis of the classification; and forms, at that time little knoAvn, or described Avith no very discriminated minuteness, ted rather to confusion, than distinction. Cronstedt first conducted his arrangement with scienti- fic accuracy, but his system was chemical, and the ge- neral rules, as Awell as the conduct of the historians of the other kingdoms of nature, rested their discrimina- tions on external fonns. Daubenton, the friend and coadjutor of Buffbn, suggested an union of these two plans, but the revolution was completed by Werner and Haiiy within a very few years. It is unnecessary to mention a great variety of sys- tematic arrangements. That of Cronstedt was com- prised in four great divisions; earths, salts, inflamma- bles, and metals, to which he has added, in an appendix, compound and conglomerated stones, petrifactions, and volcanic productions. He has been folloAved, with no change in the great outlines, by Mr. Kirwan. While the chemical mineralogists were thus meliorating their system at their furnaces or their lamps, a considerable revolution was preparing in Germany and France. In the school of Freyberg, where the subject, from the neighbouring mines, forced itself on the attention of naturalists, Werner laboured at rendering the descrip- tive language more copious, more expressive, and more accurate. To every appearance of shade, colour, hard- ness, taste, smell, &c. he gave appropriate appellations, often with a disgusting harshness which obscured Avhat he attempted to explain, but with the most minute and accurate discrimination. Haiiy, in France, was at the same- time observing with minuteness the form of the crystals, and investigating by the most patient research, aided by the most accurate geometrical constructions, the original molecule, on which the future more com- pound crystal is moulded. In this enquiry he had an assistant in Rome de ITsle, but his last most valuable Avork is wholly his own. That of Rome de ITsle was published near twenty years since. Haiiy, however, though he rests greatly on the form of the crystals, nei- ther neglects the chemical analysis, nor the strict lan- guage of Werner; and the general merit of his work has lead us to prefer it as the most convenient book of reference, to ascertain the species intended, especially as his copious list of synonyms lead us equally to the best authors of the chemical and the Wernerian schools. Hatty's first class contains the compounded acids, viz. those substances in which the acid is united to an earth, an alkali, and occasionally to both. The second comprises the pure earths, except where they may be united Avith an alkali. The third contains the combus- tibles, and the fourth the metals. The appendix is filled with those bodies whose nature is unknoAvn, com- pound, and volcanic substances. Werner, though he has so carefully improved the language of mineralogy, yet rests on chemical analysis as his chief support. The principal divisions of former authors it is impossible to overlook or neglect, for they are strongly pointed out by nature; and earths, salts, combustibles, and metals, are also his classes. He has added the classification of rocks, which he divides into primitive, transitive, alluvial, and volcanic. His object in this arrangement will be sufficiently obvious M I N 990 M I R from the titles. Of Werner's system we have no very satisfactory account in our OAvn language. His Avork on the '• External Character of Fossils" has been translated, but the language is disgusting and rugged. M.Brochant's two volumes of mineralogy, in French, give a much more favourable vieAvof his doctrines; and this work is more valuable, as it goes hand in hand with that of Haiiy, a circumstance which enhances the value of each. Mr. Jamieson's description of the minerals of Scotland, ana a lew others from the school of Freyberg, are cal- culated rather to disgust than allure the student. Werner has improved the science in one respect, viz. in preserving the natural families, Avhich, like the na- tural orders in botany, connect kindred substances. Haiiy has been equally successful in connecting these kindred tribes from the form of their crystals; and so just is his method, that the arrangement which these first suggested afterwards received their best support from chemical analysis. Another improvement of Wer- ner is the arrangement of subjects, not from the predo- minance of their component parts, but from the charac- ter. Many reputed argillaceous earths have often the largest proportion of silex, but they are arranged Avith propriety as clays. This, though sometimes attended to, Avas not before the aera of the Freyberg professor strictly kept in view, and it has greatly improved his system as a natural one; the first and great object in every department of natural history. The chief difficulty in mineralogy is the means of ascertaining species; and, when Ave proceed to other subjects which have been supposed less susceptible of the advantages of arrangement, we shall find the dif- ficulty less considerable. Every author depends on the chemical nature of the object for the establishment of species; and Werner expressly observes, that bodies, which differ essentially in their chemical nature, differ also as species. The error lies in not affixing an accu- rate idea to the Avord " essentially," for Werner often depends on differences purely accidental; and the es- tablishment of sub species in almost every modern system shoAvs the uncertainty of the foundation of specific differences. Haiiy has formed his species on the chemical nature of substances, but he has added essential external characters, very striking and discri- minated. Brochant has done the same, but not ahvays with equal success. It is a singular remark of prince Gallitzin in his " Alphabetical Collection of Mineralogical Names," that the possible combinations of the nine principal earths, excluding the saline and metallic mixtures, ex- ceed forty thousand, of which we have yet discovered scarcely more than fifty. How inexhaustible are Nature's stores, and what resources may not medicine and the arts have still in reserve ? The siliceous earths form nearly one half of the known combinations, the calca- reous only furnish five, and the aluminous seven. We have perhaps been led too far from our medical department; but this subject has not sufficiently shared the attention of the English naturalists or physicians. We shall iioav return to our proper path, and endeavour to point out the comparative advantages of each class, in a medical view. Earths. The first of these in the modern systems is the barytes, and we employ only the muriated salt, though a solution of the pure or aerated barytes has been recommended vaguely, as an anthelmintic, and, ex- ternally, as a destroyer of the life of a part. The purer or carbonated lime stones are absorbents, and, by this quality, they- appear to act as astringents. From a loose analogy, they have been supposed useful in other ex- cessive evacuations, Avhere their power will not extend. The more incapable they are of absorbing acid, the less effectual they appear, unless Avhen joined Avith some acids, they act according to common opinion as astrin- gents in the intestinal canal. Their lithontriptic power has been sufficiently explained. Magnesia is highly useful as an absorbent, and, when joined Avith acids, as a laxative: the clays we have found demulcent, and, from this effect, apparently astringent. The flints including the gems, though formerly cele- brated, are iioav deservedly forgotten; nor, excepting the portion suspected by Dr. Gibbes in the Bath waters, is there any known form in which siliceous earth is swalloAved, or in which it can be useful. The strontia has been recommended as a diuretic, and an astringent, but we cannot ascertain the authority. It is probably an absorbent. The salts are more frequently advantageous, and, in their different forms, are useful laxatives, refrigerants, absorbents, and tonics. The two former objects are obtained by the neutrals ; the two latter by the alkalis and acids. The volatile alkali is conspicuous as a sti- mulant, the vegetable acid as a refrigerant. Alum seems the chief objection to the general remark, though it appears to act occasionally as a laxative. The inflammables offer very feAv medicines, and with the exception of sulphur, and perhaps the petroleum, honev of importance. The ambergris, and the asphal- tum, are noAV deservedly neglected. The succinum used only for its salt and oil. The metals furnish the most numerous and the most valuable medicines, Avhich we need not enumerate, as, with the exception of lead only, they arc chiefly tonics ; and, Avhen we particularly examine its properties, we shall find them in some vieAvs according Avith those of the other metallic bodies. The metallic salts are often externally corrosive. If then Ave find, in the inexhaustible variety of possi- ble combinations, that Ave have yet discovered few, so in those which we have discovered, a very small propor- tion are useful as medicines; and Avhen, from the whole of the mineral kingdom, with all the various prepara- tions, Ave have selected twenty important ones, Ave need scarcely regret the loss of the rest. It must be recol- lected that the fifty knoAvn combinations from the forty thousand, are combinations of earths only ; and that the combinations of the metals only with the acids Avould furnish as manyjmore, of which a very small proportion has been actually discovered. Kirwan's Mineralogy ; Hatty Traite de Mineralogie ; Mineralogie de Brochant; Wallerii Systema Minera- logicum. MI'NIUM, (from samminia, a Chaldee word). See Plumbum. Mi'nium Gr^co'rum and Pu'rum. See Cinna- baris. MINU'TA, (from minuo, to diminish). An epithet for a violent fever, Avith such great debility as to be fatal in four days. MIRA'BILIS, (from miror, to wonder,) a term MOD 991 MOL applied to various compositions, expressive of their admirable virtues. Mira'bilis a'qua. See Piper Jamaicense. Mira'bilis peruvia'na. See Jalapa. MI'RI. See Cebipira Brasiliensibus. MISERE'RE ME'I, a name applied to the iliac pas- sion, from the severity of the pain. See Iliaca pas- sio. MISTU'RA, (from misceo, to mix). A mixture, in the strictness of pharmaceutical language, differs from juleps in not being transparent, in consequence of some powder or extract dissolved or mixed with it. See Julapium. MI'SY. We should not have retained this obsolete word, had Ave not seen it styled a sulphat of iron. It is synonymous with the calcantha or calcanthum of the ancients, q. v. and in reality a sulphat of copper. Hatty, iii. 586. MITE'LLA, (quasi mitrula, dim. of mitra, a band). A scarf for suspending the arm. In botany it is the name of some plants from America and the north of Asia, comprehended by Linnaeus under the genera mi- tella and tiarella. MITHRIDA'TUM,(from Mithridates). See Con- fectio damocratis, and Medicina (history). MITRA'LIS VA'LVULA, (from mitra, a mitre, from their resemblance). See Cor. MI'VA Cydoni'orum, (from the Hebrew term migma). Marmelade of quinces. See Cydo- nia. MI'XTIO, (from misceo, to mix)'. Mixtion. Stahl used this expression to signify the union of the first principles in the most simple compounds. Those prin- ciples of bodies are noAV emphatically called a 7nixt, which are so intimately united to each other as to be scarcely discovered, though Avithout changing the nature of either, and without any union by chemical affinity. A mixt is thus distinguished from aggregates, where the texture is loose, and the parts more easily separated. In chemical mixtures the nature of the ingredients is altered, and a new body formed. MO'CHLIA, (from /tce^Aes, a lever). A reduction of the bones from an unnatural to a natural situation. MO'CH LIC A, (from poxXevu, to move). Violent purges. MODE'RNI, (quasi hodierni, of to-day). The aera of modern learning, according to the best chronologists, is that of the capture of Constantinople by the Turks, when the Greeks fled to Italy, carrying Avith them their literary treasures. This was on the 27th of May 1453. This aera will not, however, be accurate in the history of medicine, for in tracing the progress of our science Ave have seen it gradually progressive from east to west, and sometimes even in a contrary direction; and Avere wc to fix the limits with respect to medicine,Ave should place them at the decline of the Grecian physic, in the court of Byzantium, and the last of the ancients would be Actuarius. The comparative knoAvledge and skill of the ancients and moderns have occasioned great contro- versy. It is pleasantly, though not with great impar- tiality, treated by Swift in his Battle of the Books. Du- tens' work " On the Discourses of the Ancients attri- buted to the Moderns," contains many curious and im- portant facts on this subject; but this author, like some others, catches too anxiously at casual hints, and ex- pressions, seeming to mistake a lucky but a loose con- jecture for a discovery. Pancirollus, in his work Dc Rebus Perditis et Inventis, and Baeckmann, in his His- tory of Inventions, offer many curious facts respecting the science of the ancients, and often respecting medical opinions and the use of remedies. Tavo volumes have been added by the latter author to those already- trans- lated, which would be a valuable acquisition to the English reader. MODI'OLUS, (from modus, a measure,) since it is contrived to enter only to a certain depth. The croAvn or saw of the trepan ; or a circular trepan resembling in shape the nave of a Avheel, which is its true significa- tion. See Trephine. Modio'lus, (femin. of 7nodus,) the axis of the cochlea of the ear. MODI'RA. See Colubrinum. MOFFA'T WATERS. A mineral spring near Moffat in Scotland, resembling the Harrowgate Avaters ; equally sulphureous and saline, but not equally bitter. They have been chiefly used in scrofulous and cuta- neous disorders, and more lately applied to irritable ill conditioned ulcers. Their contents are chiefly sea salt and hepatic air; but the former is in so small a dose as scarcely to act as a laxative. In indigestion from Aveakness, in calculous cases, and in biliary obstructions, they have been employed, but are not sufficiently poAverful in their action on the boAvels for the latter complaint. They chiefly act as diuretics. MOGILA'LIA, (from t*-oyis, difficulty, and XxXeu, to speak). A difficulty of speech ; psellis7nus acheilos of Dr. Cullen. See Ancyloglossum. MO'KEL. Sec Bdellium. MO'LA, (a IlebreAv term). A name for the patella, knee pan, for the 7nolares dentes, or grinders; for the maxilla; and a false conception, or a shape- less mass in the uterus, Avithout a placenta, called epicy- ema, myle, and by Avicenna, naducem. Should part of the placenta remain in the uterus after the birth of the child, this may resemble a mole; and it is then called pseudo-mola, a false mole. If the symptoms of a miscarriage happen in the first, or beginning of the se- cond month, the fcetus being then very tende'r, and ly- ing in the os internum two or three days, will dissolve, it is said, into a kind of jelly, which, coming aAvay, is called a false conception; and if, during the time of child-bearing, a flooding occurs, a large coagulum of blood, with a fibrous appearance, is discharged some timcafter its cessation: this also is called a 7nole. It differs from the placenta in being only fibrous on the outside. We cannot indeed deny, that the tender fcetus may melt into a jelly, or that coagula may become fibrous, but the appearances of molae seem to be owing to a more recondite origin. It is ridiculous to talk at this time of a plastic power, or a tendency to organization; yet either imperfect rudiments of a foetus pre-exist in ovaria, or by some unknown process there is an ap- proach to organization. We have numerous records of the remains of hair and teeth in ovaria of Avomen of character, and in circumstances Avhere there can he no deception. We have similar appearances in the brute creation. We find, too, that, when married Avomen have been in a bad state of health, Avhich has prevented con- ception, an organized mass is often discharged on their recovery before a living fcetus is produced. We have much reason to suspect, then, that in every instance M O L 992 M O L moles are imperfectly organized productions, and that they may be both formed and discharged in some instances without any blemish on the female character, whatever theory may be adopted respecting their origin. In many instances what is styled a mole is merely a coagulum of blood. The signs of a mote are, in general, the same as pregnancy. It is said, indeed, that in the former case the belly increases more rapidly than in pregnancy, and after the third month it generally produces floodings. Women of experience, hoAvever, always feel some va- riety in their symptoms and sensations, and generally suppose they are not with child. A mole is also distinguished from pregnancy by its exciting no motions in the womb like those of a living child, and by changing its situation in the belly accord- ing to the posture of the mother. The general health is commonly Avorse, after the fourth month while in pregnancy it improves. Should the existence of a mole be ascertained, assist- ance is necessary, the finger may be gradually intro- duced into the uterus, and its action excited by a slight irritation. As there is no placenta, so, if after the dis- charge of the mole the flooding ceases, the whole is at an end, except another may remain, a circumstance pe- culiarly rare, Avhich however will soon follow. See La Motte, Smellie, and Hamilton. sMOLA'GO CODE See Piper nigrum. MOLA'RES de'ntes, (from mola, a mill, and dens, a tooth). Grinders, ge7iuini; gomphioi; mola; 7no- misci; the large broad teeth beyond the canini. The two first are smaller than the rest, terminating in two points, and therefore styled by J. Hunter bicuspides. They have short fangs, which are double at their extremities. The other three on each side have four points at the basis of their bodies, tAvo anteriorly, and two posteriorly; these have generally two fangs in the lower jaw, and three in the upper. Mr. John Hunter observes, that the first and second of the grinders are nearly alike : they stand next behind the canini or eye teeth; and the first is frequently the smallest, with rather the longest fang, sometimes with its point bent. In the upper jaw, the bicuspides are rather thicker than in the lower; and bath, especially the second in both jaws, are oftener Avanting than any others, except the dentes sapientiae. The bicuspides and the molares alter very little in shape on their grinding surfaces, by use; their points only wear and become obtuse. The two first grinders differ from the bicuspides in being much longer, and in having more points and more fangs. The body forms almost a square, with rounded angles. The grinding surface has commonly five protuberances, two of which are on the inner, and three on the outer edge or part of the tooth, Avith generally some smaller points at the roots of these longer protuberances. The body towards its neck divides into two flat fangs, one forward, the other backward, which areoften bifurcated. The first grinder is somewhat larger and stronger than the second; and both have shorter fangs than the bicuspides. In the upper jaw they have three fangs; and the first and second in the upper jaw are placed directly under the maxillary sinus. The third grinder is the dens sa- pientia. See Dens. J. Hunter's Natural History of the Human Teeth. Mola'res Gla'ndula, are two glands, nearly of the same kind with the sublingual glands, each of them situated between the masseter "and buccinator muscle, resembling, in some subjects, two small lumps of fat. They send out small ducts, which perforating the buccinator, open into the cavity of the mouth, almost opposite to the last dentes molares; from which circumstance, Heister gave them their name. MOLDA'VICA Melissa. Turkey baum. See Melissa Turcica. MOLE. See Talpa. MOLL. See Lentiscus. MOLLI'TIES o'ssium (from mollis, soft). A softness of the bones, malacosteon. The principal cause is a defect of boney matter, and often occasioned by a general weakness, scorbutic, venereal, or other taint in the blood. Cleanliness, a change of air, fric- tions, a good diet, cold bathing, exercise, and chaly- beate medicines, are the proper remedies, though Avhen the cause is known, it should be previously corrected. See Morbi solidi simplicis. Distortio spinje. Gumma. MOLLIFICA'TIO, (from mollis, soft, and fio, to make). A barbarous term for a partial palsy of the muscles. MOLLU'GO, (from its softness). See Rubia syl- vatica LiEV-is, and Alyssum. MOLU'CCA meli'ssa. Molucca baum. Its qualities agree with those of melissa. MOLUS'CUM, the appellation given by Dr. Willan to a cutaneous disease, consisting in small soft wens, which may be extirpated, but not easily resolved. MOLLU'SCA, (from mollis, soft). Natural history has, within these few years, greatly extended its boun- daries by new discoveries. Philosophers Avanted neAV worlds as a supply for their ambition, neAV territories for their conquest, and they have discovered them by improving their instruments, by their more extensive and more acute observation. New planets,new metals, and new animals are daily attracting our attention, and, in the present department oP science, they have ne- glected the gaudy shell, the former object of inquiry, and the subject of classification, to ascertain the nature of the animal which inhabits it. This part of the inquiry has been chiefly cultivated' by the French naturalists, and the reader will obtain the most satisfac- tory information from these and the Linnaean Transac- tions. We must add, however, with regret, that the volumes, which relate to the mollusca by the successor of Denys Montfort, are inferior to many of the others, and the plan of that naturalist is not completed. In this place we can only skim over the surface, in order to apply it to medicine. We have already noticed the great outline drawn by La Marck and Cuvier, who divide animals into those which have articulated ver- tebrae, and those which want them. We say articu- lated vertebrae, because some of the animals before us have a bony support, particularly the cuttle fish. When vertebrae are no longer found, the blood is no longer red. All these animals were divided into insects and worms, or, as they are now called, molluscae ; but later authors have added and detracted a little from the classes of their predecessors. Bruguiere added the echinodermes, viz. the star fish and the urchins. La Marck reduced the six classes of Bruguiere to four, molluscae, worms, radiarii (echinodermes) and the polypi, including the infusory animals. Denys Montfort, M O M 993 M O N whose work, as the chief systematic one, Ave must fol- low, divides the molluscae into ten classes, the M. coriacea (cuttlefish); tentaculata(snails); ejaculatores (many of the bivalves) ; annulata (worms) ; gelatinosa (medusas or blubbers); loricata (asterias); hydra (multivalves); polypi (madrepores); cornea (lithophy- tes); infusoria (microscopic animals). In this ar- rangement, the insects, the crustaceae, and arachnoides, are excluded; for the molluscae undergo no meta- morphosis, do not change their skins, and have no really articulated limbs. The coriaceae once furnished their shells as absorbent medicines. They sunk into dentrifices, and are noAv disregarded. One species, the sepia octopus, the octopus vulgaris of La Marck is said by .Etius, and many of the other Greek physicians, as well as the poets, to be aphrodisiac. The sepia moschata (octopus -moschatus of La Marck) Avas esteemed for the same qualities,also as an emmenagogue, and as highly nutrient. All the polypi are occasionally eaten. They are a hard indigestible food, employed only from necessity, and rendered as palatable as possible by the arts of cookery. The tongue is said to be delicious, and is greedily devoured raAV. The animal styled the argonaut is of this genus; and the nautili Avhich agree in structure with it, though not like the former, are solitary animals, also eaten by the common people. With these animals the Avork of Denys Montfort concludes, and his successor is peculiarly short, imper- fect, and unsatisfactory. The tentaculatae furnish ani- mals highly nutritive, and employed on this account in hectics. The gluten of the large black* snail is said to be useful as a discutient. The only other divisions which offer medicinal substances is the seventh, which contains the sponge, and the ninth, the lithophytes, Avhich furnish the coralline. Histoire Naturelle de Buffon Ed. Sonnini. Molusca. Memoires et l'Histoire de la Societe d'Histoire Natu- relle, a Paris, Annales du Musaeum National. Linnaean Transactions. MO'LVA, (from mollis, soft). See Asellus major. MO'LY, (from puXos, battle; supposed to have sprung from blood spilt in battle). Allium latifolium lilifiorum. Moly of Theophrastus, or Homer. Va- rious plants have had this appellation, and each is a kind of garlic, though it has been styled with less reason, a species of rue. Mo'ly alpi'num. See Ophioschordon. MOLYBDjE'NA, (from fA*Xv£fos, lead; elersna, ga- 'lena). Molybdene sulphure, Hatty, iv. 289, a metallic ore, often confounded, from its resemblance, with plumbago, but differing essentially from it. It is one of those metals which, when calcined, are acid. Its texture is lamellated, the marks it leaves of a greenish colour, and its specific gravity nearly 6, Avhile the carbure of iron is compact, leaving black marks on paper, and in gravity exceeding 6. See also Chemis- MOLY'BDAS. Molybdat. Salt formed by the union of the molybdic acid and different bases. MOLY'BDOS, from fMXvQfos: ort f»joXet ets $x6os, from its gravitv. See Plumbum. MOLV'ZA, (a dim. of puXv, moly). See Allium. MOMIN. See Mamei. MOMl'SCUS, (from fA.ufA.os, a blemish). The part vol. i. of the dentes molares next the gums, usually covered Avith a tartareous matter. 'The molares themselves have the same appellation. MOMO'RDICA, (mo7-deo, to bite,) from its sharp taste, balsamina mas,pomum Hierasolymitanum,pomum mirabile, bulla, muccapira, cucumis, mo7nordica balsam- ina Lin. Sp. PI. 1433; the male balsam apple, is cul- tivated in gardens, but not used in medicine, though the fruit is cooling. Momo'rdica elate'rium. See Cucumis agres- tis. MONADE'LPHIA, (from fiovos, unicus, andxfoxtpos, frater). The sixteenth class of the Linnaean system, comprehending those plants which produce hermaphro- dite floAvers, with one collection of united stamina. It is a natural association. MONA'NDRIA, (from povos, unicus, and xvvp, ma- ritus). The first of Linnaeus's classes, comprehending plants which produce hermaphrodite flowers Avith a single stamen. MOXA'NGIA, (from f*ovos, and xyyos, a vessel). Plants which have their seeds in a single cell. MONA'RDA PURPU'REA ; m.fistulosa Lin. Sp. PI. 32. The smell is fragrant; the taste aromatic and bitterish. It has been styled a deobstruent and a stomachic; but has been chiefly employed in intermit- tents. MONE'RES, (from iaavos, alone,) properly a boat with a single oar; but figuratively applied to a melan- choly person fond of solitude. MONrO'CEROS,(from/!*evos, unicus, and xepxs, cornu, horn). See Unicornu. MONO'COLON. See Ccecum Intestinum. MONO'CULUS,or MONOPHTHALMUS, (from f*A>vos, or otpOxXftos, an eye). A roller of ten or twelve feet in length, and two or three fingers in breadth, to retain the dressings on the eyes. It is fixed on the oc- ciput, letting about a foot hang down, and from thence carried obliquely round the head, across the wound, to its commencement: having carried it thrice round, the remainder goes circularly about the temples, occipit, and forehead; the end hanging behind is then to be brought over the vertex to the forehead, and the whole secured. A napkin, or a handkerchief, is equally useful. It also signifies, as the name implies, a person Avith only one eye, or with one eye less than the other. See Monopia. MONOZ'CIA, (from fMvos, and otxos, domus). The name of the tAventy-first class in the Linnaean system, comprehending the androgynous plants, or such as pro- duce mate and female flowers on the same individual without hermaphrodites. MONOGA'MIA, (from tu>vos, and yxpos, marriage). Plants whose flowers are single. MONOGY'NIA, (from f**vos, and ywti, mulier). The name of the first order in the first thirteen classes of the Linnaean system, comprehending such plants as have one pistil or one stigma. MONO'MACHON. See Ccecum intestinum. MONOPE'GIA, (from fu>vos, and ■srvywut, to com- press). A pain in the head affecting only one point. MONOPE'TALI, (from h-ovos, and welxXov, a petal). Containing but one petal. MONOPHY'LLON, (from n*vos, and (pvXXov, a leaf,) smilax unifolia humillima, unifolium. lilium con- . 6 L MON 994 MO N vallium minus, ophrys monophyllos Lin. Sp. PI. 1442, one blade, grows in woods and thickets, and flowers in May and June. The flowers are styled alexipharmac and vulnerary. See Raii Historia. MONO'PHIA, and MONO'POS, (from ftovos, solus, and »aJ> an eye,) Monoculi and arimaspes, a term of the same signification in the Scythian language, from their custom in shooting, to shut one eye. In consequence of this habit the other Avas rarely seen, and they were said to have but one ; but the same term is applied to those Avho have one eye less than the other. When this deformity is observed in infancy, such exercises as require the use of only one eye, as looking through microscopes, telescopes, &c. should be avoided. MONO'RCHIS, from (aavos, and opxts, a testicle. MONOSPE'RMUS, from imvos, single, and rreppx, seed. MONS VE'NERIS. The hill or mount of Venus, lies before and on the upper part of the symphysis of the ossa pubis, formed by fat in the subjacent cellu- lar membrane, and in adults generally covered with hair. MO'NSTRUM, and MONSTRO'SITAS, (from mo7istro, to show). Monster, or a monstrous, i. e. a preternatural production. A monster is very judiciously defined by Dr. Ha- milton, in his valuable and comprehensive Outlines, to consist in " any considerable deviation in the structure of the fcetus from the common order of nature, whether such deviation be consistent with life or not." Monsters, according to the same author, are, 1st, those which are double, or have supernumerary parts ; 2dly, those who have a deficiency of some organ; 3dly, those who have any remarkable deviation either in the situation of the viscera, the distribution of the vessels, nerves, or secretory organs, though not externally visi- ble, or materially affecting the different functions; 4thly, the productions of animals of different species. Monsters double, or with supernumerary organs, have been often described. The Bohemian sisters, united by the glutaei muscles, with a more intimate con- nection in the abdominal viscera, are well known to phy- siologists. The monster, mentioned in the Philosophical Transactions (No. 2), consisted of two bodies equally distinct, and in various other parts of this collection there are cases where the union is more or less com- plete. This double form gradually sinks to the child growing from the side of another, recorded in the Asia- tic Transactions, down to the double head of the Hin- doo child, in Mr. Hunter's collection. Supernumerary organs are very frequent, and this peculiarity is at times confined to particular families. It is remarkable that the peculiarity will disappear for one, and sometimes two, generations, reviving again in the third. The in- ternal organs are occasionally double or supernumerary. The most singular case of this kind is where two hearts were discovered. Deficiencies are also numerous. A head, an eye, an arm, a leg, a hand, foot, or finger, are sometimes Avant- ing ; but the chief deficiency, which calls for our at- tention is that of the head. This has occasioned many speculations; but in every instance there is a point at which all the nerves converge, or from which they pro- ceed, and this contains very generally a cortical, or a nu- cleus of cineritious, matter. We may, however, remark as a fact of future application, that the acephalous children are often plump, and of no diminutive size; yet the instance has escaped us, if any has occured, where such children are not in other respects monstrous. The vital organs must be always, to a certain degree, perfect: at least neither the heart nor the large vessels can be want- ing in a child which has arrived at its full time. The third instance of monstrosity is rare, or at least rarely ascertained. We have instances on record of the viscera being on the sides opposite to those in which they are usually placed, and the pulmonary vessels are occasionally defective, or useless from the foetal pas- sages continuing open. From the last cause chiefly arises the caerulian complexion of some children. Va- rious are the changes which may occasionally take place in the distribution of the vessels, the situation of the glands, or the direction of the nerves within the limits of health; and numerous must necessarily be the instances in Avhich -these irregularities have not been observed. The imperfection of natural passages .is scarcely suffi- cient to arrange such persons under the rank of mon- sters. It is a disease of structure, which merits no such appellation, and we have anxiously excluded them by our definition. The productions of animals of different species are rare; and these very seldom, if ever, fertile. Provi- dence has thus wisely preserved every species distinct, and the world is not peopled with monsters. Yet, among animals of the larger size, which usually produce only a single offspring, twins are rarely, both, perfect. This, however, is not the case hVman, or in the lower orders of animals. We only see it distinctly in the cow. In the vegetable kingdom, we find monsters pro- duced by excess of nourishment, or by the opposite ex- treme of confinement and deficient nutriment. To the former we attribute the double unfertile flowers ; to the latter the variegated leaves of plants. We are not without similar instances in the human species. The full plethoric female is seldom a mother of many child- ren, and the Laplander, the Esquimaux, and the Cretin are deformed in their bodies, and imperfect in their intellectual faculties. They have not, however, been distinguished by the appellation of monsters. To what are these deviations from the common struc- ture owing ? We have endeavoured to render the pre- existence of the germ in the female constitution pro- bable ; and the monstrosities observable in succeeding generations are owing probably to the imperfect germ. Where, however, parts are double, or the deviations from the common structure are considerable, we can- not admit this source. M. Lemery long since contended that monsters were rendered such by accidents in the uterus. Winslow supported the idea of Duverney, who supposed the germ to have been monstrous, and first started this opinion. Each opinion has been supported with great obstinacy by their respective authors, in the Memoires de I'Academie des Sciences, An. 1728, 1740, 1742, and 1743. The double children are certainly such as from con- tiguity have accreted in their tenderest state. We can have no doubt of this in the instances recorded in the Philosophical Transactions, where they ate and slept at different hours; where their excretions and tempers were distinct and discriminated. If it be the case in these instances, may we not suppose that, by a stricter MOR 995 MOR approximation, some of the abdominal viscera may be so cloself pressed as to destroy the parietes on the weaker side, and the canals to be consequently common ? This was the case with the Bohemian sisters. Again, may not a more partial and a stronger pressure obliterate even the lower extremities of the weaker child, and the trunk inosculate with that of the stronger, as in the case recorded by Dr. Bland in the Philosophical Trans- actions? and may not a similar cause, in twins greatly disproportioned in strength, account for all the varieties of a child growing out of the side, down to the double head of the Hindoo, or even the double heart ? It was not from accident that we said disproportioned strength; for the double portion is usually small and imperfect. It is not possible to follow all the varieties. While we have admitted, at one extreme, the monstrous germ, Ave have endeavoured to support, at the opposite, the effects of pressure. We can go no farther. Where the limits of either cause may be, is uncertain ; nor is it ne- cessary to follow doubtful and unsteady lights in a track which leads to no useful purpose. One thing we may add, that in no instance is it probable that deficient or redundant monsters are owing to the fright of the mo- ther, or disgusting objects presented to her. The absurdities that crowd the pages of Schenkius, Bartholine, iElian, De Reies, Vanderwiel, Paulini, Sec. down to our own rabbit woman, and Roederer's relation of a female that brought forth a fish, must not detain us. It is enough to have stated the several facts, and to have made some approaches towards an explanation. Philosophical Transactions, No. 2, 99, 226, 228, 234, 251, 308, 320, 453, 456, 487, &c.; Medical and Physical Journal, Passim ; Memoires de l'Academie des Sciences, An. 1724, 1738—43; Mauriceau, Smellie, and De la Motte's Midwifery; Journal de Physique, An. 1774, and 1776. See Acephalos and Pr^isen- tatio. MO'NTA PA'NNA. See Palma Japonica. MO'RBI ORGA'NICI. Parts affecting the organiza- tion, sometimes synonymous with the locates. See Locales. MORBI'LLI, (a dim. of morbus, disease). The measles. Variola cholerica of Avicenna; blaccia of Rhazes; bothor; bovilla; fersa of the Arabians. Dr. Cullen places this disease under the title rubeola, in the class pyrexia, and order exanthemata, defining it a con- tagious fever of the inflammatory kind, attended with sneezing, watery eye, and a dry hoarse cough; on the fourth day, or a little later, small spots, crowded to- gether, scarcely prominent, break out, converted after three days into small furfuraceous scales. He distin- guishes two species. 1. Rubeola vulgaris, with erup- tions very small, confluent, and corymbose, hardly rising above the skin. Of this there are two varieties; in one the symptoms are more severe, and the course of the disease not so regulai1'—the anomalous measles of Syden- ham : in the other they are accompanied with a sore throat. 2. Rubeola variolaris, where the eruptions are distinct and elevated. Dr. Cullen, however, doubts whether this disease be truly measles; for the erup- tions differ, and the catarrhal symptoms are absent: in Scotland this disease is called the nirles. The measles appeared in Europe nearly with the small pox: both came from the east, both are infectious, and attack only once; both appear at a definite period after the attack of the fever. The measles is an acute disorder, of the peripneu- monic kind, sometimes only an eruptive catarrhal fever. Dr. Morton calls the scarlet fever the confluent mea- sles ; and Dr. Watson observes, that in the small pox the eruption is critical, but that in the measles it is merely symptomatic, for the cough and peripneumony are not relieved by it. It was formerly a common opinion that the measles are a good preparative for the small pox ; but in general the former leaves an inflam- matory tendency, which greatly exasperates the symp- toms of the latter. All ages are subject to this disease, but it chiefly attacks children. The measles usually announce their approach by a small, frequent, and dry cough, which often continues many days, without any other sensible complaint, though more frequently the cough is attended with a general uneasiness, successions of shivering and heat, and a se- vere headach in grown persons ; great depression of the strength, a heaviness of the head in children, giddiness, hoarseness, pain across the forehead, an inflammation, with a considerable heat in the eyes, a swelling in the eye lids, a defluxion of sharp tears, and such increased sensibility that the eyes cannot bear the light, very fre- quent sneezing, and a discharge of acrid serum from the nose. Fever and a cough soon come on, with frequent vomiting, pain in the loins, a soreness or roughness in the throat, and sometimes a looseness, which relieves the vomiting. The tongue is furred, the urine high- coloured, and the pulse very quick, often irregular. These symptoms usually increase from the third to the fifth day, at which time little red spots, like fleabites, begin to appear in the forehead, and other parts of the face, which, increasing in number and diameter, run together, forming large red spots of irregular figures, scarcely, if at all, rising above the surface of the skin. These eruptions are afterwards extended to the rest of the body ; but sometimes red effusions are seen on the breast, before any appear on the face. The eruption is not followed by so sensible an abatement of the symptoms as in the small pox; the vomiting usually abates, but the cough, fever, and headach, grow more violent: the difficulty of breathing, the weakness of, and defluxion on, the eyes, the swelling of the face, drowsiness and loss of appetite, continue, though the vomiting abates. A bilious vomiting a day or two after the eruption is often useful, and occasionally the patient is relieved by a copious discharge of blood from the nose. On the third or fourth day after the eruptions first appear the redness diminishes, the spots fall off in branny scales, while in other parts of the body they ap- pear very large and red; but in a day or two they all disappear in the same branny scales, leaving a little dis- coloration on the skin, with considerable itching. On the ninth day from the beginning, when the progress has been speedy, and on the eleventh, when it hath been slow, no trace of redness remains. As the spots disap- pear, the defluxion on the eyes, the fever, and difficulty of breathing, sometimes increase, the cough becomes more troublesome ; and these symptoms are increased by a hot regimen. These peripneumonic symptoms are often followed by a looseness, which immediately succeeds the disease, and often continues with obstinacy 6 L 2 MOR 996 MOR after all other symptoms are removed. After a hot re- gimen the eruptions sometimes turn black; but this chiefly occurs in grown persons, and is often fatal. If, during the course of the disease, or immediately after it, some considerable evacuation, such as the vomiting of a bilious matter, a bilious diarrhcea, a considerable discharge of urine, or plentiful sweating come on, the patient recovers soon after the spots disappear from the skin. The measles are sometimes followed by boils resem- bling anthraces, livid, often deep, suppurating with difficulty and pain; sometimes attended by soft pustules containing a Viscid straw coloured fluid, which appear highly salutary, by watery vesicles, and occasionally by- aphthae. Swellings of the lymphatic glands often fol- low, occasionally suppurating, and leaving, as usual, troublesome sores, which heal with difficulty. Measles is generally a disease of little importance; but it becomes dangerous when the peripneumonic symptoms are violent, and when the eruption recedes. The most favourable symptoms, as in other fevers, are the moistness of the skin, and the bowels moderately relaxed. If the cough is inconsiderable, the eyes not much swollen, the breathing moderately free, there is little danger; but the period of difficulty is often when the eruptions begin naturally to recede. The peripneumonic symptoms are then usually violent; and if at any time the eruptions should suddenly disappear, delirium, anxiety, great debility, with cold extremities and livid spots, come on, terminating soon in death. If the lungs are affected with tubercles, they are often excited to action by this disease, and the foundation of a phthisis is laid. The treatment of measles has, we think, been mis- taken and misrepresented. It has been considered as a peripneumonic disease, and the most liberal bleedings have been ordered : but the peripneumony only comes on by accident, or by mismanagement; for the disease is purely catarrhal. The common measles rarely re- quire bleeding; and, in general, the treatment is the combined management of a catarrhal and an eruptive disease. An emetic is undoubtedly at first required, and the mild relaxing diaphoretics, with neutral salts, continued through the Avhole course, will carry the dis- ease safely to a conclusion. The only remedies neces- sary, independent of these, are laxatives; which, if steadily persisted in from the beginning, will very cer- tainly prevent the occurrence of those violent peripneu- monic symptoms, which sometimes come on about the eighth or ninth day. In general it is sufficient to pro- cure tAvo or three stools daily ; but the author of this ar- ticle, when his son, whose tenderness, joined Avith ap- prehension of weak lungs, rendered the measles a dan- gerous disease, was affected, carried the evacuations farther. He watched him hourly, and found him always relieved by stools, so that about the disappearance of the spots, six or eight motions were procured daily. He thought that the recovery was peculiarly quick: the boy was soon brought into the air, and in three days from that period not a cough was heard. No other medicine was administered, except once a slight opiate when the cough was peculiarly troublesome. He mentions the single fact, but without advising an imitation, except where the attendance can be equally unremitted. The usual remedies of saline diuretics, Avith antimo- nials, and occasionally opiates, spermaceti, Ecc. must also be given, if the practitioner would not be thought ignorant or inattentive; but the laxatives should never be omitted. Should, notwithstanding the evacuations, the peripneumonic symptoms come on, bleeding will be necessary, in very young children by means of leeches; but after the age of five or six, by the lancet, Avith blis- ters, and the other remedies of pneumonia. No such instance has, hoAvever, occurred to us in an extensive practice; nor to those from whom Ave learned it, whose practice, equally long, had been more extensive. We have mentioned a diarrhcea as a favourable symptom, and Ave may now add, that it should not be chucked, but regulated according to the strength. The catarrhal inflammation may rise to suffocation; and in that case the emetics must be repeated, and blisters applied to the neck or the upper part of the sternum. A blister to die pit of the stomach is generally an useless application. When the cold regimen Avas introduced for the small pox, some rash innovators transferred the analogy to measles, often inducing the violent peripneumony they intended to avoid. Yet a very Avarm regimen is inju- rious; for we have shoAvn that it is inconsistent wi h the diapnoe, which in every febrile disease is so pecu- liarly salutary. The room should be large and airy, the child kept in an erect or a slightly reclining posture, ac- cording as either can be borne from the load of the head. The drinks should not be hot, but warm only, and the food light, diluent, and in a liquid form. If the cough is troublesome, breathing the steams of warm water will be useful, but these steams should not be drawn hot from an inhaler. The warm water should be put in a bason, and the head covered with a flannel large enough to hang over its edges. The eyes will in this way be also relieved by the relaxing vapour. Should, from debility or cold, the spots recede* convulsions, pneumonia, and sometimes phrenitis, will come on. In such cases, blisters, with warm cordials, and the warm bath, will be necessary; but this occur- rence is peculiarly rare. The continuance of diarrhoea, after the disease, is sometimes troublesome ; and the sagacity of Sydenham has been highly extolled, Avho recommended bleeding " because the halitus of the inflamed blood was carried to the intestines." We have never found the purging troublesome Avhen the bowels have been kept free dur- ing the disease; and when it has occurred, bleeding seems to have exhausted the little strength that remain- ed, often without relieving the diarrhcea. In this case a generous, but not a highly stimulating, diet, bathing the feet, and giving small doses of Dover's poAvder, have succeeded, interposing occasionally gentle laxatives. The rubeola sine catarrho, in Dr. Willan's opinion, is not true measles, nor does this disease'emancipate the patient from being aftenvards affected with the real complaint. Indeed the very vague distinctions of rashes will not enable us always to discriminate from the erup- tion alone, and to this, with the catarrh, we would add some affection of the eyes before we pronounced a child safe. The morbillous fever without the eruption is only a violent catarrh, and equally liable to deceive. The nirles, as we have said, is equally a distinct disorder from rubeola. M O R 997 MOR Dark livid spots are sometimes intermixed with the true eruptions, and in this case an alarm has been spread of putrid measles; but these little petechiae are usually attended with no danger, and a light infusion of bark, with the vitriolic acid, soon restores the colour. Real putrid measles have been described, but Dr. Willan has shoAvn very clearly that in each instance the disease has really been scarlatina. We cannot deny the existence of putrid measles, since avc have frequently seen putrid peripneumony. The plan of treatment, however, should it oceur, a. ul be nearly the same ; but Ave can- not enlarge on a disease which no one seems to have seen, and which may never occur. It has been proposed to inoculate measles like small pox, and the blood, the acrid serum from the eyes, and the matter from miliary vesicles, sometimes inter- spersed between the true morbillous eruption, have been employed. Each has succeeded, but more often failed; nor does the disease, Avhen produced, appear more mild. The attempt, therefore, has not been fre- quently made, and to avoid a complaint usually so mild, such precautions arc not necessary. See Hoffman and Sydenham, on the Measles; Home's Medical Facts; Tissot's Advice to the People; London Menical Observations and Inquiries, vol. iv. p. 132— 136, and p. 247—260; Medical Museum, vol. ii. p. 46—48; Cullen's First Lines, edit. 4. vol. ii. p. 173; Edinburgh Medical Essays, vol. iv. art. 2; London Me- dical Observations, vol. iv. art. 11; Willan on Cutaneous Diseases, part i. order 111. MORBILLOSA, belonging to the measles. MOR'BUS, (from fMpos, death). A disease; ma- lum, nosos. A disease we have already defined to be " that condition of the human body in which the actions of life and health are not performed, or performed im- perfectly." (See Causae.) The various imperfections in the functions therefore constitute it, a circumstance Avhich the accurate distinction of diseases, according to nosologists, renders indispensable. Diseases may therefore be as different as the functions injured, but this would render them too numerous, and it has consequently been usual in the morbi universales to combine a certain number of the injured functions to constitute one disease. In the local diseases, one injured function has been supposed alone to constitute a genus. Diseases, however, differ, either as many per- sons are usually affected at the same time, and they are then styled epidemic ; or, as peculiar to one country, and called endemic: when they occur accidentally, they are styled sporadic They differ also as the mind or body is affected ; as any particular organ suffers ; or from the cause Avhich has produced them: but such varieties are now disregarded; and those who pursue distinctions for the sake of diagnosis, at this time, arrange diseases from their symptoms. See Nosologia. White Ave omit many useless disquisitions respecting disease in its abstract, we have referred to this article for the more general pathological inquiries, and shall proceed to consider the morbi fluidorum ; solidi simplicis; solidi vitalis; and morbi solidorum con- tinentium, in their order. Morbi fluidorum. We begin with diseases of the fluids, as in this form our nutriment is taken in, and, if these are defective, the whole system Avill suffer; thpugh we shall soon endeavour to establish this axiom, that the state of the fluids, in the body, depends on that of the solids, particularly the vital solid. Wc have already had occasion to observe, that every devia- tion from the sound state is not disease, but that there are different degrees of such deviations Avithin the limits of health, though probably each may be supposed to form a predisposition to disease. Diseased fluids are said to differ from those in the na- tural state, from a diil^iciice in their cohesion, or from any acrimony, formed either by the animal process, or introduced with the air or aliment. The cohesion of the fluids may be too great, constituting tenacity and lentor; or too little, when they are said to be in a dis- solved state. The blood, to Avhich these diseases are chiefly confined, Ave have found consisting of different parts in a state of mixture only, and the lentor can be OAving only to a diminution of the proportion of Avater, or a less proportion of neutral salts, by Avhich some of the gluten is kept in solution. It may be doubted Avhether the excess of the fibrin or gluten may not produce a similar effect, but this we shall soon consider. The causes of lentor, which result from a diminu- tion of the watery portion of the blood, are said to be a deficiency of drink, an increase of the fluid secre- tions, a stagnation and absorption of the Avatery parts separated from the crassamentum. Each of these causes, hoAvever, is imaginary, so far as regards this change, for the secretions are so nicely balanced, that an increase of one is folloAved by a diminution of the other; and when fluids are not thrown in, they are, in a great degree, checked. Thus, a nurse who has not drank any thing for a long time, is not greatly loaded Avith milk, but immediately, on drinking, it flows freely. The circulation also keeps up the union be- tween the discordant portions of which the blood con- sists; and while the secretions are supported, no stag- nation of Avatery fluid can take place. The idea of Gaubius, that a glutinous matter, arising from foods of this kind which absorb water, from a weaker digestion, a more languid circulation, or insuffi- cient exercise, is certainly imaginary; for the glutinous foods produce no such effect, and the other causes of this supposed gluten rather contribute to lessen the tenacity of the fluids. The earthy substances and their various sources, supposed to have the same effect, rest on a foundation equally insecure. The opinion has not a single fact for its support. We know indeed but one cause of lentor, high health, with a consequent in- crease in the proportion of the gluten and fibrin of the blood; but this is connected Avith increased tone, and more powerful action of the arterial system, which prevents any bad effects, but which itself constitutes predisposition to disease, under the appellation of dia- thesis phlogistica. See Inflammatio. Increased tenacity in the secreted fluids is more com- mon; but we chiefly perceive it in the bile and the mucous follicles. It never appears to arise from any de- fect in the blood, but from stagnation in consequence of debility, sometimes in consequence of a want of irri- tability in the excretory ducts. We certainly see, in the urinary organs, that the state of the fluids, from which the urine is secreted, influences the nature of this discharge, and a suspicion may arise that a similar effect may produce morbid bile, but in neither case is MOR 998 MOR the morbid fluid referrible to lentor; and the idea of earth joined with acid, so as to form a " pitchy acrimony," is neither supported by observation nor chemical experiment. Too great fluidity is in part owing to an excess of watery fluids, and such a change undoubtedly takes place; but the causes usually assigned are often imagi- nary. Too large a proportion of watery fluids is cor- rected by the increase of the watery secretions, and increased evacuations from some glands are generally compensated by the retention of other secretions. In this view an indolent life and a humid atmosphere pro- duce certainly some effect; but the principal diseases which they previously induce are general debility and impaired digestive powers: from hence proceeds the deficiency of the gluten and fibrin; and, of course, the greater tenuity of jthe serosity. A more certain cause of preternatural tenuity is acrimony. It may certainly be of various kinds, but we can only perceive with clearness the saline acrimony. Yet Ave have little doubt of this effect being produced by many other substances. In putrid diseases, Deyeux and Parmentier did not discover an increased pro- portion of ammonia; but the union of the albumen with the serum was affected, and the crassamentum (see Blood) was weak. Symptoms also of a preter- natural tenuity of the blood come on often suddenly, without any evident cause. We dare not then carry the axiom before mentioned to its utmost extent, for causes not yet within the reach of our knowledge, often pro- duce unexpected changes. A peculiar tenuity of the secreted fluids often occurs, and it may arise from tenuity of the blood, increased, and sometimes inflammatory, action of the secreting vessels. Thus the increased flow of urine arises not only from an abundant proportion of water in the blood, but from the increased action of the vessels, as in hyste- ria, and sometimes from fright. Increased discharge of bite arises chiefly from increased action, which some- times is occasioned by mental affections, as a violent fit of anger. In hot weather it appears owing to the increase of that portion of the circulating fluid, whatever it may be, which contributes to its secretion. The tenuity of the semen arises also from increased action, owing to the indulgence of lascivious thoughts, or improper indi- gencies ; of tears and saliva from the same cause, owing often to association. When the increased tenuity is ow- ing to inflammatory action, the secreted fluid is usually acrid, as the tears in measles, the mucus of the nostrils and bronchial glands in coryza and catarrh, the bile in cholera, the urine in nephritis, though in the last instance the increased discharge covers the acrimony. Morbid acrimony of the fluids has been accused as the cause of many diseases; but in the circulating system there are few marks of its existence. When separated by the powers of nature, and carried to the excretories, we perceive only its effects. Philosophy has divided acrids into mechanical and chemical. Pathology followed, and the mechanical pathologists and therapeutists spoke with much feeling of the wounds which the tender nervous fibrils sustain- ed by cruel angles of salts, or the salutary momentum with which mercury removed obstructions. Even the later disciples of the Boerhaavian school have disused this language, and speak of acrids as chemical only. Nature has, however, anxiously guarded against the admission of morbid acrimony. The taste discovers, the stomach and the bowels reject, what is highly inju- rious. What may be less so is often altered by di- gestion, and the mixture of thejluids Avhich it meets with in that process. If, however, it prevails to any considerable degree, we have reason to think that the lacteals refuse their office. When conveyed to the thoracic duct, it is slowly added to the mass, and largely diluted by the considerable proportion of the circulating fluids, and probably sheathed by the albuminous portion of the blood. But even when admitted, either by its chemical affinity or its specific stimulus, (see Secre- tion,) it is carried to its appropriate gland, and by that outlet safely, often silently, carried away. The source of morbid acrimony may be therefore air, meat, drink, condiments, medicines, or poisons; and the air may convey either miasmata or contagion. When we mention condiments, however, as a source of acrimony, we must except common salt. This seems a necessary stimulus to the process of digestion, and pro- bably accompanies, in a small proportion, the chyle, since its acid is found in the ammoniacal salts of the blood, white its alkali appears to have undergone some change by the animal process, and to have become am- monia. We find miasmata and contagion conveyed by the air, in cases of remittents and intermittents; but a more decided acrimony is evident in the causes and consequences of epidemic catarrh and dysentery; of many of the exanthemata, and of some of the phleg- masiae. In diseases of the skin there is also evidently an acrimonious substance eliminated, for the reasons assigned under that article. See Cutanei morbi. In syphilis, in hydrophobia, and many others, it is equally conspicuous. The animal process, that is, the changes which take place in the system by the exercise of the animal func- tions, produces an acrimony which is usually covered by the bland nutriment, constantly supplied till carried off by the fluids, styled, for this reason, excrementitious. If, however, these are retained, or the supply of nourish- ment withheld, an acrimonious state of the fluids follows. What this acrimony is we do not clearly per- ceive. It is partly saline, partly, perhaps, the dissipation of, or change in, the albuminous portion of the blood, and very probably some admixture of putrid fluid. When this animal process goes on more rapidly, as in fevers, these changes are more conspicuous. The most evident consequences are, all the symptoms of pu- trefaction, with gangrene, putrid evacuations, fetid breath, &c.: convulsions and spasms, attributed to this acrimony, appear to come on in consequence of the debility which every degree of putrefaction induces. The various foods which have been accused as producing acrimony in the prima vie,and afterwards in the fluids, have probably, for the reasons assigned, little influence in this respect. The acid in the stomach produced by the continued use of acids and acescents certainly injures the digestion, and produces in conse- quence debility; but there is no trace of acid in the blood, none in the secreted fluids, if we except the ureal and arthritic concretions; and of these the latter only can be very obscurely traced to acescent aliment. An alkalescent diet is uncommon. Putrid meat, or rather meat advancing to putrefaction, does not appear MOR 999 310 R injurious, if it neither excites sickness nor uneasiness in the bowels ; and though dyspeptic symptoms have been observed after a continued course of alkaline medicines in cases of calculus, no injury seems to have been felt in any other organ. The tetradynamiae have been styled alkalescent plants; and these have been blamed for in- troducing saline "acrimony, but, on the contrary, they are the best remedies for a disease in which this acri- mony very evidently exists, the sea scurvy. The scurvy is admitted to arise from salt provisions, but in these the milder animal fluids are separated and in part decomposed ; the texture of the animal fibre is also destroyed, and in reality the disease arises from a want of the supply of that bland aliment which corrects the acrimony formed by the animal process. We have evidence of the same cause producing a similar state, where unalimentary food has been for a long time taken, though without salt. It has occurred, however, only in damp, confined situations, and each cause seems to have concurred in producing debility and de- stroying irritability. It may be said that if this were true, bland mild nourishment should be its most ef- fectual cure : but nourishment of this kind is not suffi- ciently stimulant to excite the torpid fibres; and while the state of the fluids requires acids and acescents, per- haps oxygen, the stomach is best excited by the warmer vegetables. See Scorbutus. Other acrimonies have not been distinctly pointed out. Effects similar to those of scurvy were found by Dr. Stark to arise from a diet on sugar: but he had before tried so many ex- periments, that his constitution was exhausted. A saccharine acrimony, if it may be called so, is conspi- cuous in the diabetes mellitus. We have seen a sweet secretion of a similar nature in the mouth, and have reason to suspect that the discharge in lientery is of the same kind. See Lienteria. One other source of acrimony remains, viz. the aro- matics. They are much insisted on by pathologists, but Ave have found little foundation for accusing them. We have suspected their noxious influence in those diseases of the bladder which in old age are connected with a tenderness at its neck, or some affection of the prostate gland ; but it is a suspicion which rests on a slender ba- sis. Since, however, in such cases they are not necessary as medicines, they may perhaps be more safely avoided. The subtility of modern investigators has, however, added to this subject a source of humoral diseases, not suspected in the schools of the mechanical physicians, and Avhich has not yet received a public share of the pathologist's attention; we mean those changes which depend on the composition of the animal fluids. We may repeat shortly, that the carbone and the oxygen of vegetable bodies are converted by the animal process into nitrogen and hydrogen ; but they still, in a certain degree exist, and the change of the oxygen gradually going on has been supposed the cause of animal heat. It is at least certain that a large proportion of oxygen is connected with a fresh florid colour of the blood, with increased vigour and activity of the circulating system, probably with an increased firmness of the simple solid. When therefore in excess, it constitutes a morbid state: such is the extreme of vigour, which, when the balance of the circulation is destroyed, favours topical conges- tions. On the contrary, oxygen is too copiously expended in different circumstances, so that its defect is equally morbid. It is too copiously separated in the active exertions of body and mind; but the former, if in the open air, greedily attracts the necessary supply both from the atmosphere and the food for which, by exer- cise, a craving desire is excited. In low, damp situa- tions, and in a confined air, it is, not supplied. If the food is unalimentary, the expenditure will exceed the supply; if the bodily exertions are slight, and the men- tal ones considerable, the excess of expenditure will be more obvious in the symptoms. These are, languid cir- culation, a pale cadaverous look, diminished irritability, and impaired vigour. In such circumstances the oxygen does not always appear deficient in quantity, but is not evolved in the due proportion, since it probably pro- duces its effects in the period of its separation. Thus oxygenated remedies are not useful in the proportion of their quantity of oxygen, but in that of its loose adher- ence. The oxygenated muriats are by this means more beneficial than the mineral acids; and of these the ni- trous is, from the same cause, superior to the muriatic, and the latter to the vitriolic, acid. An argument we think equally decisive may be draAvn from the effects of light. This principle certainly separates oxygen from those bodies Avhich contain it; but dark apart- ments show in their inhabitants a deficiency of this principle. In fact, it is apparently present, butf too closely united to show its peculiar effects. With the excess and deficiency of oxygen are con- nected the opposite proportions of azote, or nitrogen. They seem in the human body antagonising principles; but though they form air by an union not perhaps pro- perly chemical, we cannot trace the effects of such an union, for the halitus of the insensible perspiration, if not azote, is carbonic acid gas. With hydrogen, how- ever, the oxygen forms water; and when the oxygen disappears we sometimes see, or suspect we see, watery effusions. We can scarcely ever discover the consequences of an excess of hydrogen or carbone. The singular stories of the spontaneous combustion of the Avhole body may appear to be of this kind, and to support the delusion, we are told that the victims have been persons accus- tomed to excesses of drinking spirits ; but from such casual facts no general conclusion can be drawn. We may, with equal truth, attribute the pimples of the drunkard's face to the brandy which he has swallowed, producing an halitus of hydrogen, instead of carbonic acid gas, or azote, while they probably arise only from continued and excessive stimulus. We have found in the blood traces of sulphur, though we are unable to discover its source. We see its excess or its separation in cancerous sores, and some malignant ulcers, which, we are told by Dr. Crawford, discharge an hepatised ammonia. The source of this sulphur, and its deposition, seems subjects equally intricate. Is this (according to modern chemists) the most truly ele- mentary, body, really a composition? Is azote a com- ponent part ? or what are the consequences of an union of azote and hydrogen ? " Doceat Dies '." An excess or defect in the quantity of the fluids is scarcely an object of this part of our Avork, yet to con- sider the doctrine of plethora in this place may facilitate some future enquiries. These sources of disease are the roXvxvfA-tx and oXtyoxv/*'* of pathologists, and are, on MOR 1000 M O R the whole, the distinguishing marks of youth and old age. Each, as, may be supposed, is relative to different temperaments, and even idiosyncracies; each may be apparently in excess, and each may predispose to dis- ease, though still within the limits of health. The con- sequences of the excess of either of the component parts of the blood may be easily understood from the former observations on lentor or tenuity. We noAv mean to speak only of the excess of the whole mass, which is styled plethora. This is divided into the ple- thora ad molem; plethora ad spatium; plethora ad vo- lumen, and plethora ad vires; nor is the distinction frivolous : it Avere better that it had been more attended to by modern authors. The plethora ad mole7n, ad vasa, or ad venas, for they are synonymous in ancient authors, is the exuberance of the absolute quantity of blood, and, in more delicate habits, is seen by the fulness and redness of the minute vessels. In scrophulous habits, however, this redness does not ahvays denote plethora ; nor do they easily bear large evacuations, much less astringents, which arc often ignorantly prescribed on account of a fancied weakness. In more robust habits this kind of plethora is chiefly discovered by a full, oppressed, or rather a laboured pulse, and sometimes by a fulness of the veins. In general it occurs in strong robust constitutions, where the digestive poAvers are vigorous, and the Avaste from exercise disproportioned to the supply. The plethora ad spatium is produced Avhenthe quan- tity of circulating fluids remaining the same, the capa- city of the vessels is contracted. This happens in cold Aveather, and in the cold fits of fevers, when in Aveak . habits haemorrhages are not uncommon. It happens also more frequently than is suspected, by the rash im- prudent use of astringents, particularly in full mobile habits, in persons of a languid circulation, or in cases of haemoptoe. Plethora ad volumen usually implies an increased bulk of the blood from external heat, from violent in- flammatory fevers, from friction, from violent passions, spirituous liquors, &c. The blood, hoAvever, is not capable of any very considerable expansion, and these appearances of plethora arise from relaxation in conse- quence of external warmth, or a determination to the surface, from a more accelerated circulation. The plethora ad vires, though it exist, is still less an object of our present consideration, as it means only a greater quantity of blood than the strength will bear. This, of course, must be relative to the constitution of the patient; but we may add, that it is a more frequent source of disease than is suspected, and peculiarly diffi- cult to relieve, as Ave have often had occasion to remark, since the slightest diminution of the circulating fluids produces faintness. It will be obvious that these different plethoras are not inconsistent with each other, and that all may be occasionally combined. The disease such an union may produce will be of course more dangerous, and sudden death has often been the consequence. The deficiency of blood the oXiyoyjv^x, is supposed to arise from copious evacuations, or from famine. Faint- ness, however, arises in the former instance before a considerable portion can be lost, and in the latter the contraction of the vessels accommodates them to the quantity. In the infant, however, who dies from not tying the umbilical cord, Ave have remarked (see Me- dicina forensis) that the vessels are unusually empty, and Lieutaud, as well as Morgagni, has recorded in- stances of the vessels being peculiarly empty, though without connecting this appearance with the previous symptoms ; an omission too common in each. It is sufficient therefore to point out the existence of such a state, since from want of such information Ave cannot enlarge on its source or its consequences. Morbi solidi simplicis. This subject fills a large space in the foreign systems of pathology, and were it not from respect to the talents of men like Boerhaave, Gaubius, De Haen, and LudAvig, we should pass it over very slightly. It will not, hoAV- ever, detain us long, though Ave shall add in part to their vieAvs. The diseases Avhich can affect the simple solid are those Avhich relate to its cohesion or its chemical na- ture. The state of cohesion, the only objects of the Boerhaavian school, must be relative in different on gans, in different ages, sexes, temperaments, and con- stitutions. In general, the cohesion of the various or- gans must be in the natural proportion of each. If too slight to bear the requisite motions, it constitutes dis- ease ; or indeed if it require very peculiar caution to avoid injury from such motions, it is equally a disease, though in a less degree. Weakness, or diminished cohesion, in a solid when not ruptured, is divided into, 1st, the lax and flaccid in soft parts Avhich admit of distention by a moderate force; 2dly, the inert, or inelastic, in parts naturally elastic; 3dly, the flexible, as in bones which admit of being bent, after being previously softened. When rupture has taken place in the tender fibres of soft parts, it is styled tenerum gracile: when accompa- nied with general softness, as from putrefaction, tabi- dum. It is called fissile when parts, naturally soft, are dry and chapped ; and fragile when hard parts are bro- ken in consequence of their weakness. Rigidity, an opposite disease, consists in increased cohesion, and is styled tenax when in soft parts, as the muscles of old animals ; durum, when in the harder parts, as cartilages proceeding to ossification ; and fra- gile vitreum Avhen in the bones. In all these cases the vital solid is often the chief and the principal cause. The Avant of elasticity arises from water being poured into the cellular membrane instead of the usual halitus; the flaccidity and flexibility from previous debility. It is extremely doubtful whether the tender fibres of soft parts can be even broken, indepen- dent of previous disease, except in consequence of ex- treme violence, which is not our object; and the fra- gile vitreum attributed to cold has certainly no founda- tion, for the heat in the internal parts is uniform, and cold could not produce the effect without the previous destruction of life from its sedative power. If softness exist independent of these previous diseases, it must be attributed to the larger proportion of water, or a change in the chemical combination. A similar chemical change must take place in cases of rigidity, but Avith a diminished proportion of Avater. We shall therefore consider softness and rigidity as diseases independent of the distinctions just noticed. When softness becomes a disease, the increased pro- portion of water, as we have said, arises often from MOR 1001 M O R debility a disease of the vital solid. With respect to the chemical change, the chief substance which attracts our attention in the* composition of the soft parts is the Gelatin, q. v. We must add, however, to the re- marks contained in this article, some later discoveries. The gelatine then differs from vegetable jellies, in con- sequence of the union with lymph, an animalized fluid, containing or consisting of nitrogen. This lymph is more copious in advanced life, and in the same propor- tion the animal gelatine is less soluble in water. In the earlier periods of existence this gelatine admits of the union with Avater, but not of the later; so that softness is the disease of the young, and rigidity of the old. But we find, from Parmentier and Deyeux, that diseases chiefly affect the gelatinous parts of the blood; so that this gelatine, in early life, from its affinity with water, and in the later period if not supplied in due proportion, or with the requisite qualities, produces the diseases of the simple solid referrible to diminished cohesion. In each view, therefore, these diseases arise from an excess of water, or rather from debility ; and from opposite states, rigidity, the disease of old* age, must be un- derstood. In the latter state, also, many of the smaller vessels are obliterated; the coats of the larger, which remain, are more dense, and less irritable; the ex- halations feAver : changes which contribute to increased rigidity. The fleshy parts of animals experience the progressive changes chiefly from the gradual addition of lymph in a large proportion, of which the fibres seem to consist, as they are not very soluble in water, and appear to yield ni- trogen copiously ; for though Thouvenel obtained what he styled extractive matter from flesh, muscles probably differ from harder parts chiefly in consequence of their containing the blood. This animalized lymph is appa- rently that portion of the blood which separates in the fibrin. The cartilages are chiefly gelatinous. Bones are only subject to softness and friability, which must in this case be distinguished from fragility, as it chiefly arises from an absorption of the bony mat- ter. Bones are originally gelatinous; and in this jelly a calcareous phosphat gradually crystallizes in different forms, accordingto the shape of the bone. (See Bones). The gelatinous part assumes the form of membranes by the pressure of the bony fibres, and may be seen when the earthy salt is separated by solution in acids. The bones of the fcetus are naturally soft and flexible. They continue so in a certain degree till their shape is gradu- ally formed by the action of the muscles. The degree of softness unsuitable to the age is what constitutes dis- ease. It arises from weakness, as in rickets, and from diseased fluids, as in scurvy, and occasionally in syphilis; and immediately depends, in a great measure, on a de- fective supply of the earthy salt. In rickets, debility of the digestive organs precedes the softness of the bones, and in scurvy the whole system is weakened. In syphilis the bones are perhaps eroded, and become friable rather than softened. They are, however, some- times softened in cases of general debility, without any peculiar affection of the digestive organs, frequently frOm a sedentary life, and from confinement by a long chronic disease. This softness, which generally pro- duces deformity, and in one instance rendered the pelvis so deformed as to require embryulcia, or the Caesarian section in a woman who had before born vol. I. children of the usual size, does not produce the peculiar appearance of rickets, because it happens when the shape of the bones has been more perfectly established, as we shall see in that article. Since, however, our attention has been more particu- larly turned to the changes in the lymph, we may be allowed to doubt whether the softness of young bones, or the friability of old ones, is wholly owing to the change in the bony matter. Each may be affecjedby a change in the state of the lymph, as already explained, and in part to the greater or less extent of the vascular system: to these views we may return under Ra- chitis, q.~v. Morbi solidi vivi. The solidum vivum, in the language of Gaubius, is the living portion of our bo- dies, or, in other words, the nervous system, in which we include, with Dr. Cullen, the brain, the spinal mar- row, and the nerves either as sentient or moving organs. The distinction of every part of the neiwous system is excitement by stimuli, not acrids only, but every thing generally understood as necessary to life, as food, drink, air, heat, and even volition. As the func- tions of the nervous system are those of sense and motion, their exercise may be affected by the state of either organ, the state of the brain, or of the nerves in their progress. The diseases of* sensation are in part influenced by the state of the media through which they are conveyed, as those of the skin, the humours of the eye, Sec. These will, therefore, give the appearance of different degrees of sensibility, without any disease of the nerves. Different parts of the body differ also in sensibility. The experiments of Haller place the heart in the first rank, and, in succession, the stomach, the intestines, the diaphragm, and the muscles. These have, however, been disputed; but the controversy need hot detain us. In the sound state he is not probably in error; but, when inflamed, membranes, and particularly nervous expan- sions, are by far more sensible than the heart or the muscles. Sensibility also differs in various ages, sexes, temperaments, and idiosyncracies ; in pregnancy and child bed, as well as from habit. The state of mind has also a considerable effect on the sensibility; and sym- pathy, as well as association, often greatly increases it.. Dr. Cullen has supposed that the state of the nervous fibril, or the fluid in the nerves, greatly influences the sensibility, and the opinion gains force from the peculiar irritable state of some constitutions, chiefly known by the name of hysterical habits, where the sensibility is considerable. The state of the fibre, as affected by the blood vessels, interspersed, has a similar effect. We have just mentioned the increased sensibility from inflammation, and the professor supposes that the fulness of these vessels gives a greater tension, with which he connects, with great probability, increased sensibility. Heat increases sensibility, and cold diminishes it. The sensibility is also less in torpid constitutions, in weak states where the circulation is not carried on to the extremities, from the application of narcotics from habit, and the attention strongly directed to some in- teresting object. Will not a fixed resolution have a similar effect ? ' Depravity of sense is also an affection of the vital solid, and consists in either a false estimate of the 6M MOR 1002 MO R force of external impressions, or in referring to the ex- ternal what is owing to the internal ones. This is, however, as Ave have had occasion to observe, a disease of the brain itself, and OAving to an inequality of excite- ment", or some impediment to the free communication betAveen its different parts. See Mania. The diseases of the moving organs are nearly the same in principle, though not in name. These are irritability and torpor, corresponding in their causes, perhaps their nature, to increased and diminished sensi- bility, and generally connected with the same constitu- tions. The former is the distinguishing mark of the sanguine, the latter of the melancholic, temperament. There is, however, another state consistent with the highest health, which consequently may become disease, and is always a predisposition to disease, viz. the vigour of the muscular fibres, the attendant of the diathesis phlogistica, and in which it indeed consists. But to be more particular. Irritability is generally connected with the more de- licate texture of the solid parts, an increased elasticity of the fibres, peculiar quickness of the senses, a more fluid bfood, a tender constitution, a more rapid action of the heart and arteries: it is consequently often here- ditary, more frequent in females, in warm climates, those Avho live luxuriously without exercise, an attendant on inflammatory fevers, and considerable evacuations, the pregnant and puerperal state. The effects of this increased irritability are spasms, convulsions, irregular secretions, and unequal temper, faintings, excessive menstruation, abortions, &c. The torpor of the living solid is marked by a firmer, 4-uder texture of the simple solid, sometimes by inflexi- bility, as in the melancholic, occasionally by a want of elasticity, as in the phlegmatic temperament; by a sloAver action of the arterial system, by yielding less readily to stimuli, and by a dulness of the intellectual functions. It is the constitution of the inhabitants of higher latitudes, and has been sufficiently considered tinder the article of Cold, q. v. The effects of this torpor are a diminution of the excretions, with accumu- lations in the liver and the head, which induce many chronic diseases. The diseases arising from the state of the brain chiefly depend on its mobility or torpor, as a portion of the nervous system ; but more particularly on the free communication between its different parts. The dis- eases depending on the state of the nerves in their pro- gress depend also on their degree of excitement, or the communication through them being more or less free. We had intended in this place to have engaged at some length in the inquiry started in the article As- tringentia, how far the state of the vital depended on that of the simple solid. We could, however, add little, except to repeat the facts recorded in the pathology of the vital solid; and these seem strongly to support the opinion, that firm cohesion and vigour, a more tender texture and mobility, the first Avith diminished, the second Avith increased, sensibility, are at least very closely connected. Are they ever separated, or do they depend on the same state of Ahe solid ?. Future inqui- ries may enable us to decide. Morbi solidorum continentium. The contain- ing solids, or the parietes of cavities, are muscular or membranous; and their size may be, in different Avays, increased. When' merely dilated beyond what their elasticity or their muscular power can restore, it is styled dilatatio; when cavities, as arteries or excretory ducts, are so enlarged as to suffer the contents to pass out, anastomosis; Avhen the fibres of cavities are separated so as to suffer fluids to escape through them, diapedesis; when ruptured, diaresis; if ruptured by distention, pvfys, if by erosion, foxfyZsts. The effects of these changes will be sufficiently obvious ; and, indeed, Ave should not have introduced the subject but to explain the terms. The diseases from contraction are obstructio, when from anastomosis a denser fluid than the vessel is des- tined to carry passes into it, when its contents are in- spissated, or when a solid substance impacts it,' obsti- patio, when the thickened parietes, or any tumour, ob- structs the vessels; compressio, Avhen cavities are dimi- nished or obliterated by pressure ; collapsus, when the sides fall in from diminished contents; contractio, Avhen diminished from great elasticity or spasm; and coalitus, when the sides unite, and are conglutinated. The morbi solidorum intrumentarii are the local dis- eases of nosologists, and not a part of this subject. Haller and De Haen Commentarii in Boerhaavii In- stitutiones; Ludwig and Gaubii Institutiones Pathologiae Medicinalis. Mo'rbus atto'nitus, ca'ducus, commiti'alis, her- cu'leus, infantilis, pueri'lis, interlu'nius, ma'gnus, sa'cer. See Epile'psia. M«o'rbus coxarius. This is properly the arthro- pyosis, but various circumstances prevented our enlarg- ing sufficiently on it at that time, and Ave prefer insert- ing our account of it under this title, as the disease is better discriminated by it from psoas abscess, and from sciatica. De Haen, who first considered it distinctly, also employs this term. It generally comes on almost imperceptibly. The first sensation is a dull pain, often attributed to fatigue, to a strain, or, in more advanced life, to gout. When the pain becomes so violent as to attract attention, it is described as deeply seated, but on strong pressure it is greatly increased; the glutaei and the vastus internus are flabby; and the glutaeus, losing its elasticity, obli- terates the line which apparently divided it from the biceps and semitendinosus. The thigh itself is less, though the nates on the side affected are sometimes extended in breadth. In many cases the tubercle of the ischium is lower, and the leg, on the side affected, longer. In general, on walking, the toe drags a little on the ground; and the limb is raised, or extended sideways, Avith difficulty, though moved circularly with some ease. The pain is not considerable, except in the advanced states of the disease, but it is not confined to the joint. It sometimes extends to the knee, and is felt there vtith so much violence, as to lead to a suspicion that this joint is the seat of the disease. From the knee it extends to the ankle, but is felt there less acutely. The pain is sometimes on the upper part of the pectinaeus, near the place where psoas abscess first appears, and then it descends on the inside of the thigh, nearly' in the direction of the adductores of the triceps and vastus externus, almost in a straight line from the knee to the ankle. For some time the general health remains uninter- MOR 1003 MOR rupted; but, when the disease advances so as to be acutely sensible to the touch, with an acute or throb- bing pain, and a redness of the skin, hectic exacerba- tions come on ; the'patient starts in his sleep ; theface is of a leaden paleness, except when flushed with hectic heat; the skin is clammy; the body wastes, and the strength gradually sinks. The shortening of the limbs has been esteemed a mark of suppuration coming on ; but this is not correct. The limb is sometimes shorter from the beginning, as well as in the advanced stages; nor is any certain con- sequence to be draAvn from this circumstance, unless it suddenly becomes so, when it may give some suspicion of matter having formed. On dissection, the head, sometimes the neck of the thigh bone, is carious ; nor is the change confined to this bone, for the acetabulum equally suffers, and the matter has been found to escape through it into the cavity of the pelvis. Matter in proportional quan- tities is occasionally found in the cotyloid cavity. In this disease there is evidently relaxation of the ligament, with a slight inflammation. It probably begins Avith inflammation of the head of the bone, like that which occurs in the vertebrae, in cases of distorted spine, and gradually presses it downward, upward, or to either side, according to the portion of the head affected; and this will account for all the variety of lengthening or shortening of the limb; for the difficulty of moving the legs sideways and outwards, or, for what sometimes happens, of keeping them to- gether. It is often confounded with rheumatism, and with psoas abscess; but from each may be distinguished by the elongation or the abbreviation of the limb, by the in- creased breadth of the nates, and the laxity of the glutaei muscles. In the earlier periods also of psoas cases, the difficulty of bending the body, or of putting either leg fonvard, will sufficiently point out the part affected, while the pain on pressure, dragging the toe, and the relaxation of the glutaei muscles, will sufficiently dis- tinguish it at a subsequent period. In rheumatism also the pain is more extended, the earlier fever more considerable, Avith often external soreness. At every period of the complaint the prognostic must be un- favourable ; but if the constitution is sound, Avithout any scrofulous taint, the disease incipient, and the patient willing to pursue the necessary plans, we some- times succeed. Even when suppuration has come on the patient may escape, but it must be by the efforts of nature alone. In such cases the abscess occasionally bursts, though this sometimes does not occur, and the matter is absorbed. In each circumstance the most absolute rest, free country air, a milk diet, keeping the bowels free, with the occasional use of the bark, are chiefly useful. If any thing is more essentially neces- sary than the others, it is absolute rest, with free coun- try air. If any thing is less so, it is medicine. A stiff- ness of the joint is, hoAvever, the inevitable conse- quence. The causes appear to be most generally cold, from damp beds, and lying in damp sheets. Blows and strains also induce it; but in children it often comes on without the knoAvn influence of either, and seems to be of a scrofulous nature, as it chiefly affects those Avhose appearance shows the seminium of that disease. The cure of the disease, in the earlier or middle stages, requires peculiar attention in the practitioner, and no little resolution in the patient. Inflammation, we have said, is the first symptom, and bleeding with leeches, a moderately low diet, occasional doses of neu- tral salts, together Avith the continued discharge of a blister, will succeed. If the season permit, sea bathing or cold pumping will complete the cure. In this state, also, a light infusion of the bark, or any other bitter, seems to have been of service. Should, after a trial of this plan, the disease continue, or seem to increase, an issue should be made just behind the great trochanter. The application of a caustic will, on the separation of the eschar, form a deep sore, which should be so large as to require, both in breadth and depth, a horse bean for its continuance. Tenderness is in this case cruelty : it should be done effectually, or Avholly omitted. If the pain and fever have not been violent, or have been mitigated by the usual remedies, sea bathing may be continued Avith this issue, as it can be easily covered by leather spread round its margin Avith sticking plaster. Some surgeons have recommended a seton; but the cord does not penetrate so deep, and cannot be so con- veniently covered to admit of sea bathing, which is a most essential remedy. Instead of leeches, cupping glasses have been re- commended; and instead of blisters, the lime poultice, made of one part of quicklime slacked in the air, Avith two parts of oatmeal, made into a poultice with hogs' lard. These are less effectual remedies, though sometimes useful in irritable habits, where the terror excited by the more acute remedies might be injurious. They should be trusted, hoAvever, only in the slightest cases. Opiates, particularly in the form of Dover's powder, may, at any period of the disease, be alloAved Avith safety; and often when the pain is violent Avith advantage. Though we have chiefly trusted sea bathing and cold pumping, yet the annals of the Bath hospital speak with confidence of the utility of warm pumping; and Dr. Falconer has lately given a very satisfactory vieAvof its utility. The Bath AA-aters can only be admitted when fever has not come on, or when it has been checked by the appropriate remedies. If the patient be tolerably strong, and the symptoms moderate, the bath of 105° is used tAvo or three times a week, and the patient con- tinues in it from fifteen to twenty-five minutes. After bathing a few times, on the intermediate days, the part is pumped on for about five minutes, when the patient receives 500 strokes. From this remedy the stiffness and pain are relieved, the soreness and SAvelling di- minish, the strength and plumpness of the limb gra- dually return, and the leg, Avhatever was the change, resumes its natural length and direction. A similar application of hot Avater has been attempted at a distance from Bath ; but Avhether it arises from the heat employed being too low, or that the Bath wa- ters derive, in part, their virtues from the mineral im- pregnation, is uncertain ; the effects, however, have not answered the expectations of the practitioner. The warm sea water bath promises to be very useful, and o this a pump may be readily adapted. If the suppuration proceeds, notwithstanding everv 6 M 2 MOR 1004 31 O R effort, we have already remarked that nature must effect a cure, if the patient ever attains it; and the plan has been sufficiently detailed. Hippocrates de Morbus Internis, cap. 54—'58 ; Caelius Aurelianus de Morbis Chronicis, lib. v. cap. 1 ; De Haen de Morbo Coxario; Falconer's Memoirs of the Medical Society ofLondon, vol. vi. Mo'rbus Ga'llicus I'ndicus. See Lues venerea. Mo'rbus Hunga'ricus. See Amphemerina Hun- GARICA. Mo'rbus strangula'torius, trucule'ntus Infan- tum. See Suffocatio stridia. Mo'rbus ni'ger. The black disease, melana of Sauvages, melaina nosos of Hippocrates, of Avhich he describes two kinds. In the first the patient vomits black bile, sometimes bloody and sour ; a thin saliva, or green bile. The acrimony of the fluid occasionally inflames the mouth, and its acidity affects the teeth in the usual Avay. Vomiting relieves, but flatulence af- fects the patient when empty, and a great load is felt after eating. A slow fever, head ach, dim sight, heaviness in the tegs, and blackness in the skin, are common symptoms. Frequent cathartics, with whey, milk, and other diluent drinks, are only necessary. The second kind consists of a discharge of concrete blood of a blackish red colour, mixed with a large quantity of insipid, acid, or viscid phlegm, thrown up by vomit. This evacuation is generally preceded by a pungent tensive pain in both hypochondria, and the appearance of the disease is attended with anxiety, a compressive pain in the praecordia, and fainting, which last is more frequent, and more violent, when the blood evacuated is fetid and corrupt. In modern authors, every dark coloured discharge has this appellation, and little care is taken to distinguish its source. A black discharge may be either bile or blood. Each is distinguished by the colour when diluted, for bite is of a dark yelloAV, and blood is red. But in worn-out constitutions the bite will not always assume on dilution the yellow hue ; and in this case the black matter consists of dark flakes, or sometimes a dark pitchy matter is discharged. The latter appearance is not indeed a diagnostic mark, for it is the colour of the meconium in young children, and is the substance often discharged after long continued constipation. When these distinctions are kept in view, the practice is easy. The discharge of blood is either an active or a passive haemorrhage, generally passive, and in neither case highly dangerous. Indeed Ave have seen very considerable discharges of blood by stool, from strains in the young and active, yield to nitre, to opiates with occasional mild laxatives. The passive haemorrhages require astringents, with the vitriolic acid. The blood in these cases flows from different arteries, and its source requires no variation of practice. When the bile is dark, a previous suppression has usually occurred; and the discharge, which is essentially necessary, must be regulated by the strength of the patient. The pitch-like bile, or perhaps the grumous blood, requires also to be evacuated ; and the best me- dicine for each purpose, if the strength of the patient will admit, is calomel. This medicine, were we to re- vive the term, we should style the true cholagogue. But the pitchy and the flaky bile, in worn-out constitu- tions, must be gradually discharged, and the strength supported by Avine, by nourishing diet, by aromatics, and by any thing but astringents. Pains are uncommon; and if they occur, must be obviated by fomentations, and by opiates. They are truly spasmodic, for inflammatory pains only attend in- flammation of the membranes of the liver. The discharge from piles sometimes resembles the melaena ; but the pain, at the lower part of the rectum, the fulness and tension, sufficiently distinguish them. See Hippocrates, lib. ii. De Morbis, sect. v.; Hoff- man, Rationalis Medicina Systema; Edinburgh Medi- cal Commentaries, vol. iv.; London Medical Journal, vol. i. p. 10. MORDE'HI. A disease to which the East Indians are subject. It is a fever seemingly from bile in the stomach. See F. Hoffman, De Morb. Epidemicis. MORDE'XYN. A disorder very common at Goa, Avhich seizes the patient suddenly, attended with a con- tinual nausea and vomiting, and often proves fatal. F. Hoffman, De Morbis Epidemicis. MORHU'A. See Asellus major. MORI'LLE. See Amanita. MORI'NA. A plant, named in honour of Dr. Morin of Paris. Morina persica Lin. Sp. PI. 39, said to be cordial and perspirative. MORI'NGA. Guillandina nioringa Lin. Sp. PI. 546. A large tree in Malabar and Ceylon, whose fruit is a foot long, angular, as thick as a carrot, and delicious to the taste. The leaves, root, bark, and fruit, are said to be antispasmodic and sudorific. See Raii Historia. MO'RO (from morus, a mulberry). An abscess in the flesh, resembling a mulberry. MOROCTHUS. See Omorocthus. MORO'SIS, (from fA.apos, foolish). Stupidity, idiotism. This may be styled a mental disease, sometimes owing to a more slow expansion of the men- tal faculties, which often, however, attain their powers suddenly, and in perfection, as suppressed irritability is followed by excess of excitement. When the mental powers are developed slowly, we often find a defective conformation of the cranium, and particularly an elon- gation of the upper part, while the sides are unusually depressed. Pinel, who scarcely admitted any organic defect to produce mania, admits it as a cause of idiotism. When in a less degree, it is not connected with any de- fective organization which the knife can discover. Dr. Cullen considers this disease as synonymous with amentia. Sauvages makes it a species of amentia, and defines it a sloAvness or inability in the faculty of imagining or conceiving; consequently a debility in judgment without delirium. Stupidity differs from folly, as stupid or idiotic persons want both conception and memory. See Amentia. MOROSITA'TES, (from 7norosus,peevish,)are dis- eases wherein the desires and aversions are unnatural and depraved, and in which it is difficult to please or satisfy. A morose man, speaking of him in a state of disease, constantly requires what is injurious, and is averse to what would be beneficial. In Dr. Cullen's system these diseases are synonymous Avith dysorexiae, appetites erroneous and defective. In the last editions they are included under the class locales, because al- most all the species of dysorexy are affections of a M O R 1005 MOR particular part rather than of the whole body. The nostalgia alone, if it can be called a disease, cannot be esteemed a local one; but he thought he could not well separate an uncertain disease from the rest of dysorex- ies. See Nosologiae Methodicae Synopsis, vol. ii. MORPH.E'A, (fu>pi, forma externa). Morphew, scurf, a species of the leprosy seated in the skin. The brown itching morphew is named hepatizon. MORPIO'NES. Crab lice, so called from their resembling crabs : pediculi pubis Lin. plactula, petola, pessolata. They are flattish, more round than the common lice, with a shorter thorax, and the four hinder feet, very strong, perforate the cuticle, and stick so close that they can be Avith difficulty dislodged. They do not only affect the pubes, but the axillae, eye brows, and eye lids, and are often found on the breast, abdo- men, thighs, and legs, in persons who have those parts covered with strong hair; but they seldom fix upon the hairy scalp. They occasion considerable itching, which may be cured by destroying them with black soap, or a solution of sublimate in rose water, in the proportion of 3 ss. to ffo i. of the water: strong mercurial ointment is an effectual remedy. See Pediculus. MORS. See Death. MORSE'LLUS, or MORSU'LUS, (a dim. of mor- sus, a bite). See Trochisci. MORSU'RA, (from mordeo, to bite,) a bite, gene- rally applied to the bite of a mad dog, a viper, or any venomous animal. MO'RSUS, (from the same). A bite, or pain re- sembling that from a, bite of an insect. Mo'rsus diabo'li. See TubjE fallopianje, or De- vil's bit, and Sucisa. Mo'rsus galli'n^;. See Alsine. Mo'rsus ra'n.ie. See Microleuconymphjea. MORT DE CHIEN. A spasmodic disease of pe- culiar violence and obstinacy, not generally understood. The name is assigned by the seamen, who probably consider this disgraceful termination of their lives as the death of a dog. The disease is mentioned by Bontius, and by Mr. Girdlestone; but considered more distinctly and accurately by Mr. Curtis in his account of the Coast Diseases of the East Indies. It is a violent spasm affect- ing not only the extremities, but the bowels, drawing the intestines into a hard knot, attended with great cold- ness and debility, and Avithin a very short period fatal. It has been attributed to acrimonious bile; but previous evacuations do not prevent it, nor emetics, with purga- tives, relieve it. External warmth, with the most active stimulants, and opium, in very large doses, appear to have been the most useful remedies. See Curtis's Ac- count of the Coast Diseases of the East Indies. . MO'RTA. Synonymous with pemphigus. MORTARIO'LUM, (dim. of mortarium, a mortar). In chemistry, a mould on which cupels are formed ; in anatomy, the sockets of the teeth. See Alveoli. MORTIFICA'TIO, (from mors, death, and fio, to produce). A mortification. Sphacelus, ignis frigi- dus. Hippocrates uses sphacelus in different senses, sometimes confining it to a corruption of the bone, which, in the language of Celsus, is called vitiari; but these words are used in general to express the corrup- tion of the flesh as Avell as bones. A mortification of the soft parts only Hippocrates styles sapron, mydosen, and sepomenon. The word sphacelus was used by the ancients to express violent pains and inflammations ter- minating in mortification, as well as the withering of any part. Galen confines the term sphacelus to an incipient gangrene. Boerhaave considers gangrene as a beginning morti- fication. Mr. Pott calls it gangrene in the cellular membrane and the skin, but when attacking the mus- cles, sphacelus. A mortification in the bone is called a caries. Dr. Cullen considers the mortification not as a genus of disease, but as a termination of inflamma- tion ; and he divides it into gangraena and sphacelus. In the first, after an inflammation, the part becomes livid, soft, has little sensibility, and is often covered with ichorous vesicles; in the second after a gangrene, the part becomes black, flaccid, easily lacerating, Avith- out sensation or heat, and attended with the foetor of putrid flesh; the malady quickly spreading: the latter is, therefore, an higher degree of the former. A mortification is, the death and consequent putre- faction of one part of the body Avhile the rest is alive. Celsus describes its progress in the following terms. The flesh is black or livid, dry or parched, and the external skin generally full of blackish pustules: then that which is next to it is pale or livid, almost aerugi- nous, and without sensation. It is still worse in an inflammation, since all the symptoms spread at once, the ulcer into the pustulous place, the pustules into that which is pale and livid, the pale or livid into that which is inflamed, and that Avhich is inflamed into that which is sound. It is singular that this subject has so long remained in a state of so much confusion, not only Avith respect to its nomenclature, but to its causes and treatment. We have found in no author a connected and sys- tematic view of the subject; and Ave must, therefore, on this, as on several other occasions, endeavour to unite the scattered limbs and supply the deficient links. In this enquiry -Ave shall employ the term mortification as a generic one. The simple idea of mortification is, as we have al- ready said, the death of a portion of the body while the rest continues alive, often in a sound state. This par- tial death may arise from general or local causes. The general causes are fever, or great debility; each occa- sionally attended Avith a dissolved state of the fluids. Fevers attended with mortification are the violent in- flammatory ones, with local inflammation, or the jail and hospital fevers. Diseases of debility are those of old age, anasarca, scurvy, bruises, and causes which check the circulation of the blood, or impede the nervous influence. In these cases, the life of the part is destroy- ed by the violent excitement, or the tone of the consti- tution gradually diminished, by advancing age, a seden- tary life, or -an unalimentary diet. In internal inflam- mations Ave cannot see the progress, but it is probably the same as in the external parts. In the latter the pain ceases, the purulent matter becomes acrid and sanious; air bubbles are set at liberty, collecting in small vesica- tions, under the skin, or distending the whole organ by an emphysematous SAvelling. A slight delirium conies on, Avith either dejection of spirits, or Avith a calm sere- nity of mind; but, in each case, attended Avith a pecu- liarly wild expression of countenance; though some- times with a very peculiar expression of serenity, with a blackness- under the eyes. The pulse is usually quick, MOR 1006 MOR low, and often intermitting. In the earlier stages, deep incisions are attended Avith a discharge of blood still florid; but the skin, the muscles, and the cellular membrane, soon melt down into a broAvnish offensive mass. See Inflammatio. In the jail and hospital fevers, depositions sometimes take place, resembling, at first, in appearance, critical abscesses, but rather of the nature of the anthrax or carbuncle, running rapidly into mortification; and, when these do not appear, discolorations, apparently slight will be observed on the skin, which often run deep, and the mischief is concealed till no longer Avithin the reach of art. Mortifications, from debility, are frequent in old age, and these are sometimes chiefly local. When attended Avith great pain, they are highly distressing; but they sometimes occur without being perceived. Mr. Pott first pointed out the painful kind, as the subjects of treatment different from that Avhich had been usually recommended: the other kinds are the dry, and what has been styled the white gangrene. In the dry gan- grene the parts shrivel, the fluids are observed, but no putrefactive fermentation can take place Avithout mois- ture. The part remains attached, for a time, like an extraneous one, and may be amputated above the mark, which separates the dead from the living portion; but nature at last often makes the separation, as in other gangrenes. The white gangrene, sometimes mentioned, seems rather to be a paralytic insensibility than truly gangrenous. In general, the topical gangrenes of advanced life are owing to ossifications of the arteries, and Ave suspect the pains attending those described by Mr. Pott are owing to the effort of the arteries above, endeavouring to conquer the obstruction. We have instances of similar pains in paralytic limbs, Avhen sensation is re- covering, and in anasarcous ones, when the water is removed. What adds to the probability of the cause is, that the pains occur some time previous to the darkness appearing on the skin, which is usually first observed between the toes. Water, collected for a long time, in the loAver extre- mities, presses on the nerves and arteries, destroying both sensibility and irritability. In such cases, a slight wound often becomes gangrenous, and the vesicles, raised by the Avater, and by which it is occasionally discharged, sometimes cover a deep mortification. Such consequences arenot, hoAvever, common, and when mortification, in such instances, does folloAV, it is super- ficial, and often easily removed. See Anasarca. In scorbutic habits, particularly in sailors after long voyages, in soldiers from an unhealthy encampment, or after a siege, and in prisoners after confinement, ul- cers break out chiefly in the lower extremities, which discharge a thin ichor, and sometimes terminate in mor- tification. Instances are also recorded of mortifications rapidly coming on without any evident cause. Other causes are ligatures, wounds, fractures, where the soft parts are greatly bruised or lacerated; aneu- risms, or ruptured arteries, with whatever impedes the influence of the nervous power, or the Aoav of blood from the heart. From these causes, mortification often occurs in palsied limbs, or is the effect of severe long continued coLD,q. v. Compression of the spinal marrow in cases of distorted vertebrae, or of other tumours in the course of the larger nerves, equally produce it, by first inducing palsy. The event of mortification is always doubtful; and Avhen the cause is irrecoverable debility, obstructions Avhich art cannot remove, or ossifications of the arteries, we can scarcely expect a cure. Internal mortifications are usually beyond the reach of medicine; yet we see in cases where the operation is performed for strangu- lated hernia a beginning blackness, not followed in some cases by any fatal event; and find that even a portion of intestine may be thrown off, after intususceptio, in which internal mortification must have preceded. We should not, therefore, relax in our efforts, when ap- pearances of internal mortification have come on; and, in fact, we find in enteritis the most threatening symp- toms of this kind apparently relieved. The most important symptom to guide us in cases of mortification, is the appearance of separation. When the general principle of the disease, in the constitution, is checked, a red line, sometimes considerably above the mortified part, appears. At this line the dead part drops from the living; and, when it is discovered, am- putation above that line will greatly save the strength of the patient: were the natural separation suffered to go on, amputation would be afterwards necessary, if the stump is expected to be ever useful. In cases, hoAvever, Avhere, from the violence of the bruise, morti- fication appears inevitable, amputation, previous to its coining on, will succeed, at no great distance from the wounded part, if above the place where it is bruised, or to which inflammation has extended. When mortification appears to have taken place after internal inflammation, we have said our endeavours must not be relaxed, but Ave must check all evacuations, and support the strength Avith more generous nourish- ment, give wine so far as the original disease will per- mit, occasionally bark, and more certainly opium. In external mortifications, from inflammation, it has been common immediately to give bark. But this is not ahvays necessary, and sometimes injurious. If the increased action of the vessels still continues, it must be moderated by a stimulus, a little below that which supports the inflammation; and it is in this state that the application of a solution of muriated ammonia with vinegar is peculiarly useful. At this period also, opiates will be advantageous. When the disease has proceeded farther, and the part is wholly dead, the warmer applications, soon to be mentioned, will be ne- cessary. It has been usual to direct, in such cases, inci- sions or scarifications down to the living portion of the limb. It has been practised, and opposed, without sufficient foundation. It is often useful to admit of the access of the^stiniuli to the living part, to assist the se- paration; and there is no danger from the absorption of the putrid matter, as has been supposed. Yet, on the Avhole, the advantages of this plan, in practice, do not appear to be considerable. In those mortifications which attend jail and hospital fevers, the bark, with cordials, each in the fullest doses, are absolutely necessary; nor are there any limits to the exhibition, but what arise from the situation of the patient. In such cases, all abscesses must be opened very early. We cannot wait for a proper purulent mat- ter, Avhich nature is most frequently unable to form; for the discharge is most often fetid and sanious. MO R 1007 MO S The topical mortifications are most frequent; and, in these, Mr. Pott has taught us the superior advantages of opium. In general, this medicine is indicated Avhen great pain has preceded ; and it is probable that, as ex- cess of contraction lessens the irritability of muscular fibres, so excess of excitement will impair the nervous energy. Opium, therefore, as diminishing the cause, Avill contribute to lessen the effect. Whether opium will add to the efficacy of other medicines, or will, alone, relieve diseases of this kind, has not yet been as- certained. We have reason to think it will prove a useful addition, in the greater number of cases. If opium fails in the painful gangrenes, proceeding from ossifications, we knoAV not Avhat can be substituted. Bark, wine, and other cordials will have little effect; nor will any thing succeed but amputation. Where, however, must we amputate, or where does ossification end ? and in an old, worn out, debilitated frame, is the operation advisable ? To add a few Aveeks to a decaying constitution Avill not justify Avhat Dr. Aitkin calls an Herculean experiment. The rest of the practice is empirical. Bark, wine, ardent spirits, and opium, must be given in doses equal to the emergency, and often accumulated Avith great rapidity. It might perhaps render the practice less em- pirical, if surgeons were to distinguish more accurately when stimulants and when antiseptics were necessary. , The list of stimulants is unusually long; but the order indirecta, including Avine, alcohol, &c. is of equivo- cal use, as folloAved by loss of tone, unless the applica- tion is continued. As powerful antiseptics also they have been preferred, and we should also remember, that in general, when the disease is first checked, nature exerts all her powers to continue the salutary process. We add to the antiseptic poAver of these stimulants by camphor, which may be properly combined with them, and sometimes by the Avarmer essential oils, which may perhaps be more often used Avith advantage; and the effects, of all are increased, by their being heated to a degree so high as the patient can bear. In local mor- tifications from debility, the antiseptics are often only necessary ; and of these the myrrh is frequently very useful, and in cases of a high degree of faetor, the carrot poultice, the charcoal, the effervescing poultices, particularly Avith the oak bark, and the cummin seed, are highly advantageous. In every situation of this kind, however, the constitution must be supported, by a generous diet; by Avine, frequently by bark. In many instances, the bark is inadmissible, either from fulness, asthma, or other constitutional complaints. In these circumstances, wine, probably opium, ammo- nia, Avith stimulant applications of the greatest efficacy, must be employed. We have not found that'the other bitters will supply the place of the bark; but the ca- momile floAvers have been recommended, though mo- dern practice appears to rank them among the more inert remedies. Antiseptic poultices are of different kinds. The as- tringents, of which the chief is the oak bark, are highly useful; and this, joined Avith fermenting substances, is often highly useful. The addition of charcoal is said to correct the foetor, and it may add also to the antiseptic poAver. Since, hoAvever, it Avas introduced by the re- commendation of the first Monro, the bark has been implicitly trusted. We might add a hint, that amputation has been often employed too early, and that ecchymosis has been mis- taken for mortification. Yet, as we can lay doAvn no general rules for the conduct in cases of emergency, Ave Avould not insinuate doubts which might be prejudicial to the character of the surgeon, Avithout reason or foun- dation. The tendency to mortification from scorbutic affec- tions must be obviated by fresh vegetables, and the native vegetable acids. Those from tumours of the spine or other parts, from palsies, &c. must be relieved by- remedies adapted to the original affection. Boerhaavii Aphorismi. Hildanus de Gangnena et Sphacelo. Heister's Surgery. Kirkland on Pott's Re- marks on Fractures. Pott's Works. Bell on Ulcers, edit. 3. p. 93—122. Kirkland's Medical Surgery, vol. ii. p. 291—433. London Medical Transactions, vol. iii. p. 47. Pearson's Principles of Surgery, vol. i. p. 105. White's Surgery, p. 8. MO'RTUA TE'RRA. See Caput mortuum. MO'RUM, (from morus, a mulberry). An excres- cence on the surface of the skin in many parts of the body, resembling a mulberry. When on the eyelids, the Arabians call it alchute. MO'RUS, (from the HebreAv term mora, black). The mulberry tree, morus nigra Lin. Sp. PI. 1398. Its fruit hath the common quality of all sub-acid fruits, quenching thirst by their coolness, and by exciting an excretion of mucus in the mouth; a similar effect is also produced in the stomach, Avhere they also correct putrescency, Avhich occasions an uneasy clammy sensa- tion in the fauces. A syrup is prepared from this fruit, though but little used. See Raii Historia. The bark of the root of the mulberry tree has an acrid bitter taste, is said to be a cathartic, and has been used Avith success as a vermifuge, particularly in cases of the tape Avorm, given in poAvder, in the dose of half a drachm. MO'RXl. A pestilential distemper very common in Malabar and other parts of the East Indies. MO'SA. A liniment used in Germany, made of wheat flower and milk, nearly of the consistence of thin paste. MOSCH. The roriferous vessels, Avhich Bilsius thought that he had discovered, but never demonstrated. Castellus. MOSCHATELLI'NA, adoxa moschatelina Lin. Sp. PI. 527, ranunculus nemorosus, aristolochia rotiuida, concava,denticulata; a diminutive from moschus; called so in consequence of its smell. The root is supposed to be resolvent and detergent. See Raii Historia. MO'SCHUS, (from the Arabic term mosch). Musk, amisa, is an odoriferous grumous substance, an inspis- sated secreted fluid of the moschus 7iioschifcrus of Lin- naeus, and the Tibet musk of Pennant. This animal is of the deer kind, and the drug is found in a follicle of the size of a hen's egg, on the belly of the male only. The bag is kidney shaped, pendulous, opening by two small orifices; a naked oblong one, and another smaller Avith long hairs. The best musk is brought from Tonquin in China, in thin bags,with broAvnish hairs; an inferior sort from the East Indies is in bags with Avhite hairs. Neumann thinks both equally good. The best musk is dry, with a kind of unctuosity, of a dark reddish brown colour, in small round grains, with very few hard black clots, perfectly free from any sandy M O S 1008 M O X or other visible foreign matter. CheAved and rubbed with a knife on paper, it is bright, yellowish, smooth, and free from grittiness. Laid on a red hot iron, it flames, and burns almost entirely away, leaving only an exceedingly small quantity of light greyish ashes., The taste is bitterish and subacrid, the smell highly fragrant, in small quantities, or at a distance. Rectified spirit of wine takes up the whole of the active part; but the smell is only discovered on dilution : a drop or two communicates to a quart of wine, or to water, a rich scent. The quantity of liquor which may thus be flavoured by a certain known proportion of musk is the best criterion of its goodness. With water it is mixed only by the intervention of mucilage, as in the follow- ing preparation. Mi'stura moschata, formerly Julepum e moscho. —Take of rose water, six ounces; of musk, two scru- ples; of the mucilage of gum arabic,-and of double re- fined sugar, of each one drachm ; grind the musk with sugar, then with the gum, and add the rose water by degrees. Volatile spirits enable the Avater to suspend or dissolve more of the musk; and two drachms of the volatile spirit may be added to the above mixture. Dose, two or three table spoonfuls. In distillation, however, Avater carries over all the odoriferous matter, Avhile the rectified spirit scarcely conveys any portion of it. Though the smell of musk sometimes disorders those who are peculiarly sensible and irritable, yet, when taken inwardly, it abates those symptoms which its smell produces. It is one of the principal antispasmo- dics ; but its advantages are often lost by giving it in too small doses. Dr. Wall informs us that two persons, labouring under a subsultus tendinum, extreme anxiety, and want of sleep, occasioned by the bite of a mad dog, were perfectly relieved by two doses of musk of sixteen grains each; adding that convulsive hiccoughs, attended with the worst symptoms, were removed by two doses of ten grains each. When, on account of convulsions, no medicine could be given at the mouth, musk suc- ceeded in a clyster; and those Avho were averse to per- fumes, expressed no objection to it in a bolus; but under six grains he never saw any benefit by its use. Ten grains and upward promoted usually a diaphoresis without heat- ing or giving any uneasiness : on the contrary, it abates pain, raises the spirits, and, after the sweat begins, pro- motes sleep; and in maniacal cases hath afforded a tem- porary relief. Dr. Owen, of Shrewsbury, relates a singular instance of success from yet larger doses, viz. of half a drachm every four hours, in a convulsive disor- der, after all the usual methods had failed. See London Medical Observations and Inquiries, vol. iii. Though Ave highly respect these authorities, yet our own experience does not support them in their full extent, which may probably be owing to the medicine not being genuine. In large doses it is said to procure sleep, and as certainly to occasion a profuse sweat. It has been hence considered as a sudorific, and given in the latter stages of fever, particularly where subsultus and convul- sions had come on. In gout retroceding to the stomach or head, and in delirium, it is also said to be a valuable medicine. Some practitioners consider musk as a medicine of little or no consequence ; but for what reasons it is -difficult to determine, since the experience of every day proves it certainly a diaphoretic and antispasmodic, given in such doses as are properly adapted to the con- stitution of the patient and nature of the complaint; but, on the whole, it is not a very certain or a very powerful medicine. See Lewis and Cullen's Materia Medica, and Neu- mann's Chemical Works. Mo'schus A'rabum. See Abelmoschus. Mo'schus a'rtificialis, is a medicine lately in- troduced from Germany. Four ounces of nitrous acid are added to an ounce of oil of amber, constantly stu> ring them ; and the result is a spongy mass, highly fe- tid, but resembling in smell nitrous oxide rather than musk. This preparation has been for some years known, and was introduced as a medicine for the-hoop- ing cough; but, even among the young, sanguine inno- vators is now seldom heard of. MO'SE HAZUA'NIA. See Endica. MOSQUI'TjE. A cutaneous disorder in the East Indies, sometimes produced by sweating, sometimes by the bite of an insect of this name, mosqueta. With the pimples an itching comes on, succeeded by an ulcer. When from sweating, the relaxant or diapnoic sudo- rifics are useful; and the itching is allayed by wash- ing with vinegar in which nitre is dissolved, or with which lime juice is mixed. See Bontius de Medicina Indorum. MOSY'LLON, (f*.oo-vXXov). See Cinnamomum. MO'TA. SeeCASTANA. MOTO'RES OCULO'RUM, motorii oculorum com- munes, oculares communes, and oculo musculares,are the third pair of nerves from the head, which pierce the dura mater by the sides of the sella turcica, run through the foramen Iacerum orbitale superius, to all the mus- cles of the eyes, except the obliquus superior and ab- ductor of each. They likewise supply the levator pal- pebral superioris, and send twigs to form the ciliary nerves, to the choroides and iris. Moto'res oculo'rum externi, occulares externi, ophthalmici externi, orbitarii, and oculo musculares, ex- terni, are the sixth pair of nerves that go out from the head to the abductores oculorum, running forward on the side of the cella turcica, and getting into the orbit by the foramen Iacerum orbitale superius. By the side of the sella turcica they give off what is called the be- ginning of the intercostal nerves, but they are more properly branches of the intercostal, which join these nerves. MOTO'RIL See Spasmus clonicus, and Motores oculorum. MO'TOS, lint, (fA-olos). See Carbasus. MOUL-I'LA seu Moul-elavou, the Indian lemon tree, bombax ceiba Lin. Sp. PI. 959, the fruit of which is both acid and aromatic, like the pepper. See Raii Historia. MOUNT-SION WATER, a chalybeate, Avhich seems to retain for a long time its ingredients, without decomposition. See an Essay on the Liverpool Spa Water, by T. Houlston, M. D. MO'XA, (a Japanese term,) artemisia vulgaris Lin. Sp. PI. 1188, musia-pattra, moxa, is a soft lanu- ginous substance, prepared in Japan from the young leaves of a species of mugwort, by beating them, when thoroughly dried, to separate the fine lanuginous fibres, Avhich are then formed into small cones. The M U C 1009 31 U L down on the leaves of mullein, cotton, and hemp, are not greatly inferior. In the eastern countries, Avhen the actual cautery is required, a little cone of the moxa is laid upon the part, previously moistened, and set on fire at the top: it burns down Avith a temperate gloAving heat, and pro- duces a dark coloured spot, the exulceration of Avhich is promoted by applying a little garlic. In Asia this kind of cautery is employed in preventing and curing many complaints, particularly chronic rheumatisms, gout, the morbus coxarius, and other painful affections of the joints. See Kaempfer Amoenitates Exoticae, p. 502, Sec. Abbe Grosier's History of China. MUCA'GO, (from mucus, 7nucilage). See Muci- LAGO. MUCHA'RUM. A barbarous word, signifying an infusion of roses, in warm Avater, reduced to a syrup, with sugar. MUCIFLU'XUS ACTI'VUS, and PASSI'VUS, (from mucus, and fluo, to fiow). See Gonorrhcea. MUCILA'GO, (from mucus). A mucilage; mu- cago, a viscid glutinous liquor, made by dissolving the gum, or the soluble part of gum arabic, quince seeds, ike. in water. Young plants particularly- abound in mucilage, and seem to consist of it almost wholly. In the mallows, lintseed, and some of the cryptogamiae, as the lichens, confervae, and mushrooms, it is almost uncombined: in the milky plants it is in part separated, and united with oil and water. In every instance, it seems to be formed independent of light, which is rather an ingredient of the gluten. It is occasionally united with sugar, sometimes with oil, forming Avhat are styled fat oils. It is insipid; soluble in water; insoluble in alcohol; coagulated by weak acids, and metallic solutions ; not inflammable, but almost Avholly exhaling in carbonic acid gas ; changeable by the nitric acid into the oxalic, and by the muriatic into the citric acid. When diluted with water it becomes acid, and, in distillation, gives over the pyromucus acid. The fluid, separated from the glands about the joints to facilitate their motion, is styled mucilage. See Sy- novia. MUCILAGINO'SA LIGAME'NTA. See Capsu- LARIA LIGAMENTA. Mucilagino'sa extracta, are Avhat the French chemists have styled extractive matter. They are the mucilage of the plant, united with its proper juices, scarcely changed by heat. MUCOCA'RNEUS, (from 7nucus, and caro, flesh,) myxo sarcoma, an epithet for a tumour, or abscess, partly fleshy, arid partly mucous. Severinus. MUCO'S^E GLA'NDULA. See Cowperi glan- dule ; sometimes the name of the conglobatae, to dis- tinguish them from the glandulae conglomeratae, called VASCULOS-iE.' MUCO'SUM LIGAME'NTUM, a ligamentous cartilage, and full of mucus,s ituated betwixt each verte- bra, admitting thein to recede from, or approach nearer to, each other. To their elasticity it is owing, that at night a man is somewhat shorter than in a morning. MU'CRON ATI, (from macro, a sharp point). Leaves or fruits of plants terminating in a point, termed mucro- nated. Mucro is also the sharp point of the heart. VOL. I. MUCRONA'TUM OS.' See Ensiformis car- tilago. MUCU'NA GUA'CU, dolichos urens Lin. Sp. PI. 1020. The largest and most beautiful kind of phaseo- lus in Brasil; groAving also in Malabar. The beans are poisonous, but easily rendered fit for food. See Raii Historia. MU'CUS, (from the Arabic muk,) myxa; myxara; myxas; the viscid fluid which covers the surfaces of all the membranes, exposed to any extraneous matter, as the skin, internal membrane of the mouth, nose, lungs, oesophagus, stomach, intestines, urinary passages, Sec. It is thin at its first secretion, but more viscid apparent- ly from its union with oxygen, colourless, insipid, in- odorous, and incapable of stimulating; but if its secre- tion is suddenly increased, it becomes a Avatery acrimo- nious fluid of a whitish or a greenish yelloAV colour, sometimes acquiring a smell, and occasionally the ap- pearance of pus. In its natural state it contains some common salt and phosphat of soda, inviscated in albu- men. From Dr. C. Darwin's Experiments, Avhich Dr. Darwin himself has since claimed, it appears that, if any suspected matter be in separate equal portions, dis- solved in vitriolic acid and caustic alkaline lixivium, water will precipitate any pus which exists. Pure pus will not dissolve in a dilute alkaline solution. But an experienced eye requires no such assistance. MU'FFLE, in chemistry, a little oven, in which tests or cupels are placed to defend the metals in assaying from the contact of the fuel. MU'GILIS, (d muco, from its viscidity). Mullet. Mullus Lin. Syst. Nat. the cephalus of Aristotle and the Greeks, the cestreus of Oppian and others. It is sufficiently soluble, and nutritious. The Romans va- lued a fish of this name highly for its exquisite relish, which was probably the sur-mullet of the Avestern coasts of the channel, an exquisite dainty, which will not, however, bear carriage. See Dieta. MU'LiE. Pustules contracted either by heat or cold. MULE, any production between individuals of dif- ferent species; sometimes styled hybrid animals, or plants. The species must be nearly related, or genera- tion Avill not take place, and mules of either kind are generally barren. MU'LSUM, (from mulceo, to refresh). Hydromeli, honey and water. Acratomeli signifies wine sweet- ened with honey. MULTICAPSULA'RES PLA'NTiE, (from multus and capsula,) such plants as have several pods of seeds ' succeeding each floAver. MULTI'FIDUS SPI'NjE, Mu'sculus, (from mul- tus and findo, to cleave,) lies under the spinalis ; rises from the roots of the transverse processes, and runs to those of the spinal processes: it is commonly called transversalis, distinguished into the transversalis colli, dorsi, and lumborum. The last is also called sacer ; q.v. MULTIFORME OS, (from multus arid forma). See Cuboides os. MULTISI'LIQUE, PLA'NTjE, (from multus and filiqua,) plants which have after each fiower many dis- tinct, long, slender, often crooked seed pods. It is the name of the twenty-third order in the Fragments, and 6 N MUN 1010 MUS of the twenty-sixth in the ordines naturales at the end of the genera plantarum. MUM. A bitter infusion in beer, to which the in- gredients are added, generally while t,he beer is fer- menting, though it is sometimes made extemporane- ously by adding a bitter tincture. It is a German liquor, introduced to us from BrunsAvick, and is there said to be made in the following manner: Sixty-three gallons of water are boiled to forty- two, and with this seven bushels of malt, a bushel of oatmeal, and as much of ground beans, are brewed in the usual manner. When the fermentation begins, three pounds of the inner rind of the fir, one pound of the tops of fir and beech, three handfuls of carduus be- nedictus, two of the flowers of rosa solis, a handful and half of burnet, betony, marjorum, avens, pennyroyal, and wild thyme, two handfuls of elder flowers, thirty ounces of cardamoms, and an ounce of bruised barber- ries, are added. The herbs and seeds, however, are put in the hogshead after the fermentation has con- tinued a little time. When stopped, ten .new laid eggs unbroken are added, and it is kept two years before it is drunk. The English brewers chiefly use cardamoms, ginger, sassafras, elecampane, and for the colour, madder or red sanders. It is a warm carminative, useful in weak and gouty stomachs, used by common labourers as a warm stimulating liquor in the morning, chiefly to re- store the tone of the stomach after excess. It was for- merly drunk after dinner to assist digestion, generally from high narrow glasses. MU'MIA, (from the Arabic mum, wax). Mummy signifies piss asphaltum, bitumen, or a brown fluid found in sepulchres, in which bodies embalmed have been preserved many years; sometimes a carcass dried by the sun and sands, of the consistence of horn, and light, called white mummies. In general, the embalmed bodies from Egypt, preserved with peculiar care, swath- ed in linen, impregnated with bituminous matter, and adorned with hieroglyphics, have this appellation. Mumia medulla is the marrow of the bones. Mumia ele7nentoru7n, a balsam of the external elements. (Para- celsus and Van Helmont.) Mumia transmarina, manna. Water deposited in a phial from breathing in it has the same appellation. Mumia sometimes means the subtle, spirituous, ethereal substance, supposed to be innate in every body, and to remain in some measure after death. The mui7uny taken from a human body is a resinous matter, hath a hardened, black, shining surface, is acrid and bitter to the taste, and of a fragrant smell. That which is particularly called mummy of the Ara- bians is a fluid liquor, obtained in sepulchres by exu- dation from carcasses embalmed with aloes, myrrh, and balsam. MU'NDI A'NIMA, according to Plato, or rather his commentators, is a certain universal ethereal spi- rit, which exists perfectly pure in the heavens, as re- taining its proper nature ; but on the earth pervading elementary bodies, and intimately mixing with their minutest atoms, it assumes somewhat of their nature, and becomes of a peculiar kind. " Spiritus intus alit, totosque infusa per artus, " Mens agitat molem, et magno se corpore miscet," See ArchjEus, and Anima mundi. MUNDIFICATI'VA, (from mundifico, to cleanse), Cleaning, detergent, purif'v'mg. MUNDIFICATI'VUM PARACE'LSI. R. Mdlis Britannici terebinthinae Venet. al Ibss. vitel. quatuor ovorum coq. ad consist, unguenti et sing, unciis adde hydrargyri nitrat. rub. 3 i» MU'NDY-GUA'CU. See Cataputia minor. MUNGOS RADIX. Ophiorrheza mungos Lin. Sp. PI. 213. Its root is considered as a specific against the bites of mad dogs, and of the serpent naya. Its seeds are accounted among the febrifuges. MUOI'DES, (from fA.vs, a 7nuscle, and etfos, likeness). See Platysma myoides. MURiE'NA. The generic name of the eel. See Aliment. MURA'LIS, (from murus, a wall,) because it grows on walls. See Parietaria. MU'RECl. A tree in Brasil, whose berries are purging. See Raii Historia. MU'RIA, (from f*.v^o, to fiow). Brine, a solution of common salt: also a supposed acrimony in the fluids, resembling brine. MU'RIAS, (from muria). Muriat. Salt form- ed by the union of the muriatic acid with different bases. MURIATIC ACID. See Marlnus sal. MURICA'TUS, (from murex, a prickly fish). The stalk of a plant covered Avith prickles like the shell of the murex. MU'SA, (from the Arabic term mauz,)palmahumi- lis,ficus Indica, bala,platanus, the plantain tree, musa paradisiaca Lin. Sp. PI. 1477. Though called a tree, it scarcely merits the name of a shrub, since it hath an annual stalk like a reed. The leaves are an ell long, and three spans broad; of which it is supposed that Adam and Eve mad'e aprons. The fruit is of the shape of a cucumber, of a yellow colour, and a most delicious food, and resembles meal and butter. The stalk is cut down to obtain the fruit, the spikes of which some- times weigh fifty or sixty pounds. The fruit, when roasted, is beat in water, and the juice, styled mislaw, is drunk; and even the pulp, when dried and baked, may be used in the same way, to prepare the mislaAv. It is found in all the eastern countries, and in Africa. See Raii Historia. Mu'sa fru'ctu cucumeri'no brevio'ri. See Ba- nana. MU'SAM. See Cassada. MU'SCtE HISPA'NICjE. See Cantharides. MU'SCARI, (from the smell of its flowers). See Bulbos vomitorius. MUSCA'RUM FU'NGUS, (from musca, a fly). See Besonna. MUSCI'PULA, (from musca, and capio, to take)* Lychnis viscosa rubra, viscaria. Catch fly groAvs among corn, and is cultivated in gardens. Its seeds are said to be Avarm and diuretic. See Raii Historia. Musci'pula prate'nsis. See Behen album vul- gare.' MUSCULA'RIS ARTE'RIA, (from musculus, a muscle). See Scapulars arteria. Muscula'ris venje. A branch of the posterior or upper branch of the external jugular; it spreads in the muscles, which cover the scapula and joint of the MUS 1011 MUS humerus. WinsloAV describes it also.as rising from the axillaris. MUS'CULI OBLI'QUISUPERIO'RES NE'RVI. MUSCULO CUTA'NEUS NE'RVUS. See Cervicales. MUSCULORUM COMMU'NIS MEMBRA'NA, MEMBRA'NA MUSCULO'SA. Winslow denies its existence ; but, in fact, it consists of compacted cellular ubstance, which, in finer ramifications, penetrates be- tween the muscular fibres: in some places this mem- brane is closely united to the proper membrane of the muscles. MUSCULO'SI. A class of diseases, comprehend- ing external or muscular inflammations. » MU'SCULUS. See Mytilus and Cetus. In ana- tomy from (A.vetv, to draw or contract. Lacertuli, q. v. Muscles consist of those bundles of fleshy fibres by which the motions of all animal bodies are perform- ed, and each is divided into the head, belly, and tail. The head is the part fixed on the immovable joint, called its origin, and is usually tendinous; the belly is the middle, fleshy part, Avhich consists of the true muscular fibres; the tail is the tendinous portion inserted into the part to be moved, called the insertion; but in the ten- don the fibres are more compact than in the belly of the muscle, and do not admit the red globules. The number and their nature are supposed not to differ. The arteries, veins, and nerves, generally enter the middle of muscles, and ramify alike throughout their whole substance. The large arteries and veins run ac- cording to the direction of the muscular fibres; the less anastomose and run transversely : but a muscle seems to have a greater proportion of blood than is required for its nourishment, so that it probably assists in the performance of its functions. The muscles are commonly attached to the bones, and the tendons are inserted into the substance of the bone; but Avhen a muscle is fleshy at its insertion, it is only fixed to the periosteum. The muscles fixed to cartilages are attached to the perichondrium. Some are fixed to ligaments, as those in the fore arm ; others into membranes, as those of the eye; and others again into fleshy parts, as those of the tongue. Muscles are either oblong, hollow, or mixt; the ob- long are divided into the rectilinear, half pennifonn, the penniform, the complex penniform, and the radi- ated. The muscular fibres are united very firmly in tendons, to lessen the bulk near the joint, Avhich would have obstructed motion, and been otherwise inconve- nient, as in the hand. By this means also the fleshy part of the muscle is nearer the centre of motion; and injurious friction is avoided. The appendices of muscles are, the fascia, or aponeurosis, the annular ligament, by Avhich the tendons of some muscles are confined, and the sacculi mucosi. The more intimate structure of the muscles has not yet been ascertained. The appearance of fleshy fibres i6 Avell knoAvn; and these, we have said, terminate in while, shining, firm cords, called tendons. The tendi- nous are seemingly the continuation of muscular fibres, losing, with their more compact structure, the pecu- liar muscular appearance. Yet this is contradicted on authority that we cannot lightly pass by, and it is said that they are obviously distinct; that the muscular fibres are attached to, Avithout being continued in, them; that they are arranged in a different manner, and inserted at angles more or less obtuse. On the other side, tendi- nous aponeuroses, diminishing in thickness, constitute internal aponeuroses, giving tension to the fibres, as external aponeuroses sometimes give points of attach- ment, and almost an origin, to muscles; nor can we deny that tendinous fibres may be inserted into muscles on one side, as they are to ligament or bone on the other. At the same time it is certain that tendons partake of none of the peculiar structure of muscles, and that they are more nearly allied to the simple solid. Muscular fibres are, Avhen carefully washed, white, solid, and parallel. It is said that they are indefinitely ramified; an opinion, observes Mr. Carlisle, which an hour's labour at the microscope will refute. On these fibres arteries very minutely ramify; it is said, also, with the same indefinable minuteness : but it is at least certain, that before they escape the assisted sight they cease to give off branches. The minuter ramifications of the nerves cannot be ascertained. They enter into the muscle often at right angles, at least considerable ones; and when they spread on the fibres they lose their external coverings, and become transparent, so that we can no longer follow them. The fibres are connected by a cellular substance of different fineness in different muscles, but apparently of a more delicate texture, as the muscular fibre itself groAvs more minute, and has very seldom any adipose accumulations. From these facts, Avhich are now well established, Ave may reject the opinion of the primitive muscular fibre being globular, spheroidal, or rhomboidal, of its being wholly nervous or arterial. We OAvn that we have indulged the language of calling muscular fibres the sentient extremities of nerves, and occasionally spoken of them as such ; but if Ave have at any time ex- pressed such an opinion, we beg leave, on mature re- flection, to disclaim it. If there were no other argu- ments, the proportion of bulk in the vessel and nen-e, compared Avith that of the muscle, oppose it: the pecu- liar structure and other properties of the muscles are equally adverse. Though muscles are evidently fibrous and red, we" must not deny a muscular structure Avhere Ave do not find red fibres. The lymphatic system is probably mus- cular; for the fibrous structure is discoverable in the thoracic duct of a horse: and Mr. Home has rendered it probable that the fibres of the crystalline lens are equally so. At least we know, in numerous instances,' that muscular contraction takes place where fibres are scarcely, if at all, discoverable, and where the red mus- cular structure is not found. Yet, as a part of the fibrous structure, the muscles form a part of the pri- mordial germ. We see their influence at the first daAvn of life in the punctum saliens: their action is coeval with animation. These facts at once disprove the theory of Girtan- ner, Avho attributes muscular contraction to a kind of explosion, or effervescence, arising from the oxygen in the blood uniting with the azot, the hydrogen, and car- bon of the muscies; for contraction exists when azot is not yet formed. We admit that azot, which furnishes MUS 1012 MUS the zoonic acid, is chiefly discovered in the muscles; that their fluids are the most completely animalized of the Avhole system; that in animals Avho lead the most active lives, and in the organs most constantly exerted, it is most frequently found, as in wild animals, the red deer, and hares, the pectoral muscles of the moor foAvl, &c; but this seems the effect rather than the cause of the contraction, as we shall soon find; and, on the con- trary, the action of a lympathic, for instance, is steady, and constant; that of the heart of the embryo rapid and unremitted, while each is transparent. On what then does this action depend ? certainly on one of those intricate states connected with life, which we cannot even approach by conjecture. We have no- thing analogous to compare it Avith, nothing which pos- sesses the same properties in different circumstances to enable us to divest it of the adventitious circumstances. We must content ourselves, therefore, with endeavour- ing to ascertain its phenomena and its laws. We know, from various experiments, that a free cir- culation through the arteries of muscles is necessary to their contraction; for tying the artery will render a muscle paralytic ; and even tying the inferior vena cava above the iliacs, we are told by Kauw Boerhaave, will render the muscles of the posterior extremities in- capable of contraction. The free access of the nervous influence is equally necessary; for though Ave are vaguely told of animals Avithout a nervous system pos- sessing muscular power, none, wrhich have been examin- ed with care, are found to want this source of motion. A muscle in action increases in absolute weight, in •density, and in its power of resistance. That it in- creases in bulk may be doubted, for experiments are contradictory ; and while the middle or the belly of the muscle is evidently enlarged, the diminution of its length compensates for the increase. Though the tendon is a firm, substantial cord, it is sometimes broken by muscular exertion; while the organ is uninjured, and the patella, as well as other bones, are fractured by a violent jerk, or a sudden, peculiarly violent, action of the muscles. It is, hoAvever, recorded, that the muscles themselves are sometimes ruptured, particularly the recti abdominis in tetanus, and the gastrocnemii in cramps; and, as it is difficult to suppose that increased cohesion should occasion a solution of cohesion, it has been, suspected that this is the effect of the action of antagonists, or of unequal excitement. Neither, how- ever, could be the cause in the present instances, nor is it difficult to conceive that the material may be ruptured by excess of power. Cord entwined with great force round any body, and then wetted, will be broken by the violent contraction. The choutchouc, a very elastic sub- stance, is diminished in specific gravity by extension. Muscular action, then, consists in an attraction of the parts of each fibre in a manner peculiar to animated nature. It is not a contraction in every dimension, since it Avould be then attended with diminished volume ; but in length only attended with a proportional increase of bulk, so as to preserve the absolute volume un- changed, or perhaps somewhat increased. The force exerted by this contraction is enormous. It was cal- culated, however, by the mechanical physicians in the most extravag.,t>.' manner, on foundations almost wholly chimerical; but on better grounds, from the very dis- advantageous insertion of the muscles, which Ave shall soon enlarge on, to surmount a resistance of fiftv pounds, the deltoid, it is said, must exert a force equal to 2568 pounds. In general, it appears that the force with which a muscle contracts is in proportion to the number of its fleshy fibres, and the extent of the sur- face to which these fibres are attached; but its degree of contraction, or the extent of its motion, is in propor- tion to their length. The limits of contraction differ in the long and in the circular muscles ; for the former do not contract more than one third of their length; but the circular fibres of the stomach, Avhich, in their utmost dilatation, may be expanded to a foot in circum- ference, will, after long fasting, be reduced to a circle of an inch. It must, however, be added, that in circular muscles no fibres pass completely round : bundles of fibres are collected, and end at different points, while some begin Avhere others end. Each may, therefore, admit only of a limited contraction, Avhile the dilata- tion just mentioned may be the sum of the Avhole. Muscles are usually attached to bones near their joints, and, running almost parallel with the bone, are inserted at very acute angles. They are consequently levers of the third kind, situated between the fulcrum and resistance. By this contrivance, much force is lost to attain velocity, and to avoid deformity ; for the muscle Avould start out in its action, if conducted in any other manner, and this starting Avould be in proportion to the celerity of the action of the resisting part. At present, the hand, for instance, SAveeps through a large circle with great velocity, Avhile the muscles, Avhich raise the fore arm, viz. the biceps and brachialis internus, SAvell to a degree scarcely perceptible. In the force sup- posed to be exerted by the deltoid, a great proportion acts only in pressing the humerus to the shoulder, ac- cording to the common doctrine of the composition, and resolution of forces. Another loss of force arises from the oblique insertion of the fleshy fibres into the ten- dinous expansion, Avhich pervades them : but, Avith the Author of Nature, power as well as life is obedient to the divine fiat, and each is profusely diffused: yet all this has been resolved into jarring atoms, molecules or- ganiques, and animated filaments! Various contrivances, however, appear to have been adopted to lessen this considerable loss of poAver. In general, the extremities of the bones are enlarged, so that the muscle is re- moved from the parallelism, the tendons of the smaller line of direction of the bones are separated, or the angles at which they are inserted are augmented. Sometimes, for the same purpose, the tendons, or the muscles themselves, are reflected over pulleys. When the limb begins to move, the angle of insertion is, of course, increased. The action of muscles is never intermitted, and only diminished in the sleeping state. This action arises from a less degree of that power which moves the limbs, and is styled, by Haller, the vis insita; by later authors, irritability, or tonic power. When muscles are not exercised, this power is very slightly exerted ; but, by the position which the limbs assume, we disco- ver the relative strength of the antagonizing muscles. Thus we find the flexors stronger than the extensors; for during sleep the head falls forward, the body, tegs, arms, and fingers are lightly bent. We see the cause of MUS 1013 MUS this strength, when we find that the flexors have stronger and more numerous fibres ; that their insertion is farther from the centre of their motions, and under a larger angle, which, as we have remarked, must increase when flexion has begun. This superiority of the flexors bends the foetus in utero into a round ball. When the infant is born, the same superior power of the flexors continues, though in a less degree, and frequent pandi- culations are required, to give activity and energy to the extensors, which they again lose in advanced age. When Ave awake from a sound sleep the same yawn- ing pandiculations occur; and Barthez fancifully refers the crowing of the cock, and the fluttering of hisAvings, to a similar purpose. It is always useful to examine, in diseases, the position of the limbs during sleep, par- ticularly of children. If they deviate from the bent to a more straight position, there is generally some irregu- larity in the state of tone, and, of course, in the viral influx. It is supposed by some authors, that the vital influx is not necessary to the contraction of muscles, but that they possess irritability as a quality, and this is the strict mefhing of the vis insita of Haller; but Ave do not, in any instance, find this, for any time, unconnected with life. Irritability is, indeed, lost at different periods in different organs; for some, particularly the heart, soon lose it, while the voluntary muscles retain it; and appa- rently those Avhich derive their nerves from the inter- costal system lose it sooner than those whose nerves originate from the base of the cerebrum. Irritability is also exhausted in the agonies of death, and retained for a longer time Avhen the death has been sudden and vio- lent, except it happen from lightning. On this prin- ciple'fish are crimped; for the muscles are cut across, white the irritability remains, and the muscular por- tions contract so as to give greater firmness to the flesh. To preserve this irritability, the fish receives a blow on the head as soon as it is taken from the water, when the operation is performed, is washed in hard Avater, Avhose astringency, from the selenite it contains, assists the contraction. Irritability is also soon de- stroyed by narcotic poisons, either if partially applied, or, more generally, if life is extinguished by their means. The poAver of contraction, by volition, by association, by a stimulus on the brain, or on the nerves in their course, as it acts through the medium of the nerves, is called the nervous power; though Avhen vo- lition only is the cause, Dr. Cullen chooses to call it the animal power. The tonic power, as Ave have said, is that slate of constant contraction owing to life, or per- haps to the action of antagonizing muscles. The state of muscles differs according to their vigour and their mobility. The first attends firm and robust, the second weak, constitutions. In the latter, muscu- lar contraction frequently alternates with relaxation; and the greatest degree of this state is Convulsions, vide in vcrbo. Vigorous contraction is less subject to alternate with relaxation ; but such alternation is com- mon to muscles in general, and found in every long muscle but among the round muscles in the heart, the intestines, probably also the stomach only. Spasm is not a disease of vigour, but of a high degree of irrita- tion, and OAving to an irregular influx of the vital power. We have enumerated association among the stimuli, rather from a loose analogy than Avith strict pretensions to accuracy, including, in this way, each source of mus- cular action. Muscular irritability is exhausted not only by exercise, by narcotic poisons, and every kind of excitement, but by mental exertions also : and the student, constantly at the midnight lamp, finds it greatly diminished, not only by his mental exercise, but by disuse. Violent emo- tions have a similar and more sudden effect. At the time we observe that violent muscular action di- minishes, and occasionally destroys, sensibility. Thus, in battle, the soldier does not feci his wound; and the juggler violently contracts the muscles of his leg Avhen he runs the pin into them. These facts, which might be supported by many analogous ones, seem to shoAv that the sentient and moving poAvers are more closely connected than physiologists have sup- posed. The bulk of a muscle is chiefly made up of cellular substance and blood vessels. When each is separated, the true muscular fibres occupy a very small space, and the muscles are found equally, often more, distinct in the emaciated invalid than in the robustest subject. We may conclude from hence, that muscular fibres are not destroyed nor produced ; and we think the opinion is supported by observation. If a muscle is destroyed, the limb remains useless, or at least partially useful, by the assistance of those Avhich remain. If cut through, the fibres are united by a compact cellular substance. Yet late authors have been fond of employing the analogy betAveen the fibrin and the muscular fibre, particularly when they found the fibrin contract by the galvanic stimulus; and, in support of it, they quote an observa- tion of Haller, that the generality of muscular arteries are curved on themselves, in a remarkable manner, Avhen entering into the muscles. This structure, they think, must retard the blood, and facilitate the separa- tion and deposition of the fibrin. The muscular flesh, they add triumphantly, is the most azotic fluid of the Avhole system, and the fibrin the most animalized por- tion of the blood. If, however, the fact be as just stated, that muscular fibres are not reproduced, this ne- cessity no longer appears, and we know not that con- traction is connected Avith azot. Irritability and sensi- bility are both, however, apparently peculiar to a fibrous structure; and we knoAV so little of the means by which the nervous influence is connected Avith the nerve as a simple solid, that we may suppose this union in part depending on fibres, and, Avhen these are formed, that they may share a portion of this incomprehensible power. Thus, then, the fibrin may enjoy a certain portion of life ; thus the muscles may be more directly a part of the nervous system. Yet we have disclaimed both opinions; and, though the course of our argument has led us to this view of the subject, we must add that such reasoning appears loose and precarious. See Blood, vol. i. p. 357, &c. and Nervus. Before we proceed to a general enumeration of the muscles, we must premise, that the most fixed point is styled its origin, the more moveable its insertion. In the motion, however, of limbs, the peculiar muscles are not exclusively employed, since some distant ones are exerted to fix the part from which the muscles origin- ate. In other circumstances the fixed point becomes MUS 1014 31 US occasionally, though in a less degree, the moveable; and for this reason we have styled the origin the 7nost fixed point. In' some instances, the part from Avhich the muscle originates is equally moveable with that into which it is inserted. Muscles of the Head. The forehead is wrinkled and drawn upAvards, as are also the eyebrows, by a broad thin muscle, occipito frontalis, Avhich rises at the back part of the skull, and, covering the head, runs down the forehead, to be inserted into the skin of the eyebroAVS. The eyebrows are drawn towards each other, and the skin of the forehead pulled down and made to wrinkle, as in frowning, by a pair of small muscles, corrugatores supercilii, which rise from the root of the nose, and are inserted into the inside of the eyebrows. The ear is moved by eleven small muscles. The first three are called common, because they move the whole ear. The next five are termed proper, and only move the parts to which they are connected; Avhile the other three are internal, to move the small bone situ- ated Avithin the ear. The eyelids are closed by a muscle, Avhich, rising from the inner angle of the orbit or cavity in Avhich the eye is embedded, covers the under eyelid, then sur- rounds the outer angle, and passing over the upper eyelid, descends to be inserted, by a short, round ten- don, near to its origin, orbicularis palpebraru7n. The eye is opened by a muscle, which, rising from the inner and upper part of the socket, is inserted into the upper eyelid, to draw it upwards, levator palpebra superioris. The eyeballs are carried through all their motions by six small slender muscles to each. They arise from the bottom of the socket, and are inserted into the outer coat of each eyeball at different points. Four of these move the eye upwards or downwards, to the right and to the left; while the two remaining muscles give oblique directions to the eye, at the same time protruding it; and all acting in quick succession, enable the ball of the eye to describe a complete circle. See Oculus. The nose is affected by several small muscles of the face, but only one muscle on each side is proper to it. This muscle straightens the nostrils, and corrugates the skin of the nose, corrugator naris. The mouth and lips are moved by nine pair of mus- cles, levator labii superioris alaquenasi; levator anguli oris; zygomaticus major; buccinator; depressor labii superioris ala que nasi; depressor anguli oris; depressor labii inferioris; levator labii inferioris; orbicularis oris; which, arising from the contiguous bones of the face, are inserted into the lips and angles of the mouth: and from the termination of these muscles a tenth is formed, which surrounds the mouth like a sphincter, and closes it, by draAving the lips together. It is from the actions of these muscles on the mouth, particularly at its cor- ners, that the emotions of the mind are expressed, and the predominance of particular feelings in characters is indelibly stamped: unless in those individuals whom nature has gifted Avith an unimpressible dulness of cha- racter, or in whom the more delicate lines are filled up by too great fatness. The loAver jaw has four pair of muscles for pulling it upwards, as in manducation, viz. two pt.ir seen upon the outside of the face, and two pair concealed by the angles of the jaw. The first pair arise from the sides of the skull, above the temples, whence they are called temporal muscles, temporalis; and then descending under the bony bridges of the cheek bone, are inserted into the lower jaAV near its ends. The second pair arise, at each side, from the under edge of the bony bridge, and descending along the cheek, are inserted into the angle of the lower jaw, masseter. These four muscles act powerfully in pulling thejaAv upAvards, and when Ave bite, may be felt swelling out in the flat part of the temple, and upon the back part of the cheek. The other tAvo pair of muscles arise from the base of the skull, and are inserted into the lower jaw internally, for enabling this bone to move from side to side, the more effectually to grind the food, pterygoideus internus and externus. The lower jaw is pulled doAvnwards by- muscles, which extend betAveen it and the bone of the tongue, and which also serve to raise the throat upwards. - Muscles of the Neck. The neck is covered Avith numerous and complicated muscles: those on the fore part or throat-extend some betAveen the head and upper part of the trunk, latissimus colli and mastoideus: others between the loAver jaAV and the os hyoides; more be- tween this bone and the cartilages of the throat; while numerous other small muscles are situated between these cartilages and the trunk; and also about the root of the tongue and the back part of the mouth. Their names are sufficiently descriptive of their situations, viz. omo-hyoideus; sterno-hyoideus; hyo-thyroideus; ster- no-thyroideus; crico-thyroideus; digastricus; stylo-hy- oideus; mylo-hyoideus; genio-hyoideus; genio-glossus; hyo-glossus; lingualis; stylo-glossus; stylo-pharyn- gaus; circumfiexus; paldti; levator-palati; palato- pharyngaus; constrictor isthmifaucium; azygos uvula; constrictor phuryngis superior, 77iedius et inferior; crico- arytenoideus lateralis et posticus; arytenoideus obli- quus et transversus; thyreo-arytanoideus; arytano- epiglottideus; and thyreo-epiglottideus. Their uses are, viz. to bend the head forwards; to open the mouth by pulling the lower jaw downwards; and to move the parts concerned in deglutition and speaking. The muscles on the back part of the neck are rather portions of the great muscles, Avhich cover the back, than distinct bundles of fibres; but, having some of their extremities fixed to the back part of the skull, and also to the hinder portion of the spine of the neck, are intended to move those parts, draAving them backAvards and sideways. Muscles of the Trunk. Those are principally the muscles Avhich cover the breast; those which constitute the fore part and sides of the abdomen; and the great muscles that are spread over the back. The muscles of the back are numerous and large: they arise from the Avhole length of the spine or back bone, having their originating fibres firmly fixed to the numerous processes or handles of that bone; from the upper and posterior edge of the pelvis; and also, some portions from the back part of the skull; and from these different organs, they spread over and cover the back of the trunk, and run to be inserted, some into the base of the arm, others into the spine at a distance from their origin, and the remainder into the ribs and back part of the skull. They consequently not only cover and protect the whole back part of the body, but also serve to pull the head backwards, raov£ the whole arm, MUS 1015 M US assist respiration by acting on the ribs, and to raise the body by extending the spine. These are, the trapezius, or cucularis; rhomboideus; latissimus dorsi; serratus inftrior et superior posticus; levator scapula; splenius; complexus; trachelo mastoideus; rectus capitis posti- cus major et 77iinor; obliquus superior et inferior capi- tis sacrolumbalis; lo7igissimus dorsi; spinalis et semi- sjti/iulis dorsi; multifidus spina; semispinalis colli; scalenus; interspinalis et intertransversales. The cavity of the abdomen is completed at its fore part and sides by a few broad and thin muscles, which extend from one bone to the other, having their ends firmly fixed to the edges of these bones; and passing over each other, to constitute walls for covering in and containing the boAvels. These are obliquus externus and internum; transversalis; rectus abdominis and pyra7ni- dulis. These muscles also assist respiration by help- ing to expei the air irom the lungs : and they contribute to the movement of the body, by bending it forward as in bowing, and by raising the pelvis. The breast is covered by a.few broad and strong muscles, which arise from the whole length of the breast bone, and form the fore part of the ribs, and run- ning from each other over the chest, are inserted into the shoulder for moving the limb forward, pectoralis major; serratus magtius; levatores costarum. The ribs are raised, and the cavity of the chest en- larged, during inspiration, by eleven double rows of small muscles on each side. They grow out from the lower edge of one rib, and are inserted into the upper rim of the next: intercostales exter7ii et interni; sterno costales: at the fore part of the neck, close to the ver- tebrae, are the rectus capitis internus, major, 7ninor et lateralis; longus coli. Muscles within the Body. The principal one is called the diaphragm; it is a broad thin muscle, occupying partly a horizontal position, when the body is erect; but inclining dowmvards towards the back, and divid- ing the trunk of the body into the two great cavities, the thorax and the abdomen. It arises from the loAver end of the breast bone; from the cartilages of the seventh, and of all the inferior ribs on both sides; and from the second, third, and fourth lumbar vertebrae; and from these origins its fibres run, like radii from the circumference to the centre of a circle, to be inserted into a broad flat tendon, Avhich is situated in the middle of this muscle. The diaphragm is the principal agent in respiration, as shall be more fully described under that head. The other muscles within the body arise from the sides of the lower end of the back bone, and from the inner surface of the pelvis, and, passing down to be in- serted into the ihigh bone, a little beloAV its head, they help to turn the toes outwards, and to bend the thigh; or when the limb is fixed, they assist in bending the body, psoas parvus et 7nagnus; illiacus internus; qua- dratus lumborum. Muscles of the Superior Extremities. These anato- mists divide into the muscles that are situated on the shoulder blade, on the arm, on the fore arm, and on the hand. The muscles situated on the shoulder blade are call- ed muscles of the arm, because, though they arise from the former bone, which serves them as a base, yet they are inserted into the bone of the arm to effect its movements: the same observation holds with respect to the other divisions of these muscles. The arm then is moved by seven muscles which arise from the shoulder blade, and passing over the joint are inserted into the arm bone at its upper and middle parts. The deltoides; supra et infra spinatus; teres minor et major; subscapularis et coraco brachialis; these, to- gether Avith the muscles coming from the back and breast, already described, complete the motions of this part of the limb. The fore arm is moved in flexion and extension by three muscles, which arise from the upper part of the arm bone ; run down its Avhole length, and constitute its fulness and figure: they then pass over the elboAv joint to be inserted into the upper ends of the two bones of the fore arm. These are the biceps flexor cubiti; brachialis internus et triceps extensor cubiti. The hand is moved at the wrist by six muscles; three of these arise from the upper part of the fore arm, and descending along its Avhole length, are continued over the wrist, and are inserted into the hand close to this joint; they bend the hand, and are consequently called its Rexors,fiexor carpi ulnaris; palmaris longus et flex- or carpi radialis. The three extensors, so called, be- cause they extend the hand, and bring it backwards, arise from the loAver end of the arm bonerand passing down the fore arm also, run to be inserted into the back of the hand just beyond the wrist, extensor carpi radi- alis, longus et brevis; extensor carpi ulnaris; all these muscles, before they reach to the wrist, become slen- der tendons, which is the cause of the tapering of the. fore arm from about its middle to the hand. Besides flexion and extension, the hand has a circu- lar kind of motion called pronation and supination : the former takes place when we turn the palm down, as upon a table ; the latter when we turn the palm up- wards ; and both motions are produced by four short muscles Avhich extend obliquely across from one bone of the fore arm to the other, and roll the radius upon the ulna, carrying the wrist round in circles, supinator longus et brevis; pronator radii teres et quadratus. The fingers are principally moved by two flexors and one extensor. The former muscles arise from the upper part of the fore arm near the bend, and running down towards the Avrist, send off four round tendons each; which passing over the palm of the hand, are in- serted, the one set of tendons into the upper part of the second bone, and the other into the last bone of each of the four fingers: the latter set of tendons pass through slits in the former, Avhich help to bind them down, when the fingers are bent. The extensor mus- cle arises above the elbow, passes down the fore arm? and also splits into four round tendons, which can be plainly felt on the back of the hand, and are inserted into all the bones of the four fingers for extending them. The other movements of the fingers, and those of the thumb, are performed by muscles, chiefly situated upon the hand; and which, together with those Ave have de- scribed, complete the motions of these parts. Except the indicator which extends the four fingers, the names express their uses. The interossei hiterni et externi ex- tend the fingers, and move them in different direc- tions. The )umbricales bend the first, and extend the two last, joints of the fingers. Muscles of the Inferior Extremities. The great MUS 1016 M U S muscles which move the thigh all arise from the pel- vis, or the lower part of the trunk; covering, and also giving plumpness and shape to the external surface of these parts, they descend over the hip joint, to be in- serted into the thigh bone below its articulating head: by the action of these poAverful muscles the thigh is carried through all its motions. These are the glutai; pyriformis; gemini; obturator internus, et quadratus femoris; pectinalis; adductor longus brevis et magnus femoris; obturator externus. The teg is moved by eleven muscles, which arise part- ly from the pelvis, and partly from the upper end of the thigh bone: they descend along this bone, giving fulness and shape to the thigh, and passing over the knee joint, are inserted into the bones of the leg; the extensors into the upper edge of the knee pan, for ex- tending the leg, and the flexors into the posterior sides of the long bones of the leg, a little beloAV their heads: the tendons of these muscles form the inner and outer ham strings. Biceps flexor cruris; semitendinosus; semimembranosus; tensor vagina femoris; rectus; sartorius; gracilis; vastus externus et internus, cru- ra us et poplitaus. They bend tire leg. The foot is moved by three extensors, and by four flexors. The extensors arise, the two first by double heads from the loAver end of the thigh bone, near the bend of the knee : these heads soon after unite into the great fleshy bellies, which, swelling out, form the calf of the leg; but decreasing where the leg begins to grow small, they each give off a broad thin tendon, which also uniting, form the tendon of achilles, to be inserted into the extremity of the heel. Those power- ful muscles extend the foot by bringing it backwards, and are principally engaged in running, walking, leap- ing, &c. The third extensor of the foot arises also from the lower end of the thigh bone, and descending by a long, slender tendon, is inserted into the heel,- to assist the former: but this muscle is sometimes not to be found in the human subject. Gastrocnemius inter- nus et externus; plantaris. The four flexors arise, the two first from the upper part of the tibia, or principal bone of the leg, and con- tinuing fleshy about half way down that limb, send off two round tendons, which pass under the inner ankle, and are inserted into the bones of the foot. The other tAvo flexors of the foot arise from the superior part of the fibula or smaller bone of the leg, and sending off tAvo round tendons, which pass under the outer ankle also, are inserted into the bones of the foot. These assist the former in bending the foot by draAving it up- wards. Tibialis posticus et anticus; peronaus longus et brevis. s The toes have two extensors and three flexors. The first extensor arises from the upper part of the leg, and descending to the ankle, splits into four round tendons, which run forward upon the upper part of the foot, where they can be plainly felt, and are inserted into the four small toes to extend them : the other extensor arises from the heel, and running forward upon the foot, also splits into four tendons, to be inserted into the toes likeAvise, and to assist in extending them. The flexors of the toes arise, the first from the under and back part of the heel, and running forward along the sole of the foot, sends off four tendons to be insert- ed into the second row of bones of the four smaller toes. The second flexor arises from the back part of the tibia beloAV its head, and descending the leg, passes at the inner ankle to run along the sole of the foot, on the middle of which it splits into four slender tendons, which perforate the former, in the manner of those Avhich bend the fingers; and extending beyond them are inserted into the. extremities of the last joint of the four small toes. The third flexor assists the two former in bending the toes, and also draws them inwards. Be- sides these there are other small muscles Avhich are situated upon the foot, and Avhich, with those coming from the leg to be inserted into the great toe, complete the movements of these parts. These muscles are suf- ficiently known by their names, and what has been said on those of the hand. Thus we see that the muscles or flesh cover and spread over the whole frame of bones, connecting and securing its different divisions and parts; and not only producing all its movements, but also giving to it ful- ness, shape, and beauty. See the Croonian Lectures in various volumes of the Philosophical Transactions ; Haller's Elementa Physi- ologiae ; BroAvn on the Muscles; Winslow's Anatomy ; Cowper's and Albinus's Tables of the Muscles; Innes and Douglas on the Muscles. Mu'sculus ante'rior ma'llei, or mu'sculus ex- te'rnus au'ris duve'rnii ; anterior 7nalleolus; is placed in a fissure on the temporal bone, above the glenoid cavity, where the lower jaw plays, runs hrward, and is inserted into the Ravian process of the malleus irregularly forward from the incus; and by taking off from the vibratory motion of the bones, it is supposed to fit the, ear for receiving weaker sounds. Mu'sculus exte'rior. See Abductor oculi. Mu'sculus infe'rior. See Depressor oculi. Mu'sculus tu'bje no'vus valsa'lvje. See Circum- FLEXUS PALAXIt MU'SCUS CLAVATUS. See Lycopodium. Mu'sous cumatilus. Lichen apthosus Lin. Sp. PL 1616, is supposed to be anthelmintic, and is given in infusion or decoction to destroy worms, or to remove aphthae. The close of the powder is twelve grains to infants. Its smell is highly fetid and disgusting. Mu'scus arboreus, lichen plicatus Lin. Sp. PI. 1622, usnea officinarum. It is slightly astringent, used to stop haemorrhages, and by the Laplanders to relieve excoriations from travelling. Mu'scus lapideus. See Corallina. Mu'scus pulmona'rius. Pulmonaria arborea, oak lungs, and lung wort, is made up of flat, wrinkled, rough leaves, greenish above, and ash coloured under- neath, with several round, reddish brown spots on the surface, in which the seed is supposed to lie. It hath a bitterish astringent taste, and grows spontaneously on the oak tree. Mu'scus pyxidatus, musculus pyxoides terrestris, lichen pyxidatus major; lichen cocciferus Lin. Sp. PI. 1618. Cup moss, a species of lichen, groAving on bar- ren dry ground, with many hoary whitish green, small leaves, spread on the surface of the earth, among Avhich arise little, whitish, dusky, hollow cups, a quarter of an inch high, showing neither flower nor seed. The de- coction is reckoned a specific in the hooping cough. Mu'scus squAMosus terrestris. See Lycopo- dium. M YD 1017 M YO MUSTELA'NEI. See Anci. MU'STUM, (vinum mustum, i. e. novum, from fAAto-xos, tener). Must, gleucos. This term usually given to neAv wine, is now applied to the saccharine juice of several fruits, susceptible of the spirituous fer- mentation, and particularly of grapes, before its com- mencement. When boiled till one third is consumed, it is called carenum; Avhen to one half, defrutum; hep- sema; and when its fermentation hath been prevented, or prematurely suppressed by fumigation with sulphur, stum. See Vinum. MU'STUS, (from ftoc-^e?, tener). The white calx of urine, and whatever is young or tender, as virga musta, agna musta. MUTELLI'NA. See Meum Alpinum Germani- cum. MUTI'LLA. The velvet ant of South America, highly troublesome from its sting. It is usually found in sandy places, runs very swiftly, and lies concealed under stones and flowers. There are many European species, but these are not troublesome. MU'TITAS,(from mutus, dumb). Dumbness. The want of power to articulate words. Dr. Cullen places this disease in the class locales and order dyscinesie, defining it an inability of articulating words. The spe- cies are, I. Mu'titas organica; when the tongue is taken away or injured. 2. Mu'tijas atonica, when the nerves are chiefly affected. 3. Mu'titas surdorum, from early deafness. MY AC A'NTH A, (from t*.vs, a mouse, and xxxvOx, a thorn; because its prickly leaves, are used to preserve substances from mice). See Ruscus. MYA'GRO, and MYA'GRUM, (from p«i«, a fly, and xypeva, to seize; because flies are caught by its viscidity). Myagrum perenne Lin. Sp. PI. 893. (See Rapistrum.) This plant has a turbinated fruit, like an inverted pear, unicapsular, pressing in the stalk, con- taining one seed, with two empty cells, resembling in virtue the rapistrum, or raphanistrum. MY'CE, (from f*va, to wink.) A winking, closing, or obstruction. It is applied to the eyes, to ulcers, and to obstructions of the viscera, especially the.spleen. In botany it means a fungus; in surgery the fungus which rises in ulcers or wounds. In some authors it signifies a yellow vitriol. MYCHTHI'SMOS, (from pt»xf<£«t to mutter or groan). A sighing or groaning during respiration, while the air is forced out of the lungs. Hippocrates. MYCONOI'DES, (from nvxlvf, a nostril, and etfos, resemblance). An epithet of an ulcer, which is full of mucus. MY'CTER, (from ^vo-o-a, to blow the nose). See Nasus. MY'CTERES. See Nares. MYDE'SIS, (from fivfotu, to abound with moisture). A disease of any part from redundant moisture, applied by Galen to the eyelids. MY'DON, (from nvfota, to grow putrid). Fungous ftesh in a fistulous ulcer. MYDRI'ASIS, (from f*.vfota, diseases supposed to arise from too great influx of humours). Different complaints have been attributed to this cause, the dis- tinguishing symptoip of which is a dilatation of the pu- VOL. I. pil. These are amaurosis, hydrocephalus, worms, the adhesion of the uvea to the capsule of the crystalline, paralysis and spasm. See Amaurosis. MYLA'CRIS, (from its resemblance to fA,vXy, a grind- stone). See Patella. MY'LE, (fA-vXy). See Patella and Mola. MYLO-GLOSSI, (from fA.vXn, dens molares, and yXue-o-x, lingua). These muscles arc small fleshy planes, situated transversely on each side, betAveen the ramus of the loAver jaw and the basis of the tongue; they rise from near the inner side of the dentes mo- lares, and thence run to the basis of the tongue, but are often wanting. Mylo-hyoi'des, (from fA-vXy, a grinding tooth, and ioi&ns, the hyoid bone,) muscles which rise with a large basis from the inferior part of the lower jaw, and are inserted at the basis of the os hyoides. MYLo-PHARYNGiE'i, (from the same, and a lip). See Nymphs. MY'RTON, (from its resemblance to the myrtle berry). See Clitoris. MY'RTUS. The myrtle; myrrhine, because it smells like myrrh. My'rtus Braba'ntica and Anglica, called also rhus myrtifolia Belgica, 7nyrica gale Lin. Sp. PI. 1543, rhus sylvestris; acaron; frutex odoratus septentriona- lium elccagnus chamelxagnus Dodonxi. Gaule, sweet willow, Dutch myrtle, is a small shrub much branch- ed, with smooth, oblong, whitish green leaves, some- Avhat pointed, or converging at each end; among Avhich arise pedicles, bearing scaly cones, which include the seeds, one little seed being lodged in each scale. It grows wild in uncultivated watery places, in many parts of England, flowers in May or June, ripens its seeds in August, and loses its leaves in Avinter. The leaves, flowers, and seeds, have a strong fragrant smell, and a bitter taste : they are used to destroy moths and cutaneous insects; sometimes to preserve malt liquor; but they render it very inebriating. An infusion taken inwardly is said to destroy Avorms, and strengthen the stomach. This plant has been highly esteemed, but is little valued in this kingdom. See Raii Historia Plan- tarum ; Lewis's Materia Medica. My'rtus commu'nis Ita'lica. Common myrtle; myrtus communis Lin. Sp. PI. 673, var. y, is an M Y T 1020 M Y X evergreen shrub, with oblong leaves, pointed at both ends, in the bosoms of which spring solitary white pentapetalous flowers, followed by black, oblong, um- bilicated berries, full of white crooked seeds. It is a native of the southern parts of Europe; the berries, which are called myrtilla, rarely come to perfection with us, and they are usually supplied by those of the vaccinium myrtillus Lin. Sp. PI. 498. The berries are recommended in alvine and uterine fluxes, and disorders from laxity and debility; they have a roughish, not unpleasant, taste, and are accompanied with a sweetish aromatic flavour. The leaves are as- tringent, and, if rubbed, yield an aromatic flavour. See Raii Historia; Lewis's Materia Medica. My'rtus pime'nta vel Jamaice'nsis. See Piper Jamaicensis. MY'STAX. That part of the beard Avhich grows on each side of the upper lip. The etymon of mus- tachio. MYSTICE'TUS. See Cetus. M Y'TILUS. The mussel, mytilus edulis Lin. Syst. Naturae, musculus. A sea shell fish of a luscious flavour, found on many parts of our coast, of a moderate size, larger between the tropics, and smaller in the arctic sea. As from mushrooms, so from this shell fish very alarming symptoms are often produced, ascribed to a quality in the mussels, either proper to them, or acci- dentally acquired from their situation or nourishment. The pea crab, often found in them, has been accused; but as similar effects are observed to arise from various other causes besides mushrooms and mussels, the pecu- liarity of the person's constitution is generally supposed to occasion them. Similar complaints have sometimes been produced by eating salmon, taking the Peruvian bark, by washing the hands in water after fish hath been boiled in it, bathing in the sea, cantharides applied to the skin, and the internal use of wild valerian root. " The signs which announce the noxious effects of boiled mussels," observes an author in the second vo- lume of the Memoirs of the Academy at Brussels, " are an universal uneasiness, or numbness, that commonly takes place three or four hours after they have been eaten. These symptoms are succeeded by a tightness of the throat, a sense of heat about the head and eyes, im- moderate thirst, nausea, and sometimes vomiting. If the patient hath the good fortune to vdmit up the whole of the offensive matter, this evacuation is generally suffi- cient to stop the progress of the complaint; but if he does not bring up any or only part of the noxious sub- stance, the disorder becomes more or less alarming, ac- cording to the quantityof the deleterious matter in the first passages, and the particular constitution of the patient. The want of a sufficient evacuation, by vomit, increases the tightness of the throat, and the swelling of the face, eyes, and tongue: all the parts within the mouth appear inflamed, and, as it were, excoriated; and the redness soon spreads to the outer surface, appearing first in the face, and extending from thence to the neck, breast, and abdomen, and by degrees over the whole body. This particular eruption is the symptom the most distinguish- ing and characteristic of the malignancy of mussels; it is constantly accompanied with a kind of delirium, with singular uneasiness, and an insupportable itching. It has no affinity with the eruption produced by the ery- sipelatous fever, Avith the scarlatina, measles, purpura urticaria, or any other known species of red eruption; but has these particularities, viz. that it never appears unless mussels have been eaten; is not preceded by fever, or accompanied by symptoms which appear united in any other disease; and lastly, that the whole surface of the body, though redder than in any other eruptive disease, appears as it were spotted with an infinite num- ber of points of a deeper red than the rest of the skin. These points are infinitely smaller than a millet seed; if we examine them through a lens* we see distinctly that they are the opening or pores of the cuticle, Avhile the redness which is seen only through the epidermis appears of a pater hue." The proper treatment of these complaints is the same with that directed when mushrooms are the offending cause. (See Amanita.) The itching is considerably allayed by washing the whole surface of the body with vinegar and water for about half an hour. It is advised as a preventive 6f their injuries to wash them with water, and afterwards with vinegar, to boil them for use in an earthen pot with vinegar and water, and a few grains of Jamaica pepper. The dangerous consequences supposed to arise from eating mussels are, however, greatly exaggerated. They very rarely occur, and scarcely with the violence just described; and, though such effects are occasionally heard of, yet years elapse without such an occurrence, on coasts where mussels are a common article of food. These deleterious consequences are sometimes attribut- ed to one particular part of the fish; at others, to their lying on beds of cupreous pyrites; sometimes to their rich- ness, at others to a peculiarity of constitution. No part of the fish, however, seems to have been pointed out, the absence of which would secure the person from the peculiar effects: the symptoms are not those which fol- low the swallowing of copper, and the fish is not pe- culiarly rich. It is certainly more deleterious to some constitutions than others. M. Debeunie thinks that the cause is the spawn of the star fish (the asteria), and has added some experiments in a late volume of the Jour- nal de Physique to support his opinion. This is by no means improbable; but the little crabs often found in mussels are far from being unwholesome. MYTTO'TUM. A kind of food made of garlic, onions, and cheese, bruised together. MYU'RUS, (from (*,vs, a mouse, and ovpx, a tail). An epithet for a sinking pulse, when the second stroke is less than the first, the third than the second. The pulse sometimes sinks irrecoverably, but occasionally rises again in some degree. • MY'XAS, MYXA'RIA, (from its viscidity, resem- bling t*v%x, mucus). The sebastina domestica, cordia myxa Lin. Sp. PI. 273. See Sebesten. MYXOSARCO'MA, (from j«»f«, mucus, and r^f, flesh). See Mucocarneus. END OF VOL. I. WZ a.70 v. I < V L/ ^\ >WX/On\ X»X '-*- V S/rklSZ