- I NATIONAL LIBRARY OF MEDICINE Washington F«uW*4 ISM U. S. Department ol Health, Education, and Welfare Public Hcakh Service the :^y^ LONDON MEDICAL DICTIONARY; INCLUDING, UNDER DISTINCT HEADS, VIZ. ANATOMY, PHYSIOLOGY, AND PATHOLOGY, THE PRACTICE OF PHYSIC AND SURGERY, THERAPEUTICS, AXD MATERIA 3VIEDICA; WITH WHATEVER RELATES TO MEDICINE IN NATURAL PHILOSOPHY, CHEMISTRY, AND BY BARTHOLOMEW £ARR, M.D. FELLOW OF THE ROYAL SOCIETIES OF LONDON AND EDINBURGH, AND SENIOR PHYSICIAN OF THE DEVON AND EXETER HOSFITAL. Creditur, ex.medio quia res arcessit, habere Sudoris minimum; sed habet-----------tanto Plus oneris, quanto venia minus. Hob. Lexican contexat, nam caetera quid moror, omnes Poenarum species, hie labor unus habet. SCALIGEIJ VOL. II. PHILADELPHIA: PUBLISHED BY MITCHELL, AMES, AND WHITE William Brown, Printer. 1819. V*A «V.Vs A NEW MEDICAL DICTIONARY. NiE V X^l • 1° prescription signifies number. NA'BEA. See Ginoplia. NA'BIT. See Saccharum. NA'CTA. See Absoessus pectoris, and Mamma. NA'DUCEM. SeeMoLA. N^E'VUS,(from gnavus,—ageno, because it appears from the birth). Navus maternus, a mother's mark, macula matricis,'stig7na. (See Macula.) The same term is applied to the wen, encystis. Dr. Cullen gives ihe wen the general name lupia, places it in the class locales and order tu7nores, defining it an extuberance under the skin, moveable, soft, and without pain. All preternatural tumours on the skin, in the form of a wart or tubercle, are called excrescences; by the Greeks acrothymia; and when observed at the birth, navi materni, metrocelides, marks from the mother. Larger tumours depending from the skin are denomi- nated sarcoma. The nsevi appear on any part of the body, differing in their colour from the rest of the skin, sometimes resembling strawberries, grapes, &c. Heister advises their removal by means of a ligature, a cautery, or a knife, according to circumstances. Dr. Aitkin, in his Elements of Surgery, divides the wen into the following species. 1. Atheroma. 2. Me- liceris. 3. Steatoma, to which M. Litre adds the lipome, which contains fat. The atheroma is colourless, void of pain, containing in a cyst a matter like curd^s, inter- mixed sometimes with hard corpuscules, and sometimes with a hardish substance,*like the macerated bones of chickens. It is of an irregular shape, not easily im- pressed with the finger, and very slightly elastic. If the contained matter resembles honey, it is named meli- ccris; if suet, Steatoma, q. v. M. Litre describes the contents of the lipome to have all the qualities of common grease; and, though the fat of the lipome re- sembles in appearance that of the steatoma, yet the for- mer melts and is inflammable. When the man who had the lipome was fatigued, or had drunk freely, it in- flamed for some days after, and its contents increased the size of the tumour. See Memoires de l'Academie Royale des Sciences, l'Ann. 1709. Mr. Bell, speaking of these tumours, observes, that they each have various degrees of consistence. In judg- ing of their nature, some advantage may be derived NAN from attending to their situation. Thus, in some parts. fat is more apt to be secreted and deposited in the cel- lular substance than in others, and the steatomatous tu- mours are seldom, if ever, he thinks, met with in those parts of the body which are not usually in a state of health supplied with fat. The head, indeed, is more liable than any part of the body to encysted tumours, but they are very universally atheromatae or meliceres. The meliceris, which is distinguished by the free fluc- tuation of its contents, must be treated as a common abscess, or as directed for the hydrocele of the tunica vaginalis. See Hydrocele. When a cyst containing matter adheres so firmly to the contiguous parts as to require much time to remove it by dissection, it should never be attempted, except the patient is firm and resolute. It will be sufficient to lay it freely open through its whole extent by an in- cision, and to remove any loose portion. The"contents of the tumour will, in this manner, be completely re- moved by suppuration, and the cure may either be ef- fected in the usual way, by preserving the wound open till it fills up with granulations from the bottom, or it may be attempted by drawing the divided edges of the skin together, and trusting to moderate pressure with the ordinary effects of inflammation. This plan, how- ever, will often fail, and the whole degenerate into a malignant ulcer. If on a gland, it should never be attempted; and extirpation is, in general, the safest mode, if, from the distance of any large vessel, it is practicable. See also the article Steatoma for the method of dissecting the whole tumour out; which, when not very large, may be submitted to. See Wiseman, Turner, White, Bell, and Heister's Surgery; Warner and Gooch's Cases and Remarks, p. 281, &c. NAT CORO'NA. See Phaseolus zuratensis. NA'KIR. A violent flatulence passing from one limb to another with pain. Schenkius. NA'LUGN. A bacciferous shrub of an unknown genus in Malabar, which flowers twice a year. Its dif- ferent parts are used by the natives in flatulent and spasmodic disorders. See Raii Historia. NA'NDIA. See Ltcium. A 2 N A U < va vni F'RVAT \M. A small East Indian shrub, ,he whole of which ,s lactescent; the juice destroys worml but th» plant also has not yet been not ced by ST^matic bolanist, or the indigenous name has not hrcn preserved. Sec Raii Histona. N \NDl-UOBA,/rwi/fra scandena Lin. ^p. ri. i«'i ,15ed'in St. Domingo, where it grows, as a remedy tor »hc bites of serpents. N \P, or N A PE'CA. See CEnoplia. NAPE'LLL'S, (from its bulbous root resembling tne turnip napus). N VPH.fi AQ. See Acraxtium Hisp.vxiclm. \ APHTHA, an Arabian word, applied by the Ara- bians tOAMBEa,(sec Ambra,) nasa, terra oleum. It is the thinnest of the liquid bitumens, perfectly fluid, , Icar, colourless, of a strong smell, not highly fragrant, ♦ xtrcnulv subtile, so light as to swim on water, spread- ing to a large surface, exhibiting prismatic colours, and highly inflammable. It has the same appellation whe- ther it is separated by nature or art from thick petro- leum or grosser bituminous matter. There are three kinds as it arises naturally, the white, the reddish, and ihe grosser deep coloured, but each, by keeping, seem- ing from the addition of oxygen, becomes a dark re- sin. Naphtha issues from the earth, at Baku, in Persia,on the borders of the Caspian; is collected from the surface of wells in the same regions, and sometimes tbund on the waters of Italy. Naphtha and petroleum arc probably formed by the decomposition of bitumens by subterraneous fires; and the lighter fluid naphtha usually appears on the surface. The true naphtha dissolves resins and balsams, but not gum resins or clastic gums: it is useful as an external application for removing old pains, chilblains, nervous disorders, cramps, contractions of the limbs, paralytic affections, &c. Sec I'ktrolklm. NA'PIUM, (from its resemblance to napus, navew). See Lamps \na. NA'PTA. (Sec Naphtha.) A name also for the tumour, called nata or natta. NA'PUS, (a Rabbinical term). The seeds of this plant furnish a stimulating oil, called rape oil, used in liniments. Sec Buxias. N A'PY, (from »», not, and *•**, to eat; because it was thought not eatable from its pungent taste). See Si- va pi. N ARCE, vxpxi, the torpedo, (from vxpxoa, to stupify). \ torpor, stupor, or dulness of sensation, either from disease or medicine. NARCISSUS LUT.E'US SYLVE'STRIS, (from the youth, who, in poetical fable, is said to have been changed into this flower). Bulbus sylvestris, narcissus pseudo-narcissus Anglicus Lin. Sp. PI. 414. Wild daffodil. The roots are slightly purgative and emetic; the dose two drachms in infusion. NARCO'SIS, (from vxpxa, to stupify). A stupe- faction. N ARCO'TICA, (from the same). See Anodtna. XA'RDUS CE'LTICA,(from theSyriac word nard). Spica cettica, seliunca, Celtic spikenard, Valeriana celtica Lin. Sp. PI. 46, is a small species of valerian, with uncut, oblong, obtuse, oval, leaves, a native of the Alps, from whence we have the dry roots, consisting of a number of blackish fibres, with the lower parts of the stalks adhering: the last are covered with thin yel- low scales, the remains of the withered leaves. Its N A R virtues resemble those of valerian, which it possesses in & T^e^mruntain nard is only the root of the large ^^Sts SV.W. Spicaspica Jr,dica,sfiica nardi, Indian .p.„kard,«ahd, or Syrian vtnn androhoeon nardus Lin. bp. tl. 148J. Dtoscorides'thinks, without reason, the Indian and the Syrian nard to be different. They are the bushy op of the root, or the remains of the withered stalks and ribs of the leaves of an Indian grassy leaved plant. Linn*us, as just mentioned, has referred it to the genus andropogon; and Dr. Blane,in the Philosophical Irans- actions for 1790, considers it as another species ol the same genus, of which the trivial name is the native ap- pellation, viz. jwardncusa. Sir W. Jones, however, in the second and fourth volumes of the Asiatic Researches, refers it, with much reason, to the genus Valeriana, with the trivial name jatamansi. The error of suppos- ing it a grass arose seemingly from the term spica; but this species of valerian rises from the ground in hairy spikes like ermines' tails. Dr. Roxborough, in the fourth volume of the Researches, has given a figure of this appearance, and indeed of the whole plant. The nard, as brought to us, is a congeries of small, tough, reddish brown fibres, cohering close together, but not interwoven so as to form a bunch or spike, about the size of a finger. The spikenard of India and Syria alike resemble valerian in their virtues ; but the Indian is warmer than the Syrian, and somewhat pun- gent and bitterish. It also agrees very nearly in its virtues with cypress. The nard was highly valued in the east as a spice and perfume; and it was an ingredient in the theriaca and mithridate. Among the ancients the unguentunr nardinum was used at the baths and feasts. All the ancient physicians recommended it in dropsy, gravel, and pains of the stomach, both internally given, and ex- ternally applied on wool. In the latter mode Galen relieved the emperor Marcus Aurelius in cholera. It is used in India as a febrifuge. Na'rdus Ita'lica. See Lavendula latifolia. Na'rdus rustica et Montana. See Asarum. NA'RES, (from the Hebrew, naker). The nos- trils ; nycteres. The internal nares, or cavity of the nose, pator narium, comprehend the whole space be- tween the external nares and the posterior openings immediately above the arch of the palate, by which a probe may be passed from the nose to the fauces. From thence these cavities reach upwards to the lamina cri- bosai of the os ethmoides, where they communicate for- ward with the frontal, and backward with the sphe noidal sinus. The two frontal sinuses, the two antra highmonana, the cellulse of the os cuneiforme under the upper spongy bone of the nose, open into the nostrils, and from thence discharge their mucus. The spongy bones, two in each nostril, are covered with f^mrC,KUSmenM ^ne ah°' and thus the ^creting sur^ face of the nostrils is enlarged. The olfactory nerves without the dura mater, pierce through the hofes in the os ethmoides, and spread themselves on the mucous STSr Tnemn0Stbri,S' ^ * *»** *™ *« «*£ pair also. The membrana pituitaria, which lines the nose, is very vascular and papillous at those parts where it is most exposed to the stream of the air. The mucL^fr™ iu.fu" °f SmaI1 Slands wh"» separate mucus j and from this membrane polypous excrescences N A S 5 NAT arise. The arteries of the nares are branches of the internal maxillary; the veins discharge their contents into the internal jugulars. The nerves are branches of the olfactory, ophthalmic, and superior maxillary. The nostrils of infants are sometimes obstructed, and some unctuous substance is applied for relief,; but three or four grains of white vitriol, dissolved in half an ounce of water, solicit more effectually a discharge of the too viscid mucus. When the nostrils, after the small pox, are closed up, an opening may be made into them with a small knife, and kept distended until the wound is healed. NARIFUSO'RIA, (from nares, the nostrils, and fundo, to pour). Medicines which are instilled into the nostrils. NASA'LE, (from nasus, the nose). See Errhina. NASA'LIS ARTE'RI A. SeeMAxiLLARi.fi arteri-s. Nasa'lis, musculus compressor naris, rinaus, rises fleshy from the extremity of the os nasi, and adjacent parts of the os maxillare, and is inserted into all the cartilages of the ala. It dilates the nostrils. Nasa'lis proce'ssus. See Maxillaria superiora ossa, and frontis os. NASCA'LE,(from nasus, the nose). A pessary made of wool or cotton to raise the nose when compressed. NA'SI O'SSA. Two small bones which compose the upper part of the nose, and are supported by the septum nasi. Na'si a'l.e. See Pinnae. NA'SITAS, (from nasus, the 7iose). A speaking through the nose. NA'SO PALATINI DUCTUS. See Incisorii DUCTUS. NASTU'RTIUM. Quasi 7iasi tormentum, because the acrimony of the seed, while bruising, excites sneez- ing. It resembles the Mithridate mustard, distinguished by a less foliaceous margin, and multifid leaves. A name also for barbarea, sophia, and several other plants. Nastu'rtium aqua'ticum, laver odoratum, sisym- brium, crateva sium, cressio, carda7nines. Water- cresses ; sisymbrium nasturtium Lin. Sp. PI. 916. A juicy plant with brownish, oblong, obtuse, leaves, set nearly in pairs, without pedicles, on a middle rib, ter- minated by an odd one larger and longer pointed than the rest. The stalks are hollow, pretty thick, channelled, and crooked; on the tops grow tufts of small tetrapeta- Ious white flowers followed by oblong pods, which, burst- ing, throw out a number of roundish seeds. It grows in rivulets or the clearest standing waters, and flowers in June. The leaves remain green all the winter, but are in the greatest perfection in spring. The leaves are to the taste moderately pungent: when rubbed between the fingers, their smell resem- bles mustard, though weaker. It is a mild, aperi- ent antiscorbutic, supposed to purify the blood, and to open visceral obstructions. The expressed juice con- k tains all the virtue of the plant; but whether eaten as a salad, or the juice drunk, its use should be long con- tinued, since as a medicine it is inert. Water cresses form one of the ingredients for the succus cochleariae compositus. Nastu'rtium horte'nse. Lepidium sativum Lin. Sp. PI. 899. Common garden cresses, a low plant, with variously cut winged leaves, bearing,on the top,of the round stalk and branches, tufts of tetrapetalous white flowers, followed by roundish capsules, flatted on one side, and full of reddish round seeds. It is annual, and raised in gardens, and an useful dietetic herb in scorbutic cases, and in debilities of the chylopoietic organs. It is milder than the water cresses: the seeds are more pungent than the leaves, and agree in their general qualities with those of mustard. Nastu'rtium I'ndicum. Acriviola, nasturtium Pe- ruvianum, cardamindum ampliori folio, and majorfiore, tropaolmn majus Lin. Sp. PI. 490. Greater Indian- cress, or yellow lark spur. The leaves arc round, umbilicated, and placed alternately; the stalks trailing ; the flowers consist of five petals, formed like violets; the seeds round and rough, three in each flower ; a native of Peru. The young shoots are used as pickles ; but the leaves and flowers resemble water cresses, emitting when bruised the smell of horse radish. Their medical virtues are similar to those of the sort common with us. See Raii Historia ; Lewis's Materia Medica. NA'SUS, (probably from the Hebrew nasaph, to blow). The nose ; mycter. The external parts of the nose are the root, the arch, the back or spine, the sides, the tip, acre; the wings, ala, or pinna, the external nares, and the part under the septum. The internal parts are, the internal nares, septum narium, the cir- cumvolutions, the conchae superiores, the conchse in- feriores, the posterior openings of the internal nares, the sinus frontales, maxillares,andsphenodales ; ductus lachrymalis and palatinus. The nerves are the olfactory, and a branch from the fifth pair. The cartilaginous part of the nose is always open to admit of respiration ; but grows gradually narrower." See Nares. NA'TA, or NA'TTA ; naphtha, or napta. A wen, with a narrow basis. Linnaeus speaks of it as rooted in a muscle. NATA'TIO, (from nato, to swi7n). Swimming is a laborious exercise, and should not be continued to exhaust the strength. It is not natural to man as to quadrupeds, for the motions of the latter in swimming are the same as in walking. To man, however, it is by no means difficult, for the body is specifically lierhter than water; so that to float it is only necessary to keep the head above the surface, for the body falls naturally forward with the head downward. A slight motion of the hands produces this effect, and the body is propelled by the impulse of the feet. Oribasius gives some direc- tions on the subject, lib. vi. cap. 27. The dangers from swimming' are spasms, which sometimes arise from the cold, sometimes from the great exertions, and the inconveniencies arising from the abuse of cold Bathing, q. v. It promotes perspiration, and attenuates the fluids if used in moderation. NATES, (from nato, to flow; because the excre- ments are discharged from them). The buttocks;. and a name of two prominences on the brain. See Cerebellum. NA'TRIX TORQUA'TA, (from nato, to swim). See Anguis. NATRON, (a lake in Judea, from whence it was produced). Barilla, soda, mineral and fossil alkali. The mineral kingdom offers this alkali in large masses, though contaminated, usually, with sea salt, which shows its origin. It is also found in various plants,as the salsola, kali, sativa, soda, and tragus; sali- cornia herbacea and arabica; mesembryanthemum no- diflorum; plantago squarrosa; and fucus vesiculosa X A U I.in The salsola kali is the plant from which it is chiefly procured in the east; but the best is from the * klPYa; and the worst kind from the s. tragus. Where the natron form, a considerable article of commerce, the seeds of the salsola arc regularly sown, the plants burnt, and the salt calcined. It always contains some common salt, Glauber's salt, sometimes a sulphurated kali, and occasionally a little iron. The pure crystals arc of a rhomboidal figure, transparent, laminated. One hundred parts contain twenty of salt, sixteen of aerial acid, and sixty-four of water. An ounce of water, at 62° of Fahrenheit, dissolves about five drachms, fifteen grains of the crystals. See Alkali. Na'ikon mlriailm. Common salt. See Mari- XV S s\l. Natron prepara'tum, i. e. Sal sod*. See Alcali. Nv'tkon tabhrisa'tim. See Rupellensis sal. Na'tron vithiola'tlm. See Glauberi sal. NATSIA'TUM. See Cocculls Indicus. NATU'RA, (from nascor, to proceed). Nature. On this subject we find much unnecessary minuteness in various authors, which it would be useless to trans- cribe or examine. The term is sometimes used for the Author of nature, oa the Supreme Being ; sometimes lor the whole of his works; occasionally for essential qualities of a body, or the usual series of causes and effects. The atheists of the continent have exalted nature into a supreme power, lonjcttini; that in this change of name they voluntarily admit the existence of a deity, and give the most unequivocal testimony of the neces- sity ol an omnipotent superintending power. In this work, however, we must speak of nature in a more limited view ; and it means, in medicine, the constitu- tion which a man derives from his parents, or those powers, inherent in the whole system, by which devia- tions are corrected and losses repaired. We say a man is by nature weak; and that nature cures. In each case wc express an effect only, without, by the re- tVrcnce to nature, assigning a cause. These changes may perhaps be the necessary consequences of structure; and in some cases, they appear to be so; but we know of no principle in the constitution by whose super- intending power these salutary effects are produced, and we sometimes see such efforts really injurious. It is certainly more honourable to an all powerful author, that a system, like that of the human machine, shall be formed so as to correct accidental deviations, and to re- pair injuries, rather than to raise a subordinate agent, to iiiu ifere in every error or accident to which the func- tions or the body may be subject. NATURA'LIA, (from natura, nature). See Pu- denda. NAU SEA, (from*xvs,a ship ; because it is pro- duced by the motion of a ship). Cacositia : its least degree means a loathing; or, according to Linnseus, a fixed aversion to food. This proceeds to nausea, retch- ing, and vomiting. Nausea is one of those irregular exertions, which we have described as arising from debility, and Tsac compared !,v a slight degree of inversion of the lowed PCnStalUC ,UOlion hY "hich the food is swa" A nausea always precedes a vomiting, and is attended j NEC coming apparently from the oesophagus, which is certainly susceptible of the inverted peristaltic motion, without any affection of the stomach; as the upper Dart of the stomach is without the whole organ joining in the action. (See Emetica.) Nausea may be ex- cited by a variety of causes, and in particular habits by circumstances often scarcely, if at all, connected with the stomach. It accompanies also different attections of the brain, particularly every cause of irritation or oppression. An emetic will often for a time relieve it; but when nausea continues, warm bitters with rhuharb or aloes are the best remedies. The effervescing draughts, sometimes warm opiates,and, when from bile, the juice of lemons, will often be successful. It is an almost con- stant attendant on fevers, and seldom is permanently re- lieved till the fever recedes. If it continues after the fever, an emetic is peculiarly necessary. NAU'TICUS. A muscle chiefly used by sailors in climbing ropes. See Tibialis posticus. NAYTCULA'RE, or NAVIFO'RME OS, (from- navicula, a little vessel,) from its supposed resemblance to a boat; and from navis and forma. See Scaphoides. NAYIGATIO, (from navigo, to sail). Sailing is beneficial to weak persons. When the ship's motion is gentle, and steadily progressive, an uncommon alacrity, an increased perspiration, a keener appetite, and a rilll/^lrol* e\1 f¥*/»Q t Inn n !»*» tlio f.nniianiian/.a(. . Kilt lirnon quicker digestion, are the consequences; but when a patient is weak, violent agitation in a rough sea is dangerous. Sea voyages have been recommended in hypochondriac affections, visceral obstructions, scrofula, hypochondriac affections, visceral obstructions, scrotula, and particularly in consumptions; in the last, if pro- perly conducted, it has been considered as a very valu- able remedy. When speaking of exercise, we men- tioned sailing as the most advantageous mode for those who could not bear bodily fatigue. The constant exer- tion to preserve the equilibrium keeps various muscles in action, and promotes, as we have seen, perspiration. This with the free open air will sufficiently account for all the advantages of a sea voyage. See CEora and Gestatio The Use of Sea Voyages in Medicine, by L. Gilchrist, M. D. J NEAPOLITA'NUM UNGUE'NTUM. Neapo- litan ointment; an old preparation of mercury, for which vr f"ei?¥"» Mrargyri mite is usually substituted. to LvX fifA'NuUS MO'RBUS, (because it is said to have been first observed among the French soldier* ^ ^RS^ See L«- venerea S°ldierS NL BI POU'LI. See Bilimbi. NECR^^T Vf<5eA"' a Cl°ud">' See Albugo. .nl.^KU bib, (from vexpou, to destroy). Drv tav grene, a slow mortification of a part, without any pre vi ous_ softness, and fetid dissolution, attended o?te„P with patsnlTeedndlZPr' "t^™ &nd bl"*nessoJSS pans succeed. It is slower in its progress than Mnm,n0 become, offence, and soon ternlf te(Sef UoZ' ficatio.) Wages enumerates six species baoit)I0rPro„s,Ahr„u^^'iru8«»«—»*. 3. Necro'sis FEBRILIS,and a.«lckNoratvSer>0"s°c!ZT;.OA,When * ^"^ "» 5. Necro'sis epidemica. cor6dingEtoRRPSi.S INFANTI>IS- This complaint, ac- cording to Bell, never arises from inflammation; but NEP 7 NEP generally from some obstruction in the principal arte- ries, consequently from a defect of fluids. See Bell on Ulcers, edit. 3. p. 94. Edinburgh Medical Commen- taries, vol. ix. p. 78. London Medical Journal, vol. iii. p. 369; vol. vii. p. 263. NECTA'RIUM, (from nectar, honey,) the mellife- rous part of the vegetable, peculiar to the flower. It commonly makes apart of the corolla,but is sometimes entirely distinct from it, and is then more strictly a nectary. It is frequently in the form of a horn, or spur, sometimes in that of a cup. NE'DUM SCHETTL The name of a bacciferous shrub which grows in the East Indies, of which an ointment is made by boiling in oil, used to relieve pru- riginous disorders. It does not occur in the systematic authors. NEDYTA, NE'DYS, (from v^lvs, the belly). See Stomachus and Abdomen. NEDYU'SA, (from the same). See Sitis. NEE'DLE. A surgical instrument of considerable importance, for securing arteries, for sewing wounds, and for sutures. The largest are used for the first, and the smallest for the last purpose. The instru- ment employed in depressing the cataract is styled a needle. For depressing the lens Mr. Ware advises the needle to be somewhat larger in its tongue than usually made. NEFRE'NDES. Sucking pigs; but applied to young children, or old people, who have no teeth; quasi nefrangentes. NE'GRO. See Homo. NEI\fiRA, (from vetxpos, farthermost). See Abdo- men/ NEIEM-EL-SALIB. See Gramen crucis. NELU'MBO. See Faba jEgyptiaca. NEMORO'SA, (because it grows in woods). See Anemonoides. NE'NUFAR. See Nymphjea. NE'PA. A crab, a scorpion, and the name of the genista spinosa major. Ne'pa theophra'sti. See Genista spartium. NEPE'NTHES, (from v», a negative particle, and vevios, morning, from its exhilarating qualities). The nepenthes of the Egyptians is supposed to have been a preparation of opium and Dutrary, both the produce of Egypt. It was, according to Homer, the draupflt which Helen prepared to dissipate the uneasines> of her husband. Schultz's Historia Medicinae. Se~ also Bandura. Nepe'nthes distillatoria of Linnaeus, Sp. PI. 1354, is a singular plant of Ceylon, which *ias, at the extremities of its branches, a membranous cup, always in the morning covered with a lid, and full of water. The lid rises.during the day, and the water is half eva- porated ; but restored before the next morning. See, says Linnaeus, the true nepenthe for the exhausted botanist! The roots are said to be astringent, and the leaves are cooling. The water, in the urr, is used by the Indians in obstructions of urine. NE'PETA, (from nepte, German). See Mentha oataria. NEPHRALGIA, (from ntppos, the kidney, and xXyos, pain). Pain in the kidneys or ureters. Nephralgia calculo'sa. JVephralgy, from a stone in the kidneys. This differs from a nephritis from the same cause, as it consists in a fixed pain in the region of the kidneys or ureters, without any acute febrile affection, and seems to depend on a large stone fixed in either part. It seldom happens in both sides, and the pain usually extends along the track of the ureter in the abdomen towards the bladder, attended with a painful drawing up of the testicle of the same side, or with a stupor, or numbness of the thigh. In the violence of the pain, a nausea and frequent vomit- ing come on: by lying on the pained side the uneasi- ness is mitigated, but on that which is opposite, in- creased. The urine, in the beginning, is watery, and small in quantity; afterwards turbid and copious, often extremely hot and bloody. The chief relief arises from bleeding, rest, diluting mucilaginous liquids, decoctions or infusions of lintseed, marshmallows, barley and gum arabic, anodynes, camphor, oily medicines, the warm bath, and a thin cooling diet. See Calculus and Ne- phrotomy. Nephra'lgia rheuma'tica. See Rheumatismus. NEPHRELMI'NTICA ISCHU'RIA, (from ve See Boerhaave's Aphorisms, and Van Swietens Commentary; Fordyce's Elements, part the second ; Cullen's First Lines, edit. 4. vol. i. p. 387. NEPHROLI'TICA ISCHU'RIA, (from vetppos, the kidney, and XtSos, a stone). A suppression of urine from the stone in the kidneys. See Ischuria. NEPHROMETR.fi, (from wlpx, womb). See PS0iE. NEPHROPLETHO'RICA ISCHU'RIA. Ischu- ria, q. v. from a plethora. NEPHROSPA'STICA. Ischuria, q. v. from a spasm. NEPHROTHROMBOI'DES. Ischuria, q. v. from grumous blood. NEPHROPY'ICA. Ischuria, q. v. from purulent matter in the kidneys. NEPHROPHLEGMATICA. Ischuria, q. v. from pituitous or mucous matter. NEPHROPLE'GICA. Ischuria, q. v. from a pa- ralytic state of the kidneys. NE'PHROS, (from veu, to flow, and Qtpu, to bear, as conveying the urine). See Ren. NEPHROTO'MIA, (from veppos, and refvta, to cut). Nephrotomy, the extraction of a stone from the kid- neys by an operation. Rouset first advised this opera- tion, and in Mezeray's History of France there is an instance of its having succeeded on a convict; but from the course of the renal artery it does not appear to be possible without destroying the patient. (See Renes.) Heister has indeed told us that wounds in the kidneys are not mortal ; and if a stone or an ab- scess can be felt externally, so as to be opened without ^posing the cavity of the abdomen, there is no reason wh; the operation should not be attempted. See Avi- cenmi Serapion, Wedelius, Meckren, Heister; Medi- cal MLsaeum, vol. ii. p. 370; Bell's Surgery, vol. ii. p. 144; White's Surgery, p. 368. P NEPONES. SeeBARONES. VpfRTTTlJ1^' SCe AuRENTIA HYSPALENSIS. AtKlUJVi, (from vepes, humidus, because it grows lIi m°JSt' ,generalIy maritime places). Rhododaphne, rhododendron, oleander, laurus rosea. The dwarf rose bay, nerium oleander Lin. Sp. PI. 305. Its flow- ers resembie arose, and its leaves the bay; and it is ?^7uJT-l lJT a Shrub- The baches are divided and subdivided by threes, and the leaves grow three rZT^ f I** ueaVCS &nd fl0Wers are Poisonous; the muscles of the pharynx become paralytic; and vomit- hsgarIt1lrPUrg1^ %°n-C™eS ^' Vineg*ris said to be its antidote. See Ran Historia. Ne'rium antidysente'ricum. Lin. Sp. PI. 306. pala bark Pr°bably affords the conesi or codaga- NER 9 NE LI XERO'LI O'LEUM. See Auraxtia Hispalen- MA. NERONIA'NA. See Phlebotomia. NERVA'LIA O'SSA, (from 7iervus, a ?ierve). Sec Arcualia ossa. NERVE'A SPONGIO'SA, (from the same). See Corpora cavernosa penis. NER'VI, neuri, (from vevu, to extend, because ori- ginally applied also to the tendons and sometimes even to the ligaments). Nerves are the prolongations of the medullary substance of the brain; and, though in their progress their whole bulk seems to be greater than the nervous cord, when it escapes from the cranium, this is apparently owing rather to the separation of the nervous by cellular, substance, than any addition to their me- dullary portion. We shall find, however, some sources, from which additions may accrue. To take a more distinct view of the nervous system than any anatomical author will afford, we must exa- mine it comparatively, in the different animals of a lower order. In the human body we have described the brain, and found the spinal marrow a vast trunk, arising as from a root, from which the nervous filaments are the branches; and have seen another system, the sympathetic or great intercostal. This we shall term, for the sake of convenience in expression, the ganglionic system; for in this alone are the nerves united in gan- glia, which are subsidiary masses of medulla with its attendant cineritous substance, or communicate freely in a net work, styled a plexus. The ganglionic system is destined to the vital organs. The sensations it con- veys are indistinct, and its activity, though subject to remissions, constant; while the cerebral system des- tined to the organs of sense, and to the voluntary mus- cles, conveys distinct sensations, requires repose, and is disposed in a regular order. As we descend in the scale of animated beings we find the cerebral system gradually lessen, till it disappears, and the ganglionic alone remains. As the former disappears, the functions of nutrition and generation are more active, while those of sensibility and intelligence diminish in the same pro- portion. There are consequently two nervous systems in vertebral animals, and one only, with some slight ex- ceptions, in those without vertebrae, which are, at the same time, without voluntary loco-motion. If zoophytes have no visible nervous system, their sensibility shows that they contain nervous molecules, which may be compared to isolated ganglions. Animals which have the ganglionic system only, possess no centre of vitality, but are often propagated like vegetables, by buds. Each ganglion is, to a certain extent, independent, and each can apparently supply the place of the other, in reproducing any part which has been lost. In man, the ganglionic system begins in the neck by the superior cervical ganglion, the largest of the whole body. It is this which supplies the place of a brain in animals :yhich have none. Below is the inferior cervi- cal ganglion, which is often double. In the breast, the grand sympathetic nerve forms almost as many ganglia as it meets with nerves; and the nervous fibres scattered in every direction form two or three cords which de- scend to the abdomen, and there assume the appellation of the splenic nerve. This forms a considerable gan- VOL> II. glion near the diaphragm. In the lower orders the g:u, glia are equally numerous in the abdomen. The substance of the nerves appears, at first sight, a pulpy mass, but, if examined with a microscope, each nerve is found to consist of fibres in a parallel direction. Dr. Monro thought the fibres convoluted; a circum- stance which no anatomist has since confirmed, owing apparently to optical illusion. When spread in the or- gans of sense, the fibres are no longer discerned, but the whole becomes a nervous membrane of peculiardelicacy. We have no reason, however, to suppose the structure changed, but the fibres discovered by the microscope are probably only fasciculi of more minute ones cover- ed with a proper coat; and when this is deposited the fibrous structure eludes our sight. It is estimated, from the angle which the least visible object subtends, that the fibre which becomes sensible of a visible impres- sion must be less than the thirty-two thousandth part of a hair. Every nerve is covered at its passage through the cranium by coats of the dura and pia mater, and tu- nica arachnoidea; the two latter are said to accompany the nervous fibrils in their course. This is, however, probably true only to a certain extent, for the nerves have also a fine coat from the cellular membrane, which may be expanded by inflation, so as totally to obscure the nervous fibres: these shrink also in drying, and al- most disappear. The strong dura mater is absolutely necessary to enable them to bear the pressure of the bones, in passing through their foramina, and the shocks they are subject to in the extremities. Anatomists have, however, in general supposed, that the pia mater accompanies the nerves in their minuter ramifications ; but, whatever the membrane may be, Reil thinks that he has discovered it by dissolving the medullary sub- stance in an alkaline lixivium, and, on the contrary, has separated the nervous fibre by dissolving the coat in an acid. It is at least certain that we do not see the nervous substance distinct from its coverings, but in the retina, and the nerve dispersed on the cochlea, vesti- bulum, and semicircular canals of the ear. The nerves are probably in the same state when dispersed on the muscular fibres. The arteries of the nervous chord are very numerous, and, as hinted in the article musculus, are necessary perhaps to give that tone or tension which is consistent with the due discharge of their functions ; but it is suf- ficient in this place to remark, that the arteries are so numerous as with the usual fine injection to render the nerve of an apparently uniform colour. Though we have, however, employed the term tension, we mean not to insinuate that the nerves convey sensations as musical chords. They are incapable of such tension, and the term is rather used analogically, than strictly. The arteries are accompanied by veins, and probably also by lymphatics. The ganglions have thicker coats, more numerous, and larger blood vessels than the nerves. They are larger than the nerves which form them ; and, in gene- ral, when nerves unite, they are larger at their union than the cords of which they are composed. In the ganglion, the fibres are united, crossing each other in different directions, and the consequences have been already noticed. We need not now stay to record the experiments which show that sense and motion depend exclusivelv B \ E R 1° u„ ihe nerve*, or rather on the nerves as accompanied by their arteries. It is not only certain, that to tic the artery will render a muscle paralytic, or destroy the sen- sation of an or^an, but that a more active circulation will increase both tone and sensibility. \et the latter has its bounds; and, in the organs of sense particularly, an increased fulness of the vessels will compress the nerve, and destrov its functions. May we not, however, distinguish between a more active circulation, and dis- tention from fulness, in consequence of less irritable fibres ? This is probable, and merits consideration, as it will influence the practice; but it is not our present object. Compressing, however, the nerve, will not im- mediately destroy the sensibility or irritability of a part, unless the pressure be near the organ. If at a distance, motion at least will remain some time, and be more quickly lost in proportion as the pressure advances nearer. The first Monro relates a similar experiment more pointedly. Grasp the phrenic nerve somewhat above the diaphragm, and draw the other hand along it, with some pressure towards the muscle. It will con- tract, and the experiment may be repeated ; but the effect will soon cease, unless the pressure from the hand above be removed. If the pressure, however, at what- ever distance, is long continued, the power of the muscle is not recovered. In the organs of sense, pres- sure has a more rapid effect; we allude particularly to the amaurosis from plethora, which may perhaps arise from its acting so near the extremity of the nerve, di- vested of its defences. Independent, however, of pres- sure, various vegetable and animal substances will de- stroy the functions of the nerves, hy an action wholly distinct from any change in the organization, and, so far as we can perceive, from any chemical affinity: some gases will have a similar effect. Substances also which affect only the simple solid, as warm water astringents, or will give increased mobility or tone. Affections of the medullary substance of the brain will, of consequence, affect the nerves. Irritation will increase their action, pressure destroy it, deleterious substances acting on any sensible organ, whose sympa- thy with the brain is strong and well established, be equally fatal to it. Disputes have arisen, whether any injury on the brain is felt in the nerves on the same or on the opposite side, for authors have imagined that the fibres of the brain cross each other within the cra- nium. This argument has been supported by some facts; and in the eye, by the fibres of the optic nerve evidently crossing each other in fish. In the human body, however, the rule is by no means without ex- ception, even in the eye*. Minute anatomists have, how- ever, traced the fibrils of a nerve far beyond the spot, /rom whence it separates in a cord; and Soemering has traced the roots of the nerves, particularly those of the organs of sense, to the eminences in the parietes of the ventricles. We shall, however, speak of them in the common language of anatomists, as arising from the spot where they first appear distinct from the cerebral mass. They, however, separate from the brain at very acute angles, and can, for a time, be easily traced with- in its substance, and indeed all their divarications are equally at acute angles. Is sympathy between nerves of distant parts owing to his connexion within the brain? This has been the ^.mon of many authors; and, as it is wholly inexpli- NE U le in any other view, there is less reason for reject-" caoie a; the subject. '"before we tptrmore particularly of the functions of fhe nerves, a'nd the source of their energy, we shall ^nun e'r'ate the principal branches, and in this part we shall chiefly follow the first Monro, and \ iq. d Azyr, in the order of Willis. , From the encephalon ten pair of nerves proceed. The first pair are the olfactory, arising from the cor- pora striata, but by the older anatomists said to arise from the processus mamillares; because m brutes these points projected, and from the extension ol the lateral ventricles they were hollow; consequently, in their opinion these nerves were designed to convey the mucus from the cold, moist, brain. They become larger as they pass under the anterior lobes of the brain, and are joined, at the os ethmoides, by a branch of the fifth pair. They are very tender, and, suddenly expanding on a large surface, cannot be traced far. These tender nerves are defended from the weight of the anterior lobes of the brain, by being sunk in hollows, which give.them a triangular shape, and, from the varied depth of either sulcus, one nerve seems occasionally larger than the other. Towards the fore part, these nerves expand into an oval lobe containing cineritious matter, which lies on the bone. They are apparently the organs of smelling. The branches of the fifth pair appear to sup- ply the arteries and the mucous glands; the first pair only conveying the sensation. The second pair, the optic nerves, arise from the thalami nervorum opticorum, or more directly, accord- ing to Sabatier, from the tubercula quadrigemina, and, after a long curve under the brain, unite at the fore part of the sella turcica, apparently blended. They then di- vide, and each running forward and outward, passes at its proper foramen into the orbit, to expand in the re- tina. It is, as we have said, sufficiently certain, on the whole, that the fibres do not decussate, though this certainly in some instances, takes place. We have our- selves seen from a blow on the head an affection of the opposite eye. With the optic nerve the ocular artery enters the orbit, and occasions an insensibility at that point, which may be ascertained by an easy experiment. It is, however, equally probable that the nerve is not fitted for sensation till it is expanded in the very delicate web, the retina. This membrane is, as usual, plentifully supplied with arteries, and the active circulation, through them, greatly increases its sensibility, while distention, for any time, destroys it. The third pair motores oculorum, first appear at the anterior part of the processus annularis, and, going out at the foramen lacerum, are dispersed on the mus- cles of the globe of the eye. In a more minute exami- nation they seem to arise from the internal margin of the crura cerebri, and the perforated medullary matter between them; and they pass between the posterior artery of the cerebrum, arising from the division of the basilar artery, and the anterior artery of the cerebellum Each diverges, passing under the anterior part of the tentorium by the cavernous sinus. The situation of this nerve near the artery, accounts, in the opinion of Saba- tier, for the weight on the eyes at the approach of sleep • in fevers and states of inebriation. P * thJ^mM^ fl' PATHETICI °r trochleares, are the smallest of the encephalon, not exceeding in NER 11 NER size a common thread. They arise from the base of the testes, and running half round the root of the crura me- dullae oblongata, adhere, by a membrane, to the ante- rior lateral part of the processus annularis, pass through the foramina lacera, and are spent on themusculi troch- leares, the superior oblique muscles of the eye. They are called pathetici from their rolling the eye with vio- lence or fury. The origin of the trochleares is, however, various, and they seem to have a more intimate connec- tion with the brain than any other nerves; yet no part of their office shows such a connection, or appears im- portant. The fifth pair, trigemini, arise from the annular process, where the medullary processes of the cerebel- lum are joined to the tuber. This nerve seems to arise in two portions: the anterior is small, and somewhat elevated above the other; the posterior originates a little lower. These portions are connected by a cellular mem- brane in which a little artery often creeps. In fact, though in a few individuals connected with the cerebrum, this is truly a nerve of the cerebellum. It enters the dura mater, near the point of the petrous process of the tem- poral bone, and sinking close by the receptacula at the sides of the sella turcica, each becomes thicker, forms a distinct ganglion, and passes from the skull in three great branches; one to the orbit of the eye and forehead, through the foramen lacerum; one to the upper jaw and face through the foramen rotundum; and another to the lower jaw and tongue, through the foramen ovale. The first, the ophthalmic, before it passes through the foramen lacerum, sends off a branch to the inter- costal, and forms the first connection between the two systems. It is then distributed to the glands, fat, membranes, and muscles of the eye, with a twig to the forehead, sending a considerable branch through the in- ternal anterior orbitar hole to the brain, in order to join the olfactory nerve. These very extensive connections explain various morbid phoenomena, as the watering of the eyes, from a stimulus to the nerves of the nostrils, the effect of sneezing from a strong light, and stopping the same convulsion, by a pressure on the internal can- thus, or indeed why sneezing itself, a convulsive action of the muscles of respiration, is occasioned by a stimu- lus to the nostrils. The second branch, maxillaris superior, passes put at the foramen rotundum of the sphenoidal bone, and gives nerves to the palate, sphenoidal sinus, and nostrils, supplies the antrum maxillare, and the upper teeth. It comes out at the external orbitar foramen, previously sending a branch through the substance of the os max- illare, which comes out at Stenos duct, to be distribut- ed on the fore part of the palate. The remainder, which passes through, is lost on the orbicular muscle of the eyelids, the nose and upper lip, where it seems to unite with some branches of the seventh pair. The third, maxillaris inferior, goes out at the foramen ovale of the sphenoidal bone, and supplies all the muscles of the lower jaw, and those between it and the os hyoides. It sends a branch to the tongue, where it meets the ninth pair, and from the root of this last branch the chorda tympani is reflected, or rather the chorda is added to the lingual nerve. It then supplies the salivary glands, the tonsils, the external ear, where it joins a branch of the portis dura of the seventh pair, the teeth of the lower jaw, and from thence the chin and under lip. From these connections, convulsions of the lower jaw arc attended with salivation, angina, with a pain of the ear and teeth, and the senses of smelling and tasting are probably related. If true, that com- pressing the nostrils will destroy the sensation of the palate, the reason will be sufficiently evident from this description, and we shall equally see why the toothach produces convulsions, as well as why cauteries to the external ear, or blisters behind it, sometimes relieve pains of the teeth. The sixth pair, the abducentes, the smallest, except the fourth, arise from the fore part of the corpora pyramidalia; and, in their passage below the dura mater, where they are contiguous to the carotid, appear to send off a reflected branch, and when joined with some from the ophthalmic branch of the fifth pair, to form the original of the intercostal. The sixth pair, somewhat enlarged, now pass through the foramina lacera to be lost on the abductor muscle of the eye. A dispute has been maintained with obstinacy whether the sixth pair sends or receives this branch from the sympathetic; but anatomists have not decided the fact, and the knife probably cannot decide. The eye, of all the external organs, is, however, the only one whose motions are sometimes involuntary, and the intercostal system is exclusively destined to those muscles which are not under the influence of the will. It is singular that this circumstance, though so obvious, and useful in determining the controversy, should not have occurred; but the distinction is in a great measure new. We may add, at this place, that the third, fourth, fifth, and sixth pair of nerves, pass a considerable way under the dura mater, along the sides of the sella turcica, surrounded with a reticular plexus of vessels, and very near the large trunks of the internal carotid, before they pass through the foramina of the cranium. The seventh pair, the auditory, appear to come from the side of the root of the annular process, behind the conjunction of the medullary processes of the cere- bellum with the tuber, accompanier5'-.*•* an artery of an unusual size, and entering :• .-. tribution is to the larynx; though Sabaticr descnu^a a branch, which sometimes ascends and joins the sympathetic, high in the neck. Cutting the recurrent, and internal laryngeal nerves, it was sup- posed, would destroy the voice; but, in consequence of the numerous nervous communications, it is weakened only. When the latter is cut, the voice is u e-aker, but acute; when the former, which chiefly supplies the cartilages, it is graver and hoarse. The par vagum, in its progress downwards, forms the posterior pulmonic plexus, and, passing into the abdomen, with the oeso- phagus, supplies the stomach, particularly its upper part, and is at last lost in the numerous plexuses of the abdomen. In this extensive course it almost rivals the intercostal; but its functions are not so distinctly ap- propriated. We must regard it, however, as the great link between the cerebral and the ganglionic system, between the voluntary and involuntary functions of the body. The last portion of the eighth pair is the accessory nerve of \\ ilhs. It arises from the cervical nerves passes up through the foramen magnum, and comes out with the par vagum, like a nerve of the brain. When it has escaped from the encephalon it leaves the oar Tagum, and attaches itself to the ninth pair, sometimes by a filament, passes behind the jugular vein oblicmelv deWDJAntrdbaKkWard' Perf°"teS ^mastoidT^ £e, gmng branches to it, and then, as if still wishing for support, entangles its branches with the tkltanl N E K fourth cervical nerves, terminating in the posterior par, of the trapezius muscle of the scapula. This peculiar dstribi ion of the eighth pair will contribute to explain the reason, why tickling the fauces excites vomiting; the connection of vomiting and coughing, particular y m the hooping cough ; the sensation of a bal in the thioat, from distention of the stomach, perhaps the shrugging of the shoulders; and reply to the problem of Sabatier, why the more violent passions excite involuntary gesti- culations. , The ninth fiair, the linguales, appear, tirst, at me inferior part of the corpora pyramidalia, between these and the corpora olivaria, rise in fasciculi, and ini this disgregated state pass through the dura mater. They then unite and come out of the skull, by the condyloid foramen of the occipital bone, are connected with the eighth pair, and the ganglion of the sympathetic nerve. From its vicinity to the internal jugular vein, it is sup- posed to be compressed by it when full, as in para- lytic, apoplectic, and even in drunken persons, occa- sioning a fulness and indistinctness of speech; for, as the name imports, it is at last dispersed on the tongue, united with the branch of the fifth pair, already mentioned as going to the tongue. When it comes out from under the occipital branch of the internal carotid. it gives off a branch called descendens noni, which passes. over the trunk of the carotid, and under the thyroid vein. Two slender twigs, from the second and third cervical nerves, sometimes from the first origin of the phrenic nerve, uniting to this descending branch, together forming a ganglion, or plexus, from which many slender nerves go to the neighbouring muscles. Thus the ninth pair of nerves appears to have most extensive con- nections with the eighth pair, the spinal accessory, the sympathetic, the cervical, and the phrenic nerves. Shall we prove from this, that " out of the abundance of the heart the tongue speaketh ?" At least we know, that the motions of the tongue are sometimes involun- tary. This nerve seems to supply the motions of the tongue, while the sense of taste, which is by no means confined to the tongue, is derived from the branch of the fifth pair. It will be evident, however, that tremors of the tongue, and a loss of voice, often oc- casioned by hysteria, paralysis, and fevers, may, in a great degree, be accounted for, from these connections. ihe tenth pair, or sitroccipital nerves, which mo- dern anatomists style the first of the cervical nerves rise by two roots from the medulla spinalis, differing in many minute respects, which need not detain us in this place 1 he roots of this nerve are connected with the spinal accessory nerve, but seldom form a ganglion with it, and rather unite with the posterior roots of the se cond cervical nerve. The suboccipital nerve nassin J transversely, and a little obliquely upward" goes out * der the vertebral artery between it and theTst bra of the neck. The trunk then rises a little way t^b^«™%iSr,of8ai,8lion'and **£££> iwo Drancnes, the latter goes to the musJcle* nf *u*> head the f cWefl J^ ^™* ~f^ The.following verses from an old anatomist coC' hend the principal uses of each nair of n^S ^Zt order. un- verte- pair of nerves in their Olfaciens Cernens, oculosque Movens, Patiensoue Gustans, Abdueens, Audiensque, VagU^^n^. We shall add a table of the synonyms of all these nerves for which we are indebted to Mr. C. Bell. ? * NER 13 NER 1st pair—Olfactory nerves. 2d pair—Optic nerves. 3d pair—Motores oculorurm 4th pair—Trochleares, 5th pair—Trigemini. 6th pair—Abductores. ("Auditory nerves. 'th pair < Nervus communicans faciei. r ^tii pair <. Glosso pharyngeus. Par vagum. .Spinal accessory nerve. 9th pair—Lingual. 10th pair—Suboccipital nerve. "J Caruncule 7namillares Math, de Grad. I Processus ad nares. Gonth d'Andernac. f*8um par, Spigel. J 1st pair of Willis. ~\ Nervus visivus, seu visorius. Carpi. V* lm par antiquorum. J 2d pair of Willis. }2um par? Fallopii et Vesalii. Nerfs moteurs communs des yeux. Winslow 3d pair of Willis. ^ Minor propago 3!i Paris, id est 5"' recentiorum, Fallopii. I Gracilior radix 3" Paris, id,est 5' recentiorum. Vesalii. y Nervus qui prope nates oritur. Eustach. I 9um par, Cortes ; et Columb. J 4th pair; or, pathetic nerves of Willis. Nervus anonymous tnge7ninus multorwn. . 3um par, Fallopii, et Vesalii. 5th pair of Willis. Trijumeaux of Winslow. 4um par Fallop. Radix gracilior 5' Paris, id est 7* recentiorum Vesalii Par oculis prospiciens. >W»*fiar Casp. Bauhini. | 6th pair of Willis. J Nerfs oculo musculaires, ou moteurs externes de Win- J slow. 2um p«r Alexand. Benedict. 4um par Carol Stephan. >»5um par Vesal. et ameliorum. 6um par v. Home. _ Portio mollis, of the Moderns. JDistinctus a molli nervus. Fallop. Portio, ut precedens, 5i Paris, id est 7> recentiorum Vesal. Portio dura, of the Moderns. Le petit sympathique, of Winslow. Facial nerve. Qui ad musculos lingue et fauciu7n tendet. Fallop. Le rameau lingual de la 8e paire of Winslow. >8th pair d'Andersch. Superior fasciculus of the 8th pair of Willis. Glosso Pharyngeus. Haller. Nervus sextus Galeni et aliorum. 5» conjugatio Carol. Stephan. 7"" par Alex. Benedict. f>6«"» par Casp. Bauhini. 9U"> par Bidloo et Andersch. | 8th pair of Willis. J Le moyen sympathique of Winslow. The spinal nerve. 7um par Fallop. ' Vesal et aliormn. 1 lum par Bidloo. lO™* par Andersch. >Parlinguale 7nedium, vel nervus lingualis mtdim*-. nailer. Soemmering et aliorum. The hypoglossal, sublingual, or gustatory. The 9th pair of Willis. J 10th pair of Willis. 1st spinal, or cervical nerve, of Haller. X E R 14 i'i ,i general course of the intercostal we have already - scribed I make, however, the view of the nerves more complete, we shall add a somewhat more particu- lar account from the first Monro. When the intercostal has escaped from the os petro- ,uni it is joined by branches from the eighth, ninth, and tenth, and from the first and second cervical, to form the largest ganglion in the body, from which the nerve goes out to descend down the neck with the carotid artery. We have remarked, however, that this supposed origin is rather a branch sent upward, to it; but minuteness is here unnecessary The intercostal, in its course down the neck, supplies the flexor muscles of the head and neck, and communicates with the cervical nerves; nor will it escape observation, that the motion of the head is often involuntary ; F.'cn mitred Rochester would nod his head. As it is about to enter the thorax it again forms a gan- glion, from which nerves are sent to the trachea arteria, and to the heart; those designed for the heart join- ing with the branches of the eighth pair, and passing between the two great arteries and the auricles to the substance of that muscle. The intercostal then runs down on the side of the Yortehrse of the thorax, having additional nerves constantly sent to it f»om be- tween these vertebrae. Where the addition is made to it from the fifth dorsal nerve, a branch goes off ob- liquely forward, which joined with others from the sixth, seventh, eighth, and ninth, forms the anterior trunk which passes through its own proper hole in the dia- phragm, when it again forms a ganglion immediately above the cxliac artery, into which the eighth pair en- ters. From this, the nerves of the intestines, liver, spleen, pancreas, kidneys, and glandulae renales, are derived. The posterior trunk continues in its straight course downward, communicating with the inferior dor- sal and lumbar, and sending off branches to the kidneys and testicles. Some of its branches join with others, from the anterior trunk to form a ganglion, close to the inferior mesenteric artery, to supply part of the colon and rectum. The extremity of this nerve is even sent to the pelvis, to furnish the other parts there. In this progress the plexuses are numerous. The spinal nerves seldom rise in cords, but in separate fibres from the front and back part of the spine. They soon run into a ganglion, which is, however, chiefly formed by the posterior fibres, and they then acquire the firm coats peculiar to the other nerves. They are distinguished by the numbers of the vertebrae through which they pass, and the foramen is in the vertebra above. Seven come from the cervical vertebrae, twelve from the dorsal, five from the lumbar, and six from the false, vertebrae. The first cervical pair come from between the first N E R of the voluntary muscles affected are those of the "'The second cervicats unite, by branches, with the • ,i Vthe head the intercostal, and the first and third TS Lck and by a large branch which comes out at he outer' edge of the Semo mastoideus, with the accessory nerveg It is afterwards distributed to he muscles and glands of the head and neck, as well as the eternal ear,lhere it is connected to the^^ sometimes to the first cervical. The remamdei passes oThe levator scapul*, and the extensors of the, head and neck; but, at this place, another branch is usually sent off to join the accessory, near the superior angle of the scapulae. These connections occasion the pain to extend to the clavicle in inflammations of the parotid, and the head to be drawn toward the shoulder ot the affected side. The third cervical, on its passing from between the vertebrae, unites with the second; and a branch passing down, uniting with the fourth cervical, forms the phre- nic nerve, which enters the thorax, between the subcla- vian artery and vein. It passes by the pericardium, in a sulcus, and is lost on the diaphragm. The last phre* nic goes outward, to pass over the apex of the heart. From this circumstance, palpitations of the heart are often attended with an acute pain, which is referred to the left orifice of the stomach. The other branches of this nerve are distributed to the muscles and teguments of the lower part of the neck, and top of the shoulder. The consequence is, that any disease of the diaphragm, or the parts immediately contiguous, if they irritate this muscle, are attended with pain on the top of the shoulder. This is particularly the case in inflammations of the liver. The fourth cervical sends off a branch, as we have said, to join with one of the third, to form the phrenic, and sends filaments to the neighbouring parts. It then runs to the armpit, where it meets the fifth, sixth, and seventh cervicals, and the first dorsal. These unite and again separate in a complicated plexus, supply the tegu- ments of the thorax, and then divide into different branches to the muscles of the upper extremity. These groups we shall describe. The first of these, the scapularis, passes to the semi- lunar cavity of the upper costa of the scapula, a hole formed by a ligament passing between the angles of the scapula. It next supplies the supra spinatus and the muscles at the back of the scapula. The articularis sinks in the axilla to avoid the head of the os humeri, to rise again at the back part of it, and is dispersed on the muscles which draw the arm back or elevate it. The name is derived from its sur- rounding the joint. The cutaneus runs, superficially, down the fore part S-:f _?™'£yinS branches to the skin, and divides on * ucyi™ crrvtcai pair come trom between the first the inside of th. r^^___* ----, \ ' Ui,lucs on and second vertebra, and its branches are immediately he oalmof the til ™ ° ?™\ therteg»™nts and connected with the tenth pair of the head, thetcona . som^utfil^t J^w^? * *» *^e «• cervical and intercostal. It supplies the flexors of the neck ; but its larger branches are sent to the extensors, though not lost on them, as a few pass through them and are spent in the teguments of the occiput. Some of its fibres are connected forward with the fifth pair of the head, and the portio dura. Thus a pain in the neck is -metimes felt in hysteria; and, in tetanus, the first sometimes injured by opening the basilic vein 1 he musculo cutaneus passes through the coraco brachiahs muscle, supplies the biceps cWti and bra chKu. internus; and passing behind the tendon of the biceps, and over the cephalic vein, is distributed on he ?E.mi?Vf C °UtSide °f the*fore ™ and Cd c^halfc vtnCrVe S°metimeS hurt * «P«»»g the N E II 15 NER The muscularis runs in a spiral direction from the ax- illa, under the os humeri, and backward to the external parr of the bone supplying the extensors of the fore arm. A branch from the upper part of the fore arm, accompanying the supinator longus to the wrist, pro- ceeds obliquely over the radius to supply the muscles on the back of the hand and fingers. The principal part, however, penetrates the supinator radii brevis to reach the extensors of the hand and fingers; and one part is sent to the ligament of the wrist. The ulnaris extends along the inside of the arm to supply the extensors of the fore arm and the teguments of the elbow. At the lower part its course is somewhat oblique, that it may pass out at the groove behind the internal condyle of the os humeri, through which it runs to the ulna, supplying the neighbouring muscles and teguments till it reaches the wrist, when a branch is sent obliquely over the ulna to the back of the hand and the outside of the fingers. The largest portion of the nerve goes to the os pisiforne on the in- ternal side of the wrist, where it sends off a branch which passes through the tendons to supply the interos- sei and lumbricales, terminating in the muscles of the thumb and fore finger. The remainder supplies the little finger, and divides into three branches, two of which pass with the sheath of the flexor tendons of the little finger to furnish its inside; while the other is dis- posed in the same way on the side of the ring finger. Some of the branches, however, from the last cervical and first dorsal run distinct to the ring and little finger, since these are sometimes affected independent of the other fingers, and a pain or a violent paralysis of these, when they are exclusively affected, has been removed by a caustic at the internal angle of the scapula. A numbness of the fingers often arises from leaning on Ihe internal condyle, and a blow on it gives a tremulous sensation through the fore arm and hand. The last bundle, the radialis, passes with the humeral artery to the elbow, supplying the flexors of the cubit in its way. It then pierces the pronator teres, supplies the muscles on the fore part of the fore arm, and continues its course to near the wrist, giving branches to the muscles in its way. Near the wrist it sometimes gives off a nerve to the back of the hand and fingers, instead of a branch of the muscularis. The larger part of the nerve, however, passes behind the annular liga- ment of the wrist, supplies the thumb, and sends a branch on each side of the sheath of the tendons of the flexors of the thumb, fore finger, and middle finger, and one to that side of the ring finger next the middle one. In each instance of these groups passing through muscles the action of these do not seem to affect the sensibility of the nerve, and we have already stated that the action of the muscles consists of contraction in length only. The twelve dorsal nerves send each a branch to the intercostal, and others to the muscles behind. The principal trunk passes outward to the furrow in each rib, where they pass between the external and internal intercostals to supply the muscles and integuments of the thorax. The first dorsal having contributed its branch, forms with the two branches of the inter- costal, as they come down the thorax, a considerable ganglion. The six lower dorsal nerves give branches to 4.he diaphragm and abdominal muscles. The twelfth joins with the first lumbar, and gives nerves to the qua- dratus lumborum and iliacus internus. The five lumbar nerves on each side communicate with the intercostal and with each other, giving branches backward to the loins. The first joining with the last dorsal supplies the abdominal muscles, the psoas, iliacus, and the teguments of the fore part of the thigh, while its principal branch, with other nerves, forms the crural nerve. The second passes through the psoas, and is distributed like the former. The third has a similar distribution. Branches of the second, third, and fourth make up the obturator or pos- terier crural nerve, which passing through the pelvis, goes to the thigh at the notch of the foramen magnum, between the pubis and the ischium, and is lost on the adductores and the teguments on the inside. The anterier crural is formed by united branches from the firat, aceond, third, and fourth lumbar nerves, runs along the psoas, and escaping with the iliac vessels under the tendon of the external oblique, supplies the muscles and teguments on the fore part of the thigh. One branch of this nerve runs down on the inside of the leg, near the vena saphaena to the upper part of the foot; and is sometimes wounded in opening this vein, near the ankle. The remainder of the fourth and fifth lum- bar join in composing the sciatic nerve. From this dis- tribution we see the reason why a stone passing through one of the ureters, which crosses the psoas obliquely, will occasion pain when the body is erected; a paralysis of the thigh ; a swelling, and a convulsive retraction of the testicle. The six pair, which come from the/a/s nen kept from the air it scarcely undergoes any spontaneous chanin.-; but in the air it soon becomes fetid, of a green colour, exhaling; copiously ammonia. It cootam.pho^ nhat of lime, of soda, and ammonia, though togethei in a very small proportibn. The rest is apparently albuminous, though different in some of its affinities from albumen, and its real nature has hitherto eluded chemical investigation. In our examination, therefore, of the xkrvous influ- ence wc must be guided by observation. We see cords extended from a common sensorium, consisting of pulpy matter, apparently fibrous, confined or defended by firm strong coats. These cords evidently convey impressions to the brain, and derive from it an active power, which a principle residing in the brain can direct to a determined end. Yrt, for the purposes of mere animal life, a brain seems unnecessary, and what is a subordinate system in the human body, alone supplies the lower orders of animals: in them there is no common sensorium, apparently in the lowest, no volition. They seem to obey a principle which in the middle ranks of animated nature we rail instinct, pro- bably a necessary consequence of given stimuli in a sys- tem suitably organized. We must look then to the nerves themselves for the principles of sensation and of motion; for the brain is only a common centre, the residence of volition. The phenomena of sensation and motion require a rapid communication from the extremities to the brain, or to that origin of nerves which supplies its place. The nerves are not elastic, and the idea that they convey impressions by tremors similar to those of a musical chord is consequently improbable. We ac- quire our ideas of solidity from resistance, and it may be said that this resistance which, variously modified, gives some information of the nature of the resisting body, may be the mean of conveying the impression to the mind. The numerous modifications, however, conveyed by the nerves, particularly by the nerves of the eye and the ear, are wholly incompatible with this system, and except, perhaps, the simple resistance, we obtain our knowledge of the nature of the resisting body by the medium of some fluid. It is at least generally agreed that the nervous power is a fluid. Dense fluids are incapable of rapid motion, so that it must be one of peculiar rarity; and as the effect continues for a short time after the object is re- moved, it is equally certain that this fluid is elastic. When we pursue the nerves to their extremities, where X E It theil. peculiar functions ^^^X^ropeiSe^f positing all their coats, so ^J/^P^ntrary, as Thev Serves cannot reside "iti™*'™«^"bable that an alkali and the other m an acid. Again, when we coniu-irc the appearance of the nervous cords m the compa c m^ "FF rifiirate miluv membrane in best microscopes with the delicate puyy ,llsnect as their sentient extremities, we are led to suspect as already hinted, that the fibres, which appear in the greatest magnifiers, are in reality fasciculi of more^de- ficate ones; and that, therefore, it is highly impro- bable they should be hollow, or contain, within cavities, a direction below. Mr. Caverhill gives an equahy strong representation of the necessary force; yet we must add, that these were applications to the nerves through their dense coats, the resistance of which it was necessary to overcome. Every fact, every observation, as well as the most careful deductions from both, seem to show that the nerves are fibrous, that their power resides in a subtile, clastic fluid inherent in them, permeating freely through them, and confined by their coats, either from waste or an improper direction. This is no peculiar pheno- menon in nature. The magnetic fluid is confined to iron in a peculiar state, and its direction is preserved by an armature of brass; the electric passes freely through metals, but is confined by glass or wax. Suppose, then, we now speak analogically, a metal divided into the minutest fibres, each coated with wax, and that coating deposited at one extremity : If the superior extremity is charged, the fluid will be conveyed with undiminished, possibly with increased, energy, to the lower. This analogy is realized in the torpedo. The galvanic shock, we have said, is of the nature of the electrical; it is peculiar to the nerves, which are dis- posed so as to confine it, and the principal nerves pass, in the electrical ray, commonly called the torpedo, under a muscle, which can check its influx. When the mus- cle is relaxed, apparently at the will of the animal, the whole force is directed to a given point. Like the nervous power, it is more active in proportion to the vigour of the animal; its activity is diminished by exer- tion, and is lost by death. We have said, that this is analogy only, but we may be allowed to add, it is ana- logy so close that it may assume a better name, and rea- son cannot revolt at its being styled a probable theory. Once more : electricity in activity excites the powers of a nerve following its fibres, equally confined by their coats. In a kindred fluid it will probably excite a similar activity, and the effect is the same with that of all inordinate stimuli, exhaustion, with a loss of irrita- bility, which we commonly perceive from excessive ex- citement, or from deleterious miasmata; that it arises from excess of excitement is evinced by its causing pain and muscular contraction when not immediately fatal. See Electricitas and Galvanismus. NER 17 \E R Whence then does this principle originate, how is it continued, how supported, and in what manner de- stroyed ?" These may be styled unfair questions, when we have professed to step, but a little way, beyond the confines of analogy. Yet we have no scruple to answer' them. We consider then this fluid inherent in the nerves in their original germ, excited by the action which gives life, supported by the natural stimuli of food, warmth, &c. exhausted by too great excitement, or causes which at once destroy its activity, and ceasing finally to act when the solid which it accompanies loses its organization by the gradual diminution of its arte- ries. When we speak of the natural stimuli we may be accused of using the jargon of Brown. But, in his system, life itself is a forced state: we contend only that the support of life depends on causes of excite- ment, a fact rather than an opinion ; and these stimuli appear to act exclusively by supporting the circulation, while the decay of old age arises from the obliteration of the arteries. The arteries, however, not only give activity to the nerves in their extremities, but seem to have a considerable influence on them in their origin. The brain, we have seen, is coated to a certain depth with cineritious substance, a colour derived from nu- merous minute vessels; but in various parts of the substance of the brain, in the ganglionic system, even in the nerves themselves, striae of a similar colour are discoverable. This circumstance has led to the idea that the brain was a gland, and the nervous a se- creted fluid. The glandular apparatus appeared to Dr. Cullen so striking, that while he would not admit a secreted fluid for the purposes of sensation and motion, he thought it assisted nutrition : vide in verbo. There is, however, another view to be taken of this subject. We allowed the fibrin of the blood to be the most highly anamalized of our fluids; we admitted its contraction by the Galvanic stimulus, and gave its full force to the argument, though we disclaimed the con- clusion that contraction was the result of such organiza- tion. May it not then be said that the brain, a fibrous mass, is supplied with blood in vessels so exceedingly mi- nute, that the circulation must be languid, and the fibrin strongly disposed to separate; that if animalization be connected with a fibrous structure, the cause will here be found adequate to the effect ? It cannot, however, escape even a superficial inquirer that the animation of the fibre must be previous to the circulation; and every view which we have hitherto been able to take of the subject seems to show that the primordial germ is fibrous, and that it is animated in the moment of con- ception. If this be true, the separation of the fibrin is an effect only. But may it not supply nervous sub- stance once lost? The question will arise, is nervous substance ever supplied with* its original powers and functions ? We think not. Nerves are united like any other simple solid ; but from the experiments of Fontana, and his microscopical views of the united nerve, it seems to be only joined by a dense cellular substance. If the sensation below is not destroyed it is weaker, and we have every reason to believe that neigh- bouring nerves, when one is destroyed, acquire addi- tional powers to supply its place. The fact recorded by Santorini is a very strong one, that the origin of the VOL. II. portio mollis was particularly large in a blind man, whose hearing was peculiarly acute. We have seen various communications between the nerves after escaping from the encephalon, and the influence of these communications in exciting what have been styled sympathetic motions. Many others (see Svmpathia,) cannot be explained by any known nervous connection, and physiologists have supposed with great reason that the nervous fibres communicate in the brain. We have seen that such communications are very extensive. The sensibility and importance of a part must not be estimated by its proportion of nerves. Those of the heart are few and small, and some parts of the body, particularly the more compact ones, are acutely sensible when inflamed, though very inconsiderable fibres have been traced to them. This has appeared so striking to some physiologists, that they have been inclined to believe a nervous aura, from neighbouring organs, could give sensibility. Such is the opinion of Reil, but a highly improbable one. Many animals, as leeches, were said to be destitute of a nervous system, till they had been more accurately examined, and some parts of the body equally so, till the small nervous branches had been more minutely investigated. It is not at present asserted that the generation of mosses is equivo- cal, because the fructification of some kinds has not been indusputably demonstrated. We may be allowed in this place to sum up very shortly the whole doctrine which we have endeavoured to establish on this subject; though it will lead to some repetition, we are now by the additional steps enabled to give a complete view of the whole. The primordial germ exists seemingly in the female. It is animated by the male, who certainly influences the form, the habits, the temperaments, and constitutional diseases. This germ contains in embryo the fibrous parts of the body only, convoluted into a form so minute as to escape for a time the assisted sight, and of this fibrous germ the principal part is the brain and nervous system, the carina of Malphigi. This ani- mated nervous system gives vigour and activity to the other fibrous portions, the muscles, which soom impel a fluid, received from the maternal part of the uterus, and gradually evolve the rest of the body in succession. While the nervous power animates the arteries, it receives from them in turn a greater degree of vigour and activity. Inorganic matter is gradually added be- tween the fibres, which is either loose in a cellular substance, or compacted with the fibres into mem- branes. Thus the body by degress acquires a bulk. Its shape and form depend on that of the original fibrous, or more strictly the nervous, germ; for the body cannot expand beyond the point to which the convoluted nerves are able to extend, without death en- suing. That they will occasionally admit of a some- what greater extent we see from painful tumours, which are supplied with arteries at times apparently of recent formation. If there is a power in the constitu- tion to form new arteries, probably it is limited to the power of extension in the nerves. If it was unlimited, deformities and irregularity of figure would destroy the peculiar dignity of the human frame', and wc should be justified in attributing all to chance. C N K R 18 NER Man thus slowly expands, and su erosive organs of peculiar structure, destined for their varied functions, are gradually evolved. The arteries, however, after a certain period begin to lose their energy ; the blood is accumulated in the veins, the smaller vessels are obliter- ated, sensibility and irritability proportionally decrease, till the animation of the brain can be no longer sup- ported, or some important vital function be discharged. The whole machine is then no longer in action, and the affinities of unanimatcd matter reduce it again to earth, to oil, to salts, and air!! See Winslow's Anatomy ; Monro's Dissertation on the Nerves, annexed to his Osteology; Steno, Vieus- sens, Willis, Ridley, Leuwenhoeck, and Ruysch; Whytt on the Sympathy of the Nerves and Nervous Disorders; Kirkland's Dissertation on the Brain and Nerves, and on the Sympathy of the Nerves; Monro's Observations on the Nervous System; Yicq. d'Azyr Anatomie du Cerveau; Soemering de Cercbro et Nervis ; Scarpa Tabulae Ncurologicae. Nk'mvi va'gi, nervi sympathe'tici medii, nervi stoma'chici. See Par vaolm. NERVI'NA, (from nervus, a nerve). See Neuro- tica. NERVOSA I'E'BRIS; morbus cardiacus. Nerv- ous fever is the milder typhus of Cullen, and might perhaps with propriety have been referred to that head ; but it is also so nearly connected with those slow fevers which sometimes arise from a sedentary life, from internal obstructions, and other causes, that it can, perhaps, be more advantageously considered in this place. Nervois fever, the typhus mitior of Dr. Cullen, is defined, a contagious disease in which the heat is not much increased; the pulse small, weak, and generally frequent; the urine little changed; the functions of the sensorium much disturbed; and the strength greatly di- minished. In the early stages there is no particular symptom to distinguish it from nervous diseases with fever, except the constitution of the patient, the existence of an epidemic, or occasionally a marked attack. In general, nervous fever comes on slowly, with occasional chillness, so light as often to elude the attention and escape the recollection. It is, however, from the beginning attended with giddines, or a mist before the eyes by clay, and a want of sleep by night. A great lassitude, frequent yawnings, with flying pains, increased greatly towards the evening, want of appetite rising even to loathing and nausea, sighing, oppression at the region of the stomach, with dyspnoea, in succes- sion come on. This gradual increase of symptoms, with the peculiar pale, sunk, countenance attending fever, will give the alarm, even when other nervous diseases with which the earlier symptoms have been confounded are present. The tongue continues for a time with little change, but is occasionally rough and dry, and after a few days white, at last assuming a browner hue. The pulse are usually quick and small from the beginning, and perhaps Dr. Cullen has been too cautious in stating it only, as " for the most part" frequent. The skin is generally dry, though profuse, clammy, debilitating sweats comeon about the third day, and the heat is at no time considerable. After about the tenth day the weakness increases considerably; the remors become convulsive; with despondency and alien- ation of mind, at first observable only in the night, but soon continuing with little intermission. It is, however, only the mild delirium of-pathologists; wandering ra- ther than p'nrensy. The disease is often protracted to the twenty-hrst day, and often to even a longer period. It seems seldom to have a regular crisis, but gradually proceeds to a fatal termination in debility and convulsions, or a gradual restoration to health, evinced by more natural sleep, a more favourable appearance of the look, the tongue more florid at the edges, the mind more col- lected, the nausea disappearing or changing to an appe- tite, often whimsical and unsteady, but still distant from the former loathing. We have stated sufficiently the distinction of nervous fever from nervous diseases with fever. If the chilliness is not observable, the look and the evening exacerbation will generally decide, for purely nervous diseases are easier towards night. Another distinction is not less striking. Though in nervous diseases the appetite is capricious, yet food of a proper quality, and in mo- derate quantities, is borne with ease and even advantage. In fever it always overloads. In the former, wine cheers; in the latter, it heats and oppresses. Yet in the beginning of nervous fever, error is often un- avoidable. Nervous fever is seldom sporadic, and when epide- mic usually proceeds from the common causes of epidemic fevers, viz. miasmata; nor is there any doubt of its being occasionally contagious. The form of this fever arises probably from the constitutions it affects, viz. the languid, the studious, and the sedentary. What in a crowded jail, in a camp, or in a besieged town, would be typhus petechialis, in a city where the air is free but the constitution debilitated, is probably typhus mitior or nervous fever. The disease is not, however, essentially different, and every cause of weakness pre- disposes to it. The cause of fever we have endeavoured to show is debility, perhaps more strictly a debility of the senso- rial power, attended with irregular action of the whole muscular system, and its consequences internal conges- tion, particularly, for the reasons stated, in the liver and the brain. We should not have repeated this opinion were it not to show how nearly it approaches to that of Dr. Clutterbuck, which in the moment of writing has reached us. He supposes fever a local disease, and to consist in inflammation of the brain, which, from its connection with the whole system, induces the various disorders in the vital, the animal, and the natural functions. We mean not to urge, in contradiction to his fair and well drawn inductions, that the inter- costal system is distinct from • the cerebral, and not likely to be affected by it, for this at present is untried ground, but to remark, that in his argument he seems not to have attended to the distinction between active inflammation and congestion. He distinctly proves the otter, but not the former. The best practitioners at his time will not admit of any practical distinction be- tween membranous or parenchematous inflammations, but no doubt can arise respecting the greater or less de! gree of inflammatory action. If this object had been in our view, we could not have pursued the distinc- tion more closely than we have done in the article in- flammation, q. v. and in the various parts of this NER 19 NER work where we have pointed out the effects of conges- tion as distinct from inflammation. The real difference arises first from age, where the congestion is chiefly venous ; secondly, from the degree of the vis a tergo, excited by the obstruction. In the brain the limits in the first case, are the apoplexies in advanced life, and those cases which Hoffman calls hemorrhagie cerebri; in the second, the languid inflammation from Concus- sion, q. v. and the active ones which produce phre- nitis. To come nearer the present point, the state of the brain in violent delirium from inflammatory fever, and in the mild delirium of the nervous, seems to be equally at the extremes of the beam; and though the former approaches phrenitis, the latter is far distant from it. With these distinctions we fully agree with Dr. Clutterbuck in his ideas of the state of the brain dur- ing fever; nor do we wish for more able supports of our opinion than the facts which he has so industriously collected, or so ingeniously applied. There is, however, yet another view which we have taken of the subject, and which we think requires equal attention, viz. the state of the epigastric region, and particularly of the liver. This seems, in the treatment of every fever, to require a very particular attention, nor will the arguments which show the influence of the brain on the digestive organs, explain the fulness, the tension of the region of the liver, or explain the neces- sity or the good effects of laxatives. In the disease before us, the epigastric region is generally tense; and stools are easily borne. The affection of the head is the delirium mite only of pathologists. In fact, the debility is so great that the alteration in the balance of the circulation is less obvious, and the practice has been generally feeble and inefficacious; or mistaken and ill-directed. We might refer, in general, to the observations on the remedies of fever (see febris); but some modifications are necessary. Even when bleeding was considered as indispensable, the lancet was dreaded, or employed in this disease with a timid caution. Practitioners have since found it injurious, and even fatal; nor is there any period when it appears truly indicated. Emetics are useful in the beginning, but the active exertions of vomiting prevent their frequent repetition, as they seem to exhaust the strength and diminish the excita- bility: nauseating doses of antimonials exhaust it still more, and are highly injurious. Purgatives seem also to have been forbidden, as lowering the strength and lessening the vital powers; yet, at a time when in more active fevers clysters were chiefly trusted, and we were told, with the most frigid caution, that if stools were necessary, they must be procured by their means only, we shall not be surprised to find that in cases of such great debility the increase of the alvine discharge was dreaded. Nervous epidemics are, however, peculiarly rare, nor have we had an opportunity of bringing the use of purgatives to the test. In the last we saw they appeared injurious; but in the sporadic cases of this nature we have found them rather beneficial: but in such the practitioner must be " with caution bold." The Peruvian bark would appear to be strongly indicated, and it has had powerful recommendations. Yet the period at which these recommendations ap- peared give us some room for doubt. It was when fevers of the continued kind were supposed to consist of repeated paroxysms, and to be as easily checked by this remedy as intermittents. Practitioners too often see what they wish, and medicines always appear to answer a preconceived opinion. The management, in which all seem to agree, is to check colliquative sweats, which often arise, by free cold air and cold drinks; to give wine with caution, accord- ing to the state of debility, and opiates, with or without stimulants, which alone seem to act as cordials. Yet to these we would add blisters, which are certainly necessary to lessen the accumulation in the brain, and laxatives at least to such an extent as will prevent or lessen the infarctions of the liver, which are inseparable from every fever which we have seen. The power of the laxative should be adapted to the patient's strength; but his feelings and his pulse, after every evacuation, should be carefully examined, for from thence we should draw our indications for their repetition. We strongly suspect that the bark would have been found a more useful medicine had laxatives been properly premised; but in the use of this remedy practitioners have been peculiarly timid. Camphor is a medicine which has been spoken of differently, according, perhaps, to the nature of the epidemic, or the prejudice of the practitioner. In ge- neral, it promises to be effectual; and the ether, which seems never to have had a fair trial, is a remedy of equal, apparent, value. While the colliquative sweats have been often a troublesome symptom, practitioners have greatly feared the semicupium or warm fomenta- tions; yet, in a low temperature, when the sweats do not come on, they may be useful. They should never be higher than 96° nor below 92°. The cold affusion has not been tried, though sponging the body with cold water, or water and vinegar, was no uncommon remedy among the ancients. The heat of the body is, however, so inconsiderable, that sponging only can be admitted, and this should be employed with caution. When convulsions come on, either camphor, castor, or opium, are necessary; and these in combination are often highly useful. In this state also, mosch and the fetid gums have been employed with consider- able advantage. Whatever be the inconveniences of the bark during the fever, it greatly assists the recovery of the strength during convalescence. The debility is often considerable, nor have we seen any fever where the mind is reduced to more infantine weakness. Nervosi morbi, the neurodes of Dr. Cullen may seem to require some particular notice. These, how- ever, occur under their respective heads; but a term so generally employed may be sought for in a dictionary, and we shall endeavour, on the foundation of our nervous pathology, to give some general and more dis- tinct views than may be found in former authors, in the most concise, comprehensive, form. The two great divisions of the morbid states of the nervous system are increased or diminished sen- sibility, connected with increased mobility and tor- por in the moving fibres, with tenderness or firmness in the simple solid. The deranged state of the ner- vous system is chiefly considered in the article Mama, q. v. Nervous diseases, in the common meaning of the term, chiefly consist in the former state, in which, to C2 a- K 1? 20 NER prevent prolixin, wc shall constantly include its con- nections Tin /constitutes the hysteric constitution, and indeed, in imagination, " all the evils flesh is heir to " In hysteria, wc considered that marked definite affection, distinguished by its appropriate symptoms; but there are many complaints depending on excess ot excitement, sometimes within the limits of health, though occasionally stepping beyond the first boundaries of disease. As they are so numerous, we must pursue them in the different functions, distinguished as vital, animal, and natural. - The vital functions suffer numerous inconvenient de- viations from their natural regularity. The circulation is usually rapid, but often greatly accelerated and irre- gular, not only in the synchronism of the action of the heart, but in the direction of the circulating fluids. We thus find, from the slightest excitement, the pulse unusually rapid; the heart fluttering with irregular beats; the face flushed, while the extremities are cold, or a sensation of cold water pouring down the back is felt. The respiration is equally irregular; the lungs are ineffectually expanded, and inspiration repeated, to re- lieve the anxiety thus occasioned. At times, the respira- tion and circulation cease, and a death like faintness, attended occasionally with convulsions, supervenes. These symptoms recur at irregular intervals, and sometimes vanish spontaneously, leaving the usual deli- racy of infirm health, but no particular inconvenience. They are induced and carried off by causes equally slight, and leave the patient subject to the charge of caprice, fancy, or dissimulation. Thus they are brought on by a sharp noise, a fetid odour, a disagreeable object, and carried off by similar means. To rouse the atten- tion, to keep it suspended by anxiety and expectation, in fact, to take the patient from herself, since the mor- bid affection is almost peculiar to females, furnishes the best plan for relief. To bring on misfortunes is not the province of the physician, but accidental ones raise her above herself. In the animal functions, the tendency to disease is no less conspicuous. The sensibility is extreme, and the u Miseries of Human Life," overcharged perhaps in the modern popular publication, are wholly the patient's own. The wind blows with too suffocating or too chilling a breeze; the birds chirp with too shrill a sound; the odour of new mown hay is offensive; and the glaring sun blinds the too tender eye. As the In- dian is all face, the nervous patient feels in every organ as if that organ had no defence. The affections of the natural functions are mixed with those of the vital and animal. The muscles, in general, are susceptible of sudden and violent contractions, no longer obedient to the will. These arise to hysteric, sometimes to epileptic, paroxysms. The appetite is ca- pricious, irregular, and occasionally depraved; the sto- mach often distended with flatulence, and disturbed with borborygmi; the bowels unequal in their exer- tions; the kidneys occasionally yielding to the impulse of the blood, and secreting a serous fluid with little change, sometimes resisting the usual impulse, or obey- ing it, after some delay, when the urine is highly chiir^cd with its animal salts and oil. Nervous patients, in this way, suffer acutely with lit- . tic commisseration, and few attempts at relief. They are told that they must be their own physicians, and are Ieft to the pity, ota to tHe ndic e of ^world. ^ :ibi.Uy,yand those which restore the balance of the dTo beein with the latter. An equable warmth is ne- cessarv and every means by friction, by rubefacients, and byexeTcise, of keeping the lower extremities in a duete^^^ should be employed with caution. If so violent as to Sue, and a little will fatigue, it is injurious; nor can u patients often endure the requisite degree o bodily exercise without inconvenience. A carriage, or ahorse, are therefore required, but, in each, the mind Preys on itself, and it maybe literally said, post equi- Temsedet atra cura. No general rules can be there- fore laid down: the prudent physician will adapt his advice to the circumstances and the disposition ot his patient; but, in general, a journey, cheerful company, a change of scene and of engagements, will best suc- ceed. Thus do the fashionable watering places, the chalybeate springs, triumph. Another mode of keeping up the due balance ot the circulation is by the use of laxatives. The convulsive motions of the muscular organs take place in the sto- mach, and distention of this organ, followed by eructa- tions, are often a most distressing symptom. It is ne- cessary then to keep up the peristaltic motion of the bowels, which, while it contributes to carry down the flatulence, relieves the fulness of the vessels above. The medicines which succeed most effectually for this. purpose are the stimulant cathartics, which increase the action, the peristaltic motion of the intestines, parti- cularly the aloes and the rhubarb, and the effects of these are greatly increased by uniting them with the fetid gums. Too great sensibility is blunted by various narcotics and carminatives. The complaints of the stomach are relieved by the fetid tinctures, by the warmer car- minatives, and by every stimulus. It is painful to be obliged to add, that what was first resorted to as a me- dicine is often continued from habit, and the officinal tincture is exchanged for common spirits. Let there- fore every nervous female be cautious in this respect, for thousands have been thus incautiously enticed to their ruin—the ruin of their constitutions and of their- moral character. Let them recollect that aqua ammo- niae is less dangerous than brandy, and that infusions of pepper-mint, of rosemary, or the warmer aromatics of the east, though injurious in excess, are far less so than what are styled indirect stimulants, which lull rather than relieve pain, which intoxicate the senses, instead of removing thedisease. In such cases, for this purpose,' opium is often an useful remedy, but it should be con- fined to medical exhibition. In excess it acts only as a dram, and we fear, like spirit of lavender, is often used as such, under the name of medicine; many a patient " pretexit nbmine culpam." Other narcotics are the henbane, the cicuta, perhaps the bayberries, and the narcotic bitters. The two for- mer have been recommended as not producing costive- ness, and the henbane seems particularly useful. The bayberries, though stimulant, unite the narcotic powers of the plant, and are often useful remedies. To restore the strength is rather to repress the mobility; and. in NEB 21 NE U this latter view, bitters appear chiefly useful. The nar- cotic ones are most effectual, and those which unite astringcncy often fail of producing the expected benefit. If the bark is ever useful, it is when combined with va- lerian. Acid in the stomach is corrected by lime water, by magnesia, often by the acid of vitriol, and some- times even by columba root; occasional spasms by the fetids and carminatives. The metallic preparations, particularly iron, often recommended, are two power- fully astringent; and zinc, lately introduced in union with columba, often injurious. We have lately learnt from Dr. Bardsley that the oxide of bismuth is highly useful in these complaints, and that it calms the irrita- bility of the stomach more effectually than any other medicine. This medicine was originally recommended by Dr. Odier, and communicated to the public by Dr. Marcel. (See Bismuthum.) It is particularly adapted, however, to the increased irritability in consequence of a scirrhous pylorus; and perhaps before we arrive at the article scirrhus, we may be able to communicate the result of our own experience. Free air and large rooms are indispensable; and sea bathing often gives tone without increasing the inflammatory tendency. To discharge accumulations of phlegm, emetics are occa- sionally necessary, but should not be too often repeated. What may be styled the moral treatment of such complaints requires a steady hand. While to ridicule fancies, not in the patient's power, is inhuman, to hu- mour them is an indulgent cruelty. Every imagined feeling is to them a reality, every whim a want. Rea- son is often unavailing, authority is harshness, and a cold indifference cruel insensibility. Their own reason is inadequate to the task of correcting their wanderings, for they are truly such, nor will they hearken to that of others. In general, a kind indulgence in trifles, and a steady firmness in opposing the wilder eccentricities, is useful; and to point out with an affectionate mildness the errors, and their apparently certain consequences, will often succeed. Much, however, must be left to the prudence and judgment of the attendant, which must be regulated by the patient's temper and habits. The at- tendant should, however, have the confidence of the pa- tient, which she should never forfeit by unnecessary harshness, or abuse by injurious indulgences. Nervous diseases of the opposite kind are, we have said, those of torpor. Less varied in their forms and symptoms, we need not so studiously distinguish the functions affected, though we shall silently follow the same order. In these diseases, then, the circulation is slow, and sometimes sufficiently regular; but the equi- librium is by no means properly balanced. The liver and the brain, as usual, when the fluids are not properly distributed to the surface, have a large share; and as the muscular fibres are with difficulty excited to action, congestions, in each, take place. In the brain these appear by all the marks of compression, languor, inac- tivity, and insensibility: in the liver, by costiveness, indigestion, and a dark yellow hue on the skin. " Thick coming fancies" disturb the mind ; the .sleep is inter- rupted, or a torpor resembling sleep, in all but its re- freshing power, succeeds. The appetite is inconsidera- ble, but sometimes voracious and indiscriminate, and the bowels generally torpid. It is the disease, as we have had occasion to remark, of the sedentary and the studi- ous, who are found by the midnight lamp, and cheer or instruct the world at the expense of their health and constitutions; for the mind is often vivid, when the body is depressed. The divin.ae particula aurx will often appear then to burn with peculiar lustre; nor is this, when properly considered, an objection to our former opinions. The remedies of this state are exercise, blended with some interesting occupation ; an attention to the state of the bowels ; and, above all, every method of keeping up the balance of the circulation, particularly directing it to the extremities. In general, the conduct in cases of Melancholia, q. v. of which this is a less degree, will be proper. The tepid bath, for reasons which will be readily understood, is a valuable remedy. For nervous fever, see Huxham, Gilchrist in the Edinburgh Medical Essays, and Sydenham. For nervous diseases, Whytt, and the authors re- ferred to under the article Hysteria. NERVO'SUS, (from nervus, a term in botany,) ap- plied to a leaf whose vessels extend in lines from the base to the top without meeting. Nosologically, an epithet annexed to fever, and other diseases, where the nerves are supposed to be chiefly, and often primarily, affected. See Nervosa febris and Nervosi morbi. NERVORUM RESOLUTIO'NES, (from resolvo, to loosen). See Comata. Nervo'rum tum'ores, are discovered by the pain being felt only in the direction of the nerve, particular- ly below. They may be extirpated without danger, but it is safer to divide the nerve than to run the risk of inflammation, unless it is large or highly important. See Home, in the Transactions for the Improvement of Medicine and Surgery. Nervo'rum vuln'era. Wounds of the nerves are often attended with very troublesome symptoms, and trismus or tetanus have been the consequence. The general opinion has decided, that if the nerve be wholly divided, the effect may be avoided or lessened, and with the remedies proper for these spasms, a division of the nerve is also necessary. In bleeding, the nerves, as we have shown, may be easily wounded ; and when it is seen which vein has been cut, the injured nerve is immediately known, and it may be readily traced by dissection, so as to divide it above the wound. Mr. Pott supposes, that, as the wound must be at the up- per or under angle of the orifice, it may be sufficient to enlarge it either above or below. In fact, however, the injury first produces inflammation, probably from the external air being admitted into the sheath of the nerves, and it will be therefore preferable to divide it above. Mr. Bell thinks a transverse incision above the original wound a sufficient security: but the dis- section and division of the nerve above is the preferable plan. See Trismus. NE'STIS, (from ve, non, and e * *™^ n,31e mtrT a.c,id a&rees ^ its tonic power with the other mineral acids, but from its oxygen bem^ more loosely connected with the other component nart«T or from the acid being more easily borneon S?e stomach t has lately been preferred to the vitriolic and mf" m cutaneous complaints, and other clses where Tla^er wehavealriadyno^r^eLuEr^ " ^^ INFLAMMATIONS but also in H*MORRHAGES Q' V " In active inflammations of thPtui!' q"J', nitre, he,d in ,„e mouth, ^.loo*^™' ti^ NOL 25 NOM diuretic, but it has this property only in a slight degree; and when the dose is increased, it often produces a difficulty and pain in making water. The inconve- niences felt in the stomach from a large dose prevent it also from being used as a laxative. It seems to add to the virtues of camphor in removing pains in the head, and in the more violent fevers of the inflamma- tory kind; and, thus united, they have been celebrated, perhaps with little reason, for curing ulcers of the legs. In large doses it occasions violent pains in the stomach, bloody urine and stools, convulsions, and death. Pure nitre in solution is not affected by nitrats of silver and barytes. It should seldom be given in larger doses than fifteen grains; about ten grains is the most com- mon and most effectual. See Hoffman de Salium Medicorum, et de Praestan- tissima J^itri Virtute; Stahl de Usu Nitri Medico; Neumann's Chemical Works; Lewis's Materia Me- dica. Ni'trum antiquo'rum. See Anatron. Ni'trum artificia'le Hoffma'ni is made of the spirit of sal ammoniac and spirit of nitre. It perfectly dissolves in rectified spirit of wine. Ni'trum calca'reum ve'rum, a solution of calca- reous earth in the nitrous acid. See also Acton. Ni'trum facti'tium and nati'vum. See Borax. Ni'trum stibia'tum, anodynum minerale the salts collected by washing the residuum after making the calx of antimony. They contain but little of the anti- mony. NIX. Snow, a name given to substances which re- semble snow in their colour and lightness. Nix fu'mans. See Calx. Nix antimoni'alis. See Antimonium. NOCTAMBULA'TIO, (from nox, night, and am- bulo, to walk). See Somnambulo. NOCTUI'NI O'CULI, (from noctua, the owl). Grey eyes, like those of the owl. NOCTILU'CA TERRE'STRIS, (quia noctu luceat). See CiciNnELA. NODOSA, (from nodus). Knotted. In surgery an epithet for a suture, for various bandages, and for gout, as attended with knots in the joints, in consequence of calcareous depositions. See Arthritis. NO'DULUS, (from nodus). A knot tied on a rag, including some medicinal ingredient with which an in- fusion or decoction is intended to be impregnated, as well as a bag, in which such ingredients are included. NO'DUS, (from the Hebrew term anad, to tie). See Gumma. A protuberant joint in the stem of some plants, particularly in corn and grapes, in order to strengthen their*hol!ow culms. NOE'LA TA'LI. The Indian barberry tree, with an orange leaf. It grows in Malabar; its fruit resembles barberries in their taste and virtues. See Raii Historia. NOLI ME TA'NGERE. Formix. Touch me not. In botany, the persicaria siliquosa, or the mimosa. In surgery, a species of ulcer, and a kind of wart on the eyelid, which appears blackish, and, if touched, morti- tifies. Sometimes it means a cancerous sore, exasper- ated by medicines, or a-species of scirrhus and herpes. See Herpes, Polypus narium. NO'MA, NO'ME, (from vepiu, to eat away). A VOL. II. phagedenic ulcer, sometimes a species of herpes. See Herpes. NOMENCLA'TURA. It was the opinion of a poet of the middle ages, Nomina si pereunt, perit et cognitio rerum; and the history of science shows, in the strong- est light, that no impediment has so powerfully ar- rested its progress as a vague, imperfect, or a fanciful nomenclature. The list of synonyms has been thus unreasonably extended; and the student, misled by a name, has often found it difficult to recover the proper track. As this subject has lately engaged the particu- lar attention of philosophers, a somewhat fuller account of their improvements, than would otherwise be neces- sary, may be required. The nomenclature of a science implies its peculiar and technical terms. These have been generally kept distinct from the language of common life, perhaps at first from a wish to preserve an air of mystery, and give to the author a fancied pre-eminence above the world in general. There are, however, better reasons. In me- dicine we thus avoid the indelicacy of common appel- lations, and, in general, we escape the varying caprices of fashion; quern penes arbitrium et jus et norma lo- quendi. Some authors have adopted arbitrary appella- tions, particularly Van Helmont and Paracelsus, as we have seen in various articles; though it is not improbable that they had some fanciful allusion to the sources and action of the diseases and the remedies they designated. Later and more rational pharmaceutists have sometimes also adopted these arbitrary terms. Modern botanists, in their appellations of new genera, have equally em- ployed them in honour of different cultivators of their science, though probably without giving that perspicu- ous lustre to it which an opposite conduct might have afforded. How much superior, for instance, is the ge- neric term epilobium, ent Xofiov tov, a violet on a siliqua, to Linnsea, Thunbergia, and Commcrsonia. Minera- logists have in general preferred announcing the quality and appearance by an euphonous appellation; and we hope to make some advances in the same way in the neglected doctrine of nosology. Such descriptive ap- pellations have been preferred by anatomists, though not always formed with the most accurate precision, and more lately in the improved nomenclature of the chemists. • The object of a scientific nomenclature is to convey in one word a sufficiently distinct idea of the body or organs, to preclude a repetition of the description when- ever it is mentioned. When, however, objects are nu- merous, and the discriminating points with difficulty seized, one word is not sufficient. This induces us, in botany, to adopt the first natural associations, styled genera, and the appellation of the genus must accom- pany that of the. species. In nosology it is generally less necessary; in pharmacy it would be perhaps useless, as the form itself supplies the place of a genus, which in anatomy is understood from the part described. As nomenclature has received the last polish from philology, in the chemical department, we shall first notice the improvements in its language lately intro- duced. We there find, among- some absurdities, the descriptive language laboured with no common care, and the numerous synonyms of former systems are only retained as keys to the works of the elder chemists. The D X O M 2b N O U pcnus is, in this case, preserved in the epithet. It is vitriolated kali, arsenical soda, sulphurated ammonia; and though we may dispute the propriety of some terms, as hydrogen or azot, they must be considered as constantly discriminating substances of distinct proper- tics. One great difficulty arises from some of these being indeclinable. There is a want of euphony in oxygen gas, which disgusts the nicer ear; and these harshnesses pervade every branch of pneumatic che- mistry. Another error in this part of the subject is a >vant of uniformity : thus the azot generally implies a substance in a gaseous form ; but though we use the term azotic gas, oxygenated or nitrogenated gas are not allowable. Was chemistry more peculiarly our object, we might point out other anomalies which require cor- rection. It is enough to notice those already adduced to lead chemists to a still farther reform. Dr. G. Pear- son has laboured successfully in this field, and to his attention we would willingly leave it. The subject can- not be in better hands. The improvements in the nomenclature of pharmacy have not kept pace with those of chemistry. The awkwardness arising from the indeclinable substances, kali and natron, might have been easily avoided by adopting the terms lixivia and trona; the former adopted in one of the older editions of the Edinburgh Dispen- satory, and the other by Dr. Black. Many errors in nomenclature might be noticed, of which a prominent one is the aqua, when applied to salts and earths in a liquid form. These are strictly solutions; and a distinc- tion is necessary between these and the distilled waters, which are properly aquae. The wines are also anomalies, which should have been avoided. They are properly in- fusions or solutions; but if a distinction was necessary, the old word elixir would have been applicable. Bota- nists employ single names as genera, and very generally a single epithet as a trivial distinction. These, as we have remarked, are sometimes descriptive, and the lat- ter generally such. Single words strike the mind at once, and convey the idea unimpaired. When such single words, therefore, are sanctioned by custom, and readily understood, science is, we think, injured by a change. Thus philonium, theriaca, cinnabar, and some other appellations which had become denizens in the language of pharmacy, might have been, like alcohol, ether, and some others, properly retained, or at least, if changed, might have received euphonous titles greco fonte parce detorta; nor is it easy to say why we should deny to the pharmaceutists what has been so liberally granted to the botanists, the honour of giving an ap- pellation from a name. We might consequently have retained the confectio Fracastorii and the pillulse Run, when the nature of these compositions are generally understood, without any injury to science. The Edin- burgh College, peculiarly eager and zealous in reform, have made their titles descriptions. We, in general, wan only the vehicle and the proportions to supply the whole formal* from them; and we have sometimes not only the nature of the formula, but often the means of preparing it. Another redundance in their nomencla- ture is, the introduction of the trivial, as well as the genenc names of plant, i„ pharmacy, the pharma- ceutical term is only neces^ry. The botanical appel- lations are taught m other aystem8. The j^g College seems also to have refined too far, in adopting the genitive case of the substantive instead of the ad- jective, according to the sound principles of the new- chemical nomenclature, as tinctura scillac, instead of tinctura scillitica. It is, in fact, a tincture possessing the nature and qualities of squills. Pharmacy is, how- ever, a science in which method has not been intro- duced; but its objects are so few that arrangement h less necessary. We may, however, make some attempts to give it a more regular form in that article. In anatomy the nomenclature is still very defective, and the synonyms, particularly of the muscles, consc quently numerous. The terms superior and inferior, anterior and posterior, are fixed with little precision, and their meaning varies in different systems. Mus cles are named from their shape, from their action. or the occupations in which they are used. Were the whole of the nomenclature reformed, much of minute and uninteresting description might be avoided. Vicq. d'Azyr made some unsuccessful attempts to attain greater accuracy. Chaussier's improvements were more judicious, and in osteology they merit great, though not unreserved, commendation. The same principle, however, viz. expressing by the terms the relations of proximity and connection, does not succeed so well in the myology; and the nomenclature of Chaussier, and his coadjutor Dumas, when applied to the muscles, exhibits an inelegant, unharmonious, combination of unpleasing sounds. The error is not in the .principle, but in the authors* pursuing it with too great rigour. If they had aimed at less exactness they would have succeeded better. Our couhtryman, Mr. Barclay, has attempted to re- form the anatomical nomenclature with more success; and though the change cannot be rapidly made, we * trust it will be gradually introduced. We at first in- tended to have employed it in the present work; bvk language so singular to the student would have per- plexed, and might have misled him. The terms superior and inferior are generally used with relation to the different parts of the human body in an erect position. Their force is, however, lost in a reclined one, and neither is peculiarly applicable to the relative organs in other animals. In the trunk, there- fore, for these Mr Barclay proposes the terms attentat and sacral, from the two extremities of the spine- for anterior and posterior, which are subject to similar am- biguities, sternal and dorsal; for internal and external, derma and central; or, with respect to an organ, fieri. Pheralor central. \Vhen external and internal sign fy the side and midde of a surface, suppose a plane, styled me- sion, to pass along the middle of the neck, the mediasti- num and linea «««, through the body parallel to the sut face, thenAateral and mesial may be ihe terms employee" Instead of right and left, Mr. Barclay employs dUtrll and sinistral, as less equivocal in some parts of comoa rative anatomy, or, when there is no occasion for ih tinction, lateral will be sufficient. In the heart r^neThr^STh81^ thC righUnd left vemridS are neither, and the terms anterior and posterior though more correct, are not always applicable to com parative anatomy. Mr. Barclay's distinction nr tnb case, perhaps less simple than the others, isto term the wSe'b'odv H ""IK7 *, b,°°d ■>*"» ^e ^gs ^ £ whole body, viz. the pulmonary veins, the left sinus auricle, and ventricle, with the aorta and its brancnes: NOM 27 NON systemic; those which carry it to the lungs, the pul- monic; and in marking their relative situation to the trunk, or to each other, the terms atlantal, sacral, &c. already mentioned, may be employed. The extremities are termed atlantal or sacral; the ends of the bones nearest or farthest from the trunk, proximal and distal. In the atlantal extremities the two lateral parts are, with Winslow, styled radial and ulnar, the two others anconal (from ancon, the Greek word for olecranon) and ^eraa/(from thenar, the Greek appellation of the patm); but the peculiar term for the palm, in Mr. Barclay's system, is vola. The distin- guishing aspects of the sacral extremities will, by simi- lar reasoning, be proximal and distal; dermal and cen- tral; tibial and fibular; popliteal and rotular. Planta is the term for the sole on the popliteal side of the foot. The usual terms of superior and posterior, &c. when applied to the head, become very equivocal in those general discussions where the heads of animals, as well as men, are described. Mr. Barclay, therefore, pro- poses that the axis of the vertebral column should be, in imagination, prolonged till it meets some bone in the head or face. This bone he would call the atlantal; those opposite to them, at the basis of the skull, sacral. The terms sternal and dorsal, when applied to the head, are those parts in the same plane, or in planes parallel to the sternum and dorsum. Where these are parallel, the planes on the sternal side will always be sternal, an'd the contrary. In the human species the whole face and lateral sides of the head will be sternal; in sheep and oxen the maxillary curves will be so only; and in frogs and serpents the basis of the skull will be sternal, and the maxillary curves dorsal. With respect to the particular bones of the face, der7nal, central, distral, sinistral, and mesial, are appli- cable ; but five new ones are required; for the base and crown, the hind fore part of the cranium, and for the face. The two first are to be styled the basilar and co- ronal aspects; the occiput, the inial, from tviov, its Greek name. The opposite side to the inial, where the bones of the nose are united to the os frontis, he styles glabel- lar, from its Latin appellation glabella. The part of the face, t at the greatest distance from the occiput (inion), in a straight line, is styled the antinion. If lines are drawn through these aspects, or from the right and left, they will form the corono-basilar; the inio-glabel- lar, the inantilial, and the dextro-sinistral diameters. The measure of these different diameters will show the varying proportions of the heads of different animals, of the same species, or of others in the lower scales. The facial angle and its variations we have already no- ticed. (See Craniologia.) These terms, by altering the termination, may be used adverbially so as to sig- nify a direction towards either aspect, and this termina- tion is in ad, instead of ab and ar; and by changing it to en, it may express connexion. Thus a radial artery or muscle may be either with a radial aspect, while a radien artery enters the radius itself. Such is the plan of Mr. Barclay, which, it may be observed, is in embryo only, neither co-extensive with what anatomy has demonstrated, nor with the great va- riety of animated nature in its different branches. Yet, in its present state, this nomenclature merits particular commendation; and, if divested of some refinement, par- ticularly the mesion, which should perhaps be rendered more simple and familiar, might with great advantage be adopted. We know nothing less easily compre- hended by the untutored mind than the doctrines of planes. The nomenclature of muscles he has only slightly noticed in his introduction. We have already remark- ed, that the fixed point is named the origin, and the muscle is " inserted" into the bone to be moved. This, however, is at times with difficulty ascertained ; nor is the motion usually performed by a single, or by a few, muscles. Many concur in fixing the origin; others in giving force and direction to the motion. Mr, Barclay proposes that the muscles should be classed from their origin and their insertion, and the name fixed from the most obvious distinction, neglecting the origin of the minuter bundles of fibres. Thus the sterno-humeral can mean nothing but the pectoralis major, which, in the nomenclature of Chaussier, is the sterno-costo- clavio-humeral. In the blood vessels he points out the necessity of an uniformity of language; for the appella- tions of arteries often differ, as the names of the organs to which they are distributed vary. This, of course, re- quires an uniformity in the appellations of the organs themselves. The same name is at present often em- ployed also to express two different relations, as the ar- tery which runs along the humerus, and that which enters it is equally called humeral. Branches of ar- teries, and often minute branches, are sometimes ho- noured with a name, while the trunk,from which they proceed is not distinguished by any. Such anomalies require a remedy; and we should be happy to find the language of anatomy freed from its great uncertainty and barbarous language. Nosology, yet in its infancy, has had the advantages of the attention of Linnaeus and Cullen, who have la- boured to render its language euphonous, without greatly departing from the received appellations. They had, indeed, before them the Greek terms, which they could easily reduce to the Latin orthography, and they wanted no more. Selection was alone necessary, and we find no proofs of defective taste. In generalizing the inferior groups, it has been sometimes necessary to employ terms in a new signification, in the nosological sketch offered in the present volume. We trust that they have been selected with sufficient care. See Barclay's New Anatomical Nomenclature; Chaus- sier's Tabular View of the Skeleton; Pearson's Chemi- cal Nomenclature; Dickson's Essay on Chemical No- menclature, with Kirwan's Observations; Linnaei Cri- tica Botanica; Culleni Nosologia. NONA'NA, (from nonus, the ninth). An erratic in- termittent, returning every ninth day. NON-NATURA'LIA. The non-naturals. A fanciful term given to functions or accidents not strictly belonging to man: as, air; aliment; exercise and rest; passions and affections of the mind; wakefulness and sleep; repletion and evacuation. See Dr. Fr. Clifton's Translation of Hippocrates on Air, Water, and Situation; Wainwright on the Non- naturals; Sanctorius's Medical Statics; Keil's Animal Economy; Mackenzie on Health. NONUS HUMERI MU'SCULUS PLACE'N- TINI. The ninth muscle of the shoulder. See Co- RACO-BRACHAUS. D 2 xo s 28 NO 8 NORLANDIC.tI BACCiE. The cooling subacid fruits of the rubus articus Lin. Sp. PI. NORTHAW, or Nort hall water, is of the purg- ing kind, and similar to that of Epson), but not so strong or so nauseous. It contains a little calcareous earth, selenite, with a small proportion of sea salt, and is slightly purgative. XOSOCO MIUM, NOSODO'CHIUM,(from»«•«?, a disease, and xo/ua, to take care of, or fox"-> 1° receive). An hospital. The institution of hospitals, coeval probably with the era of Justinian, was the first effort of Christian charity, taught by its great master, who commanded us to love one another, and that he was our neighbour who showed mercy. It is impossible to conceive a more pure phi- lanthropy than the institution of a receptacle where the only claim to admission is the immediate necessity of relief; where to want is the only requisite to demand a supply. Ancient philosophy offers nothing so exalted; and even the benevolent host of Homer, who sat by the way side to assist travellers, *-«»7f« yxp a-tXeesxe, can scarcely exceed it. With regret, however, we learn, that the mortality of hospitals exceeds even the calcu- lation that can be made from the state of the objects admitted. We allude not to the mortality of the Hotel Dicu, which may literally be said to contain the victims of the Almighty, but to modern institutions, where, perhaps ancient regulations are still too strictly follow- ed. To consider the subject carefully, we shall first add some remarks on the construction of hospitals generally, and then apply them with those modifications which their particular object may seem to suggest; nor will this attempt be thought presumptuous in one who has been physician in a large hospital for thirty-three years. Were a situation to be chosen for an hospital, it should be an elevated, dry spot, facing, as near as pos- sible, east and west, for the sake of alternate changes of air and warmth. The building, at least the wards, should be single, so as to admit of transverse ventila- tion, and the windows should be from the top to the bottom, open at either extremity, carefully secured however, at the bottom, to prevent air from crevices. The length of the ward should not exceed thirty feet, and it should be rather more than half that breadth. The beds should be placed at right angles to the wall, and there should be a window between every second bed. If the door is at one end, and the fire place at the other, one fire will be sufficient: if in the middle, there should be two. In this way the ventilation will be complete. The windows may be opened on either side, in differ- ent degrees, according to the state of the wind or wea- ther, either aboye or below. The under windows should be opened for a short time every day, on either, or on both, sides, according to external circumstances; for carbonic acid gas is heavy. A ward, when opened, cannot always smell fresh and pure; but it should not be offensive or close. If the beds are parallel and close to the sides, the floor cannot be ventilated ; if mpre nu- merous, the air cannot be admitted to each patient. 1\ e have not mentioned ventilators on the top; for if the temperature be moderate "they will be useless, and they cannot be applied to a ground floor. The privies should be at each extremity of the ward • but if that is impracticable there should be one in eachj and always separated from the ward by a short passage, in which there should be a ventilator or a window. It possible, each should be a water closet; but the dress- ings and the contents of the night boxes should be always immediately immersed under water. The separate apartments for particular complaints should not be small, but should never contain more than two beds on the opposite sides of the room, while the door and the window on the two other sides will contribute to the ventilation. The chimney, if one is necessary, may be in the angle. If required for patients who may be occasionally in violent pain, in convulsive paroxysms, and delirium, they should be separated from the ward by a short passage. For the sake of attend- ance, they must be contiguous. The offices containing the baths, the brew and bake houses, the elaboratory, Sec. should be separated from the principal building, that they may not render it too i; and the apartments for hectic and asthmatic ._.._ _i____ij i-— — i__nAK«M#.«iniri rruoca mniT Ko irk no- warm warm , aim uic apai uii^uio »v/i ■■>'V"^ •»»..* ~w.....~.~*. patients should be also separated. These may be in pa- villions, joined to the house by a colonade, which the architect may render ornamental, though this is of less importance. If any apartments are connected with the offices, it should be those adapted for chronic rheuma- tism, for syphilis, and for amenorrhaea. The colonade may furnish covered walks open to the north and south, and over these the apartments just mentioned may be situated. From this sketch it will be easy, we think, to construct an hospital, which will unite every advan- tage to be expected from such an institution. In the arrangement of the house every impurity should be immediately removed, and every noxious matter immediately immersed in water; and, after the dressing of the sores, the upper and lower windows should in turn be for a short time opened, while the patients are secured from their effects by their bed clothes. The linen should be changed, not from the regulations of time, but of circumstances, under the directions of a judicious apothecary. Air and cleanli- ness will make all aspersions with vinegar and all fu- migations useless. - Ointments afford an offensive smell; for the axunge cannot be long preserved free from rancidity. It is, therefore,, highly proper that those plasters only which are employed in peculiar circumstances should bespread in the ward; and Dr. Percival's advice of using mucil- age with neatsfoot oil, occasionally united with Gow- land s extract, instead of the common plasters, is judi- cious. If hntseed meal be used, even the oil will be unnecessary. The diet of hospitals is regulated by custom, which it is heresy to attack; nor is it indeed necessary to notice it particularly, since any occasional errors may be cor- rected by the physician. Perhaps, according to Dr. Percival s advice, salep may be occasionally substituted for rice, and malt infusion for beer; but his other obser- vations in this respect rest too strongly on a disputable foundation, experiments out of the body Iron bedsteads will neither retain infection nor bues • and their upper ends should be raised with a screw It would be always proper to have supplementary wards- for nothing should hinder each ward from bei7g white! washed, thoroughly cleaned, and the window frames painted,mzn distemper, every year. The beds also should be repeatedly ripped, and their contents aired. N OS 29 s o s See Percival's Thoughts on Hospitals, and the Me- moires de la Societe Royale de Medecinc. NOSOLO'GIA, (from von-os, a disease, and Xoyos, a discourse). Nosology. When the numerous advantages of arrangement were so conspicuous in the advance- ment of botany, it was soon extended. to many other branches of natural knowledge; and as the great end to be obtained from it was a ready and accurate distinction of species, it was soon suspected that it might be highly useful in sciences where discrimination was equally difficult and important. Yet, except in the arrange- ment of the vegetable kingdom, method has seldom been found singularly useful. In zoology it has con- nected animals of a nature very discordant, and living in elements essentially different: in mineralogy it has been obliged, till lately, to borrow assistance from the elaboratory; and in medicine it has connected the most trifling with the most important diseases, and maladies of a nature very dissimilar. Even in botany, where its utility is acknowledged, the endless disputes which have arisen respecting the principles of arrangement, have at last subsided in the establishment of an artifi- cial system, chiefly because it has been extended with the rapidly increasing bounds of our knowledge. Many of these difficulties, as well as their source, are easily understood. Systems are the work of our own minds; for nature advances by almost imperceptible, shades; and where we can point out the termination of one family, and the commencement of another, it is only confessing that the intermediate link is unknown: thus, when our knowledge advances, the advantages of our systems lessen, for our limits are lost. This disadvantage is felt even at the first step of our analysis of the objects of nature, namely, in our dis- crimination between the animal j vegetable, or mineral kingdom, and follows, with equal inconvenience, every subordinate distinction. It is felt less in artificial ar- rangements, and affords a strong argument in theiy fa- vour; so as, in the opinion of many naturalists, even to counterbalance the advantages of a natural method. It is very inconvenient in mineralogy, where the compo- nent parts and the obvious qualities often differ very strikingly. What, however, was so useful an assistant in botany, what was at least not injurious in zoology, and advan- tageous in the lower orders of animated nature, was tried with very unequal effect in mineralogy and dis- eases; but of mineralogy we have already spoken. The arrangement of diseases is still in a very imperfect state. To the inconveniences which attended the arrange- ment of minerals, some difficulties, apparently insur- mountable, were added. If the forms, the hues, and other properties of the mineral forbade us to expect uniformity, the infinitely more fleeting, the more mi- nutely varied forms of diseases seemingly mocked every attempt to bring them within the limits of a definition. If a foundation could be obtained, it was apparently by considering the disorder as connected with an internal change, which would then afford what might be styled an object, whose properties we might examine. This, however, increased the difficulty, for few would agree respecting this change; and the system must vary with the opinion, perhaps the fancy, of physicians respect- ing what we now call the immediate or proximate cause. To this must be added, that, in a strict systematic view, the error would not be less than in classing minerals from their component parts, in other words, their che- mical nature, a,s we have already observed. (See Causa and Morbus.) It was necessary then to consider each disease as a concourse of symptoms, in general fixed, leading to an injured function, and to some permanent change in the system, whatever it might be. In this way the disease is the unknown algebraical quantity designated by a letter; but this letter, in the hands of the mathematician, may be managed as readily as a de- termined object. It may have powers and proportions ultimately depending on the value to be discovered; but, at the same time, independent of it. Thus we can speak of a fever, its degree, its changes, and cure, without attempting to examine in what it consists. We can distinguish an unknown change by symptoms, and can arrange it from these alone. The importance of distinction will be at once obvious, when we recollect the extensive disquisitions in which every practical au- thor engages under the head of diagnosis. Sydenham, certainly no friend to fanciful refinements, was seem- ingly the first author who suggested this method; and Gaubius, who had seen the systems of Sauvages, of Linnaeus, and probably of Vogel, hopes that an at- tempt so happily began will soon be perfected. Since the time of Dr. Cullen, we have witnessed few attempts of this kind; and the neglect certainly has not arisen from the degree of perfection his arrangement has attained. Nosology is seldom mentioned, but to be ridiculed or despised. Some late authors who have pretended to oppose it, have, in their arguments, shown not only their ignorance, but the necessity of the study; and those who have adopted systems of arrangement, have demonstrat- ed that they have little attended to its principles. If nosology does not render the distinction of diseases easy and comparatively obvious; if, by bringing disor- ders of a similar nature together, it does not elucidate them as well as the method of treatment, it is useless, and will be deservedly neglected. We shall endeavour to show that each end may be readily obtained. The reasons which have impeded the advancement of nosology are numerous; but it is needless to examine them minutely: even Linnaeus, by whom method had been so much improved, has wholly lost sight of his own rules, when applied to the arrangement of dis- eases; and Dr. Cullen, who has formed a system, im- posing from its simplicity, elegance, and perspicuity, has erred in the threshold, by his first separation of general from local diseases. Yet no distinction appears more clear, more obvious, or on a more secure founda- tion : the difficulty is felt only in the application, and is soon perceived when we find the same disease some- limes general, sometimes local, and varying, with al- most undistinguishable shades, from one to the other. To connect the feverish disorders into one class is equally judicious in appearance; but a similar objection recurs. The same disease is often attended with fe- ver, and is occasionally without it, and this in almost every degree. Even in the genus cynanche, which he laboured with no common care, and in which he thought himself peculiarly successful, he has erred against his own principles; and formed, as we have X OS 30 X OS cm, \idc in vcrbo, an association wholly discordant, merely from the vicinity of the parts affected. It is singular that even in botany Linnaeus began with establishing classes and orders; Ray and Jussieu in their more natural systems did the same, and perhaps it is unavoidable. The mind catches at the larger asso- ciations, and, captivated with their simplicity, or their theoretical connections, makes the subordinate parts bend to their powerful influence. The error is probably unavoidable: the fault consists in continuing to wear the fetters, when their weight and inconvenience is felt. Dr. Cullen, for instance, had an order of profluvia, which he placed in the class pyrexia, and thus limited the genera, omitting the catarrhus vesicae, gonorrhoea, leucorrhois, and many similar diseases. When this in- convenience was felt, he should perhaps have rejected the class. If he retained it in order to have an associa- tion strictly natural, his system was defective; for the nature of the other complaints was the same, the treat- ment in many respects similar. The great difficulty which has, however, been felt by every systematic author, is to ascertain what in- dividuals are species, and what varieties. Even in botany, where the species are now clearly distinguished, it was once so difficult, that in the system of the accu- rate Tournefort, one third of the species have been found varieties. In mineralogy the species are not yet clearly fixed; and, for obvious reasons, many fluc- tuations in the arrangement must take place before these can be ascertained. This difficulty is peculiarly felt in nosology, and it will be advantageous to consider the subjec t more fully. Linnaeus has justly observed, that the species are, in number, equal to the individuals created. Yet this remark affords little assistance to the systematic botanist If he finds a plant differing in bulk and size only, with the more essential parts in some degree imperfect, he will readily suppose it to be a variety, changed in con- sequence of a less genial climate. In any greater difficulty he sows the seed, and finds, by degrees, the variations less. Though the botanist has many other resources in ascertaining the distinction between spe- cies and varieties, yet these are the more important methods, and peculiarly applicable to the present sub- ject. Thus the erysipelas, which in the north assumes a phlegmonous appearance and nature, in a crowded metropolis must be treated with cordials and tonics. The remittent fever, which chiefly requires evacua- tions, with a moderate proportion of bark in temperate climates, soon proves fatal without a very different treatment within the tropics. The diseases are con- fessedly the same, and these are consequently varieties. The erysipelas and the remittent fever are therefore species. Again: the small pox is a disorder propagated by infection. The seminium may be consequently con- sidered as the seed of a plant. We know that the most distinct kind, in a bad constitution, and, by experiments probably not strictly justifiable, that the worst matter in a good one, will produce respectively a bad and good kind. Similar instances occur in the epidemic measles. These are cases analogous to the mode in which the botanist distinguishes species from varieties, and the variola and rubeola are consequently species. If a botanist meets with a plant to him unknown, he at once supposes it a new species, or a variety of one formerly known. If it does not agree with any known group of species, for these constitute a genus, q. v. he supposes it a new one, or at least the fixed point to ' which others may be referred. It is a common error to say that a naturalist has discovered a new genus ; for a genus is an association. If this be true, and we fear no contradiction, the real source of nosological error and difficulties is at once cut off, and we may proceed with the same steadiness and success which has crowned the labours of the botanist. The difference only is, that the sub-species or the varieties are of more importance than in other departments. The great advantage of nosology is distinction, and the discussions connected with arrangement are so many points of discrimination, which the proper order has suggested. If the place of a disease cannot be ascertained, it is evident that the symptoms have been inaccurately described. One circumstance is, however, still wanting; the accurate discriminate language of description so useful in botanical arrangement. We still want a delineatio morbi in imitation of the deline- atio plantae in Linnaeus. The first attempt at classification of diseases was made by Sauvages. It was published in a more abridged form in octavo, before that vast mass of medical erudition, his two quarto volumes, were com- pleted. It was first styled pathologia, and the name was changed to prevent its being confounded with a branch of the institutions of medicine. His first class was vitia, slight cutaneous diseases, or such as require chirurgical assistance. The second, febris ; the third, phlegmasia ; the fourth, spasmi ; the fifth, anhelationes (difficult respiration); the sixth, de- bilitates ; the seventh, dolores ; the eighth, vesa- nia ; the ninth, fluxus ; and the tenth, cachexia. Linnaeus brought to this office all his comprehensive accuracy, with a quaintness of language which, when explained, is no longer unpleasing. The exanthe- matici are eruptive; the critici, common fevers; and the phlogistici, fevers attended with inflarama- tion. The dolorosi are painful diseases; mentales consist in the abolition of judgment; the quietales ot motion; the motorii in involuntary motions- the suppressorii in obstructions of the natural passages • and the evacuatorii in evacuations. The deformes are changes in the solids, and the vitia those of the surface. The classes of Vogel, whose work appeared in 1764, are, febris, profluvia, epischeses (sup- pressions); DOLORES, SPASMI, ADYNAMIA (debilitiesV hyperastheses (more acute or depraved sensationsV cachexia, paranoia (aberrations of mind); vitia' superficial, and deformitates, more solid deformU ties. Sagar, who published his nosology in 1776, has divided diseases into thirteen classed vitia; pLAga (wounds); cachexia; dolores; fluxus ; suppres siones; spasmi; anhelationes; debilitates e*T themata; phlegmasia; febres; and vesan a. Dr" Cullen'. classes are few: pyrexia, neuroses ca chexia, and locales. proses, ca- The last general work on this subject is the philoso phical nosography of Pinel, differing W fc it, SuSS. X o s 31 NO.S from the common systems, but with too great refine- ment, and, we think, useless minuteness in the sub- divisions. The classes arc fevers, inflammations, ac- tive HEMORRHAGES, NEUROSES, LYMPHATIC DISEASES, with an indeterminate class. The existence of the last shows a want of those comprehensive views which every systematic author should possess; but as the work is not generally known, we shall pursue our ac- count of it in the more subordinate divisions. The first class of fevers contains six orders; the angi-stenic (inflammatory); the meningo-gastric (bili- ous); the adeno-meningcal (pituitous, containing the hectic and intermittents); the adynamic (putrid); the ataxic (malignant); and the adeno-nervous (the plague). We need scarcely observe, that in this arrangement fe- vers of the same type, of similar appearances, which are relieved by the same remedies, are scattered in dif- ferent orders, from the occurrence of an accidental symptom: the genera are consequently, in many in- stances, varieties only. The plague is perhaps properly a fever; but it should have been.arranged among the ataxic or adynamic diseases of our author. The inflammations are divided into five orders; 1. the inflammation of mucous membranes; 2. of diapha- nous ones; 3. of the cellular substance, the glands, or the parenchyma of the viscera; 4. of the muscles ; '•>. cutaneous inflammations, including the exanthemata. The active haemorrhages are those common to both sexes, and uterine haemorrhages. The nervous diseases contain four orders; 1. the ve- sanie, not febrile; 2. spasms; 3. local anomalies of the nervous functions; and 4. comatous affections. The fifth class contains three orders; 1. cutaneous diseases; 2. diseases of the lymphatic glands, including phthisis, lues, and rachitis; 3. dropsies. The undetermined class contains the jamidice of new born children: diabetes; worms; the bites of insects and serpents. We need not add any remarks on this arrangement. Its imperfections will be at once obvious, nor is it one of the least, that often the general, frequently the subordinate, divisions, rest on the uncertain foundation of a theory; of theory, at least, not generally admitted in this country. Were we to proceed to the genera we should find them badly arranged, imperfectly distinguished, with numerous omissions. Indeed, for many diseases, the author's system has no place. A more limited system is that of Selle, whose Rudi- menta Pyretologiae Methodicae was the subject of his thesis, and re-published at Halle in 1770, under the title of the Methodi Febrium Naturaiis Rudimenta, and afterwards in a more extensive form, under the first title, at Berlin in 1786. As it is highly commended, and often quoted, we shall give a somewhat more ex- tensive view of it than of the former systems. The first order of fevers is styled continentes, divided into two genera, the inflammatory continent, and the putrid. The second order contains the remittentes, di- vided into the gastric or bilious, the bilious inflamma- tory fever, the bilious putrid, and the pituitous fever. The last is sub-divided, as it is combined with x, a wormy colluvies,£, a metastasis of milk to the abdominal viscera, y, internal ulcer, fo, obstruction of the viscera. The third order is styled the atacta,viz. the nervous and putrid fevers; and these are divided into the spo- radic, nervous fever; the epidemic from contagion; and the slow nervous fever. The fourth order is entitled intermittentes; and the genera are, the inflammatory, bilious, pituitous, wormy* and nervous intermittents. The active inflammations are included under the inflammatory continent fever; and to these are added. in separate sub-divisions, erysipelas and rheumatism. Under the same genus we find the complications of catarrh, dysentery, and exanthemata. Many of these are repeated under the putrid continent fever, and under the different genera of remittents, with little accuracy of distinction. Under the acute sporadic nervous fever we find as species, phrenitis, hydrophobia, and febris soporosa; and, under the contagious nervous fever, the plague. which in its mildest form is placed as a variety of pu trid nervous fever. To the last edition Selle has added natural classe."- of diseases. These are inflammatory, putrid, bi- lious, PITUITOUS, WORMY, MILKY, NERVOUS, PERIODICAL, OBSTRUCTIONS, gouty, rickety, scrofulous, can- cerous, VENEREAL, SCABIOUS, SCORBUTIC, POISONOUS, and organic. This is evidently only an outline, for the genera are not filled in, and it will be obvious that they depend almost exclusively on causes, and are con- sequently theoretical. They approach nearly in the manner of their formation the natural orders of plants by Jussieu. These are the chief systems founded, or pretended to be founded, on symptoms; for the arrangement of Macbride into universal, local, sexual, and infantile diseases, scarcely merits our attention in this place. If we were to examine each system, it would appear that, except in those of Linnaeus and Cullen, there is no arrangement of classes, no traces of what in the article botany we have styled a methodus. The metho- dus of Linnaeus is somewhat fanciful, that of Dr. Cullen into universal and local diseases, as we have remarked, injurious. In all, the fundamental error appears of forming classes without having ascertained species; so that in reality the classes are orders, and the orders, in general, claim no higher rank than the first associations of species, genera. In general we may remark, that there are some associations so obvious, that they at once seize the attention of every nosologist, for no one thinks of separating.fevers or inflammations, and, except Dr. Cullen, the passive haemorrhages and profluvia from the active. Each slides into each other by such insen- sible shades, that we know not where the one begins and the other ends. Another error, which seems to pervade every system, consists in the definitions. The symptoms are seldom scientifically arranged so as to facilitate investigation. In botany, either the character'of the sections, or the first part of the character, at once informs the student whether the plant belongs to that species or to one far below. The nosologists have collected their symptoms with little care, and in their anxiety to distinguish dis- eases have rendered their definitions almost complete descriptions. This is particularly the error of Vogel and Sagar. To render their works also complete, they NO S NOS have included the minutest deviations from the natural appearance, forgetting that it was an arrangement of diseases, the essence of which consists in injured func- tions. Reflecting on these natural groups, and having es- tablished in our minds the distinctions between varie- ties, species, and genera, it occurred to us whether dis- eases might n~t be arranged in imitation of the natural orders of the botanists; and having succeeded at least to our own satisfaction in this attempt, we laid the foun- dation of it in what may have appeared the dispropor- tioned or inapplicable inquiry into the foundation of na- tural methods in Botany, q. v. We shall therefore add a new, and what appears to us an improved classifica- tion of diseases on the same principles. The orders in this arrangement are twelve: Py- rexia, Phlegmasia, Eruptiones, Profluvia, Sup- pressorii, Spasmi, Advnamia, Paranoia, Cachexia, Intumescentia, Ectopia, Plaga. In this arrange- ment there is a concealed methodus, which, as it is not an object of importance, we need not explain farther than by adding, that feverish complaints, increased and diminished evacuations, increased, diminished, and ir- regular nervous excitement, diseased fluids, appearing either in increased or diminished bulk, the displace- ments and solutions of continuity, follow in order. Order I. PYREXIAE. Genus I. Intermittens. Sp. 1. Quotidiana. 2. Tertiana. 3. Quartana. 4. Erratica. 5. Complicata. Genus II. Exacerbans. Sp. 1. Mitis. 2. Maligna. x Autumnalis. fl Icterodes, y Asthenica. 3. Hectica. Genus III. Continua Sp. 1. Synocha. 1 2. Typhus. x Carcerum. ft Neurodes. y Gastrica. 3. Synochus. Order II. PHLEGMASIA. fl Pericarditis. 8. Gastritis. 9. Enteritis. x Mesenterica. (} Epiploitis. y Peritonitis. ^ Rheumatica. 10. Nephritis. 11. Cystitis. 12. Hysteritis. 13. Odontalgia. Genus II. Phlogosis. Order III. ERUPTIONES. Genus I. Exanthema. Sp. Erythema. Phrenitica. Anginosa. Pneumonica. Puerperalis. Genus I. Inflammatio. Sp 1 Phlegmon. 2 . Ophthalmia. * Epidemica. /3 Sporadica. y Tarsi. 3 Phrenitis. 4 Cynanche. * Faucium. /3 Trachea. y Parotidea. 5. Pneumonia. * Pleuritica. 0 Peripneumonica y Diaphragmatica } Hepatica. i Rheumatica. 6. Hepatitis. 7. Carditis. * Mediastina. Genus HI. Catarrhus. Sp. 1. Coryza. * Contagiosa. /S Senilis. y Arthritica. 0s Trachealis. 2. Dysenteria. x Epidemica. fi Sporadica. 3. Phthisis. 4. Coeliaca. 5. Leucorrhaea. 6. Cystirrhaea. 7. Gonorrhoea. 8. Leucorrhois. Genus IV. Arthritis. Sp. 1. Rheumatismus. * Lumbago. ft Ischias. y Pleurodyne. Arthrodynia. Podagra. Hydrarthus. x Coxarius. £ Genu. §1- Epidemicum. >. 1 Variola. * Confiuens. /3 Crystallina 2. Vaccina. 3. Rubeola. x Maligna. f& Variolodes. 4. Varicella. 5. Milliaria. * Purpura. |3 Alba. 6. Scarlatina. x Cynanchica. 7. Erysipelas. 8. Pestis. 9. Pemphigus. 10. Aphtha. x Maligna. Genus V. Exostosis. Sp. 1. Periostea. § II. Sporadicum. 11. Urticaria. 12. Strophulus-Infantum. 13. Achor. Genus II. Efflorescentia. Sp. 1. Psora. 2. Prurigo. * Pudendi. & Senilis. 3. Lichen. 4. Petechia. 5. Vibex. 6. Phlyctena. 7. Herpes. 8. Tinea. 9- Eczema. Order IV. PROFLUVIA. Genus I. Hamorrhagia. N O S 33 NO S Sp. 1. Epistaxis. 2. Stomacace. 3. Haemoptysis. x Febrilis. |3 Asthenica. 4. Haematemesis. 5. Melaena. 6. Haemorrhois. 7. Maenorrhagia. 8. Haematuria. x Febrilis. /3 Senilis. 9. Vicaria. x Narium. (3 Pulmonum. y Ventriculi. \ Venaru7n Hamor rhoidalium. e Vesica. | Gingivarum. Genus II. Apocenosis. Sp. 1. Vomitus. x Cholera. (3 Pyrosis. y Atonica. 2. Diarrhoea. x Lienteria. /3 Aquosa. j. -Diabetes. x Mellitus. /3 Mucilaginosus. 4. Diuresis. x Chronica. (i Spasmodica. 5. Ephidrosis. 6. Plica. 7. Epiphora. 8. Ptyalismus. x Hydrargyratus. & Paralyticus. y Mellitus. 9. Exoneirosis. Order V. SUPPRESSORH. Genus I. Constrictoria. Sp. 1. Dysphagia. 2. Obstipatio. x Pylori. jZ Intestinerum. y Recti. 3. Polypus. x Narium. |3 Cordis. y Uteri. Genus II. Anhelatio. Sp. 1. Asthma. . x Spontaneum. (& Plethoricum, y Senile. 2. Dyspnoea. * Catarrhalis. vol. ii. /3 Terrea. y Aquosa. ^ Organica. e Venenata. Genus III. Epichesis. § I. Sanguinis. Sp. 1. Amenorrhaea. 2. Dyslochia. 3. Dyshaemorrhois. § II. Excretorum. 4. Icterus. x Calculosa. 0 Biliosa. y Spasmodica. 5. Ischuria. x Renalis. /3 Ureterica. y Vesicalis. & Urethralis. 6. Dysuria. x Ardens. (3 Spasmodica. y Compressions. S~ Irritata. 7. Sitis. 8. Dyspermatismus. x Organicus. /3 Spasmodicus. 9. Agalaxis. . Order VI. SPASMI. Genus I. Tonos. Sp. 1. Trismus. a Infantum. /3 Traumatica. 2. Tetanus. x Opisthotonus. /3, Emprosthotonus. y Catochus. 3. Contractura. * Colli. p Artuum.' 4. Priapismus. 5. Strabismus. Genus II. Clonos. Sp. 1. Epilepsia. x Cerebralis. (3 Sympathica. y Irritata. 2. Convulsio. x Idiopathica. j3 Irritata. 3. Hysteria. x Asthenica. (2 Irritata. 4. Chorea. 5. Raphania. 6. Palpitatio. x Hysterica. fl Irritata. 7. Pertussis. 8. Colica. x Stercoraria. |8 Venenata. 9. Hydrophobia. 10. Pandiculatio. 11. Beriberia. Order VII. ADYNAMIC. Genus I. Coma. - Sp. 1. Carus. x Catalepsis. (3 Ecstasis. 2. Apoplexia. x Sanguinea. /3 Serosa. y Hydrocephalica. ^ Asthenica. e Suffocata. £ Metastatica. 3. Paralysis. x Hemiphlegia. /3 Paraplegia. y Partialis. $ Venenata. 4. Syncope. x Cardiaca. j3 Metastatica. y Occasionalis. & Angens. Genus II. Anepithymia. Sp. 1. Anorexia. 2. Dyspepsia. x Idiopathica. /3 Metastatica. 3. Chlorosis. 4. Amentia. 5-. Amaurosis. x Intermittens. /3 Nyctyalopia. 6. Agenesia. 7. Atrophia. Order VIII. PARANOIA. Genus I. Morositas. Sp. 1. Bulimia. a. Helluonum. P Syncopalis. y Convalescentium. 2. Pica. x Chlorotica. (3 Pregnantium. y Afrorum. 3. Hypochondriasis. x Nostalgia. E NO S Genus II. Hallicinatio. Sp. 1. Satyriasis. 2. Nymphomania. 3. Erotomania. Genus III. Vesania. Sp. 1. Melancholia. 2. Mania. x Mentalis. 0 Metastatica. y Venenata. Paraphrosyne. Auc- torum. 3. Oneirodynia. x Actinia. 6 Gravans. Order IX. CACHEXIA. Genus I. Impetigo. Sp. 1. Scorbutus. 2. Syphilis. 3. Aurigo. 4. Phaenigmus. 5. Melasma. 6. Rubigo. Genus II. Macula. Sp. 1. Echymosis. 2. Petechia. tier X. INTUMESCENTIA. Genus I. Tuber. § I. Universi. Sp. 1. Polysarcia. § II. Partium. 2. Rachitis. 3. Exostosis. 4. Physconia. * Hepatica.' j3 Splenica. y Renalis. o* Uterina. e Visceralis. £ Mesenterica. *) Externa. § III. Cutis. 5. Elephantiasis. 6. Framboesia. 7. Pellagra. 8. Lepra. 9. Verruca. 34 10. Ganglion. § IV. Glandium. 11. Sarcoma. x Pterygium. p Hordeolum. 12. Scrophula. 13. Encystis. * Atheroma. j3 Steatoma. y Testudo. ^ Meliceris. 14. Scirrhus. 15. Cancer. 16. Parotis. Genus II. Phlegmatia. Sp. 1. Anasarca. x Oppilata. /3 Exanthematica. y Anemia. £ Dolens. 2. Hydrocephalus (ex- ternus). 3. Hydrorachitis (Spina Bifida). 4. Hydrothorax. 5. Ascites. x Asthenica. /3 Metastatica. 6. Hydrometra. 7. Hydrocele. 8. Exomphalos. Genus III. Cystis. Sp. 1. Aneurisma. 2. Varix. 3. Mariscus. 4. Staphyloma. 5. Hydatis. 6. Abscessus. Genus IV. Emphysema. Sp. 1. Pneumatosis. x Traumatica. /3 Venenata. 2. Tympanites. x Intestinalis. f& Abdominalis. 3. Physometra. Order XL ECTOPIA. Genus I. Hernia. Sp. 1. Enterocele. Intestini. 2. Epiplocele. Omenti. 3. Gastrocele.- Ventriculi. 4. Hepatocele. Hepatis. NOS 5 Splenocele. Lienis. 6 Hysterocele. Uteri. 7 Cystocele. Vesica. 8. Encephalocele. Cere- bri. Genus II. Prolapsus. Sp. 1. Exophthalmia. Oculi. 2. Blepharoptosis. Pa/- pebra. 3. Hypostaphyle. Uvula. 4. Paraglossae. Lingua. 5. Exania. -Red"- 6. Exocyste. Vesica. 7. Hysteroptosis. Uteri, vel Vagina. Genus III. Luxatio. Sp. 1. Calcis. 2. Capitis. 3. Carpi. 4. Claviculae. 5. Coccygis, 6. Colli. 7. Costarum. 8. Digitorum. 9. Femoris. 10. Fibulae. 11. Genu. 12. Humeri. 13. Malleoli. 14. Manus. 15. Maxillae. 16. Metacarpi. 17. Nasi Ossis. 18. Olecrani. 19. Patellae. 20. Tali. 21. Vertebrarum. Order XII. Plaga. Genus I. Dialysis. Sp. l. Vulnus. 2. Ulcus. 3. Punctura. 4. Excoriatio. 5. Ruptura. 6. Sinus. 7. Fistula. Genus II. Clasis, Sp. 1. Fractura. 2. Fissura. 3. Rhagas. 4. Arthrocace. Genus III. Diastasis. Sp. l. Symphysis Pubis. N O S 35 N O 8 Though from mature reflection we are convinced of the advantages of this plan, we have not ventured to disturb, through this work, the usual nomenclature, nor the received definitions. We have also, in general, avoided nosological disquisitions, as we wished to con- fine all our observations on these points to a single ar- ticle; and, consequently, if our ideas are rejected, we shall occasion no difficulty to the student, either by innovations of language or arrangements. We shall, therefore, now proceed to the definitions, and shall close this article with some remarks in defence of the present system,' and the definitions now introduced. Order I. PYREXIA. Heat, after coldness and shivering ; debility ; mind unsteady; tendons of the wrist tense; pulse either preternaturally quick or weak. Genus I. Intermittens. "Fever," returning after various and generally regular intervals, having each paroxysm apparently ter- minated by sweating. Sp. 1. Quotidiana. Intermittent fever, returning after an interval of twenty-four hours. 2. Tertiana. Returning after an interval of forty- eight hours. 3. Quartana. After an interval of seventy-two hours. 4. Erratica. After intervals generally uncertain, but always longer than seventy-two hours. 5. Complicata. Irregularly returning paroxysms, from a complication of a tertian and a quar- tan, two tertians, or two quartans. Genus II. Exacerbans. " Fever," exacerbating and remitting, without ever disappear- ing ; remissions distinguished by sweating, or a cloud in the urine; one paroxysm only occurring in twenty- four hours. Sp. 1. Mitis. "Exacerbating fever," without re- markable debility or putridity. 2. Maligna. With great debility, often with pu- trefactive symptoms, rapid and usually fatal. 3. Hectica. Exacerbations distinctly returning every evening, terminated very commonly by sweating. Genus III. Continua. " Fever," with remissions less evident, and seldom marked by critical discharges; having usually two exacerbations in twenty-four hours. Sp. 1. Synocha. " Continued fever," with great heat, frequent, strong and hard pulse, urine red; mind but slightly affected. 2. Typhus. " Continued fever," with pulse and heat, in the beginning moderate, and remis- sions unusually distinct; mind very un- steady; debility considerable; urine clear; in the advanced stages, putridity, tremors, and convulsions. 3. Synochus. " Continued fever," commencing like synocha; in its progress resembling typhus, though more mild, and often at- tended with bilious discharges. Order II. PHLEGMASIA. Local fixed pains, with a laesion of the functions of the diseased organ, an. increased discharge from its vessels, usually attended with " fever." When external, the parts affected are floridly red, generally swollen ; the tu- mour often circumscribed, ending in effusion, suppuration, or gangrene. Genus I. Inflammatio. Local " phlegmasia" with fever, usually inflammatory. Sp. 1. Phlegmon. " Local inflammation" on the surface, pain generally throbbing. 2. Ophthalmia. Inflammation in the eye, or its lids; light painful, and the pain peculiarly acute. Var. * Epidemica, Egyptian ophthalmy. 0 Sporadica, accidental inflammation of the eye. y Tarsi, inflammation of the eye lids. 3. Phrenitis. Pain of the head; the pain from light and sound highly acute; face flush- ed; eyes red; synocha,with watchfulness and delirium. 4. Cynanche. Redness and pain of the fauces and throat; swallowing painful and difficult, often impossible; swelling in the tonsils, and sometimes in the neck; breathing oc- casionally difficult, and stridulous. Var. x Faucium. Redness at the back part of the throat, conspicuous and consi- derable. j3 Trachea. Redness less conspicuous, breathing difficult and stridulous. £ Parotidaa. Tumours external, diffi- culty of swallowing slight, often al- ternating, with tumours of the testes; in females of the mammae. 5. Pneumonia. Pain in some parts of the chest ; cough, at first day, afterwards attended with expectoration, often bloody. Var. x Pleura. Pulse full and hard; pain vio- lent; synocha severe; often without expectoration. « Pulmonum. Pulse less hard, and pain less pungent; dyspnoea acute; suf- focation on lying down; face pur- ple; sputum glutinous, green, and yellow; towards the solution white and equable. y Diaphragmatis. Pain at the lower ribs, extending to the back; breath- ing interrupted and painful; hic- cough, without expectoration. e Hepatica. Pain extending downward toward the right side; pulse less full and hard; sputum yellow. £ Rheumatica. Pulse hard and strong, without cough; side affected, exter- nally sore. 6. Hepatitis. Tension and often soreness in the right hypochondrium, extending occasion- ally to the right shoulder; expectoration generally yellow. 7. Carditis. Pain under the sternum, sometimes E 2 NO S 36 NOS pungent; violent palpitation, with great anxiety; pulse small, and generally un- equal. Var. x Mediastina. Pain more strictly con- fined to the middle of the sternum, with less palpitation and anxiety; without expectoration. 0 Pericardii7*. Pain more acute; pal- pitation violent. 8. Gastritis. Pain with frequently a circum- scribed tumour, and soreness at the pit of the stomach; vomiting, even of the mildest fluids, incessant; pulse soft, weak, and sometimes fluttering. 9. Enteritis. Violent colic, with soreness of the abdomen; costiveness obstinate, often with vomiting, frequently with ischuria. Var. x Mesenterica. Pain deeply seated, with- out soreness of the abdomen; cos- tiveness and ischuria less violent. & Epiploitis. Tumour more sensible; seldom with ischuria. y Peritonitis. External soreness, and pain extreme, increased on raising the body; without constipation or relief from stools. £ Rheumatica. Great external soreness and acute pain, chiefly felt at the lowest ribs, and the spine of the ileum. 10. Nephritis. Pain shooting from the loins into the thighs; micturition painful and fre- quent, with a retraction of either testicle, and a numbness of the thigh on the same side; often with vomiting. II. Cystitis. Inflammation, pain, and swelling of the hypogastrium ; micturition painful or obstructed; frequently with tenesmus. 1.. Hysteritis. Swelling and pain of the hypo- gastrium ; micturition slightly affected; the os tincae sore and painful. 18. Odontalgia. Pain of the teeth and jaws, ex- tending to the ear, and often to every part of the head on the side affected; at first increased, afterwards relieved, by heat. Genus II. Phlogosis. Inflammation; pain less vio- ent; tumour inconsiderable; redness less florid, irregular, extending; with debility, often with typhus; terminating generally and rapidly in gangrene. Sp. 1. Erythema. External " Phlogosis" of a pink colour, disappearing on pressure; pain burning; terminating generally in branny scales, often in phlyctenae or vesicles, at last in gangrene. ' Var, * Mitis. Pernio. From cold, generally in the fingers, toes, or heel. Combustio. From violent heat. $ Maligna. "* w?£'" u A **rd deeP seated t^our with a burning heat, of a dark co- >, pa lour, rapidly hastening to gangrene 2. Phremtica. Pain of the head inconsideXfj face pale; restlessness, low delirium, with. occasional fits of violence. 3. Anginosa. " Phlogosis" of the throat and fauces, frequently with ulcerations, deep and ragged at the edges; severe typhus; deliquium; often with erythema on the skin. 4. Pneumonica. Symptoms of pneumonia, but with the face pale, the features sunk, and a pulse, though apparently strong, stopped by a slight pressure; deliquium, particu- larly after discharges. 5. Puerperalis. Typhus, usually attacking on the third day after delivery; pain and soreness of the abdomen; face pale; eyes sunk; a tensive pain in the forehead, with a retro- cession of the milk. Genus III. Catarrhus. Inflammation of the glands of the mucous membrane, with an increased discharge of mu- - cus, at first thin, acrid and discolour- ed, afterwards whiter and of a greater consistence. Sp. 1. Cozyra. Catarrhal inframmation of the mem- brane of the nose, fauces, and bronchiae, with sneezing and coughing; occasionally epidemic and infectious. Var. x Contagiosa, with typhus,, and consider- able depression of strength. /3 Senilis, with fever slight and incon- siderable, but with great discharge of mucus. y Arthritica. From gout repelled or ir- regular, with a copious discharge of an acrid, greenish, mucus. f Trachealis. Great difficulty of breath- ing, with a stridulous sound, ter- minating in suffocation from a con- creted effusion. 2. Dysenteria. Violent colic, with tenesmus • very frequent stools, mucous and often bloody, rarely, except in the decline of the ralT^Sr5 ^^ ^-^ S— Var. * Epidemica. With typhoid fever, great dejection of Spirits, and tf e* strength. U1 a Sporadica^ With milder fever, and , r .. I«» debility; not epidemic. 3. Cehaca. Colic generally without fever ex cept after some continuance; without te" KSEi.the dhd-r^ ~ *&£ 4. Phthisis. Cough, at first short and dry, after wards more violent, with a mucous7and at" last a purulent, expectoration; g ea" de bihty and emaciation; fever exac^W in the evening, pulse unusually quick ing 5. Cystirrhta. A light, white, flocuTent dis charge accompanying the urine no fi.? i" micturition painful without tenesmu, ^ 6. Leucorrhea A mucous discharge from th. vagina, of a yellowish white co!m?r- C to green; without intent o? ^K N O S 37 N O S making water; disappearing during men- struation. 7. Gonorrhea. A discharge resembling that of leucorrhoea, from the penis or vagina, ge- nerally with inflammation at the orifice of the urethra, and pain in making water ; not disappearing during menstruation. Var. *t Venerea. From venereal infection ; contagious. |3 Benigna. With little pain in making water; not contagious. 8. Leucorrhois. A whitish discharge from the anus, often with haemorrhoidal tumours, some- Genus I. times periodical. in the heat of the bed, and sore to tin touch, generally from lues. Sp. 1. Periostea. Chiefly confined to the periosteum. Order III. Genus IV. Arthritis. Inflammation usually con- fined to the joints, occasionally ex- tending to the adjoining muscles; ge- nerally with fever; often with hectica. Sp. 1. Rheumatismus. " Articular inflammation," chiefly of the large joints, with pain; sy- nocha; generally increased heat of the part; not terminating in suppuration. Var. x Lumbago. Rheumatic pain in the loins, not shooting down the thigh ; chiefly felt on motion. /3 Ischias. Pain in the hip joint; without peculiar debility, emaciation of the nates on the affected side, or elonga- tion of the limb. y Pleurodyne. Pneumonia rheumatica, q. v. 2. Arthrodynia. " Articular inflammation," with little or no fever; limb cold and rigid, without swelling. 3. Podagra.^ Inflammation and pain, chiefly "of the smaller joints, preceded by anorexia, dyspep- sia, a dejection of spirits, or want of sleep; returning after intervals, sometimes regular, and alternating with atonic, occasionally with inflammatory, affections of the head, stomach, or bowels. A. Hydrarthus. Deep-seated pain in the joints ; swelling slight, without discoloration, often ending in suppuration, sometimes with- in the capsular ligament; attended with hec- tic. Var. x Psoadicus. , Pain beginning in the back, increased by stooping, or extending either leg ; the suppuration pointing in the groin, the thigh, or the back ; with hectic. 0 Coxarius. Pain in the coxendix, at first slight and obtuse, afterwards acute; nates of the side affected extenuated, leg elongated, attended at last with hectic. y Genu. Hydrarthus affecting the knee, attended in the latter stages with acute pain and hectic fever; in fa- vourable circumstances terminated by anchylosis. CJenus V. Exostosis. A swelling apparently of the bone, generally near the middle, painful, ERUPTIONES. Erythematous or phlegmonous eruptions on the sur- face, or the fauces, generally distinct; thelatter rising above the skin, circum- scribed, roundish; generally containing a fluid, sometimes in the decline puru- lent. Exanthema. Eruptions generally depend- ing on specific contagion, often epidemic, usually with fever. Sp. 1. Variola. Synocha, followed on the third day by the jeruption of small phlegmons, com- pleted on the fifth, suppurating, and forming crusts on the eighth, frequently leaving cuti- lar cicatrices or depressions Var. x Confiuens. Phlegmons numerous and crowded, not rising in separate heads. (Z Crystallina. Phlegmons filled with a clear watery fluid, seldom or imper- fectly suppurating. 2. Vaccina. Phlegmon only on the part affected, from inoculation or infection in consequence of milking diseased cows ; the phlegmon nearly round, with a dark brown depression in the middle; fever usually inconsiderable. 3. Rubeola. Catarrhus, with synocha ; cough harsh ; eyes inflamed and watery ; followed by red papulae, running together, scarcely rising above the skin ; terminating in branny scales. Var. x Maligna. Catarrhus with typhus ; the papulae dark, interspersed with dark coloured petechiae ; great oppression at the breast, without expectoration. /3 Variolodes. Papulae resembling phleg- mons, catarrhal symptoms absent or inconsiderable. 4. Varicella. Pustules resembling the variolous, following a slight fever, after no definite pe- riod ; seldom suppurating, but disappearing in branny scales. 5. Miliaria. Fever typhoid, with sighing, anxiety, and sweat of a sour smell; followed by nu- merous distinct papulae, terminating in points. Var. x Purpura. Apices of the papulae pur- ple ; with typhus. /3 Alba. Apices of the papulae white, with slight synocha. 6. Scarlatina. Fever, often at night with delirium ; on the fourth day a swelling, and a scarlet effusion on the face, with a similar effusion soon afterward on the breast, and in succes- sion on the body and legs ; the effusion often in large spots, frequently coalescing and ter- minating in branny scales. Var. x Cynanchica. Scarlatina, " with phlogo- sis anginosa." NOS 38 NOS 7. Erynipelas. After a fever of three or four days, phlogosis in the face, occasionally in other parts, accompanied, more often suc- ceeded, by delirium; terminating in branny scales. Var. * Intermittens. Erysipelas irregularly re- turning at distant intervals, chronic, with little fever. «. Pestis. Asthenic fever, with great internal heat, terminating in bubos of the groin or axilla, sometimes in anthrax. 9. Pc7nphigus. Fever generally typhoid, terminat- ing in vesicles filled with thin ichor; some- times with a lighter coloured serum. to. Aphtha. Fever followed after a few days by a swelling in the tongue, and a purplish colour on the fauces, terminating in white, frequent- ly distinct, sloughs on the fauces and palate ; frequently with diarrhoea and coeliaca, some- times with haemorrhage. Var. -x Maligna. The sloughs of a darker co- lour, leaving, when abraded, a dark ragged ulcer. /3 Sporadica. Seldom attacking numbers at the same time; the eruption more slightly connected with fever. I 1. Urticaria^ Exacerbating fever; eruptions after each attack, sometimes resembling the sting- ing of nettles, sometimes rising in small pa- pulae ; seldom suppurating, but terminating in dry scabs. \2. Strophulus. After sickness and uneasiness in new born children, an eruption of red papulae, rising above the skin, frequently coalescing, though sometimes distinct, and filled with a serous fluid. 13. Achor. Swellings in different parts of the body, resembling phlegmons, discharging sebaceous, sometimes puriform, matter, from minute foramina ; fever slight, often indis- tinct. tienus II. Efflorescentia. Eruptions not rising, or rising slightly above the skin, without fe- ver; not epidemic. Sp. 1. Psora. Pustules, at first white, afterwards filling with serum, degenerating into little red inflamed papulae, chiefly between the fingers ; itching, particularly when warm in bed; con- tagious. ■2. Prurigo. Itching in different parts, often without pustules, or with pustules not filling with se- rum ; terminating in branny scales. 3. Lichen. An extensive eruption of papulae, gene- rally connected with internal disease, usually terminating in scurf; recurrent; not contagi- ous. Var. x Purpura chronica scorbutica Hoffmani. 4. Herpes. Efflorescence, consisting of clusters of small red pustules, itching with a burning heat, and terminating in a branny crust. 5. Phlyctena. Vesicles pellucid, filled with a serous fluid, inflamed at the base ; painful when burst. •>. Petechia. Spots not rising above the skin, re- sembling the bites of fleas, at first red, after- wards of a cinnamon colour, in succession brown and black, often with spontaneous hae- morrhage. 7. Vibex. Marks on the skin in stripes, of a dark brown colour, often mixed with petechiae. 8. Tinea. Ulcers in the hairy scalp, pouring out a fluid^ concreting into a white friable crust; generally rounded in its figure. 9. Eczema. Small vesicles with considerable itch- ing ; vesicles scarcely distinguishable from papulae, with often an erysipelatous swelling; from the use of mercury. Order IV. PROFLUVIA. A flow of blood, or of secreted fluids, from their respective vessels or ducts; often with fever. Genus I. Hjemorrhagia. A discharge of blood. Sp. 1. Epistaxis. " Haemorrhage" from the nose, preceded by headach, and often a burning heat in the nose. 2. Stomacace. Blood oozing from the gums, without fever. 3. Hamoptysis. Blood thrown up by coughing, preceded by flushed cheeks, dyspnoea, a sense of weight in the head and breast. 4. Hamatemesis. Blood thrown up by vomiting, preceded by sickness and faintness ; seldom coagulated, generally in considerable quan- tity. Var. ot, Febrilis, preceded or attended by fever. /3 Asthenica, in weak or scorbutic habits. 5. Melena. A discharge of a blackish substance , from the stomach or intestines often foliated or filamentous, sometimes verging to a yellow- ish brown colour. 6. Hemorrhois. Blood flowing from the anus, often preceded by pain and load in the head; fre- quently accompanied by painful, livid tumours near the verge of the anus, or a painful weight within the rectum. 7. Menorrhagia. An unusual flow of blood from the vagina, often with a sense of weight in the loins, and occasionally with a sensa- tion of weight forcing down on the os exter- num. 8. Hematuria. A considerable discharge of blood with the urine, often with violent forcing pains, felt at the extremity of the penis- tenesmus, without sickness. 9. Vicaria. Discharges of blood from different organs, in consequence of suppressed eva- cuations, or the natural ones not taking place. s Var. x Narium, from the nose. /3 Pulmonum, from the lungs. y Ventriculi, from the stomach. } Venarum hemorrhoidalium, from the haemorrhoidal veins. e Vesica, from the urinary bladder. | Gingivarum, from the gums. Jenus II. Apocenosis. Increased discharges from NOS 39 NOS glands, or the cavities into which their contents are usually poured; in general without fever. Sp. 1. Vomitus. A discharge from the stomach, ei- ther bilious, mucous, or watery. Var. x. Cholera. A discharge of bile, often with colic; when violent and inces- sant, attended with spasms of the legs. (8. Pyrosis. A discharge of cold water, generally preceded by acute pain. y. Atonica. Constant vomiting of what- ever is taken in, with a large pro- portion of heavy mucus; often after repelled gout and eruptions, gene- rally in old age; the consequence often of high living, and the abuse of spirituous liquors. 2. Diarrhea. Frequent discharges by stool; often with colic; generally without fever. Var* x. Lienteria. The discharge apparently chylous. /3. Aquosa. Without faeces or scybala. 3. Diabetes. An immoderate discharge of urine, with thirst, anorexia, and emaciation; with- out pain or fever. Var. x. Mellitus. Urine sweet, without any portion of the urea or animal matter. p. Aquosus. Urine differing little from water; discharged often involun- tarily. y. Mucilaginosus. Containing a large proportion of mucilage or gluten. 4. Diuresis. A discharge of limpid urine, re- turning at intervals, without emaciation. 5. Ephidrosis. An immoderate discharge of sweat without fever. 6. Plica. The hair twisted in cirrhi, in conse- quence of a discharge of blood or serum from the bulbs into the cavities of each hair; with fever ; contagious; and in Po- land endemical. 7. Epiphora. An increased discharge from the lacrhymal glands. 8. Ptyalis7nus. An increased discharge of saliva. Var. x. Hydrargyratus. In consequence of large doses of mercury, often con- tinuing after the medicine has ceased to act. (3. Asthenicus. The drivelling of idiots, or those affected with palsy. y. Mellitus. With a sweetness or mucil- aginous taste in the mouth. 9. Exoneirosis. An involuntary discharge of semen during sleep, independent of lascivi- ous dreams. Order V. SUPPRESSORH. Obstructions of na- tural passages, and of natural or mor- bidly critical discharges. Genus I. Constrictoria. " Obstruction" from or- ganic disease. Sp. 1. Dysphagia. Difficulty of swallowing from a sensible obstruction of the oesophagus. 2. Obstipatio. Obstruction in the track of the stomach and intestines below the oeso- phagus. Var. x. Pylori. Food taken into the stomach, often returned by vomiting, eruc- tations, loss of strength and flesh ; with costiveness; frequently un- conquerable, always obstinate. /3. Intestinorum. Bowels obstinately cos- tive, without vomiting; fulness often in some part of the abdomen, to be felt through the integuments. y. Recti. A retention of solid feculent matter, with tenesmus, and a slight watery diarrhoea; a contraction often within the reach of the finger. - 3. Polypus. Obstructions in the heart or other natural passages. Var. x. Narium. Breathing through the nose difficult or impossible ; sometimes with load in the head, or symptoms of hydrocephalus. /3. Cordis. Palpitation of the heart, with anxiety and dyspnoea. y. Uteri. Weight and bearing down of the uterus, generally with amenorr- hcea, often with a serous discharge resembling leucorrhois; generally without pain. Genus n. Anhelatio. An obstruction to the passage of air into the lungs. Sp. 1. Asthma. A difficulty of breathing, with a sense of constriction in the breast; hissing sound in respiration; cough, terminated by expectoration; temporary; recurrent. Var. x. Spontaneum. Suddenly, often unex- pectedly, recurring without any other disease; seldom terminated by expectoration, or at least expec- toration in any considerable quan- tity. p. Plethoricum. From suppressed san- guineous discharges, or from ple- thora. y. Senile. Frequently recurring, with copious expectoration. 2. Dyspnea. Difficulty of breathing constant, with a sensation of weight, rather than constriction on the breast; cough constant, with little or insufficient expectoration. Var. x. Catarrhalis. Chronic catarrh of old people. /3. Terrea. Dyspnoea from calculous concretions, frequently discharged. y. Aquosa. With a scanty discharge of urine, in leucophlegmatic habits. Genus III. Epischesis. § I. Sanguinea. Sp. 1- A7nenorrhea. A deficiency or obstruction of the menstrual discharge, at the time of life, or the periods, when it should naturally take place. NOS 40 NOS Var. x. Dolorifica. A deficient discharge, at- tended with violent pain. ;. Dh'lochia. A want or suppression of the lo- ch ial discharge. 3. Dyihemorrhois. A suppression of the hae- morrhoidal discharge, attended with head- ach, dyspepsia, and fever. II. Excretorum. 4. Icterus. An obstruction of the bile, known from unfrequent, white stools, and a yel- lowness of the skin; urine of a yellow red colour, tinging linen immersed in it of a yellow colour. Var. * Calculosa. With acute pain at the pit of the stomach. fl Biliosa. In persons of a studious, se- dentary life, often attended with hypochondriasis. y Spasmodica. Following violent fits of anger. 3. Ischuria. An obstinate, and often a com- plete, suppression of urine. * Renalis. With a pain and weight in the loins, without tumour in the hypogastric region. fl Ureterica. With a sense of weight in the lower part of the pelvis, without hypogastric tumour. y Vesicalis. With a tumour in the hy- pogastrium, a frequent desire to make water; a pain felt at the ex- tremity of the penis. } Urt'thralis. With a tumour in the hy- pogastrium, a frequent desire to make water, and a-sense of obstruc- tion in the uretha, not admitting the introduction of a catheter. e Paralytica. Without symptoms of ac- cumulation in any part of the uri- nary track. 6. Dysuria. A painful, and in some degree an obstructed, discharge of urine. Var. * Ardens. With pain, and often inflam- mation of the bladder and urethra. fl Spasmodica. From spasm in other parts, communicated to the neck of the bladder. y Coinpressa. From tumours in the neighbouring parts, compressing the neek of the bladder. } Irritata. From calculus. t Arthritica. In gouty habits, with a dis- charge of greenish mucus. 7. Sitis. An unconquerable desire for liquids, sometimes accompanying diabetes or fever. 8. Dyspermatismus. An obstruction to the ex- cretion of semen, or a slow, painful, and insufficient discharge of it. Var. x Organicus. From strictures of the ure- thra, or neighbouring tumours. p Spasmodicus. From terror, apprehen- sion, or sudden surprise. 9. Agalaxis. A suppression of milk, either when first expected, or after the secretion has come on. Order VI SFA SMI. Violently continued or irregular action of the muscular fibres of dif- ferent parts. Genus I. Tonos. Muscular contractions, sometimes remitting,but not succeeded by complete relaxation. Sp I. Trismus. A violent and continued action of the muscles which close the lower jaw. Var. * Infantum. Trismus of newly born in- fants, with usually a retention of the meconium. /3 Traumatica. From wounds, particu- larly lacerated ones in hot climates ; sometimes from ulcers. 2. Tetanus. Tonic spasm of the voluntary muscles, beginning with pain and tension on the back of the neck, occasionally confined to one side, or, at least, a considerable portion of the body. Var. x Emprosthotonus. Tetanus of the flexor muscles. /3 Opisthotonus. Tetanus of the extensors. y Catochus. Tetanus gradually approaching without dyspnoea- 3. Contractura. Tonic spasm of particular mus* cles. Var. x Colli. Of the sterno mastoid, producing the wry neck. /3 Artuum. Of different limbs, chiefly from confinement or the irritation of ab- scesses. 4. Priapismus. Tonic spasm of the erectores penis, with violent pain. 5. Strabismus. Tonic spasm of the abductores, the adductores, occasionally of the other muscles of the eye, usually at first attended with double vision. Genus II. Clonos. Muscular contractions rapidly and repeatedly succeeded by relaxation. Sp. 1. Epilepsia. Clonic spasm of all the muscles, ge- nerally with carus, returning after intervals, often regular. Var. x Cerebralis. Without evident cause, or preceding symptoms, except some- times a slight giddiness. P Sympathies Preceded by an obscure feeling in a distant part, and a sen- sation of cold air, rising from that part to the head. y Irritata. From irritation in different parts, particularly the stomach and the head, without the sensation of cold air. 2. Convulsio. Clonic spasm of all the muscles, without carus, seldom recurrent Var. x Irritata From the stomach, injuries of the brain, teething, &c. 3. Hysteria. Clonic spasm, preceded frequently by a rumbling sound of the stomach, with a sensation of a ball in the throat, impeding de- glutition ; urine copious and limpid; temper NOS 41 NOS Var. x Asthenica. In weak mobile habits, often without any evident cause. 0 Irritata. From any sudden affection of the mind, or irritations in the sto- mach and bowels. 4. Chorea. Clonic spasm, particularly in the fin- gers, legs, and lips, producing strange ges- ticulations and grimaces; with a weakness of either leg; often insensibility. 5. Raphania. Clonic spasm, with often a con- traction of the joints; pain very violent; intermitting. §. Palpitatio. Violent and irregular action of the heart. Var. x Cardiaca. From diseases of the heart, or larger arteries. /9 Hysterica. Occurring in the mobile habits, subject to hysteria. y Irritata. From irritations chiefly in the stomach and bowels. 7. Pertussis. Cough violently convulsive; in- spiration sonorous; recurring in paroxysms; contagious; at the end with expectoration. 8. Colica. Violent pain in the bowels, remit- ting and exacerbating, chiefly felt about the navel, with vomiting and costiveness. Var. x Stercoraria. From accumulated con- tents of the intestines, preceded by costiveness or slight watery stools. ft Venenata. From poisons, often of lead. 9. Hydrophobia. Convulsions of the pharnyx, excited by an attempt to drink water or any fluid, preceded by melancholy, and in- creased sensibility; in consequence of the bite of a mad animal. 10. Pandiculatio. The extension of almost all the limbs ; involuntary, generally with gaping. 11. Beriberia. A convulsive retraction of the knees in walking, with tremor, a sense of creeping, and a hoarseness of voice. Order VII. ADYNAMIA. A defect or a diminution of sensation, motion, or the natural func- tions ; often with stupor. Genus I. Coma. A deep and continued stupor, with a diminution or loss of muscular power; of- ten with stertor. Sp. 1. Carus. A continued stupor, and insensibility without stertor. Var. x Catalepsis. Limbs flexible, continuing in the posture in which they were placed. fi Ecstasis. Limbs rigid, retaining the position in which the person was seized. 2. Apoplexia. Coma with stertor. Var. x Sanguinea. After heat, violent exer- cise, or blows on the head; in the young and plethoric. P Serosa. Coma gradually approaching in advanced life^ y Hydrocephalica. Coma, with scanty VOL. II. urine, obstinate costiveness, and strabismus. 3" Asthenica. Coma, rapidly, often sud- denly approaching in impaired con- stitutions ; frequently with convul- sions. t Suffocata. From noxious gases, hang- ing or drowning. £ Metastatica. From serous, excretory, or sanguineous obstruction, gout or repelled eruptions. 3. Paralysis. A loss of motion in some of the limbs, and impaired natural functions; without stertor; sometimes, without stupor. Var. x Hemiphlegia. With loss of motion on one side. « j8 Paraphlegia. With loss of motion in the lower extremities without stu- por. y Partialis. With loss of motion in particular limbs, without stupor or stertor. ^ Venenata. From poison of lead, to- bacco, or deleterious gases. 4. Syncope. A diminished motion of the heart and arteries, often with stupor ; occasional- ly recurring. Var. x Cardiaca. From some defect in the heart or larger vessels. fl Metastatica. From retrocession or repulsion of exanthemata, or gout; sometimes from fever or scurvy. y Angens. With violent pain in the breast, shooting down to the arms, often with a sense of stricture, on the breast. Genus II. Anepithymia. A diminution of power in the different functions. Sp. 1. Anorexia. Loss of appetite, with languor, flatulence, and a sense of sinking in the stomach. 2. Dyspepsia. Flatulence with sour eructations ; often with sickness, and a putrid taste at the back part of the fauces. Var. x Idiopathica. Without any previous disease. fi Metastatica. From repelled eruptions, obstructed discharges, depressing passions, atonic gout, &c. 3. Chlorosis. Languor and debility, with pale complexion, often dyspepsia; without fe- ver ; generally attendant on amenorrhcea. 4. Amentia. Impaired mental functions from excessive evacuations, irregular living, or old age ; generally with debility. 5. Amaurosis. Impaired sight, with an enlarged pupil, not contracting on the approach of a strong light. Var. x Intermittens. Blindness sometimes recurring at night; at others only on the return of daylight, nyctyalo- pia auctorum. 6. Agenesia. The power of generation impaired. 7. Atrophia. Emaciation of the whole body, F N O S 42 often with hectica, frequently with a swell- ing of the abdomen. Order VIII. PARANOLA. Violent or irregular ex- ertion of the different corporeal or mental functions, often alternating with languor and depression of body or mind. Genus I. Morositas. Violent or irregular derange- ments of the appetite, occasionally of di- gestion. Sp. 1. Bulimia. A craving appetite for a la/ger pro- portion of food than the stomach can digest, or oftener than the system requires. Var. * Helluo7iu7n. From indulgence of glut- tony. . ... /3 Syncopalis. From a sense of inanition. y Convalescentium. After fevers, or ex- cessive discharges. 2. Pica. An aversion to common food, and an eager desire for substances not esculent or alimentary. Var. x Chlorotica. Attending amenorrhoea, often about the age of puberty. /3 Pregnantium. The pica of pregnancy. y Afrorum. Cachexia, Africana, dirt eat- ing ; a disease of negroes in Jamaica. •S. Hypochondriasis. Dyspepsia with costive- ness, fancies irregular, mind desponding. Var. x Nostalgia. Hypochondriasis, with a longing for home, when in a foreign country. Genus II. Hallucinatio. Violent or irregular sexual passions. Sp. l. Satyriasis. Violent and excessive lust, with priapism. 2. Nymphomania. Satyriasis of females, with in- flammation of the nymphae. 3. Erotomania. Chaste love in excess, when the object is unattainable ; with melancholy, sleeplessness, and often hectic. (lenus III. Vesania. Irregular exertion of the men- tal functions, occasionally with excess of excitement, sometimes of depression ; without coma or fever. Sp. 1. Melancholia. Depression of the mental pow- ers with erroneous judgment, though in general .with correct perceptions, without dyspepsia. ?. Mania. Erroneous perceptions or judgment, often of both ; with great violence. Var. x Men talis. Apparently from passions of the mind only. /3 Metastatica. From repelled eruptions, gout, or obstructed discharges. y Venenata. From narcotic poisons, pa- raphrosyneauctorum. VanHelmont. 3. Oneirodynia. Disturbed sleep, sometimes with an imagination peculiarly active, at others, with a sense of oppression. Var. * Activa. Sonambulism. /3 Gravans. Ephialtes, night mare. Order IX. CACHEXIA. A change in the colour of NOS the skin, generally from a chemical change in the nature of the fluids. Genus I. Impetigo. A change of colour in the whole body. Sp I. Scorbutus. Livid spots over the whole body, F particularly at the roots of the hair, with great loss of strength, and bleeding from the gums; generally from food not alimen- tary. e ., Var. x Nautarum. The scurvy of sailors on long voyages, without a supply of vegetables. 0 Asthenica. Occurring in besieged towns, or from poor living in con- fined apartments without exercise. 2. Syphilis. Spots sometimes level with the skin, but occasionally rising in small tubercles, particularly at the roots of the hair, dege- nerating into crusty ulcers; pains in the middle of the bones, particularly when warm in bed, with exostosis; generally af- ter some local complaint of the genitals. 3. Aurigo. A dark yellowness of the skin, with dyspepsia, generally terminating in dropsy; stools natural; urine not tinging linen yellow. 4. Phenigmus. Redness of the skin, either dif- fused or in spots; without fever. 5. Melasma. A dark blue or purple colour of the skin, generally with dyspnoea and pal- pitation, from the blood not flowing freely through the lungs. 6. Rubigo. A general redness of the skin: of- ten with coma. Genus II. Macula. A partial change of colour. Sp. 1. Ecchymosis. A blue colour in particular parts, sometimes black, changing to a brown and yellow ; from fluids effused in consequence of a bruise. 2. Nevus. Irregular marks on the skin, some- times of a bright red, at other times yellow or brown, absurdly attributed to the mo- ther's longing. . Order X. INTUMESCENTIA. Enlargement of the whole body, or of particular parts. § I. Total. Sp. 1. Polysarcia. General enlargement, usually from accumulated fat. § II. Partial. 2. Rachitis. Bones of the joints enlarged, head swollen, particularly in front; with phys- conia. 3. Exostosis. See Periostea. 4. Physconia. Enlargement of the abdomen, without fluctuation. Var. x Hepatica. A hard tumour in the right hypochondrium, verging towards, and sometimes appearing at, the pit of the stomach. (3 Splenica. A little below the false ribs, on the left side, and towards the spine of that side* NOS 43 NOS y Renalis. Oblong; in the loins on ei- ther side, near the spine. 2" Utcrina. In the hypogastrium on ei- ther si(|e ; hard, with unequal edges. e Visceralis. Filling more generally the abdomen. £ Mesenterica. In irregular masses, yield- ing to pressure. y> Externa. Distinct tumours, not refer- rible to any other species, of very dif- ferent degrees of hardness and size. § III. Cuticular. 5. Elephantiasis. Skin thick and rough; hair falling off; face deformed by hard tubero- sities; insensibility in the limbs; voice harsh and nasal; contagious. 6. Frambesia. Small tubercles resembling mul- berries, chronic ; often contagious. 7. Pellagra. Inflation of the skin, with tuber- cles, in parts exposed to the air except the face; at first remitting; preceded by me- lancholy and debility; at last constant, with increased irritability and an alienation of mind. 8. Lepra. Skin covered with hard,branny, white crusts; hair thin, or falling off; voice harsh and weak; contagious. Var. x L. Icthyosis. Crusts imbricated like the scales of a fish. /3 L. Furfuracea. Crusts branny, deci- duous, leaving an inflamed, often an ulcerated, surface. 9. Verruca. Hard cuticular swellings, circum- scribed and distinct; red at the base; painful when bruised. 10. Ganglion. Soft round swellings on the ten- dons, elastic. § IV. Glandular. 11. Sarco7na. Soft swellings of the consistence of flesh, frequently in the sebaceous glands. Var. x Pterygiu7n. In the canthus of the eye. /3 Hordeolum. At the edge of the eyelids. 12. Scrofula. Swellings of the conglobate glands, chiefly in the neck; with a florid com- plexion, fair smooth skin ; upper lip usually enlarged ; tumours seldom suppurating, or the wounds with difficulty healed. . 13. Encystis. A moveable soft swelling without pain or inflammation. The varieties are not easily distinguish- ed ; or synonymous. 14. Bronchocele. A swelling of the glands in the fore part qf the neck without inflammation or scrofula, never suppurating, sometimes occasioning dyspnoea. 15. Scirrhus. A tumour of any gland, hard, and unequal to the touch. 16. Cancer. An ulcer in any glandular organ, sometimes in other parts, frequently follow- ing scirrhus ; swelling large and livid, veins full and dark, pains acutely lancinating. 17. Parotis. A large, hard, irregular swellingbelow the eur ; suppurating with difficulty, forming a malignant ulcer, without much pain, gene- rally with hectic. is II. Phlegmatia. Increased bulk from accu mulated fluids, generally with a dry parched tongue, and a diminished secre- tion of urine. . 1. Anasarca. A pale inelastic swelling at first in the legs, afterward extending over the whole body, generally serous. Var. x Opilata. From compression of the veins, in consequence of tumours either na- tural, as in gravidity, or morbid, which prevent the return of venous blood. /3 Exanthematica. After erysipelas or scarlatina, occasionally after other eruptions if suppressed. y Anemia. In constitutions exhausted after long fevers. £ Do lens. Tumour of one leg painful, inelastic; after parturition. 2. Hydrocephalus. A soft inelastic swelling of the head, with the sutures of the skull pre- ternaturally open. 3. Hydrorachitis. A soft inelastic tumour on the loins ; vertebrae deficient; lower extre- mities paralytic. 4. Hydrothorax.- A sense of fulness and tension in the chest; dyspnoea on lying down; sleep disturbed by ephialtic symptoms. 5. Ascites. A swelling of the belly, tense, im- perfectly elastic; with a sense of fluctua- tion if the hand be placed on one side of the belly, and a slight stroke given to the other. Var. x Asthenica in exhausted constitutions. /3 Metastatica. From repelled gout or eruptions. y Opilata. From diseased viscera. 2* Imperfecta. Fluctuation partial, with irregular hardness in the other parts of the abdomen. 6. Hydro7netra. A circumscribed tumour in the hypogastrium; urine in small quantities, without ischuria or pregnancy. 7. Hydrocele. Soft pellucid pyriform tumour of the scrotum, gradually increasing without pain. 8. Exomphalos. A soft inelastic tumour at the navel, yielding to the touch with a sense of fluctuation. enus III. Cystis. Increased bulk, without the af- fection of any large portion of the body; generally from a fluid. Sp. 1. Aneurisma. A soft tumour in the course of a large artery, with pulsations, synchronous with those of the heart; not steatomatous nor glandular 2. Varix. A soft tumour on and connected with a vein ; veins above indistinct. 3. Mariscus. Small, soft, and often livid tu- mours round the anus. 4. Staphyloma. A watery tumour on the eye. 5. Hydatis. A cuticular vesicle full of a clear fluid in the viscera, often the causes of ascites. Vide in verbo. 6. Abscessus. A circumscribed phlegmonous F 2 NOS 44 NOS tumour, at first hard, afterward with a feeling of fluctuation, generally with a pe- culiarly soft point at one particular part. Genus IV. Emphysema. Increased bulk; tumour elastic; with a crackling sound when pressed. Sp. 1. Pneumatosis. Emphysema of the whole body. Var. x Traumatica. From a wound of the thorax. fl Venenata. From fish poison, or other narcotics. 2. Tympanites. Emphysema of the abdomen, sometimes with costiveness and atrophy. * Intestinalis. From wind confined in the intestinal canal, relieved by dis- charges of flatus, or by stools. ft Abdominalis. . From wind in the cavity of the abdomen, without costive- ness. 3. Physometra. A smooth elastic tumour in the hypogastrium, with occasional discharge of flatus through the os tincae. Order XI. ECTOPIA Parts removed from their proper place, with tumour in the region usually below, and disordered functions of the displaced organ ; with superficial, sometimes with deep-seated inflamma- tion ; generally painful. (ienus I. Hernia. Displaced viscera covered with the integuments. For the species, see general classification. II. Prolapsus. Organic displacements without integuments. See general classification. III. Luxatio. Displacement of any joint from its socket, or articulation. See Luxatio. Order XII. PLAGA. A separation of parts natural- ly united. Genus I. Dialysis. A disunion of soft parts. Sp. 1. Ulcus. Dialysis, with purulent or ichorous discbarge, and generally loss of substance. 2. Vulnus. Dialysis by mechanical force, ge- nerally bloody. 3. Punctura. A division of the skin extending inwards. 4. Excoriatio. A separation of the cuticle or skin not extending inwards. 5. Ruptura. A separation of tendon or ligament, without displacement of the joint. 6. Sinus. An ulcerated cavity, extensively sinu- ous, terminating in a narrow orifice. 7. Fistula. A. sinus with callous sides often reaching an ulcerated or carious bone. Genus II. Clasis. A disunion of hard parts. Sp. 1. Fractura. A violent and mechanical disunion of bone. * Complicata, combined with " Vulnus." ?.■ Fissura. Bone not wholly divided, but par- tially split. 3. Rhagas. A hardened crustaceous wound. 4. Arthrocace. An ulcer in the marrow, or in the epiphyses, with caries, exostosis, pain and hectic. Genus III. Diastasis. Separated cartilages. Sp. 1. Symphysis pubis. Having thus offered those definitions which, in the generality of diseases, are sufficiently descriptive for the purpose of discrimination, we shall add a few remarks in defence of our arrangement and nomenclature, li- miting their extent chiefly to necessary explanations. We have observed, that the natural groups of diseases, like the natural orders of the botanists, were too ob- vious not to be caught at by every nosologist. Fevers, inflammations, and haemorrhages, are as evidently con- nected as the tetradynamiae, siliquosae, or umbellatae ; and it is only necessary either to escape from confines purposely narrowed, or from wanderings too extensive. Fevers form certainly one of these natural groups, and we have separated them from inflammation, since, in many diseases which decidedly merit the latter appella- tion, the fever is occasionally slight or inconsiderable; so that complaints sometimes attended with considerable fever, if we wear the strict fetters of Dr. Cullen, must be placed at an immeasurable distance. The definition of fever has been supposed a task of peculiar difficulty, but this has been enhanced by refinements, perhaps quib- bles. The previous shivering is sometimes not ob- served, but, in such cases, it ushers in the paroxysms, which are at first distinct: the pulse is not always quickened, but this exception is peculiarly rare, and, if not quickened, they are extremely weak. In every case of fever, the powers of the mind are, in some degree, im- paired, the tendons, at the wrist, tense. Headach, which occurs in many definitions, is here omitted, as unnecessary to the distinction, and as connecting fevers with inflammation. According to Dr. Clutterbuck's idea (see Nervosa febris) it would be indispensable, but it certainly is owing to congestion in the brain, and, consistently with the ideas offered, is more connected with active inflammation than with pure fever. The first genus is intermittens, and, from the view formerly given, it must be strictly a genus, since it is composed of individual diseases, which are varied only by accidental circumstances. A question has arisen, whether a febrile attack, terminated by one paroxysm is truly a fever. We have not included an ephemera as it is often an accidental circumstance, and admits of no practical directions, which will not apply to intermit tents, consisting of repeated paroxysms. Were an eohe mera to be admitted, the sudor anglicus, terminatinr either in returning health or in death, within twenty? four hours, should be a species; but the disease is no longer known, and the circumstances relating to it arr not ascertained with such precision as to ensure our confidence. Ul It was necessary to introduce the terms "generally regular, since the qmntana, sextana, Scc.of authors are «°:::zf?> "sk r ;and the9e are inciuded ^ * erratica. The last species, complicata, includes the tertianae and quartanae duplices or duplicate of authors Each occasions an apparent irregularity, and the sue! cession of the double intermittents may give some NOS 45 NOS ambiguity to the character, as it precludes, in a few in- stances, the termination by sweating. If a specific distinction can be established in any branch of natural history, it must be so in the separation of remittents from intermittents. The fever, in no pe- riod wholly disappears, and one paroxysm only occurs in twenty-four hours. It is chiefly necessary to remark, thatliy icterodes is meant the yellow fever of America, and by asthenica, highly debilitating remittents, which De Hahn observed at Breslaw, and sir John Chardin experienced at Gombron. These are generally epide- mics, and we have introduced the hectica, to discrimi- nate that kind of exacerbating fever which arises from causes within the system. It is indeed generally symp- tomatic, but when the original disease is not obvious it is itself original. Indeed this fever merits particular attention, since it so frequently attends weak and irri- table habits as to give to chlorosis often the appearance of phthisis, and it admits of accurate discrimination. The genus continua, continued fevers of authors, is sufficiently established, and the species are those of Dr. Cullen. The existence of synocha, independent of to- pical affection, has been doubted, but the subject has been already considered. See Inflammatory febris. The varieties of typhus are sufficiently obvious, but we may add, that the neurodes is the Nervosa fe- bris, q. v. and the gastrica, the common bilious epi- demic. The only doubt which will arise is, whether this is not a species of synochus. Perhaps it ought to be so; and, in general, the greater number of typhi are truly synochi. We reserved, when treating of fever, for this place, a very obvious subject of discussion, viz. how far the numerous varieties described by authors really merit particular distinction. To examine it fully, however, would require a reference to each, and an examination of the peculiar symptoms of the fever, which every au- thor has described ; an inquiry that might fill a volume. In general, however, it would be found, that these nu- merous fevers are chiefly distinguished by some leading symptom; that the epidemic is, in other respects, the same; nor can any be discovered, which is not either intermittent, exacerbating, or more continued, which has not one or two remissions in twenty-four hours. (See Pituita.) Dr. Cullen, with almost every practi- tioner of discernment, rejects the continent fever of au- thors, viz. fever which continues without variation. Phlegmasiae constitute an order so strictly natural, that it could not escape the attention of any nosologist. Yet there are such obvious anomalies in the order, as established by each author, that if comprehensive, it must be in the same proportion less natural. If active inflammations are arranged in this order, many of the erythemata must be included : if inflammations of the mucous membrane form a subordinate group, we cannot separate leucorrhcea and gonorrhoea, because general fever is occasionally wanting. It was necessary to guard the definition with peculiar care, and the diseases of this kind are distinguished by fixed pain, laesion of the functions of the part affected, with increased dis- charge from its vessels. When this increased discharge is not immediately obvious, it is discovered from the consequences, as adhesions, &c. The diseases of this order are the true inflammations; the erysipetalous; inflammations of the mucous membranes; of the joints, of the muscles chiefly felt in the joints ; and in the bones, often the periosteum. These are distributed in five ge- nera; infiammatio; phlogosis, a term derived from the burning heat; catarrhus, a title taken in its more gene- ral sense; arthritis, rescued also from its more confined meaning; and exostosis, a word commonly employed. Infiammatio is chiefly distinguished by the character of the order, and the species are the usual genera. I shall add only some remarks, which may be less obvious. The chances of war have obtruded on our notice an epidemic and contagious ophthalmia, the Egyptian; the sporadic is the common disease from cold; and the o. tarsi, the inflammation of the lids, usually a symptom of scrofula, though sometimes a truly epidemic disease. The cynanche has only two varieties in the strictest sense, yet, as a febrile disease, sometimes obstructing swallowing from local inflammation, the parotidaea (themumps) could not be excluded; though, from what we have observed, we should be inclined to include it under exanthema. There are certainly doubts respect- ing the second, the trachaealis, for it generally accom- panies the erythematous cynanche: it would, however, be rash to assert, that it never is seen from active in- flammation of the upper part of the larynx. The diffi- culty of breathing generally arises from the tumour. The croop is more properly referred to catarrhus. The species arranged as varieties of pneumonia are, in almost every author, raised to the rank of genera; but the cause is the same, the part affected contiguous, the symptoms very nearly alike, and they often pass into each other. We have seen the same fever successively attended with each. These varieties cannot, indeed, be always discriminated; nor, in a practical view, is dis- tinction necessary. The mediastina of authors cannot, we think, be sepa- rated from carditis; and the pericarditis is equally un- distinguishable. The varieties of enteritis cannot pro- bably be always distinguished, though we have endea- voured to discriminate, with care, the one which more particularly requires distinction, the e. peritonitis, as its practical treatment differs. We are by no means con- fident that the other varieties can be distinguished, except the rheumatica, in which the pain is felt at the origin and insertion of the muscles. We have often distinctly observed this pathognomonic symptom. The character of nephritis is certainly confined to one species, the n. calculosa, from a stone either in the pelvis of the kidney, or escaping through the ure- ters into the bladder. It is difficult, if not impossible, to distinguish real inflammation of the kidney, as the organ is, in general, insensible; and when inflamed, from us deep seat, the disease is generally confounded with enteritis : perhaps minute distinction is unne- cessary. Odontalgia is generally considered as rheu- matic, and it seems more properly to belong to articular inflammations. If disputed, however, there will be little inconvenience in removing it. To include the erysipelatous inflammations, which we have connected under the genus phlogosis in this order, may appear improper, as the topical affection and the fever are so essentially different Yet, in dif- ferent climates, the same disease approaches to either genus. Phlogosis also is attended with topical redness, a laesion of the functions of the part, and a discharge from the neighbouring vessels. An additional advantage N O S 46 NO S arises from this arrangement, as it brings together dis- eases nearly rcs< mblmg each other, which require dis- tinction, ps the inflammatory and putrid sore throat, the more active and putrid pneumoniae. We sec the dis- tinction externally, in phlegmon and erythema, which are equally accounted inflammations; and authors have so generally acknowledged the connexion, that they have divided inflammations into membranous and pa- renchematous. Dissection does not, however, counte- nance this arrangement; and if we examine minutely their definitions of the latter, they often seem to point out the diseases we have united in the present genus, which is a perfectly natural association, nor do the spe- cies require a comment. The number might perhaps be increased, since every active inflammation may be occasionally erysipelatous. It has been remarked, that we have extended the meaning of catarrhus; and for this we have the authority of Schneider and I Ioffman; indeed the etymology of the complaint. It was necessary to distinguish what is usually called catarrhus, therefore, by a new term, and wc have adopted one of its synonyms, coryza. The varieties require some particular remarks. Of these, the first is, that, in nosological arrangements, the fever cannot always form a discriminating mark, since it even differs in the varieties of one species which cannot be excluded from it. Thus the c. senilis and c. arthritica are seldom attended with fever, while the common and contagious coryzx are accompanied with violent febrile symptoms, though of opposite kinds. 2. Even in dis- eases most apparently similar, the practice-must be often different and even opposite, for the contagious and common coryza; require medicines very dissimilar, the senilis and arthritica still different ones. It does not, however, follow from hence, that methodical arrange- ment is of no utility, since it is not one of the least of its advantages to prevent prescribing to a name, and to obviate a general, indiscriminating, practice. The addition of the croup to this species is a step which re- quires some apology. It is, however, certainly an in- flammation of a mucous membrane, attended with a discharge from the vessels of the part: the organs affected are the same as in coryza; this complaint very generally precedes, and the disease differs only in the nature of the discharge, which is gluten. The peculiar symptoms arise wholly from its inspissation. The definition of dysentery is laboured with peculiar care, to distinguish it from diarrhoea, coeliaca, and leu- corrhois, with which it is very often confounded. Phthisis, if diseases are to be distinguished by symp- toms, must belong to the genus catarrhus, for, though we know from dissection, that it sometimes arises from suppurating vomicae, yet the symptoms are through its whole course truly catarrhal, as limited in the defini- tion of the genus; and there certainly are cases which prove occasionally fatal, in which purulent matter is never discharged. (See Phthisis.) The definitions of the other species scarcely require a remark. Arthritis is rescued from its limited sense, and ex- tended to a generic association from its etymology. It is a genus strictly natural, for each species is attended with fever occasionally exacerbating. The arthrodynia is too intimately connected with rheumatism to be se- parated, though it approaches very near to palsy; and indeed we have remarked, that in the most violent pains of gout, there is a weight and numbness of the Jimb, whfch distinguish it from other inflammato y^affect= chronic inflammation which distingui The hudrarthus consists in that of the muscles or joints which insiduously hastens on to suppuration, and destroys by its peculiar fever. If odon- Z .admitted in this genus, where few perhaps vou d look for it, as the union of the teeth with a aw though a pure articulation, would scarcely occur without smite reflection, it should follow rheumatismus, or perhaps be included among its varieties. Exostosis scarcely deserves the rank of a genus, yet it could not with great propriety be arranged under phlegmon, and its peculiar appearance as well as its cause required a particular distinction. The greatest difficulty in constructing the third or- der, which is certainly a natural one, consisted in find- ing a title. Eruptiones is, in no respect, scientific or euphonous, but a better could not be discovered, except at the risk of occasioning confusion. The definition is sufficiently discriminating, and includes all the diseases, except the eighth species of exanthema. Pestis, in- cluded in this order from the authority of Dr. Cullen, should perhaps have been arranged under asthenic fever. In connecting diseases of the skin, nosologists have erred by contracting their limits too rigorously, or extending them too liberally. While Dr. Cullen confined himself to febrile exanthemata, and from spe- cific inkctio.i, his inferior associations would be neces- sarily few, and those not strictly limited by the defini- tion of his order. If every cutaneous disease, on the contrary, be included under the the title, the list will be too miscellaneous to deserve the appellation of natural, and many appearances within the limits of health will find a place, as in the systems of Sauvages, Linnaeus, and Vogel. In limiting this order, it was necessary at first to select the febrile exanthemata, without confining our views to specific infection, or, in reality, without contracting them within the common idea of eruptions. This was the real reason for our originally including pestis, which, on reflection, appears improper. Aphtha is more strictly related to cynanche, but we have seen a mild kind, more than once, epidemic, without any affec- tion of the throat. This seems to justify its insertion. The diseases which can be traced to specific infection consequently are first introduced, and others, usually epidemic, are added, though no peculiar virus is sus- pected. These are included in the first section. In the second are the sporadic eruptions, attended with fever, though less distinctly depending on it. The genus exanthema includes both. Of the variola two varieties are marked, the confluent from the difference of the ap- pearance, and the crystalli7ie for the same reason, and as there appears some probability that the second at- tacks of small pox have been pustules of this kind. Were the fact well ascertained, it would justify the formation of a new species, and we thus perceive one of the numerous advantages of nosology in suggesting circumstances of inquiry. Vaccina will now be acknow- ledged a distinct species, since doubts have arisen whe- ther it be really a security from small pox. We have formed the definition with some hesitation, uncertain if it will in all cases clearly distinguish the vaccine pustule • yet its peculiarly rounded figure, and the brown de- pression (the Latin word coccineus would probably dis- criminate it more distinctly) appear to be sufficient for NOS 47 NOS his p urpose. The malignant rubeola, in Dr. Willan's opinion, is a scarlatina; yet, as authors have pointed out a disease of this kind, and as, from the analogy of other fevers with topical affection, such may occur, we have inserted it. The other variety has not been very clearly distinguished, and the absence, or the very slight appearance, of catarrhal symptoms, render us somewhat sceptical on the subject. It seems more probably the essere included under urticaria. It has been supposed owing to an union of small pox and measles, but this is not true; for, when these diseases are present in the system, at the same time, they are never mixed. We have seen two epidemics of this kind, and have found, that, if small pox was the first disease, measles would stop its progress; and on their recession the small pox has resumed its course. If small pox preceded, both would go on together, but the pustules of each would preserve their own character. Miliaria we have mentioned at some length, and have considered it as sometimes an idiopathic disease. The definition is collected from authors who have seen it more frequently than ourselves. But we can add, from our own observation, that the sour smell is often owing to an overflow of milk. The scarlatina some- times occurs without an affection of the throat; and, on the other hand, during the prevalence of scarlatina, the throat is sometimes diseased with very inconsiderable, general fever, and no eruption. It will scarcely be credited, that in such circumstances children have ex- perienced very little inconvenience, though the throat has been full of ragged deep ulcers. The distinction of the variety of cynanchica is thus obvious, but the dis- ease, without eruption, belongs to another species, the phlogosis anginosa. If the definition be compared with that of rubeola, no difficulty of distinction can be felt. As erythema, externally, is opposed to phlegmon, so is erysipelas to variola. We have no doubt of its being an idiopathic disease, as we have twice seen it epide- mic. The delirium, which sometimes follows the com- plaint, occasionally attends it, and there is no reason for thinking it owing to metastasis, as the inflammation of the head and face continue at the same time. There may be doubt, whether the chronic, intermitting erysi- pelas should not be rather referred to erythema; but some fever we think generally attends, and this is the most proper place for its insertion. The only other species, which requires a remark, is urticaria. The de- finition is left somewhat too open, to include numerous papular eruptions, which require notice. We need not, however, add to what we have said, under the article Esseke, q. v. The genus efflorescentia is designed to include those cuticular diseases in which fever is not a constant at- tendant, or with which it is not indispensably connect- ed : these, however, so nearly resemble the exanthe- mata, as to render a distinction necessary. As we have thus extended the limits of eruptions in a general view, it will be reasonably asked why we do not include le- pra, pellagra, and similar complaints in the same rank. The reason was that the species included in the genus efflorescentia were diseases of the extreme vessels, not depending on a general state of the fluids, while the lepra appears in the constitution, before the defoedation of the surface comes on. The voice is previously ob- tcrved to be shrill and tremulous; the complaint can be traced to an hereditary disposition ; the faculties of the mind decay with the impaired health. The same general disease appears more strongly in the pellagra, as described by Strambio, in his collections on this dis- ease (Mediolani 1786-89,3 vols. 4to.) We have ob- served the same previous changes in elephantiasis ; and the Cretins are equally distinguished by imbecile minds, and weak bodies. To enumerate all the species of efflorescentia, how- ever strictly limited, would be a difficult task. They appear in every form and every variety; and we have left one species open, as already remarked, to include the anomalies. In general, they are chronic diseases, and connected with effusions on, or under, the skin. In prurigo, indeed, there is no evidence of this effusion; but the itching seems to show that it probably exists. The only ambiguity arises from syphilitic eruptions, which ought, perhaps, strictly, to be included in this order, from the appearances; but, as connected with depraved fluids, is grouped with other asocaitions. The eruption, however, is only symptomatic, and the diffi- culty may be removed by a comparison of the addi- tional symptoms. The definitions of the species will sufficiently dis- tinguish them. The only circumstance of doubt re- spects the lichen, which, perhaps, is only the chronic, intermitting, erysipelas. The purple colour of the more violent species, and its general appearance, seem to in- dicate a disease in some measure distinct; but it is suf- ficient to suggest the question for further examination. Petechie are often symptomatic, yet they sometimes appear independent of fever and of any considerable de- bility. The morbus petechialis sine febre is noticed by the French and German authors, of which we have seen several instances. The title of the fourth order, profluvia, is limited to its simple obvious sense, morbid discharges; and the association requires no comment. Profluvia differ either as the discharge is bloody, or excrementitious; a fever, though occasionally a leading symptom of haemorrhages, is but slightly connected with this order, as they most commonly happen independent of it, or at least, its de- grees are so various, and its appearance so fleeting, as often to evade the possibility of distinguishing it in any given profluvium, and prevent us from availing our- selves, except in the marked instances of active haemorr- hage, of such distinction in practice. The species require no comment; but the insertion of vicaria is scarcely regular in a systematic view, for all vicarious haemorrhages must be symptomatic. Yet so numerous are these discharges, and so important are they in a practical view, that we trust the physician will commend, what the nosologist must disapprove. The definitions of hemoptysis and hamatemesis are pecu- liarly contrasted, as distinction is sometimes difficult. We mean not to defend what in each may appear doubtful, but only to observe, that such are the re- spective symptoms as they have occurred to us ; such at least we have thought the distinguishing circumstances of haemorrhage from either organ. It is difficult some- times to distinguish the haemorrhage from the bladder, from the blood discharged in consequence of the irrita- tion of a calculus ; but the quantity of the discharge, and the absence of the more striking symptoms of calculus, will prevent any error.- The two varieties will be easily X o * 48 distinguished. It will be obvious from the character of melenu, that we rather consider it as a bilious than a bloody discharge; but we need not add to what we have observed in that article, vide in verbo. In com- pliance with the language and opinions of practitioners, its insertion in this place was indispensable. The title of the next genus is borrowed from Dr. Cullen, but used in a more limited sense. The defi- nition requires neither apology nor defence, and the species are sufficiently connected. Vomitus may appear a simple object, but it involves some contradictions, at least some subjects of disquisition. It may be said, that the aliment, not the excrementitious fluids are dis- charged, and sometimes no fluid which is naturally car- ried to it. The first objection is, however, guarded ni; inst, in the definition of the genus; and it may be fiuily observed, that no vomiting takes place without some evacuation of the mucus of the stomach. The pyronis, however, consists in a discharge not naturally contained in that organ, viz. a cold fluid; but however difficult the explanation may be found, the variety is obviously connected with the species, and the latter with the tfenus. The atonic vomiting, the consequence of retrocedent gout, repelled eruptions, &c. is equally a subordinate affection inseparable from the rest. Diarrhaa is usually divided into different species from its causes, but it seems, in practice, or in its symp- toms, to require only two subdivisions, viz. where the discharge is chylous, or where it is watery, in which the truly faeculent matter is retained. The mucous dis- charges from the intestines would appear to be proper- ly inserted in this place, but these are more generally attended with fever, and mucus is scarcely a natural evacuation from the bowels. Of the diabetes we have mentioned two varieties, for, in every instance, the chief form of the complaint is un- derstood by the species; at least it should be, and the varieties arc marked, when they are exceptions to" the usual form, or when they require a variety in practice. The first of these is the mellitus, for, if the discharge is merely the increased watery secretion, it is understood from the definition of the species. The diabetes melli- tus has lately claimed much attention, but the pathology and the cure are still imperfect. We have added another species, chiefly to notice a singular fact, that, when dropsical swellings are observable in almost all the cavities, if the urine is in considerable quantities, a large proportion of mucilage or gluten is found in it. The species diuresis may require an apology, for it is often a symptom, but sometimes it appears rather as an idiopathic disease, arising from terror, surprise, or any peculiar sound, in some constitutions; as when " a bag- pipe sings in the nose." Its distinction is obvious from the definition. The species ephidrosis may appear su- perfluous, for it is often a symptom of fever or debility; but its partial occurrence, particularly in the feet, is sometimes the object of the practitioner's attention. For plica we could find no more suitable place, though it is less proper in this order, as connected with fever. Did we know the nature of the fever better, we might place it with more accurate discrimination, but at present we must look on it as an increased excre- mentitious discharge; and does not Shakspeare call A.•'♦liens' beard, " the pedlar's* excrement?" If this NOS The Ptyalismus y of one striking observed, in several, an approach every noso- be not authority, we have ^ better. mellitus is introduced on the au case, though we have ^Obstructions are generally connected in i • 1 c„ut#.,n pvcer>t where the local are separated K^endcSSS.; butin the species enumerated are many of these local diseases, which are the objects of general practice. Dysphagia may arise from tumour, accretion, inverted motion, flatus, spasm, or debility The two first are the only objects of the genus, which is lfmited to organic affections. The third is a symptom of vomiting, thf fourth and fifth of hysteria, and the las of palsy. The existence of tumour, or accretion, cannot be ascertained in many instances, even by the probang, for spasm, as we have seen, will give the sensation of resistance, like a tumour, both in the oesophagus and urethra; but a repetition of the trial will show the na- ture of the cause, for spasm is seldom constant. Obstipatio is generally passed over in nosological systems, as a local disease, but it is an object of consi- derable importance. A scirrhous pylorus, tumours of the omentum,or of some of the chylopoietic viscera, m- tusceptio, and a scirrhosity contracting the rectum, are diseases which require distinction, and which can be discovered only by the symptoms. These we have en- deavoured to distinguish in the different definitions, so far as the variety of symptoms would permit. Polypus requires no particular remark, except the fact of its sometimes preventing the return of blood from the head. A case of this kind occurred some years since, while transcribing the definition, and the fact was confirmed by dissection. It was necessary to form a separate genus for asthma, and dyspnea, since they certainly belong to this order, and are not always organic, nor constantly depending on suppression of excrementitious discharges. The term anhelatio is familiar to nosologists, and neither the spe- cies nor the definitions require a comment. The genus epischesis can require neither comment nor defence. The definition of dyshamorrhois is guard- ed in a manner, which would not be accepted in the school of Stahl, since it implies that the discharge is not required, except when established from habit. See Hjemorrhois. Obstructions of the secreted fluids are regularly as- sociated, though, as there is a group of diseases depend- ing on discoloration of the skin, perhaps icterus might have been more properly referred to it. The white stools are, however, a symptom equally obvious, and it is a disease much more general than the greater num- ber which occur in that association. By the definition of the calculus icterus we do not mean to say that every instance of calculus is attended with pain, or that every painful jaundice is owing to calculus. Such, however, are the more common cases ; and the spasmodic icte- rus is generally pointed out by authors. We find no subject of remark, or explanation, in the other genera, except to add, that sitis we have seen in two instances as idiopathic disease; at least, we have not been able to trace it to any morbid state of the body, except the vague idea of acrimony, apparently shown by slight eruptions on the skin. It was proper, however, with these cases in our view, to mark it especially, as we had the sanction of former nosologists. NOS ■IV N O S The order spasmi is an association so constant, that it requires little observation ; nor are the species so un- common, the definition so peculiar, as to demand any commentary. It will be obvious that we have kept in view the distinction formerly made of convulsions being irregular rather than increased action, and the species chorea, raphania, and beriberia, are evidently proofs that this irregular action is closely connected with extreme debility, as each verges on, and is sometimes terminated by, palsy. ■ Pandiculatio is equally connected with im- perfect or irregular excitement. In the varieties, where it was necessary, we have equally kept in view the principle of convulsion arising from sensible irritation, or, in weak mobile habits, from irritation, often unper- ceived. The history of hysteria fully illustrates this principle, which pervades, without the author being conscious of it, the whole of Dr. Whytt's works on nervous diseases. The adynamia form equally a natural association. We have scarcely stepped from the common systems, except in the varieties of apoplexy. The distinctions of the second and fourth may appear to be made with- out a difference. We meant, however, to distinguish the last moments of a constitution gradually sink- ing from that progressive stupor, which arises from effusion : each case we have distinctly observed. The a. hydrocephalica we have introduced in compliance with the authority of Dr. Quin, of Dublin; and we think (hat we have been able to distinguish this species, though we know not that any words will discriminate il,irom hydrocephalus. It chiefly occurs in females of a fair complexion, blue eyes,-and light hair. Perhaps, however, this is the strictly proper place for internal hydrocephalus, since there is no increased bulk. The paranoia, a term derived from preceding noso- logists, comprehends all the irregular or excessive ap- petites, and all the- irregular exertions of the nervous powers. We begin with the diseases of the stomach, followed by those of the sexual organs, in which the mind is particularly affected, and ascend to those in ' which the mind chiefly suffers. Hypochondriasis is the connecting link; but the arrangement would have been more perfect; if the sexual passions had preceded, as the hypochondriasis and melancholia are so nearly con- nected. The introduction of e7-otomania may excite a smile; but it is often truly a disease, and, as an unsus- pected one, is frequently troublesome. The species and their definitions require no farther remark than the pages of this work will afford. Under the 7iiania ve- 7ienata, Van Helmont is quoted, who relates with singu- lar eloquence his own feelings in these circumstances. The cachexia also require no remark, except that the rubigo is inserted from the authority of Coutanceau, in the Memoirs of the Medical Society of Emulation, who e;i!ls it cutaneous apoplexy. The intumesccntie scarcely form a natural order, and even the genera are not always natural associations ; but it was impossible to avoid these anomalies. We have endeavoured to remedy the inconvenience, by passing from the more to the less solid, from thence, in succes- sion, to the watery and aerial tumours; and on a com- parison of the species of the first genus, it will be ob- vious that these could not be associated with the erup- tions. We have again introduced exostosis; and it may remain if the inflammation is not thought a VOL. If. sufficient reason for its retaining the former por- tion. The genus physconia, is, like some others, left open for anomalous tumours, of which the more important are distinguished, and may be ascertained by the organ affected. The p. hepatica and uterina (including in a more enlarged sense the whole uterine system, and particu-- larly the parts most commonly affected, the ovaria) are the most common. The externa can be confined by no definition. We have thus included scirrhoidea, the sarcomatica, the graviditates falsae, the megala, and po- lysplachnina, the steatomatosa and strumosa of authors; but have not noticed the hydatidosa, because we could find no symptoms by which they may be distinguish- ed, as we have confessed under the species hydatis, which authority, rather than conviction, induced us to insert. The dropsies, phlegmatia, require no comment; and if some of these are partial tumours, the general relation will excuse the anomaly. The hernia we have not again enumerated. Lest the list might be unnecessarily prolonged, we have also omitted the varieties, arising from the situation of a prolapsed intestine, which may be seen in the- present work, and the impaired functions will at all times fur- nish the symptoms. See Hernia ; Luxatio ; and the different terms inserted in the general classification under prolapsus.' The species of diastasis have not been noticed by au- thors, though several may be observed; and the only one which has particularly challenged the attention of prac- titioners is that mentioned supposed to occur in labour, and facilitate delivery. Having concluded a new ar- rangement of diseases, we must leave it to the candour of the public. Had we not thought it meriting their attention, we should not have offered it in this place. While its reception is uncertain, it would have been improper to disturb the general system by even these few novelties of appellations or arrangement. If re- ceived with approbation, it may at a future period be incorporated with the whole, when its utility and ap- plication will be more striking, and when its founda- tions may be more fully developed. At present it has been with great care abridged, that those who disap- prove, may not complain that much time and space have been mis-spent or misapplied. See Sauvagesii Nosologia, 2 vols. 4to. ; Culleni Nosologia; Macbride's System of Medicine ; Pinel Nosographie Methodique, 2 vols. 8vo. ; Selle Pyretologia Methodica; De Haen Theses, Sistentes Febrium Divisiones. NO'SOS, (from the Hebrew term nosis, infirm). See Morbus. NOSTA'LGIA, (from nostras, our own country, and xXyetx, niteroi-). National insanity, in which stran- gers have such an unconquerable desire to return to their own country, that they become restless, with loss of appetite and strength, succeeded by dejection of spirits, insanity, or death. Dr. Cullen distinguishes two species, nostalgia simplex, and co77iplicata. It is, in fact, a species of insanity from hope delayed, to which the Swiss, from a strong attachment to their native country, are generally subject; and the familiar tunc, called Ranz de vaches, played at milking the cows, is forbidden in foreign armies, as it excites the tender re- collection of what they have left. NO'STOCH. See Cosli flos. G NUT (from votts, spurious). 50 See N I T a the fact that when the nerve leading to any part a" divided the larter was emaciated, seemed -to assist was divided, tne ianci *_____^ f^ hp never rested NOTH* CO'ST* C M?THUS, (from the same). A variety often of a . the conjecture fo^—^^1^ We shall ite svmotoms of the on it, noraw tether, in a few words, the It was no more, for he never See See disease, not attended with the acute symptoms more active kind. Thus peripneumonia notha is a ca- tarrh without violent inflammatory symptoms. NO'lTAUS. (from vu\.s, the back). See Medulla SPINALIS. ,_ ~ NUBE'CULA and XU'BES. See Urina Encal- ma, and Albugo. Nube'cula suspe'nsa. See En^orema. NUCAME'NTA, (quasi nucis amentum) Amentacei flores. NU'CES OLEOSA. See Farinacea. Ni-'ces purga'ntes. See Cataputia minor. NUCHA, (from the Arabic terms nucha, the spinal marrow, or nekra, the cavity between the shoulders). The back of the neck. __TIT,T-n * NU'CIPRUNI'FERA, and NUCI'FERA Nux Virginia.va. NCCIO'SITAS. See Myopia. NUSIPE'RSICA, (quasi nux Persica). The nec- TARINK. NUCI'STA. See Nux moschata. NUCLEUS,^ nuce). A kernel, that part of the fruit which is inclosed in a hard shell. NU'CULA TERRE'STRIS, (a dim. of nux). See Bulbocastanum. NU'CULJE SAPONA'RIj£,Aacc$, populus, and xyuyos, ductor). See Agyrtas. O'CHRA, (from axpos, pale, earth of a pale yellowish colour). Yellow ochre, sometimes brown, occa- sionally red: the latter is called red ochre, rubrica fabrilis, Creta rubra, arcanne, marking stone, rudd, and ruddle, oxydated iron of Haiiy, iv. 105. See Lewis's Materia Medica. Neumann's Che- mistry. O'chra ni'gra. See Plumbum nigrum. O'CHRUS, (from uxpos, pale, from the pale muddy colour of its flowers,) lathyris, ervilia, pisum ocrus Lin. Sp. PI. 1027. It bears cylindrical pods with round seeds as'large as peas, which, though eatable, are in- digestible. OCHTHO'DES, (from oxOos, callous, tumid, lips of ulcers). See Ulcers. OCIMA'STRUM, OCYMA'STRUM, (a dim. of ocimu7n, basil,) lychnis sylvestris alba simplex; wild white campion; lychnis dioica Lin. Sp. PI. 626. /3. Found in hedges and borders of fields ; flowers in May. The flower is said to check the fluor albus and inward bleedings; the herb to cure convulsions in children : but its virtues have not obtained it a place in practice. See Raii Historia. It is a name for the circea lutetiana, and several species of lychnis. O'C-KOW. A Chinese remedy for diseases of the breast, said to be the flesh of the common ass, boiled down to the consistence of a thick glue. It succeeded in relieving the author of this account, in the eleventh number of the Edinburgh Medical Journal, Dr. Baildon, of a consumptive complaint; but the digitalis was taken at the same time, so that the effects of the remedy are equivocal. OCRE'A. See Tibia. OCTA'NA, (from octo, eight). An erratic inter- mitting fever, which returns every eighth day. OCTA VUS HUMERI MUSCULUS, OCTA'- VUS HUMERI PLACENTI'NI MU'SCULUS MINOR. See Teres. OCTANDRI'A (from octo, eight, and xvqp, a man). A class of plants having eight stamina. - OCULA'RESCOMMU'NES,(fromocM/«*,c«et/4 See Motores oculorum. Ocula'res externi. See Motores oculorum ex- terni. OCULA'RIA, (from its use in complaints of the eye). See Euphragia. O'CULI CANCRO'RUM, crabs' eyes, cancro- rum lapides, et lapilli, are stony concretions, found in the head of the astacus fluviatilis, or river craw fish, lodged in a bag on each side. These stones are round- ish, 'flatted on one side, white, having sometimes a red- dish, and at others a bluish cast, of which the blue are preferred, as the white are taken out after the fish hath been boiled : they are internally foliated. The largest quantities are the produce of Muscovy, particularly of the river Don. They were formerly used as absorbents of acid hu- mours in theprimae viae, and supposed, when combined with the acid, to be more aperient than the other ab- sorbent earths. The earth of crabs' eyes differs much from that of crabs' claws, for the first is not convertible into quick lime; and in its chemical relations is said to resemble the earth of hartshorn. It is therefore, like the bones, a calcareous phosphat. These stones are counterfeited with pipe clay, chalk, or the shells of fishes; but these compositions are easi- ly distinguished from true crabs' eyes, which are of an uniform texture, stick to the tongue, soften with water, and dissolve in acids. See Tournefort's and Lewis's Materia Medica. O'CULO-MUSCULA'RES. See Motores ocu- lorum. O'cui.o-muscuL.v'res externi. See Motores ocu- lorum externi. O'CULUS, (from o7rjofA,xt, to see). The eye; illos. The external parts are the eyebrows, the eyelids, the extremities of which, where the eyelashes grow, are called orchos, the cilia, the fore part of the globe, the membrana conjunctiva, the cornea lucida, the iris, the pupilla, the carunculae lachrymales, and angles of the eyelids, &c. The external eyes are named paropia; the internal pega. The internal parts are the globe of the eye, the adnata or albuginea, the extremity of which is calledpremnon; the sclerotica, the choroides, the retina, the aqueous humour (hydatodes, hydatoides; ooides; ovatus ovifor7nis vel albuginosus humor); the vitreous humour, hyaloides; crystalline humour, phacoides; the muscles that move the eye, and the optic nerve, &c. For the particular descriptions, see the different articles in verbis. To explain, however, the theory of vision, it will be necessary to add a short account of the different parts of the organ in a connected view. The eye is an irregular sphaeroid, projecting a little at its fore part, where it is seen between the lids. In this projecting portion we find a fluid, in which a fine membrane, perforated in the centre, floats. Beyond this fluid is a more solid transparent body, in the shape of a lens, and still farther back, a gelatinous fluid which covers a very fine semi-opaque membrane. All these fluids are confined by a dense substance which supports and protects them, called the coats of the eye. Having given this very general idea of the organ, we shall proceed to notice the containing coats. From the eyelids to the ball of the eye a very thin vascular membrane is extended, in some degree to support the eye, and to prevent substances passing between it and H 2 O ( I 60 ocu rht edges of the orbit. This is the adnata or conjunc- tiva, in which, even when not diseased, red vessels may be distinctly seen, and which is the most common seat of ophthalmia. A hard, white, firm, tendinous ■substance forms the outer coat, viz. the sclerotica, which in the projecting part of the eye is transparent, and called the cornea. The sclerotica is peculiarly strong in the foetus; the cornea comparatively weaker than in the adult; each may be divided into laminae, but these are more distinct in the cornea, and separated by a cellular substance, containing a watery fluid, dis- tinct from the aqueous humour already mentioned. In fact, if the compacted laminae of the sclerotica are sup- posed to be separated, with a very pellucid fluid inter- posed between each, it will at once give a correct idea of the projection of the cornea, and of its transparency. When the optic nerve, which is inserted behind, reaches the globe, the external coat of its sheath covers the sclerotica externally, and the internal, internally: the external membrane of the eye is thus inserted between the coats. Le Cat and others have described the eye as a bottle blown from the optic nerve, preserving its coats in the coats of the organ; but this is a refinement, if true, of no practical advantage either in the theory of vision or the pathology of the organ. The projecting part, or cornea, is described as the segment of a smaller circle; but it is by no means a portion of a circle, as its margin is flat towards the nose. The fluid between the laminae gives it tran- sparency ; for in fevers this fluid becomes more opaque, and the eye acquires that dulness so constantly ob- served : when coagulated at the approach of death, the light is even reflected from it, and the eyes are said to be glassy. Over the cornea there is a very thin glassy membrane, probably derived from the ad- nata, and by maceration it is said that the cornea separates from the sclerotica. The cornea is sometimes the seat of abscesses, and seems to be supplied with vessels; but in a sound state these do not carry red blood. Within the sclerotica is the choroid coat, covered u-ith a black, or at least with a dark coloured pigment, which, in very fair persons, is of a lighter colour, and m the albinos, almost white. The choroid is minutely vascular, and not in every part connected with the retina. It consists of two laminae; the outermost is that which supports the numerous vessels, and the innermost, the tunica ruyschiana, has the structure of a secreting membrane, for the appearance is villous, and these villi have been styled tapetum. The black pig- ment is a mucous substance, sometimes wanting in old persons, and in animals who seek their prey by night. It seems, however, more conformable to the analogy of nature, that in these, as in the albinos, it is of a grey or white colour. When the choroid coat reaches the margin of the sclerotica, to accommodate it to the smaller circle of the cornea, it is folded in plaits, called the ciliary pro- cesses, still covered with the dark pigment, resembling, when this is washed away, the valvular doublings of the villous coat of the intestines. Previous to its inflection it is firmly fixed to the sclerotica, and is closely united with the root of the iris. At their internal extremities they are attached to neither, but are loose and floating. These processes leave an impression both on the vitreous humour and the retina at the edges, where they are in conjunction, which have been styled sulci ciliares, the ciliary processes of the retina, Sec. which only con- found a simple idea, and multiply terms without reason. The ciliary processes collectively are called corona or circulus ciliaris,ligamentum or corpusciliare, and arc of great importance in vision: it is of consequence to remark, that their connection with the retina is the only means by which it is kept expanded, and the only mode of connection between the humours of the eye and their coats. The iris or uvea is the coloured circle which we sec in the eye, perforated by the black spot, styled the pupil. When put in water and examined with a microscope, the anterior surface appears to be covered by minute villi, whose colour fades when putrefaction begins. The fibres of the iris are transparent, and the colour chiefly depends on the pigment at the posterior surface. The iris consists, it is said, of two sets of fibres, both irritable and muscular; the one surrounding the pupil, the other radiating from or to the circular, and, as it is called, muscular margin. The muscularity, how- ever, has been denied, and its contraction and relaxation supposed to depend wholly on a stimulus on the retina. It is copiously supplied with nerves from the ciliary. Two large ciliary arteries, and two lesser anterior arteries, which pierce the ligamentum ciliare, freely anastomose round its root, and send serpentine branches to the margin of the pupil, where they again anasto- mose, and send off branches towards the edge of the iris. The corresponding veins pass into the vasa vorti- cosa of the choroid coat; some between the choroid and sclerotic, and some piercing the latter, pass out, and spread on the surface of the eye. In fact, these ves- sels seem to constitute the whole of the iris, which is probably vascular rather than muscular. The retina is the most important part of the eye, since it is the nervous expansion on which visible objects are painted; and by this means the image, we mean not to say the material image, is conveyed to the sensorium. The optic nerve enters, we have said, not immediately at the back part of the eye, but a little on the inward side towards the nose. At some distance, before it passes through the sclerotic coat, an artery pe- netrates its vagina, the arteria centralis retina, so that if the optic nerve be cut after its entrance, the artery re- tracting, leaves a little foramen, called by ancient ana- tomists theporus opticus. The extremity of the optic nerve, before it expands in the retina, forms a little co- nical point, which we suspect to be a ganglion. The retina itself is spread over the choroid coat, rest- ing on a reticulated membrane which supports its ves- sels, probably derived from the pia mater, the lamina cnbrosa : from its texture the name was apparently eiven In this membrane the branches of the arteria centralis derived from the optic and ophthalmic artery, and soon after entering the sclerotica, divided into many laree branches, from which numerous anastomosing sub-' divisions proceed, are most profusely scattered The retina seems to terminate at the ciliary processes,: but the lamina cnbrosa probably passes over the posterior part of the lens. This idea will reconcile many dis- putes, and some, seemingly discordant, observations. The membr ana papillaris is a small vascular membrane s OCli 61 ocu which extends over the pupil in the foetus. At about the seventh month it begins to disappear, and is scarcely, if at all, discernible at the ninth. Its^ larger arteries come from the iris; smaller and more numerous branches from those of the lens. Its use is not known, nor does it merit any minute disquisition. It certainly prevents the iris from contracting in utero; but there is no cause for its contraction, and apparently no inconve- nience would arise if no impediment existed. It is not impossible that some imperceptible remains of this membrane may prevent too violent effects from the first access of light. The fluid, in which the iris floats, is called the aqueous humour, and its floating fibres are supposed to divide the projecting part of the eye into two chambers, the anterior before, and the posterior behind, the iris. The error, however, is considerable, for there is no space behind the iris which merits the name of a chamber, since the iris moves almost in contact with the lens. In the foetus, this fluid is red and turbid, in the adult, per- fectly transparent, but seldom exceeding in weight five grains. Mr. Chevenix found it to~be an albuminous fluid, containing also gelatine and muriat of soda, but in such small proportions that the specific gravity of this fluid is not more than 10,053. We might perhaps re- mark, that the common salt assists the transparency, since salt water is peculiarly so, but that it is in so small a proportion that tne aqueous humour has little, if any, taste. (Philosophical Transactions for 1803, p. 96.) It seems to be secreted from the vessels of the iris, and is regenerated, after being discharged, within a few hours. The crystalline is almost immediately behind the iris. 11 resembles a flatted sphere. The anterior surface is the segment of a sphere about eight lines, the posterior of about five lines. The anterior is consequently the flatter surface. The crystalline increases in density from the surface to the centre. On the average its specific gravity is about 10,790, without any traces of muriatic acid. It contains, therefore, much larger proportions of albumen and gelatine, with less water. It putrefies rapidly, splits when dry, into lamellae, so that at firsi it exhibits a star- like fissure, and is at last divided into shreds. When its density, its rapid putrefaction, and its fibrous struc- ture are considered, we must conclude, that it contains a large proportion of fibrin, and we shall more readily admit the modern doctrine of its muscularity. The lens, it is now acknowledged, has a distinct capsule, and a canal surrounds it, called from its,discoverer, Petit. The vitreous humour fills the larger proportion of the cavity of the eye. It does not float loosely, but is contained in cells, so as not to flow freely without pres- sure. When removed from these it appeared of the same specific gravity as the aqueous humour, and simi- lar in its chemical relations. Fourcroy found in these humours some phosphat of lime, which Mr. Chevenix could not discover. The canal of Petit is formed, it is supposed, by a double layer of the vitreous humour, which forms also the capsule of theMens; but the cap- sule and the canal are distinct. Mr. Bell supposes that the Petitian canal is formed by the vascular membrane of the retina, which also forms the membrana pupillaris of the foetus; and his arguments render the opinion highly probable. ,f The eye is surrounded by numerous muscles, whose irregular action occasion that motion of objects which we perceive in vertigo. These muscles arise round the foramen, and are inserted into different parts of the fcrbit, giving, by their tendinous expansions, the brilliant whiteness of the fore part of the organ. Four of these muscles are called recti from the direction of their fibres, and it is these which have been supposed to compress and change the figure of the eye. The rectus superior rises the eye upwards, the attol- lens and levator oculi, and as it expresses pride, is called also super bus. The rectus inferior lowers the eye, styled, for similar reasons, deprimens and humilis. The rectus internus moves the eye towards the nose adducens oculi; and as it is directed to the glass while drinking, bibitorius. The rectus externus turns the eye outward; abductor oculi, indigabundus. The origin and insertion of these muscles will be obvious from their action. There are two oblique muscles. The first is the obli- quus inferior, longissimus, which rises from the bottom of the orbit by a slender tendon, passes the upper part of the eye ball fleshy; then forming a smooth round tendon, it passes through a cartilaginous pulley, in the margin of the orbit, and is inserted in the middle of the eye ball. It gives an oblique motion to the eye, and contributes with the other muscles to roll it. From its passing over the pulley, it is styled trochlearis. The last is the obliquus superior brevissimus. It rises from the nasal process of the superior maxillary bone in the edge of the orbit, passing obliquely back- wards and outwards under the ball of the eye, is inserted opposite to the obliquus superior. This muscle is in every respect the antagonist of the inferior. The eye is an organ of peculiar delicacy and im- portance; but without the other senses it would afford generally imperfect, and often erroneous, ideas of exter- nal objects. This subject has been examined at some length, with great ingenuity, by Dr. Reid, (Inquiry into the Human Mind,) in what he styles the geometry of visibles; to which we must refer the reader, as it scarcely forms' a part of our present subject. To explain the theory of vision, we premise a few re- marks on some of the first principles of optics. When light passes through a flat plate of glass it proceeds in a direct line, or at least nearly so; but when the glass is convex on either side it is bent from its direction towards the axis, or the line which passes through the centre. Numerous rays passing, therefore, from a point, and necessarily converging through a con- vex glass, are turned towards the axis, which must of course occasion them to meet at some point on the op- posite side. This is styled the refraction of the rays ; but rays impingingon the glass with a considerable obli- quity do not pass through it, but are thrown back; and this is called the reflection of light. The degree of refraction differs with the density and the nature of the medium through which it passes. To applv this popular view of the subject to vision we must remark, that the pupil of the eye, the aperture at which the light enters, projects, that it consists of transparent laminae, with a very bright fluid inter- posed. By passing through this fluid the light is a little diverted from a rectilineal course, but it is more so in passing through the lens and the vitreous humour. By oc u 62 o c u their united effects the rays meet in a point, at the bot- tom of tiic eye or on the retina. Its image is there ac- cu ately painted, and this image conveys to the mind an idea of an object, corrected by the touch and by experi- r:-.'-c. The touch corrects the idea respecting the form of the object; experience respecting its distance. We have observed that the refraction is greater in proportion to the density of the body, through which light passes, and it is greater in proportion to the obliquity of the impinging rays; if that is not in so great a degree as to occasion reflexion. To bring all the rays from a given point accurately to a focus, the density of the refracting body must therefore not be uniform, but must increase at its centre, where the obliquity of the rays is less. This is the case with the lens; and when, from causes to be hereafter explained, the image is not distinct, the eye lids are partly closed, to prevent the more oblique rays from entering. It may appear singular, that while refraction is so simple an operation, such a number of refracting media are connected in the organ. In general, hdwever, re- fraction is not regular. Some rays are broken in the operation, and resolved into their colours, giving the image, or sp'ectrum as it is called, with coloured (iri- descent) fringes. This irregularity is different in different bodies, and sometimes the irregularity is on opposite sides. The opticians, therefore, who felt its bad effects in telescopes, employed glass of such kinds as to correct this defect by their opposed powers; and it is singular that the structure of the eye had not suggested this mode of correction, rather than that the correction should elucidate the accuracy of the image in vision. It appears probable that the fluid interposed between the laminae of the cornea has some effect in this way, and that the irregularities of refraction from passing through the cornea are thus corrected, previous to the rays reaching the lens. The only inconvenience is the loss of light; for rays passing through different media are lost, or rather give an indistinct glare. The object of nature, however, in the structure of the eye, is to mo- derate the light; and we not only find many rays thus suffocated, but the vitreous humour is enclosed in cells, so that the refracted rays must be every moment passing through media of different densities before they form the image. When it is at last formed, it is compara- tively very minute ; and as each part conveys, a correct idea to the mind, it is evident that every portion must, at least, impinge on a nervous fibre, and that each fibre must'be of the minuteness of the image which the least visible object affords. Thus De la Hire calculates, that the image of the sail of a windmill, at the distance of 4000 toises, is but ^^ of an inch, but very minute por- tions of this sail may be distinguished; and such reflec- tions induced us to remark, when speaking of the nervous fibres, that what appeared in the microscope the smallest fibre was more probably only a fasciculus, and perhaps not the ultimate one. When it was observed that the image was pictured on the retina, it was at once supposed that it was thus con- veyed to the brain, and contemplated by the immaterial principle at its leisure. This, however, is highly im- probable for the reasons stated, that, without the correc- tions of touching and experience, our ideas of visible objects are often erroneous. It is improbable, also, from another circumstance; the image in the eye is inverted, and numerous.have been the speculations to explain how this inverted image is again restored to its proper position. It was once supposed that the fibres in the optic nerves decussate in crossing; and again, that they are mixed in a ganglion near the sella turcica. The former is not true, nor would either explain the diffi- culty. Others have supposed that the soul looks at the image by reflection; an idle fancy, unworthy of a phi- losopher. The fact is, that experience corrects this and other errors: our knowledge of relations and relative positions are not conveyed by the eye. With two eyes we see only a single object.^ This too has been explained on the principle of decussation which does not take place, and of the ganglion which can have no such effect. It chiefly arises from the axes of the eye being directed to the same point, which gives indi- viduality to the idea excited in the mind. Experience teaches us that two objects cannot be in the same place, and we thus conclude the image to be single. This may be evinced by an easy experiment. A slight distortion of either eye, in every one's power, will give the ap- pearance of a double object. If the uniform direction of the axes be gradually restored, the two objects will be seen to coalesce and become one. By diseases which affect the very minute motions of the eye, as a foul stomach, narcotic poisons, or spirituous liquors,, which produce irregular action, no longer under the command of the will, objects seem also double. Why then, it may be asked, have we two eyes? With two we see objects brighter; we see them more completely, for we take in a larger circle ; nor are we left in the miserable state of blindness should an acci- dent happen to one. It has been said, that when one is destroyed the other expands, and the loss is after a short period no longer felt; but this is not true. The person from habit is not sensible, indeed, of his loss, unless par- ticularly required to examine the whole of an object, as of a column, and a minute motion of the head may assist him in this examination; but no expansion of the remaining eye can take place, for there is no apparatus for such a purpose. Our ideas of the distance of objects is, we have said, the effect of experience; but the power of accommodat- ing our vision, so as to survey objects at very different distances, has been the subject of much controversy. It has been supposed that the ciliary ligament is muscular, and draws back the lens; that the lens itself is muscular, and can change its own shape; or that the reclimuscles, whose tendons may be supposed to reach, perhaps to spread over, the cornea, may contribute to flatten it. Each opinion has had its advocates. Yet this accom- modation of the eye to distance is very limited. A near- sighted person, with all his efforts, cannot easily extend his sphere of distinct vision, though he can considera- bly reduce it; but to reduce it he must render the eye more convex, which neither of the means suggested will effect. Much of this supposed change in the form ot the eye, however, apparently results from a greater exertion of attention, as images within the sphere of distinct vision, when from some accidental circumstance confused, are readily perceived by an exertion of atten- tion, without any change in the external circumstances. It either of the powers above mentioned have any effect m this respect, it is the action of the reclimuscles; and m .trying experiments of this kind with attention, OCL 63 OCU we think we have been sensible of compression on the ball of the eye. Habit has, however, a very considerable effect on the appearances of objects. Distortion of either eye, the effect of accident, is at first attended with double vision; but the object is soon seen single, though the cause remains. This circumstance, however, does not invalidate the former reasoning, since it arises from the power we possess of examining objects with one eye only. This is often done, particularly when the eyes are not equally acute. Distinctness of vision depends much on the state of the organ, and this on the state of health. In disease we see imperfectly, because the eye rolls with an in- voluntary motion; and the person who sees dark spots in the bed clothes, in a fever, constantly finds them moving, and his hands rove to catch them. It is not enough for peculiarly distinct vision that the object should be at the proper distance. All adventitious light should be removed ; for this, as opticians know, gives a fringe, an indistinctness, to the outline. If objects are carried- to the remotest limits of distinct vision, by an exertion of attention, they will be seen more per- fectly. Objects reflected from a convex mirror, or looked at through a glass somewhat more concave than the eye requires, will appear at a distance indeed, but peculiarly distinct. In the article Amblyopia, we anticipated some of the most common irregularities of distinct vision; viz. the myopia and presbytia. We are now in a capacity to consider them more accurately. The myopia, it was observed, arises from too great refraction of the rays, so that they are brought to a focus before the image reaches the retina. The defect has been attributed to a greater convexity of the cornea, which, as we shall find, flattens by age, so that the disease is by time di- minished. This, however, is but one cause, for many near sighted persons are not relieved by advancing years. From what we have said, it will appear that it may arise from an increased density, and conse- quently the increased refractive power of the fluid between the laminae of the cornea, the increased den- sity of the lens in general, its less uniform increase towards the centre, or the increased refractive power of the vitreous humour. That these causes often take place is certain, since, in many families, short sight is constitutional and hereditary. There is no doubt, however, but that both the myopia and presbytia may be acquired. The former is often the disease of those accustomed to survey minute objects at short distances, as the student, the watch maker, 8cc.; the latter of persons used to strain their sight to distant views, as the sailor. How this is acquired we are not prepared to say. When we spoke of" distinct vision, we admitted, in some degree, the power of the rectimuscles to flatten the eye; and in the sailor this power may produce the effect. The opposite change is more diffi- cult of explanation. But is it a change ? May not the eye naturally admit of distention; and may not this dis- tention be particularly directed forward, as the coats of the eye are there less dense, unless counteracted by the rectimuscles ? When not exerted we may readily suppose that, as usual, their tone is weakened. In this supposition there is some probability, since it is the acquired myopia which is chiefly relieved by age. It may be some confirmation of this opinion to add, that if a short sighted person uses a glass of too great con- cavity, he feels his eyes peculiarly weak; and he finds it difficult to adapt them even to the usual distance of distinct vision. The- remedy of myopia is obvious. As it is impossi- ble to lessen by any art the convexity of the cornea, or the too great density of the humours, it is necessary to lessen the obliquity of the rays. This is effected in part by wrinkling the brow and closing the eyelids. The latter alone is not sufficient, for the arch of either lid is the segment of so large a circle, that to close the lid only, would scarcely impede any oblique rays. By wrinkling the brow we depress the inner corner of each lid, and cut off the oblique rays which pass by the inner eanthus, and in some, though in a less degree, those at the outer. As a concave glass, by a power op- posite to that of a convex, disperses the rays, so a glass slightly concave lessens their obliquity, and prevents their union by refraction so early. To choose then the degree of concavity which will produce the requisite obliquity only, will be an object of importance. It is advised, in general, to ascertain such a degree of it (marked usually by numbers from one to fourteen,) as will bring the eye to the common state of perfect vision, and to select the number immediately below, because it is supposed that the use of the glass will by- degrees correct the defect. This indeed would be the case had the eye the considerable power of accommo- dating itself to different distances, which physiologists have been so anxious to explain. We believe, however, that no change takes place by such a glass which would not otherwise be observed ; and, indeed, we know that after many years using an inferior number, that above it has been found in the same degree of superior utility as at first. If, therefore, a glass must be employ- ed during a whole life, there is no reason for aban- doning the peculiar advantage of the most perfect vision which art can supply. In the constitutional myopia there is seldom any change ; and even the habits of the sailor will not conquer it. We have not, however, seen any such instance, except where the cornea has been distinctly prominent; so little foundation is there in the remark, that age will flatten it. The presbytia is in every respect the opposite dis- ease. It arises from the gradual change in old age, when the vessels, no longer distended, are in part obliterated. The eye sinks, the cornea is flatter, and but that the humours apparently increase in density and refractive power, sight would decay faster. This corresponding, or rather antagonising change, seems to preserve the sight of some old persons to a very advanced period. When from the diminished refraction, the picture thus falls beyond the retina, it is remedied by a convex glass, which more strongly refracts the rays, and brings the image more correctly on the retina. These glasses are neither so accurately ground nor so regularly num- bered as the concave, and should be boughf of an op- tician of character, rather than an itinerant, who pur- chases the glasses refused by the former. It was thought at one time advantageous to have the glasses tinged of a green or blue colour; but this defect is accompanied with some insensibility of the retina, and oiu 64 UDO to read, a strong light must be often thrown on the paper, either from the sun or a large candle. Each complaint varies in its degree, according to the state of health ; but disease seems chiefly to weaken the attention, and to affect the mind rather than the organ. If any part of the change in the shape of the eye de- pends, however, on muscular action, we may readily suppose, that diminished or increased irritability, or diminished tone, may have a considerable effect on dis- tant vision. We have spoken, through the whole of this discus- sion, of the retina as the seat of vision, though fully aware of the controversies which have arisen on this subject. The difficulty first arose from the insensibility of the spot where the optic nerve enters the globe of the eye; and as the choroid coat was discontinued on that part while the nerve was there, it was supposed that the coat rather than the nerve was the proper seat. We need not enlarge, however, on this point, for we know that any disease of the nerve between the eye and the brain will prevent our being sensible of visible objects; and there is no communication between the choroid coat and the brain. This would be decisive, in- dependent of the numerous facts which prove that the itate of the visual organ corresponds with that of the brain. The fact is, that in no instance do the nerves in their course show their peculiar properties or powers. They must be divested of their armature, and their evolved fibres exposed to the impressions. Much of the difficulty has arisen from the idea that the picture was essential to vision; but the impression alone is so, and the picture is an accidental, rather than a necessa- ry effect. The dilatation and contraction of the iris on the diminution or increase of light is, with difficulty, ex- plained. The contraction is not owing to the stimulus of light on the iris, for it seems to have no muscular power. The ends do not recede when divided ; it is not con- tracted when wounded, or light thrown on it, without entering the pupil. It has been thought sufficient to re- mark, that its motions correspond with the stimulus on the retina. This is, however, in many respects unsatis- factory ; and it has been with more reason concluded, that the dilated is the active, the contracted the passive state of the iris. The author of this opinion thinks the action of light stimulates the arteries of the reticu- lated coat of the retina, and the increased action of its vessels fills also those of the iris, which communicate with them. But vessels when filled are tortuous, and of course shorter in straight lines (see Exeter Essays, p. 202); the breadth of the iris is consequently less, and the pupil enlarged. We more readily acquiesce in this idea, since we think that it explains one remarkable fact, that in some cases of amaurosis the pupil contracts and dilates. This we can easily suppose may depend on the state of the vessels. If the palsy, as usually hap- pens, is communicated to them, contraction and dilata- tion will not on this system occur. In contrary circum- stances these alternations may be observed. The crystalline lens, as we have hinted, grows denser, and somewhat coloured by age ; and in general its transparency is preserved by warmth, and, after death, may be restored by it. Cold seems chiefly to act by coagulating the fluids. In new born children its density is inconsiderable, and the cornea is not stretched to it? due degree of convexity; so that they see imperfectly. The aemeous humour in this early period also is some times not transparent, and it is by no means certain that some portion of the membrana pupillans may not re- main. All these circumstances will increase the imper- fection, and occasion the phenomena already noticed. A new born child never keeps its eyes fixed on any one object, and it will not wink if any object approaches it. It does not, however, follow that he does not see, but that his vision is imperfect, the reason of which has been explained. See a Description of the Eye, and its Adjacent Parts, by J. Warner; Winslow's Anatomy; Cheselden; Bell; Zinn; and the very elegant plates of Soemmering. Artificial eyes are made of concave plates of gold, silver, or glass, stained so as to resemble the natural organ. They must be taken out to clean every night, and replaced in the morning. If no more of a diseased eye is removed than what preternaturally projects, or if the muscles are unhurt, the artificial eye will have a little motion. If it does not fit well, it irritates and in- flames the other eye. On disorders of the eyes, see St. Yves; Benedict Duddell; Remarks on the Ophthalmy, by J. Ware, and J. Warner; Bell's Surgery, vol. iii. p. 232—519; Scarpa on the Diseases of the Eye. In botany oculus means the bud of a plant, and also a name affixed to many herbs supposed to resemble the eye of some animal. O'culus. See Coi.iqUAMENTUM. O'culus bovi'nus and elephantinus. See Prop- tosis. O'culus bo'vis. See Bellis major. O'culus bu'bulus. See Proptosis. O'culus chri'sti. See Horminum sylvestre. O'culus ge'nu. See Patella. O'culus la'chrymans. See Epiphora. OCYxMA'STRUM. See Ocimastrum. Ocyma'strum verrucca'rium. See Circea. OCYMOI'DES, (from uxvy.ov, basil, and etfos, like- ness,) lychnis sylvestris, sive aquatica purpurea sim- plex. Red wild campion, silene armeria Lin. Sp. PI. 601, grows in hedges, and flowers in summer. The seeds are cathartic, but it is not at present employed. See Raii Historia. O'CYMUM, uxvs, swift, (from its sudden growth). Basilicum. Ocymum basilicum Lin. Sp. PI. 833. Ocy- mum is chiefly used for improving the flavour of sp. vo- latilis aromaticus. O'cymum caryophilla'tum,minimwm, vulgarius, me- dium, citratmn. See Basilicum. ODAXI'SMOS, (from o<$Ws, a tooth, and fotxwu, to bite). A biting sensation, pain or itching in the gums. See Dentitio. ODONTAGO'GOS, (from ofovs, and xyu to draw). See Dentagra. ODONTA'GRA,(from ofo&, and xygeva, to seize). ODONTA'LGIA, (from oy the fingers or forceps. The common precautions and the usual management are sufficiently known. See Bell's Surgery, vol. iv. p. 248; Dr. Cullen's First Lines, edit. 4. vol. ii. p. 38; also Dens. ODONTIA'SIS, (from ofovltxa, to put forth the teeth). See Dentitio. ODO'NTICA, (from «&«). Remedies for pains in the teeth. ODONTIRRHCE'A, (from oHs and pea, to flow). Bleeding from the socket of the jaw after tooth drawing. ODO'NTIS and ODONTITIS, (from ofovs; be- cause the decoction was supposed to relieve toothach). Lychnis, fios cuculi Lin. Sp. PI. 625, /J. ODONTOGLY'PHON, (from o&«, and yXvQu, to scrape). See Dentiscalpium. ODONTOI'DES, (from ofoxs, and etfos,form). The tooth-likc process of the second vertebra of the neck. VOL. II. ODONTOPHY'IA, (from oftvs, and s, and %va, to scrape off.) A brushing of the eye. OPHTHALMOXY'STRUM, (from os, and gvo-lpov, a brush). A brush for the eye, blepharoxy- sis, formerly made of the beards from barley or rye. It was drawn across the inside of the eye lids, to draw blood. OPIA'TA, (from opium). Medicines in which are opium ; but an appellation also of Electarium, q. v. O'PII. Tinctu'ra camphora'ta. See Paregori- cum Elixir. OPISTHOTONOS, (from <>*<•*», backward, and rovos, from reivu, to stretch). See Tetanus. O'PIUM, (from ovos, juice; /A-ipuSves ottos; and, from hence, xxr' etfix^i *w<«v). Affion, afiun, anfian, manus Dei. Opium is the milky juice of the papaver somni- ferum Lin. Sp. PI. 726, x, when incisions are made in their heads; and it is gradually dried in the sun to the consistence in which we receive it. Opium is brought from Turkey, Egypt, and the East Indies, obtained, ac- cording to Neumann, by pressing the juice from the heads of the poppies; but the best kind is that obtained from the incisions. In marty provinces of Asia they sow the white poppy (for this is the variety from which the true opium is procured) as we sow wheat. As soon as the heads appear, a slight incision is made in them, and some drops of a milky fluid exude, which are suffered to dry, and then collected. Tournefort tells us, that the great- est quantity of opium is made by bruising and pressing the heads; but Kaempfer and Belon, though they speak O PI 80 OPI of three kinds of opium, describe each as produced by incision and exudation only. In Persia, the opium is^ collected in summer, when the heads are nearly ripe; and these are wounded on one side by a knife, which makes five incisions at once. The next morning, the inspissated juice is collected with a spatula. The opera- tion is then repeated on the other side of the heads, but the first tears, styled gobaar, are preferred : these are whitish, or of a light yellow, but become brown in the sun, or when too much dried. The second tears are darker, and less efficacious; those of the third operation, black and inefficacious. When the opium is collected, it is beat up with a little water or honey, till it has the brilliancy of pitch. It is then rolled into cylinders, and, in this state, offered to sale. If small quantities are wanted, they are cut off with scissors. Sometimes the honey is in so large a proportion as to prevefit its drying, and to soften- its bitterness. This is the state of the East India opium. The most remarkable preparation of opium, in the East, is uniting it with nutmeg, cardamoms, canella, and mace. It is called philonia, and is the philonum of the Persians, supposed to strengthen the heart and the brain. Others add only saffron and ambergris, and almost every one varies the additions, according to his fancy. A celebrated liqour, called Cocomar, is men- tioned by Kaempfer, which is an infusion or a decoction of the leaves, sometimes of the heads, adding various ingredients, to please the palate. Another preparation to produce a temporary intoxication is called an elec- tuary, and often employed. Olivier in his travels into Asia saw the plantations of poppies on a large scale, chiefly in the vicinity of a vil- lage, called Affiom Kara-Hissar (the black castle of opium). The poppy is sown in autumn, transplanted in spring, and the harvest is collected about July. Various attempts have been made to cultivate the poppy in England for the purpose of making opium, and Mr. Ball received a premium for this purpose from the Society for the Encouragement of Arts; but the quantity used is too inconsiderable to render it a na- tional object, and the uncertainty of our climate will render it a very precarious speculation. The inspissated juice of the decoction of our white poppies is sometimes used, and the heads are boiled down to make the poppy syrup; but the former is of inferior virtue, though ap- parently less virulently narcotic, and white. We think the syrup, when properly made, an highly useful pre- paration, for reasons to be assigned hereafter; we fear, it is seldom the true watery extract of the poppy head. The seeds of the poppy are oily, and the flowers are cultivated in France for that purpose. Opium is brought into Europe in flat cakes, or irre- gular masses, from four to sixteen ounces in weight, cDvered with leaves. It is a gummy resinous substance, softish, and tenacious, especially when warm, or much handled; of a dark reddish brown colour in the mass, and yellowish when reduced to powder, with a faint disagreeable smell, and a bitter taste. If chewed a little, it affects the tongue with a very slight sense of heat, which spreads to the palate, and then in a less de- gree to the lips, provoking a discharge of saliva, and sometimes sneezing. That in which no visible impurities are lodged; which, when broken, appears of a dark red blackish colour; dry, not unctuous, but moderately ponderous and com pact; that which is inflammable, of an acrid bitter taste, a fai'nt smell resembling the odour of unripe poppy heads, without any empyreumatic flavour, communi- cating to water a reddish tincture, is the best. Belon observes, that sometimes a pound contains only about four ounces of pure genuine opium; but such adulterated kinds rarely reach us. Sand is added to increase its weight, and many foreign bodies are found mixed with it. It is ordered to be purified by dissolv- ing it in twelve times its quantity of proof spirit, and distilling the tincture to dryness, after filtering. Opium is softened by the heat of the fingers, but is not fusible, though highly inflammable. Water and alcohol dissolve it in different proportions, and no se- paration of the opium in the watery solution takes place on the addition of alcohol. When water is added to the tincture, some resin is deposited. Alcohol or water carry over, into a receiver, the narcotic powers of opium, which, by long boiling, or drying, are lost. A portion remains, which neither alcohol nor water will dissolve, supposed, by Gren, to be albuminous; by Bucholtz, caoutchouc ; by Josse, a virulent glutinous substance ; by Proust, wax, or combined with wax; by Duncan, gluten, approaching in its nature to the fibrin of the blood. Neumann procured from 1920 parts of opium 1520 of alcoholic, and 80 of watery extract; and, in- versely, 1280 of watery, and 200 of alcoholic extract. In the first case, the residuum was 320, in the last 440 parts. The solutions of opium, especially the watery, give copious precipitations by infusions of galls. The resin is separated either in a soft or hard state, and the former is sometimes called its essential oil: in this the narcotic power has been supposed to reside. The gum- my part seems to contain a small proportion of an earthy salt. It would be useless to enlarge on the numerous dis- quisitions to which the chemical analysis of opium have given a temporary importance, but we shall add a few remarks, applicable to practice, that may be drawn from them. This celebrated drug contains, like all other mat- ters, a resin and gum. The extractive matter contains the mucilaginous portion with resin, and it appears, that, while this union is least interrupted, we attain the seda- tive power with the smallest portion of the virulently narcotic. By the long tedious processes of the French chemists, we obtain a large portion of resin; but this is the product of the operator in consequence of the union of oxygen. The black drop, prepared at Lancaster, is not, we have said, the solution of opium in a vegetable acid; nor does it appear to be a strong spirituous tincture, and is certainly more active than any tincture not viru- lent after its immediate action. It is equal, in efficacy, in the dose of four drops to seven of the common tincture of opium, and, in the mildness of its effects, though not in their degree, we have come near to it by a tincture made with a weak spirit; for we have uni- formly found, that, with a diminished portion of the - uncombined resin, the anodyne effects were best se- cured, without the subsequent inconveniences of head- ach, nausea, &c. We should, therefore, suspect that it is a weak, spirituous tincture, with a proportion of watery extract. At least, we know, that in this way, a medicine of very similar powers may be procured. With this exception, we think Dr. Duncan has very OPI 81 OPI justly observed, that the attempts of some pharmaceu- tists to obtain a' preparation of opium, which should possess its sedative without its narcotic effects, only succeeded in so far as they diminished its activity. The effects of opium on the living body have been represented in very opposite, contradictory, terms. It has been keenly disputed whether it is stimulant or se- dative, as if it was necessary that it should be either. If by stimulant is meant a medicine, which, by its action on the stomach, will increase the heat of the body and the quickness of the pulse, it by no means deserves the title. If given to a healthy person, the pulse and the heat are both lowered; every pain, every care, is soothed; cheer- fulness and hilarity are the consequence. If the dose is increased, the face is somewhat flushed, the hilarity rises to intoxication, the mind is unsteady, and the hands tremble. Nausea, faintness, and headach fol- low, when the influence of the medicine is at an end. This brings the medicine within our class of indirect sti- muli, which are generally narcotics; and the error seems to have arisen from what we have often stated as a fundamental one in medical reasoning, viz. not dis- tinguishing between increased and irregular action. If we speak of its effects more generally, to the serenity and calmness which it induces, we should add respira- tion, slow and deep, a suppression of all the excretions, except that of the skin, pulse slower and fuller, with steep in circumstances often the most unfavourable to it. With some persons, however, instead of sleep, a mild pleasing delirium comes on, the mind wanders in the delightful regions of fancy, and the duration of time is to the imagination greatly extended. It is a striking instance of a material cause influencing an intellectual idea. With others, this delirium is attended with hor- ror. Suspended rocks are ready to fall ; the torrent hastens to overwhelm them, or the edge of a precipice yields under their feet. After considerable doses, vertigo, convulsions, and apoplexy come on, the blood is con- fined to the large vessels, usually the veins, and a rup- ture has sometimes ensued. To explain these symptoms has appeared difficult. It was supposed, from dissections where venous plethora was so conspicuous, that the blood was rarefied, and that sleep was produced from its pressure; but this opinion is no longer supported, for opium produces its effects in very small quantities, and more rapidly than will admit of its reaching the circulating system. In general, it has been concluded that it possesses both stimulating and sedative powers, the first of which is conspicuous soon after its exhibition, and at last con- quered by the second. It is not easy, however, to con- ceive two such opposite powers in a substance, except where the excitement is so violent as to exhaust the irritability, and then the medicine would be strictly a stimulant. In conformity with the principle which we have just stated, we think it will appear to be a sedative, or rather a narcotic only; and we shall endeavour to explain all its effects from this power. A sedative or narcotic re- medy will necessarily first lessen irritability, and this power is immediately obvious in the calm serenity it induces, in conscemence of lessening the effect of irri- tation. The pulse becomes slower and fuller, because the heart, less irritable, is more completely filled before it is stimulated to contraction; the mind is unsteady VOL. II. from diminished, and of course unequal, excitement; the secretions checked from the confinement of the blood in the larger vessels ; and thoseof the skin more full, as the relaxation of the cutis, by which they are confined, diminishes the resistance. A similar effect we have seen from warm bathing. (See Balneum.) In the other secretions there is no obstacle to the ful- ness of the vessels from a constringing membrane. Marks of a stimulus are however occasionally striking. If given in inflammatory complaints, it will sometimes increase the action of the pulse ; and if it does not pro- duce sleep, it renders the patient unusually restless. Yet these effects may be readily explained without contradicting the general principle. If, as in cases of pneumonia, the solution of the disease depends on the yielding of the excretories, to oppose this effect must aggravate all the symptoms, particularly the fever. Yet it aggravates also acute rheumatism, though said to open the cuticular excretories. But, in this case, it opposes a disease which consists, as we shall find, in a constric- tion of the cuticular vessels, from a different cause. If this constriction is not relaxed by very different medi- cines, we must expect injurious effects from opium. This reasoning will be confirmed by the advantages de- rived from peculiar modes of administering it, which coincide with the principle laid down, of its being pure- ly sedative. See Rheumatismus. Nor is it surprising, that, when it excites unpleasant images, and renders the patient restless and uneasy, it should increase fever. The constant agitation is alone sufficient for this purpose; and, when the excitement is unequal, it depends on idiosyncracy whether the deli- rium shall be pleasant or distressing. When the idea of its changing the circulating fluids was abandoned, it was doubted whether it acted on the stomach or the heart; and the second Monro has pubT lished some experiments, which seem to show that its chief effects are on the latter. These, however, only prove that, when opium is injected into the sangui- ferous system, it produces no effect till it reaches the heart. The small quantity which in the stomach will produce the peculiar effects ; the little diminution which is found in a pill of opium, when it has proved fatal; and the rapidity of its action, sufficiently show that, in diseases, it acts exclusively on the stomach. All the subsequent symptoms, those which follow its continued use, and those which arise from the increased dose, con- tribute to show a sedative power. The test of this reasoning must, however, be sought for in practice ; and, for this purpose, we shall consider its utility in the various diseases for which it has, at any time, been recommended. We know of no question either in theory or practice more difficult than the use of opium in Fevers, q. v. We have in that article given the outline of its advan- tages, but we must consider the subject more carefully, at this time, when we possess the necessary information respecting its action. If fevers consist in debility and in irregular action, and opium is a sedative, producing also irregular action, it will appear that no medicine is so unsuitable to the disease. We might rest on this, and at once, with many respectable practitioners, con- demn it; but experience forbids; and we must examine whether any unsuspected circumstance of the disease, or any new property of the medicine, either alone or in L OPI 82 OPI combination, will explain the apparent inconsistency. When we spoke, with Dr. Darwin, of the quiescent state of the capillaries during fever, we did not exclude spasm, or irregular action, in consequence of debility ; and in considering the state of the brain, we saw numer- ous proofs of unequal excitement. If, then, the irrita- tion from the latter cause could be prevented ; if, by any means, we could determine to the surface without in- creasing the heat, we might expect to relieve the febrile state. These ends may, we think, be obtained by mo- derate doses of camphor, joined with the opium, and occasionally with an antimonial. Each is assisted by the warmer ammoniacal neutral, and, as we have re- marked, should opium not disagree, we preserve the strength by a few hours rest. When the unequal ex- citement, in consequence of increasing debility, is so great as to produce subsultus and convulsions, there can be little doubt of checking the inequality by re- moving all irritation ; and this we are often compelled to attempt by opium, though aware of its sedative power, since the excitability would be soon destroyed by the violent excitement. Camphor, in this case, acts not only by its antispasmodic power, but also by its stimu- lus ; for, in considering the effects of this peculiar medi- cine, we remarked, that we were more frequently obliged to add nitre than aromatics to it. Intermittents. The use of opium in intermit- tents supports, we think, the former reasoning. It is employed with the warmer stimulants, sometimes with relaxants, to keep up the discharge from the sur- face, and prevent the formation of the cold fit. Boer- haave's sudorificum antipyreticon rarofallens contained two grains of opium; and the compound powder of ipe- cacuanha, assisted with the ammonia, will often suc- ceed. In the hot fit it produces, according to Lind, that relaxation of the skin which hastens and facilitates the sweating stage, relieving by this means the head- ach and delirium, rendering the solution more com- plete, and the fever less liable to return. In continued fevers, according to the same principles, it will contribute to determine the fluids to the surface, as we have already explained, and to dimi- nish irritation; but we must be particularly cautious that it do not stop the other secretions, particularly the alvine, on which the success of our practice so much depends. In inflammations, opium, for the reasons assign- ed, viz. its tendency to check secretions that would be salutary, is not very frequently employed. Yet with calomel it has been given in every form of active in- flammation, with success; for reasons which will be readily understood, since to a medicine which determines so steadily to the skin, opium must be an useful auxi- liary. In phrenitis, opium is inapplicable, except as a diaphoretic; and in cynanche, as it occasions thirst and dryness of the mouth, it can seldom be used with ad- vantage. In pneumonia, except where a diarrhoea is found to exhaust the strength, and check expectoration, opium is seldom admissible, since it will have a similar effect; and is only employed to prevent exhaustion, since it is scarcely more than a temporary impediment to the salutary discharge. Yet De Haen gave two grains of opium with two ounces of olive oil, a practice which has not been imitated; and we have left it in doubt (see Oleum), whether oil may really assist expectora- tion. In enteritis opium is highly useful; and* we have already spoken of the'propriety of checking the spasm previous to the exhibition of laxatives. But, independ- ent of this power, it is often necessary to quiet that irritation of the stomach which prevents food or medi- cine from being retained. In nephritis it is often ne- cessary, with oily laxatives, to relieve pain; but, as it powerfully checks the discharge of urine, diluting li- quors should be freely drank with it. In rheumatism, with relaxing remedies, often with calomel, it is highly useful (see Rheumatismus). In gout it is frequently indispensable to relieve the pain, nor is it found, if the action of the bowels be supported, really injurious. In the exanthemata, opium is often a valuable medicine; and in variola, it is an exception to the in- juries feared from it in inflammations, for when these tend to suppuration, no inconvenience results from its use. In the convulsions, previous to the eruptions, it is highly advantageous ; and on the sixth and seventh days, it allays the pain of suppuration, without checking the ptyalism. In morbilli it is less useful, as will be obvious, if what we have alleged of the utility of a free discharge from the bowels be considered. In every view, the dry cough and the pneumonic symptoms for- bid its use, unless considerable irritation prevail. In the scarlatina, as in cynanche, it is still less proper. In the hemorrhagic it is not often employed, from the apprehension of its stimulus ; but, as it sooths and calms, rendering the pulse slower, and determining to the surface, it will be often of service. We have found it so, and particularly in those haemorrhages at- tended with considerable irritation, as the uterine, and those which precede or threaten abortion. When haemoptysis is aggravated by cough, it is equally so, and when discharges of blood from the anus are produced by,diarrhoea, opium is the most salu- tary remedy, particularly if joined with demulcents. In the profluvia of Dr. Cullen, it is chiefly useful in dyse7itery, and with the mild laxatives, occasionally with the relaxing antimonials, or with ipecacuanha, very effectually relieves. In catarrh, unless joined with peripneumony, it is a most useful medicine. If there were in nosological systems a class of do- lores, opium would be the chief remedy. It is useful in pains of the stomach, the violent pains from the pass- age ofabiliary or urinary calculus; in pyrosis, in dysme- norrhea, odontalgia, in those cases of sphacelus at- tended with great pain. In general, also, in painful dis- eases, as in spasms, the"dose of opium, however large, acts only on the constitution, in that portion which is in excess beyond what is necessary to relieve the pain. Thus, if ten grains are given, and nine are required, to procure ease, the constitution only experiences the" in- convenience which would arise from one grain. In spasms of every kind it is an almost indispensable remedy, particularly in tetanus, trismus, convulsio, &c. In puerperal convulsions, after bleeding, it is almost the only effectual remedy. In all flatulent diseases, it acts as the most effectual carminative. Opium, some years since, was recommended as an infallible remedy in venereal complaints, and constantly used, for a time, in the military hospitals. It indeed seemed to suspend the disease, without making any pro- gress in the cure. It may be used, therefore, tike the nitric acid, to prevent the symptoms from increasing, OPI 83 OPP while the constitution recovers some degree of strength from former mercurial courses, but cannot be depended on for a complete victory over the disease. With many, opium disagrees, and numerous have been the correctors proposed. Ammonia sometimes succeeds; more often camphor; or camphor with cas- tor. The vegetable acids, so highly extolled, have been in our hands useless in this respect. Five grains of camphor, with as much castor, made into three pills, with conserve, may be combined with a grain, or a grain and half, of opium; and, in this form, will fre- quently produce no inconvenience. While a blister is rising, opium will be often borne with ease; and, in almost every case of fever, camphor should be com- bined. The nausea, the drowsiness, and vertigo, after taking opium, are relieved most effectually by a cup of strong coffee; but seldom disappear till after a night of sound sleep. Opium should not be given with astringents, alkalis, or metallic salts, as by these it is precipitated when in solution. It is not, however, certain that any real chemical change in the essential part of the remedy takes place; but should it be suspected, the combina- tions may be made in pills, where there is little room for the play of affinities. The chief officinal preparations of opium are, the pulvis ipecacuanhae compositus; pulvisopiatus; tinctu- ra opii confectio opiata; pulv. e creta C. cum opio. In the pilula ex opio, it is mixed with liquorice in the proportion of one grain to ten. In the camphorated pills of opium, each grain of the latter is united to two of the former. In the compound opium pills, a grain of opium and of camphor are united with a quarter of a grain of tartarized antimony. The emplastrum opiatum contains a very small proportion of opium, with the litharge plaster, stiffened with dry pitch and some wax. As an anodyne it is wholly useless. For opiate clysters and injections, see Enema and Injectio. One grain of pure opium is generally a sufficient dose; three grains can scarcely be taken with impunity by a person not accustomed to it; though, by habit, even an ounce in a day may be administered. Garcias knew a person who took ten drachms a day; and in Turkey, five or six drachms are often taken when vio- lent pains, or other symptoms, require it. Frequent experience manifests the propriety of large doses in spasmodic complaints; twenty-two grains of pure opium, besides three hundred drops of laudanum, have been given in the space of thirty-six hours, without any remarkable inconvenience. Different constitutions re- quire different doses to produce the desired effect; so that practitioners should be careful in ascertaining the proper dose for each constitution, by beginning with small portions, and gradually increasing them till the end is obtained. Where, however, opium disagrees, both small and " large doses are equally inconvenient. In general, the doses should seldom be less than a grain, unless often repeated. The effects of opium seldom continue above eight hours, and if the action is to be continued, it should be repeated in six. In large doses it does not check the secretions, but, on the contrary, sometimes seems to pro- mote them. When it conquers obstructions, it often appears to do so; and in taking off the spasm which prevented the passage of a stone or obstructed the'bile, or, in similar effects in the urinary passages, it seems to be laxative or diuretic. When imprudent doses havebeen taken from mistake, or design, stupidity, giddiness, a redness of the face, swelling of the lips, troublesome dreams, starting, con- vulsions, cold sweats, a considerable dilatation of the pupil, imperfect speech, slow full pulse, quick breath- ing, nausea, itching in the skin, vomiting, madness, hiccough, fainting, &c. follow. A vomit of vitriolated zinc is then necessary, and after it a spoonful of sharp vinegar is recommended; sinapisms must be applied to the feet, blisters to the arms, and frictions freely em- ployed. Vinegar is the supposed antidote, but cordials and ammonia will be more successful. Alkaline salts diminish, it is said, the soporific effect of opium; and the fixed alkaline salts are supposed to render it diuretic. The volatile carries it through the skin; and acids, in the opinion of many authors, destroy its powers. See Koempfer's Amoenitates Exoticae; Wedelius's Opiologia; Cullen's and Lewis's Materia Medica; Neumann's Chemistry; Alston's Dissertation on Opium in the Edinburgh Medical Essays, vol. v.; Medical Museum, vol. i. page 473, &c.; Jones's .Mystery of Opium; Tralles'Usus Opii. • OPOBA'LSAMUM, (from ovos, juice, and (ixXo-xftov). Balsam of Gilead. See Balsamum. OPOCA'LPASON, (from ottos, and xxXirxo-ov, a tree of that name). Opocdrpason, or opocdrphathon. See Carpasus. OPODE'LDOC. The name of a liniment said to be invented by Mindererus; but often mentioned by Paracelsus. (See Linimentum saponaceum.) A composition is-sold under the name of Steer's Opo- deldoc, considered as a powerful remedy for strains, bruises, and similar complaints. It is made in the following manner : I$> Solution, saponis cum camphora aq. ammoniae acetatae aa. § i. aquae ammoniae purae 5 ss. m. OPODEOCE'LE. A hernia through the foramen ischii, and into the labia pudenda. OPO'PONAX, (from ottos, juice, and zrxvx%, the pa- nacea). The plant from whence the gum thus is pro- duced is known by the names of opoponacum, panax heracleum, c'ostinum, and pastinacea. Hercules' all- heal, pastinaca opoponax Lin. Sp. PI. 376, nat. order umbellate. See Pastinaca olusatra. This gum is brought from Turkey and the East Indies, sometimes in little round drops, but generally in irregular lumps, of a reddish yellow colour on the out- side, with specks of white, internally of a paler colour, and'often variegated with large white pieces. It has a disagreeable smell, and a bitter, acrid, nauseous taste, dissolving in water and in spirit, and yielding a little essential oil in distillation. As a medicine, it is used as an attenuant and deobstruent; and, in large doses is said to be laxative: its dose is from 9 i. to 3 i- Opoponax re- sembles, and is the least disagreeable of the fetid gums, probably also of the least virtue. See Raii Historia; Cullen's and Lewis's Materia Medica; Neumann's Chemistry. OPPILA'TIO. See Obstructio. OPPO'NENS POLLI'CIS. The flexor of the me- tacarpal bone of the thumb. OPPOSITIFOL1US PEDUNCULUS,(from ofipo- L2 ORB 84 ORC situ. and folium). Growing opposite to a leaf of a plant. OPPRESSIO. See Catalepsis. O'PTICI NE'RVT, (from ott'Io^,, to see). The op- tic nerves are the second pair united in the brain, but soon becoming two distinct cords, each passing through the foramen opticum of the sphenoid bone, to their re- spective orbits. They unite on the anterior part of the glandula pituitaria, before they escape from the skull; but soon separate again, without mixing their fibres, and are inserted obliquely towards the nose. The optic nerves are surrounded by the four recti muscles of the eye. OPU'NTIA. Cactus opuntia Lin. Sp. PI. 669, a shrub which nourishes the cochineal insect, whose flowers expand like a case, having each a great number of stamina in the centre, growing upon the tops of the ovary. The ovary becomes a fleshy umbilicated fruit, with a soft pulp, inclosing many seeds of an angular shape. The leaves are used as emollients in inflam- mation. See Coccinii.la. OPUNTIOI'DES,(from opuntia, and etfos, likeness,) a marine plant, shaped like the opuntia, but brittle and hard, reckoned among the vermifuges. O'RANGIA. See Aurantia Hispaliensia. ORBI'CULARIS LABIO'RUM, (from orbiculus, a little ring). See Labia. ORBICULA'RE OS, (from the same). Lenticulare os. See Auris. ORBICULARIS PALPEBRARUM MUSCU- LUS, (from the same). Constrictor palpebrarum. The orbicular muscles of the eye litis rise fleshy from the -outer edge of the orbitar process of the superior maxil- lary bone, and from a tendon near the inner angle of the eye. Thefibres run a little downward and outward over the upper part of the cheek below the orbit, covering the under eye lid, and surround the external angle. Then passing over the superciliary ridge of the os frontis, they mix near the inner canthus with the fibres of the occi- pito frontalis and corrugator supercilii. After covering the upper eye lid, they descend to the inner angle, and adhere to the inner angular process of the os frontis, and to the short round tendon which serves to fix the palpebrae. It is inserted into the nasal process of the superior maxillary by a tendon which covers the ante- rior and upper part of the lachrymal sac. The fibres which run on the eye lids are elliptical. These muscles shut the eye lids, compress the lachrymal gland, and convey the tears to the puncta lachrymalia. Orbicula'ris, (from the same). See Sphincter ant, and Lycoperdon vulgare. Orbicula'ris clvcsor. The orbicular muscle of the eye lid. Orbicula'ris labio'rum. See Sphincter labio- rum. O'RBITA, (a dim. of 07-bus, a globe). Cyclos. The orbit of the eye, or the spheroidal cavity in which the eye is placed ; its angles are called canthi. ORBITA'LES ARTE'RIjE, (from orbita,) are branches of the inferior maxillary arteries. See Max- illaris ARTERIA. ORBITA'RE EXTE'RNUM FORA'MEN, is in the os maxillare, below the orbit. Through it the nerves and vessels, which come from the teeth, pass to the cheek. Orbita're intf/rnum fora'men, is a little above the os planum; through it goes a branch of the fifth pair of nerves to the nose. ORBITA'RII NE'RVI. See Motores oculorum EXTERN!. ORBITA'RIUS PROCESSUS. See Maxillaria superiora ossa, Frontis os, and Sphenoides os. ORCHE'A, (from opxcv, parsley). Mountain parsley. Athamanta oreoselivum Lin. Sp. PI. 352. Apium montanum ni- grum ; orcoselinum apii folio minus. The roots are slen- derer than those of the daucus, and not lactescent; the leaves like those of the parsley; the seeds oval, flat, large, striated, marginated, and sometimes cast off their husks. It grows on the mountainous parts of Germany and other countries, is pungent and diuretic. Oreoseli'num prate'nse cicv'tm fo'lio ; peuce- danum Alsaticum Lin. Sp. PI. 354. Daucus Alsaticus ; angelica pratensis apii folio. Oreoseli'num a'pii fo'lio ma'jus ; athamanta liba- notis Lin. Sp. PI. 351. Libanotis nigra; gentiana nigra; daucus montanus; cervaria nigra; daucus seli- noides major ; mountain' dauke, or black hero frank- incense. The seeds of these plants resemble those of the mountain parsley, and are styled diuretic and em- menagogue, but are seldom employed. ORE'STION, (from opos, a mountain,) helenium Di- oscoridis, inula helenium Lin. Sp. PI. 1236. See Enula. ORGA'NUM. Any part of the animal body, which from its structure is adapted to particular offices. This structure is from thence called organizatio. ORGA'SMUS, (from opyxa, turgeo). Sudden vehemence, generally applied to the venereal impulse. Hippocrates transferred this term to the agitation ex- cited by superfluous excrementitious fluids, to produce the necessary discharges. Linnaeus calls it a subsultus of the arteries. Quincy considers it as an impetus of the blood or spirits, distending the muscles with unu- sual force. It is in fact a violent determination of the blood to any organ. ORl'CIA. A species of fir, called from Oricus, a citv of Epirus, where it grows. ORIENTA'LIA FO'LIA, (from oriens, the east). See Senna Alexandrina. ORIENTA'LE GU'MMI. See Gum Senegal. ORI'GANUM, (from opos, a mountain, and yxvou, to i-ejoice ; because it grows most luxuriantly on moun- tains). Wild marjoram; marjorana sylvestris, ole- racea,et mancarana; origanumanglicum,etspontaneum; onitis 7najor; origanum vulgare Lin. Sp. PI. 824. ihraclo'eticum, from Hcraclea. Common wild mar- joram is a plant with firm round stalks; ova!, acu- minated, uncut, and somewhat hairy leaves, set m pairs on short pedicles. On the tops grow scaly heads of pale-red labiated flowers, whose upper lips are entire, the lower cut into three segments, set in a con- vex umbel, intermixed with roundish, purplish leaves ; each flower is followed by four minute seeds inclosed in the cup. It is perennial, grows wild on dry chalky hills and gravelly grounds in several parts of England, and flowers in June. The leaves and flowery tops have an agreeable aro- matic swell, and a pungent taste, warmer than the garden marjoram, and much resembling thyme, with which they agree in medicinal virtue, as well as with marjoram. Infusions of the leaves are drunk as tea in weakness of the stomach, and disorders of the breast, to promote perspiration, the fluid secretions in general, and the catamenia. They are sometimes used in anti-rheu- matic baths; and the dry leaves powdered are a good errhine. For internal use, half an ounce of the leaves is infused in a pint of water. In distillation with water they yield a moderate quantity of a very acrid, penetrat- ing, essential oil, smelling strongly of the origanum, but less agreeable than the herb, called oil of thyme, often put into a hollow tooth to allay pain. See Lewis's Materia Medica, and Neumann's Chemistry. Ori'ganum Cre'ticum. See Dictamnus Cre- ticus. Ori'ganum majora'na, seu foliis ovatis. See Majorana majori folio. ORLEA'NA, (from the place where it grows,) arbor Mexicana ; oretlana ; the roucou or arnotto tree, bixa orellana Lin. Sp. PI. 730. This curious shrub rises commonly to the height of eight or nine feet, thrives best in a cool rich soil, and shoots most luxuriantly near springs and rivulets. The seeds are covered with a kind of wax called te7-ra orella- na, roucou, and arnotto. When the seed vessels are mature, the seeds are put into convenient jars, to which is added as much hot water as will suspend the wax. When this is washed off, the seeds are taken out, and the fluid left at rest till the wax thoroughly subsides. The clear liquor is then decanted, and the sediment dried gradually in the shade. This mass is afterwards made into balls or cakes, and dried in an airy place, until fit for use, or the market. The wax is a cool, agreeable, rich cordial, and hath been long in use amongst the Indians and Spaniards in America, who still mix it with their chocolate, both to heighten the flavour and raise the colour. It is said to be a success- ful remedy in dysentery, is used as a pigment, and often mixed with other ingredients both by painters and dyers. The roots resemble in virtue the wax, but are more diu- retic. The Indians prepare an arnotto of a bright shining red colour, almost ecjual to carmine. The arnotto dissolves with difficulty in water, tinging it of a pate brownish yellow ; more readily in rectified spirit of wine, to which it gives an orange-red colour; and it is used in varnishes, to give an orange hue to the pale yellows. Alkaline salt renders it soluble in boiling water, without altering its colour. See Achote. ORNITHO'GALUM, (from opv.ios, of a bird, and yxXx, milk ; because the colour of its flower resembles the nutky fluid found in eggs). Ornithogalum U7nbella- tum medium angustifolium ; ornithogalare, ornithoga- lumumbellatumlAn Sp. PI. 441, the star of Bethlehem, flowers in May. The root is bulbous or tuberous, and OS 86 O S C is a wholesone nutrient: indeed the roots of all the species possess the same properties. (See Raii Historia.) It is also a name for squills. See Scilla. ORNITHOGLO'SSUM, (from opvts, a bird, and yXuro-x, a tongue, from their shape). Bird's tongue. The seeds of the common ash tree. ORNITHROPO'DIUM, (from «?»«?, and tths, afoot, from the likeness of its pods to a bird's claw). Bird's foot; telephium ; chironium; scorpioides ; scorpion- wort ; ornithopous scorpoides Lin. Sp. PI. 1049, grows on sandy and gravelly places, and flowers in summer. The seeds are said to destroy the stone in the kidneys; but are very rarely used. See Raii Historia. O'RNUS, (from the Hebrew term orn). See Fraxinus ornus. It is also an appellation of the sorbus aucuparia. See Sorbus sylvestris. OROBA'NCHE, (from opoQos, a wild pea, and xyxa, to suffocate; because it twines round and suffocates the orobus). See Hypocistis. O'ROBUS, (from epevlu, to eat). Karemyle astra- galus ; astragaloides; orobus tuberosus Lin. Sp. PI. 1028. Wood pease, heath pease ; grows in woody places, flowers in April, ripens its seed in May. The tubera of the root are highly nutritious, taste like liquorice, and in Scotland are used for the same pur- poses, and chewed like tobacco. See Raii Historia. O'robus, and Orobry'chis peregri'na, (from opoZos, and \%pvxa, to eat). See Ervum. OR'PIMENT. See Auripigmentum. O'RRIS. See Iris vulgaris. ORTHOCO'LON, (from opSos, straight, and xuXov, a limb). See Anchylosis. OR'THOPONfJE'A, (from op6os, erect, and irvea, to breathe). This disease, when neither connected with asthma nor dyspnoea, is only a symptomatic. It consists in a sighing suffocating respiration, and the patient must be erect to breathe. It is a symptom often of hysteria, sometimes of hydrothorax, occasionally of polypi and diseases of the heart or larger vessels. In some cases it arises from fat, from poisons, deleterious vapours, or any cause of compression on the lungs. ORVA'LA, (from orvale, French). See Hormi- NUM. ORVIETA'NUM. A celebrated antidote, called from Orvieto, a city of Italy, where first used, or from Orvietanus, its inventor. ORY'ZA, (from the Arabic term orez). Rice; the seeds of the oryza sativa Lin. Sp. PI. 475 ; arac. Its grains are disposed in an oval panicle, covered with a thick husk, like barley- It is less viscous than wheat, but less nourishing, and used as a diet in diarrhoeas; but the salep is preferred by Dr. Per- cival. It ferments slowly, and corrects putrefac tion imperfectly; but is preferred by Dr. Cullen as a grain highly productive and nutritious. The idea of its being hurtful to the eyes is without foundation. Rice flourishes in a moist soil, and even in water. In China the liquor called arrack is distilled from it. See Arac. Ory'za Germa'ntca. A species of barley. Os, ossis, (from the Hebrew term ozam, strength). A bone. Bones consist of a mucilage and an earthy matter. Acids dissolve this earthy matter, leaving the bone of its original shape, but soft. See Bones. Os, Oris, (from oro-x, the voice). The mouth. Its external parts are the lips, the angles of the mouth, the border or edge of each lip, the fossula which runs from the septum narium to the edge of the upper lip, and the transverse fold which separates the under lip from the chin. The internal parts are the palate, the septum palati, the uvula, the amygdalae, the gums, the fraena of the lips, and the tongue, with its apex, root. sides, and fraenum. Os exte'rnum, and internum. The first is the entrance into the vagina; the second the mouth of the womb. Os leo'nis. See Antirrhinum. Os tincje, amphideon and oscheon. If the os inter- num is long and hard, when pains, like labour, come on, a clyster and an anodyne may be given, for labour has not commenced. The os tincae is sometimes open, a month or two before the period of labour; but its thickness and softness remain the same, until labour comes on. Nor does it always point in one direction during pregnancy, or in the beginning of labour. When opened by the membranes, it is soft, and if con- tracted again from the discharge of the waters, it is easily dilated. It sometimes is hardened and thickened by age, or by frequent labours; and the birth, though natural, is in that case somewhat retarded. To dilate these parts, the fingers must be gradually introduced, and when the hand is in the vagina, the os internum must be slowly and cautiously dilated; and the more carefully in proportion to the rigidity of the parts. When the hand can be introduced into the uterus, the back should be contiguous to it, and the palm to the membranes. OSCE'DO, (from os). See Oscitatio. OSCHEOCELE, or OSCHEOPHY'MA,(from»c- Xi»*, the scrotum, and xvsXii, or s, broth). We should not have introduced this singular term, but that the experiments of M. Thenard, who suggested it, were not within our reach when the former part of this work was written. It is the animal substance peculiar to muscles, or muscular flesh, which gives odour and flavour to the decoction or soop ; and by these qualities, as well as its colour, is distinguished from gelatine. Its proportion to the latter, in flesh, is as about one to five. Four pounds of muscular flesh, bruised and washed with cold water, produced nearly six drachms of this sub- stance. The decoction of bones is gelatinous only. This is the animal matter not yet sufficiently examined, which gives the zoonic acid its peculiar properties, for it is originally the acetous. OSMU'NDA VULGARIS, PALU'STRIS, and REGA'LIS. See Filix Florida. O'SSA BA'TUS. See Borozail. O'ssa spongiosa, sometimes distinguished by the epithet inferiora, as two turbinated portions of the ethmoid bone, by some anatomists described as parts of the ossa palati, are frequently called superiora. They are certainly distinct in the early periods of life, and con- sist of a spongy lamella in each nostril, the convex sur- face of which is towards the septum, and the concave towards the maxillary bone, covering the opening of the lachrymal duct. Two processes rise from its upper edge. The posterior (the broadest) hangs on the edge of the antrum highmorianum; and the anterior forms the os unguis, and a part of the lachrymal duct. These bones are complete in the foetus, and lined with the mu- cous membrane. The sides of the maxillary sinus, ap- parently turned downwards, seem to form two other bones, and some smaller bones, irregular in their size and uncertain in their number, occasionally project into the nostrils to extend the surface of the olfactory organ. O'ssa e co'rde ce'rvi. The bone of a stag's heart, formed by the ossification of the arteries, was formerly used in asthma. OSSI'CULA AUDI'TUS. See Auris. ■OSSICULUM, (a dim. ofos, a bone). In botany it is the shell or hard covering of seeds, like bony la- mellae. OSSIFICA'TIO, (from os, a bone, and fio, to be- some). Ossification. The calcareous phosphat of which bone consists is deposited from arteries ; but pre- vious to the deposition, the arteries are distended; and those which did not before carry red blood are now vi- sible from their containing this fluid. In this blood the knife discovers hard particles, which gradually unite; for these bony fibres are flat, and radiate as from a centre ; no membranous parts are formed, and their shape is generally irregular. In the blood vessels the mem- branes supply the place of those usually connecting the osseous particles in cartilages, forming the body of the cartilage from which the bone by maceration slips per- fectly distinct. While the bones are increasing within cartilages, the cartilages are extended; and from the pressure which they suffer from the bone within and the integuments externally, they decrease continually. and are at last entirely destroyed. Dr. Hunter, in his Lectures, supports this opinion, by curious anatomical preparations, in opposition to Kerkringius and others, who contend that bones are originally cartilaginous. Dr. Hunter had a preparation of the^patella, in which he demonstrated that the ossification of that bone began by the arteries ossifying in the centre of the cartilage, which, in young subjects, supplies the place of the bony patella. Mr. Cruikshank prosecuted the subject, from the first appearance of an ossifying artery, to the perfect formation of the patella. He supposed that the same thing took place in all other bones, and demon- strated that ossification is not only begun but carried on by the ossifying of the arteries. Morbid ossifications frequently happen in the aorta, lungs, pericardium, and even in the corpora cavernosa penis. The natural process advances in infants in pro- portion to their strength. In flat bones it hegins in the centre, and shoots towards the circumference ; in long ones, in the middle, shooting towards the extre- mities. See Kerkingius, Ruysch, Nesbit, Albinus, and Monro. OSSIFRA'GA, (from os, a bone, and frango, to break). See Osteocolla. OSTA'GRA, (from ofAM, occurs indeed in the treatise De Internis Affectionibus, which is generally accounted spurious; and the different species are certainly different diseases; for the first is an asthenic typhus, with consi- derable accumulations of bile, &c. in the epigastric region ; and the last, the dropsy, which follows fevers of peculiar severity. See James' Medical Dictionary, and Le Clerc's Histoire de Medecine, lib. iii. c. 11. page 181. PACO CA'ATINGA. A coniferous species of Bra- silian canna, the costus arabicus Lin. Sp. PI. 2. Its stalk, if chewed, occasions a spitting: if the saliva is swallowed, it is said to cure gonorrhoea in a few days; and to be occasionally Iithonlriptic. See Raii Historia Plantarum. PACOEI'RA. See Banana. PA'DRI. A siliquous tree in Malabar, not yet accu- rately described: the juice of the leaves is a cure for mania; that of the bark, mixed with the fruit of the pera, is supposed to restrain the menses. See Raii His- toria. PA'DUS; prunus padus Lin. Sp. PI. 677; cerasus avium nigra, cerasus racemosa; the wild cluster cherry, the bird's cherry, grows on mountains, and the berries are used to hang about the necks of children as a cure for the epilepsy; and internally to cure dysentery. The bark, a narcotic bitter, and slightly astringent, has been said to cure intermittents and syphilis. (See Dale, and Raii Historia.) A name, as is said, also for the lauro cerasus, but in reality a species of prunus, resembling the lauro cersus, so called by Clusius. See Lin. Sp. PI. 678, where it is arranged with this trivial name. P^EDA'NCHONE, (from srxis, a child, and xyxa, to strangulate). See Angina. PjEDARTHROCA'CE, (from srxis, x^e?ov, a joint, and xxxov, an evil). The joint evil ; as it frequently appears about the joints of children, and oftener than in adults. Severinus calls the spina ventosa by this name; and adds that its tumours are frequently attend- ed with pain, redness, and all the appearances of in- flammation, while the paedarthrocace has little or no pain in the beginning. But these names are used very promiscuously ; and the term is sometimes applied to anasarca. Dr. Cullen places it as a variety of the first species of phlogosis, under phlogosis phlegmone. See M. A. Severinus's Treatise De Recondita Abscessuum Natura; also Spina ventosa, and Caries. PiEDOPHLEBOTO'MIA, (from srxts, and QxeGo- To/A,tx, opening a vein). The bleeding of children. PvENO'E, vateria Indica Lin. Sp. PI. 734. A large tree in Malabar; the root, bark, and fruit of which yield a resin, which is burnt instead of incense in their sacri- fices. The kernels of the fruit, made into an emul- sion with warm water, is supposed to strengthen the stomach, relieve nausea, colics, and cholera. See Raii Historia. PiEO'NIA, (from Peon, who is supposed to have first used it). Piony; ephialtia, idaus dactylus,pento- robus, peonia officinalis Lin. Sp. PI. 747, x and /3, viz. MALE and FEMALE PIONY. The male piony hath dark green leaves, pale red single flowers, long thick roots, with red streaks in the stalks and pedicles; the female, longer, pale, and nar- rower leaves, deep red, double flowers, and irregular roots, composed of several tuberous pieces, hanging by rough filaments from one head. The male is preferred; but the difference is inconsiderable, and the female is most frequently used. The fresh roots and seeds have a faint narcotic smell, with a slight acrimonious bitter and astringent taste; but, when dried," lose wholly, or in a great degree, both. Watery extracts are insipid, spirituous ones bitter, and slightly astringent. Every part of this plant has been considered as anti- spasmodic and tonic. The roots were at first directed to be hung round the neck; and if relief did not fol- low, a drachm of the dried root was to be taken two or M 2 P A 1; 92 PAL three times a day. On the continent the expressed juice is preferred. The piony is chiefly used in epilep- sy ; but in this country it has not succeeded, and is now neglected. The roots, flowers, and seeds, are anodyne, but their efficacy is very inconsiderable. The flowers impart their colour, smell, and taste, to water and to spirit. See Lewis's Materia Medica. PAGA'NICA. A ball used by the Romans in their exercises ; confined to the villages. PAGI'NA, (from vrvyu, to compose). The superior and inferior superficcs of the leaf of a plant. PAGU'RUS, (from zrxyos, a rock, and ovpea, to keep; because found in rocky places). See Cancer ma- rinus. PAHUATLA'NICA. See China occidentalis. PAIA'NELI; bignonia Indica Lin. Sp. PI. 871. A tall pod bearing tree in Malabar, used by the natives in several disorders. See Raii Historia. PAIDATRO'PHIA, (from *rx,s, and xrpotptx, atro- phy). See Atrophia. PAIDI'ON, (from ttxis, a perfect child in the womb). Hippocrates. See Conceptio. PAIN DE MADAGASCAR. See Cassada. PAI PARGLA, couradi; grewia orientalis Lin. Sp. PI. 1367. A bacciferous shrub in Malabar. An apo- zem prepared of the leaves, fruit, and roots in water, is said to be useful in gout. See Raii Historia. PA'LA. See Nux moschata. Also a tall pod bearing tree in Malabar, tabernemontanu citrifolia Lin. Sp. PI. 308; used in various disorders. See Raii Hist. PALiE'TYRUS, (from ■axXxtos, old, and rvpos, cheese). See Caseus. PALA'TI O'SSA, (from palatum, palate). The bones of the palate are two, irregular, and continued up the back part of the nostrils to the orbit. These additional parts, viz. the pterygoid process, the nasal lamella, and orbitar process, we shall soon notice. The square bones situated in the roof of the mouth join each other backwards, and the maxillary bones forward ; on the posterior part there is a lunated edge, whence the velum pendulum palati is suspended. The upper part of its internal edge rises in a spine, to be joined with the vomer : its anterior edge is ragged, to connect it more firmly with the process of the maxillary bone. The internal edges, by which they join, are thick and smooth. The internal point projects, for the origin of the palato staphylinus. On the side towards the max- illary bone there is a fossa, which, applied to a similar one in the maxillary bone, forms a passage for the pala- tine branch of the fifth pair of nerves, and a small twig passes through a hole behind. The pterygoid process of this bone passes between the ox maxillare superius, and the pterygoid process of the os sphenoides: it is of a triangular shape, broad at its basis, and small above. The nasal process is very thin and brittle, rising up- wards, covering a large part of the aperture of the maxillary sinus, and closing the cavity between the sphenoid and the projecting part of the maxillary bone. From the middle internal side of this plate^ a cross ridge, resting on a similar one of the maxillary bone, extends, and. on it the back part of the os spongiosum inferius rests. A perpendicular fossa, made by the palate nerve, is observable on its outside. At its superior part the os palati divides into two processes, called the orbi- tar, of which the anterior is the larger, and its fore part is contiguous to the back of the maxillary sinus : its pos- terior surface is cellular, contiguous to the ethmoid cells, and placed on the opening of the sphenoidal sinus, so as to leave a small hole above. Sometimes this hole is wholly in the palate bone, and through it a nerve artery and vein belonging to the nostrils pass. The palate bones are very complete in the infant, and the nasal plates are thicker and stronger than in the adult, but the orbitar processes have no cells. In old persons, all these bones are firmly united. From the connexions described, we see why the eyes are so often affected in ulcers of the palate; or why, on the other hand, the palate suffers from Egylops, q. v. PALATI'N^E GLA'NDULJE, (from palatum, the palate,) are conglomerated glands, situated in the sep- tum and arch of the palate, near the tonsils. PALATI'NUS, (from palatum, the palate,) is a branch of the upper maxillary branch of the fifth pair of nerves, running before the pterygoid apophyses of the os sphenoides in the canal formed by the os maxil- lare and os palati, and through the foramen palatinum posterius: it spreads in the glandular coat of the palate,' and parts adjacent. Palati'nus ductus. The Eustachian tube. Palati'nus proce'ssus, (from palatum). See M.tx- ILLARIA SUPERIORA OSSA. PALA'TO PHARYNGEUS, (from palatum >, a fountain; from its great secretion). See Pancreas. PANDALITIUM. See Paronychia. PANDE'MIUS, (from *rxv, and foif*t>s, a people). See Epidemicus. PANDICULA'TIO, (from pandiculor, to gape and stretch.) Stretching ; distentio; is that restless stretching and uneasiness which accompany the cold fit of an intermitting fever, and one of the irregular actions from debility. PANICULA. A panicle. A stalk diffused into several pedicles, sustaining the flowers or fruits, like the oat, millet, 8cc. Panicula is also a diminutive of panus, a species of tubercle ; and a name for crude bile. PA'NICUM, (a paniculis, from its many panicles,) elymagrostis; elymos; common panic ; pa7iicum dac- tylonhin. Sp. PI. 85. The spike consists of innumera- ble thick seeds, disposed in lesser spikes, so as to appear like a cluster. It is cultivated in Germany; and the seeds have been used as food, but are not regarded in medicine. See Raii Historia. PA'NIS, (from irxa, to feed). Bread ; artos, fari- nacea panis. Good bread should be composed of flour well kneaded with the lightest water, seasoned with a little salt, fermented with the yeast, and sufficiently baked. The viscidity of unfermented bread, called duratos, is destroyed by fermentation; and the bread is thus rendered more digestible, but at the same time in- clines the substances fermented to acidity, whence un- fermented bread only can be proper where acidity abounds in the stomach. (See Bread.) To this article we have little to add except the kinds distin- guished by ancient authors. The purest and best bread was styled panis siligineus, mundus, athleticus; isungia coliphius and robys. The next in quality, from which the bran was not wholly sifted, had the appellations of secundus, smilaceus, or smilagineus; the third containing the whole of the bran, was styled antopyrus, synco- mastus, and confusaneus. A fourth kind consisted wholly of bran, and was styled cacabaceus, sordidus, furfuraceus, or furfurativus, bissus, and leibo. Pa'nis canina'ceus. See Canic./E. Pants furfura'ceus, impu'rus, a'ter, ciba'rius, grega'rius. See Coliphium. N PAP 93 PAP Pa ms cu'culi. See Acetosa. Pa'nis porcinus. See Arthanita. PANNI'CULUS ADIPO'SUS. See Cellulosa MEMBRANA. Pannt'culus carno'sus. A fleshy membrane which assists the corrugation of the skin, found, with a very few exceptions, only in brutes. PANNO'NIUM. See Arthoicum. PANNO'NICA,(froni^anra««, a rag). See Hiera- cium alpinum. PA'NNUS, (from -sroveu, to labour). Woollen cloth ; synonymous also with albugo, and with a venereal spot. PANO'CHIjE. See Bubo. PANOPHO'BIA, (from ttxv, and , the voice). Cacophonia. Depraved voice, including in general dumbness and difficulty of speech. ' Dr. Cullen, confin- ing it to the depraved voice, distinguishes the following species: 1. Puberum, that change of voice remarkable in boys about fourteen years of age. 2. Rauca, the hoarse and rough voice, from the dryness of the fauces. (See Raucedo.) 3. Resona7is, rhenaphonia, when the voice seems to come whistling through the nostrils. 4. Palatina,from a defect of the lip, the palate,or uvula (see Asaphia, or Asaphodes.) 5. Clangens, leptophonia, oxyphonia, when the sound is shrill or squalling. (See Clangor). 6. Comatosa, a voice resembling stertor. PARAPHRENE'SIS, (from nxpx, and s, the tes- ticle). A detention of the testicles, in the abdomen or at the ring of the muscles, called cripsorrhis, or con- cealed testicles. Usually about the time of the child's birth they descend into the scrotum; but the time of their descent is very uncertain in different persons, and in the same person both testicles will not always de- scend at the same time; sometimes they never pass into the scrotum. Mr. Pott observes, that he knows not of any particular inconvenience arising from the deten- tion of a testicle within the cavity of the belly ; but its lodging in the groin exposes it to be hurt by accidents. When hurt it may be mistaken for a different disease, anel occasion very improper treatment. To which con- siderations he adds, that there is no kind of disease to which the testicle is liable in its natural situation, but •vhat may also affect it in any or all its unnatural ones. in the first cause related by Mr. Pott, a testicle being detained in the groin of a young healthy seaman, who hurt the part by hitting it against a piece of timber, the tumour, became extremely painful, and was mistaken for a bubonocele, from which it might have been more readily distinguished by the following circumstances, had not the extreme tenderness of the injured testicle prevented any examination by the touch ; and the very hard swelling'of the scrotum precluded any certainty of a testicle being there or not. Mr. Pott adds, tha: the tumour in the groin did not, like the bubonocele, point obliquely from the ilium towards the pubes, bin lay across the groin, and when the scrotum became soft no testicle could be felt; two striking circumstances to determine the nature of the case. In the earlier part of this young man's life, the detained testicle had been mistaken for a rupture, and a truss had been applied to it. In the second case the testicle was detained in the groin; and the patient was also advised to wear a truss, which he could not bear from the pain it occasioned At last, when infected with a gonorrhoea, this detained testicle inflamed, forming a hernia humoralis, unfor- tunately mistaken for a bubo. The tumour, however, was moveable, and the scrotum on that side contained no testicle; two circumstances of importance in the diagnosis. Each patient was cured by the reme- dies for inflammations of the testicles in their usual situation. PAROTIDjE'A, (from Trxparts, the parotid gland) See Cynanche parotid.?, a disease, and Xoyos, a discourse). We have already observed that the institutions of me- dicine were usually divided into the physiology, patho- logy, hygieine, and therapeutics. The more general division was, however, into the hygieine and jatrike; the latter including the pathology, the prognostics, and the therapeutics. In this view the pathology includes the differences, the nature, the causes, and effects, of diseases; but even this division is now neglected. The differences of diseases are referred to nosology, though this, at the period of the publication of Sauvages' first edition, was styled pathologia methodica. The parti- cular causes and effects of diseases are referred also to the particular description, so that little remains under this head in modern authors but the general doctrines. We have already anticipated the greater part of the disquisitions respecting the general doctrines under the article Morbus, q. v.; for there, in a work of this kind, the reader would look for the diseases of the fluids, of the simple and the vital solids. The diseases of the containing 6olids, of the organized solids, and the particular secreted fluids, could not be separated from the particular diseases. The distinction of the causes of diseases in general we have also noticed (see Causa), and the particular causes might perhaps be referred to the diseases which they produce. We have certainly anticipated almost every part of such disquisitions, as they rest on the more improved chemical knowledge of modern times, and to combat ancient fancies would fonn a very uninteresting part of the present work. It is sufficient then to ob- serve, that the causes of diseases as distinguished by the latest pathologists, are those from the injurious effects of the atmosphere ; from food and drink; the improper use of remedies; poisons; errors in the animal mo- tions; injuries from particular positions or motions; immoderate mental exertions ; perturbations of mind ; excesses of sleep and watching ; unnatural excretions and retentions; causes of calculus ; diseases from ani- mated beings, or other external causes, as clothing; accidents from bruises or fire; substances swallowed, or in any manner introduced into the cavities. The predisposing causes, seminia, are those common to each sex or age, or those peculiar to particular tem- peraments and constitutions. To which are sometimes added preternatural predispositions, which are little else than concealed idiosyncracies excited to action by acci- dent. See Air, Aliment, Venenum, Hypochondria- sis, Somnus, Calculus, Vestitus, Ambustio, Prog- nosis. PATIE'NTIA, (from potior, to bear, from its gently purging qualities). See Lapathum hortense. PATIE'NTIA MUSCULUS, (from the same,) be- cause its action is expressive of patience. See Leva- tor SCAPULuE. PA'TOR NA'RIUM, (from pateo, to be open). See Nares. PATRA'PIUM. See Apium. PA'TRUM CORTEX, vel PU'LVIS, (because it was introduced by the Jesuits). See Cortex Peruvi- anus. PATU'RSA. See Lues venerea. PAU DE SA'NGUE. See Gummi rubrum as- tringens. PAULI'NA. Confectio, (from trxvu, because it pro- cured rest). A warm opiate; the paulina of Aristar- chus, and the same with the confectio Archigenis. The London college have rejected it from their Pharmaco- poeia of the year 1788. PAVA'NA, i. e. Mollucce'nse li'gnum. See Ca- taputia minor, under Grana tiglia. PAVA'TE, PAVETTE. See Malleamothe. PAVI'NA. See Hippocastanum. PA'VOR, (from paveo). Fear. See Pruritus and Pathema. PECHE'DION, (from wvxefo**). See Perineum. PECHURIM CORTEX. (See Faba pechurim) It agrees in quality with the bean, and is used in dysen- teries and dyspepsia. PECHYA'GRA, (from wxvs, the elbow, and xypx, seizure). See Arthritis. PE'CHYS, (from ■arnxvs, the elbow). See Olecra non. PECHYTY'RBE. See Scorbutus. PE'CTEN. See Pubis ossa. Pe'cten veneris. See Scandix. PECTINA'TIO, (frompecten, a comb). Combing ; a species of friction. PECTINA'US vel PECTINA'LIS MUSCULUS, (from pecte7i, the pubes,) from the colour lividus, rises from the upper part of the os pubis, on the outside of Poupart's ligament, runs downwards, backwards, and outwards, and is inserted into the linea aspera below the little trochanter: it draws the thigh outward and in ward, and assists in rolling it. PECTINATI MUSCULI, (from their resemblance to pecten, a comb,) the fasciculated muscular fibres of the right auricle of the heart. PECTORA'LE DECO'CTUM. See Hordei de COCTUM COMPOSITUM. PECTORA'LIS, (from pectus, the breast,) an epi- thet for medicines appropriated to disorders of the breast. Employed in this general sense the term is improper, and the more limited one of modern authors, viz. expectorantia, should be commonly used. If the pectoralia may, with M. Lieutaud, be of three kinds, demulcents, astringents, and resolvents, it will be very obvious that the general term will lead to confusion. Pectora'lis major, vel addu'cens hu'meri, rises in a radiated manner from the anterior and inferior part of the clavicle, then from the sternum, and at the lower part from the third, fourth, and fifth ribs from the car- tilage, and partly from the bony portion of the sixth rib, sending its tendinous fibres over the upper part of the external oblique and rectus abdominis, passes to- wards the arm with its upper edge contiguous to the deltoid, and between them the cephalic vein penetrates. Near its insertion the pectoralis doubles in on its lower edge, forming a posterior and anterior lamella, and runs to be inserted into the anterior part of the biceps groove. This doubling has occasioned Winslow to di- vide the muscle into two parts. From its tendon it sends off fibres, which contribute to form the fascia that covers the muscles of the arm; and this muscle, with the latissimus dorsi, forms the cavity of the axilla. The pectoralis is partly a rotator of the arm, but its great use is to bring the arm forward close to the body. It assists also in moving the trunk of the body when the arm is fixed, and Haller thought that it assisted re- spiration. Pectora'lis mi'nob, serratus amicus and serratus PED 119 PEL amicus minor, lies beneath the pectoralis major, rises by three digitations from the third, fourth, and fifth ribs, then passes obliquely upwards and outwards, and joins with the short head of the biceps, to be inserted into the coracoid process of the scapula. It is some- times called a muscle of the scapula, or of respiration, according as the one or the other termination is consi- dered to be the fixed point. Pectora'lis inte'rnus. See Trianularis sterni. PECTORA'RIA HE'RBA, (from its use in affec- tions of the breast). See Angelica sativa. PECTORIS OS. See Sternum. PE'CTUS, (from w«*r»«, compact). The breast; chelys; from its resemblance to the back of a tortoise, X(*av»; also the metatarsals. PECTU'SCULUM, (dim. of pectus). See Meta- tarsus. PEDICULO'SUS MORBUS, (from pediculus, a louse). See Phthiriasis. PE'DIBUS BO'VUM O'LEUM EX. Neat's foot oil, prepared by boiling the joints of horned cattle in large vessels. See Anchylosis. PEDI'CULI INGUINA'LES et PU'BIS. See MoRPIONES. PEDICULA'RIA, (from its destroying lice.) See Staphisagria. PEDICULA'TIO, (from the same). See Phthi- ItlASIS. PEDI'CULUS, (from pes, a foot,) from their great number of feet. A louse. Pediculus humanus Lin. Systemae Naturae, vol. ii. p. 1016; an animal " familiar to man," though often inconvenient from its bite. Lice have been supposed hermaphrodites; and are certainly oviparous. A louse will lay, in six days, fifty eggs, without exhausting its store, and in twenty-four days the young ones are capable of laying eggs themselves. From calculation, it is supposed that two female lice may produce eighteen thousand in two months. The largest animals of this kind were discovered by Lin- naeus, in the warm caverns of Falhum, in Sweden. Those which conceal themselves in clothes are appa- rently different from the lice of the hair; for in India, however dirty the person, he is only infested with the latter. It is a common remark, that navigators lose them in the tropics, and recover them on their return to the same spot; but it is not supported by observa- tion. Monkeys, the Hottentots, and some races of ne- groes, are said to eat them; and in some receptacles of lunatics, it is reported that they are put into the hair to produce irritation. When new-born children were affected with a suppression of urine, a louse was for- merly introduced into the urethra; and the same re- medy has been used, in similar complaints of horses. It acts, as is supposed, by its irritation. It is said also that they quit any person ill of an infec- tious disease, multiplying most in the strongest consti- tutions. It is at least certain that animals, particularly fish, are seldom infected with them but at the period of their greatest perfection. They are said to be useful to children in epilepsies, diseases of the head, and in scrofula, by producing sores; and it is added, that the worst consequences have arisen from drying these sores. Asa remedy, this animal is not likely to be again em- ployed, and it is carefully destroyed, when discovered. The most fatal poisons to it are the mercurial calces. the seeds of veratrum, staphisacre, menispermum, rue, opium, angelica and laurel, saffron, pepper, sedum, lycopodeum, pinguicula, and nicotiana. In botanv, the term is synonymous with pedunculus. PE'DICUS, (from pes, a foot). See Extensor Dr- GITORUM BREVIS. PEDI'LUVIUM, (from pedes, and lavo, to batheu lavapediwn, a bath for the feet. The extreme ves- sels of the feet sympathize with those of the rest of the system, the stomach, and the head. If the feet are cold, colic pains come on, the skin is rough, perspiration de- fective, and the salutary evacuations from the uterus and haemorrhoides checked. Pediluvia are consequently extensively useful. Baths for the feet should be used at bed-time, to procure a general perspiration. If used a few days before the menstrual discharge, they are said to promote it, and are particularly useful in affec- tions of the head, as well as the commencement of febrile complaints. It is sometimes injurious, by deter- mining too powerfully to the head, and should be used with caution in its diseases, or the temperature should not be raised above 98°. See Balneum. PE'DION, and PELMA, (from pes). The sole of the foot. See Pes. PE'DORA, (from pes). The sordes of the eyes, ears, and feet. PE'DRO DEL COBRA. See Cobra de Capello. Pe'dro del po'rco. See Bezoar hystricis. PEDU'NCULjE CEREBE'LLI. See Cerebel- lum. PEDUNCULA'TUS, (from pedunculus). Growing upon foot-stalks. PE'GANON, (from -nrnywu, to condense). See RUTA. PE'GE. A fountain. See Oculus. PE'LADA. A loss of hair from a venereal cause. PELECA'NUS, the name of an instrument for drawing the teeth ; and of a glass vessel, formerly used for the digestion and circulation of liquors, poured in at their narrow necks, which were afterwards hermeti- cally sealed: at present two mattresses are used, in- stead of a pelecan, the neck of one being inserted into that of the other. ESH°A'™ ' (f5°m *"*"> black> See Sugillatio. PELLAGRA, (from pellis, the skin, and ccypa, a dis- ease). This singular disease has attracted particular attention, within these last thirty years, not wholly from its novelty, but from its becoming more violent, and from its being more generally accompanied with pecu- liar nervous affections. It comes near the lepra asturi- ensis of Sauvages, but seems more closely to resemble the elepha7itiasis, as we have described it, vol. i. p 598. As a new disease, it is necessary to notice it with some minuteness, but we shall, at the same time, con- fine our account within limits of no great extent, and refer, at the end, to a numerous list of authors, who have treated of it, in a chronological series, from the era of Frapolli, who first publicly noticed it, in a tract published at Milan in 1771. The symptoms which show the approach of the dis- ease are those of debility only; languor, listlessness, gloom, a weakness and stupor in the legs, unsteady walking, imperfect ideas, and vertigo. After these PEL 120 PEL appearances, which are, however, sometimes absent, at the approach of summer, a sense of tension, burning, and itching in every part exposed to the sight, except the head, is felt, and followed by an inflation of the epidermis, and tubercles of a shining red colour. If exposed to the meridian sun, those affected become languid, faint, and fall down insensible, though they soon recover, on being carried into the shade. After some days, the tubercles desquamate, the skin appears at first red, but soon recovers its natural colour. The advancing summer removes every complaint; and, though some relapse in autumn, in the winter every disagreeable symptom vanishes. While the disease continues, the pulse is small and weak; when it recedes, the usual strength returns; and no return of the com- plaint is, in many cases, observable for several years. In the second stage, every symptom is exaggerated ; the itching is more pungent, the heat more fiery, the skin harder, cracked, and chapped, the debility greater, the mental functions disturbed, with peevishness and impatience, the sleep broken, the appetite irregular and unequal, pain of the head and spine, with delirium and confusion of ideas. The local disease is not now troublesome ; but the nervous complaints are greatly exasperated. Vertigo increases, the patient is sad, loves solitude, and the melancholy delirium occasion- ally alternates with the more violent: the tedium vitae is insupportable, and self-murder is a frequent conse- quence. Strambio remarks, that those who labour under pellagra have the greatest tendency to drown -themselves, " as by a delirium opposite to the hydro- phobia." Coercion is at last necessary; and a diarr- hoea, atrophy, or dropsy, closes the dreadful scene, if the patient does not sink, from a loss of both mental and corporeal power. It is necessary to mark a few of the symptoms more distinctly. The affection of the skin first appears truly erysipelatous; but with different degrees of burning heat, redness, and desquamation, sometimes attended with large phlyctenae, full of an acrid, often a yellow, fluid, as from burns. The crusts on the hands appear first to resemble the effects of heat and hard labour, though, when minutely examined, they are very differ- ent. They affect the parts exposed to the sun, particu- larly the backs of the hands and feet, seldom the head, except on the tip of the nose or the forehead. Those who have dreaded the disease have avoided the sun; but though they have escaped the cutaneous affection, have suffered in the other respects, and scarcely in any instance have the lips escaped being dry and chapped. The pains of the head and back are almost constant attendants, and often even precede the cutaneous affec- tions. Those of the head are pungent, lancinating, piercing, gnawing, with a sense of burning, as if flames were kindled in the brain, with a most troublesome singing in the ears, and a pulsation in the substance of the brain. The spine suffers from an uneasy titillation, and occasionally from a stroke resembling that of elec- tricity. The pain passes through every part to which nerves are distributed, and from this pain the weakness of the muscles, and the spasms which affect different portions of the body in all their varied forms, occa- sionally rising to epilepsy or syncope, seem to proceed. Hemiplegia sometimes attacks one side; sometimes the palsy is more general. Vertigo was also a very early symptom, but most conspicuous in those who exposed themselves to the burning sun. From this the double vision and the tin- nitus aurium apparently arose. The delirium sometimes proceeds like an acute disease, terminated by a most offensive sweat, resembling mould, or the cocoons of silk-worms macerated in water. At other times it is chronical, and gives a fierceness to the countenance not to be described. From this description, the essential or pathognomonic symptoms are obvious, and pellagra may be defined, " inflation of the skin with tubercles, in parts exposed to the air, except the face; at first remitting; preceded by melancholy and debility; at last constant, with increased irritability and alienation of mind. It is thus related to lepra, elephantiasis, Sec. Pellagra is sometimes complicated with nervous fe- ver, with inflammations, and, towards its close, with dysentery. It is sometimes, from the descriptions of Odoard and Soler, accompanied with every variety of scorbutic symptoms; an union which appeared to them more singular, as scurvy is almost unknown in the duchy of Milan, though occasionally observed at Ve- nice, and in both districts it is endemic. These appear- ances are, however, symptoms of debility only; and with them may be united petechiae, vibices, Sec. which often attend the disease. Strambio mentions an her- petic affection as a concomitant, and Soler the Grecian elephantiasis. Dissection seems only to have shown the effects of the disease in numerous visceral obstructions. The pellagra is indisputably hereditary ; and, though it seldom appears till after puberty, even in infancy the experienced eye can, it is said, trace the germ of the complaint. It is not always, however, conveyed to the , offspring; but the means by which it is avoided are by no means clear. It does not depend on air or situation, though an endemic disease ; for in every variety of soil and situation, in the districts of Milan and Venice, it is observable. The condition of the peasantry is, indeed, in these truly miserable. Their strength is exhausted, at a very early age, by labour, to which they are un- equal ; and their diet chiefly consists of bad, ill fer- mented bread, made of maize ; their drink of stagnant ..-■ water, or, on the mountains, an inferior kind of wine, la posca. Their habitations are close, confined, and filthy in excess, which they share with their cattle. Their countenances are, consequently, gloomy, their complexions yellow, face tumid or contracted, the limbs stiff, the catamenia irregular, abortions frequent, ! births laborious, old age premature. The foundation of the disease is certainly debility, and causes of debi- lity often induce it, when dormant; but similar causes frequently occur, without producing pellagra. Weak- ness is, therefore, a predisposing cause only, and the activity of some latent contagion is necessary; a con- tagion constitutionally conveyed to the offspring. Though very unusual, persons, otherwise firm and strong, are sometimes affected ; nor is it, apparently, communicated, by infection, from husbands to wives, or the contrary. Yet it is singular that, at the little town of St. Rivolta, in the district of Lodi, after a man, infected with the disease, had resided there, it became comparatively frequent, though unknown before. Ti- tius seems to suspect that it may have been originally communicated by cattle. ' Some authors have attributed the pellagra to the P E L 1JL PEL influence of the sun, and supposed similar to a coup de soleil; but the disease begins in the spring; and those, we observe from authors, who endeavour to escape it byavoiding the burning heat, only experience a slighter cutaneous affection> The other symptoms come on with ecmal severity. It seems probable that the virus is collected in winter, and produces its effect in spring, drawn to the surface by the warmth ; and it is certainly connected with the manners and habits of a country life, since the inhabitants of villages are very rarely, those of cities scarcely ever, affected. If evacuated by the skin, that is, if the tubercles discharge and desqua- mate regularly, the nervous symptoms do not appear, or are more slight; but when the skin is more hard and solid, the worst consequences follow; and if the tuber- cles are repelled, sudden death is often the consequence. To this must be added, that persons not exposed to the sun often experience the nervous symptoms without the impetigo. The solar light, therefore, only produces the eruption. Authors have divided this disease into hereditary and acquired, into moist and dry; but these distinctions do not contribute to our knowledge of its nature or treat- ment. Each is little understood. It has been consi- dered as a particular species of scurvy, from the spots on the surface; as hypochondriasis, from the visceral obstruction, and the gloomy delirium ; as elephantiasis, from the tubercles ; as the lepra asturiensis of Thierri; and as a periodical chronic nervous erysipelas. The two first opinions are wholly without foundation; but as we have stated the pellagra to be of the family of ele- phantiasis, we must now notice the distinguishing marks. They agree in being founded in an exhausted consti- tution, in the pustules being symptoms rather than es- sential marks of the original disease, in their fatal ter- mination by dropsy, atrophy, or some other asthenic jdisease. They differ, as the elephantiasis affects the face, the roots of the hair, the palate bones, and as the disease of the skin increases with the increase of the other complaints. In pellagra, it lessens when the nerv- ous symptoms are most violent. The pellagra also is distinguished by the thick urine, double vision, and the peculiar mouldy smell of the sweat. The lepra asturiensis agrees with the pellagra in many of its symptoms. The pustules are, however, very painful, offensively fetid, and attack the head in- discriminately with other parts, as well as the roots of the hair. The mind is but slightly affected, and its dis- ease is that of timidity rather than delirium. The last opinion, that of Titius, is not supported by any conclu- sive evidence. It must, therefore, as we have said, be placed among the impetigines, between the lepra and elephantiasis. The cure, unfortunately, is very difficult: indeed, when the disease has proceeded «o far as to affect the nervous system, it is impracticable. All the evacuants are injurious, and the tonics have not been sufficiently tried. The metallic tonics, as mercury or arsenic, pro- mise most success, if given with medicines which assist the cuticular discharge. Mercury, conducted so as to salivate, has been found injurious. When the first symptoms have appeared, persons have escaped by re- moving into towns, or wholly leaving the district. Per- haps removing into a warmer climate, without being exposed to the sun, might be useful. VOL. II. See Thierri Rccucil Periodique d'Observationes d> Medecine, a Paris, torn. ii. 1755. Vanden Heuvell Ten- tamen Nosologicum, Sistens, Morborum a vitio vis Vi- talis Divisionem Sistens, Leid, 1787. F. Frapolli Ani- madversiones in Morbum vulgo Pellagram, Milan, 1771. Zanetti de Morbo vulgo Pellagra, 1775. Extat in Nova Acta Naturae Curiosorum Norimberg, 1776. D'Una Specie parlicolare di Scorbuto, Dissertazione del Dottore Jacobo Odoarde; Extat in Nuova Raccclta d'Opuscola Scientifici et Filologici, torn. xxx. Venice, 1776. Delia Pellagra Descrizione di Michele Gherar- dini, Milan, 1780. Atti della Societa Patriotica di Mi- lano, vol. i. Milan, 1789. Trattato Teorico-prattico delle Malattie del Insolato di Primavera, Volgarmente detta Pellagra, del Medico-fisico Giovanne Maria Al- bera d'Oleggio, Varese, 1784. De Pellegra Observa- tiones quas in Regio Pellasgrosorum Nosocomio Col- legit D. Cajetanus Strambio Mediolani, 1786—1789, an. i. ii. iii. De Pellagra, Morbo in MediolanensiJDu- catu endemio, Auctore X. W. Jansen Leidae, 1787. Videmar de quadam Impetiginis Specie, Morbo apud nos in Rusticis nunc frequentori, vulgo Pellagra ap- pellate, Mediolani, 1790. Memoria sopra la Pellagra del Territorio Padovano da D. Francesco Fanzago, Padua, 1789. Discorso Comparativo sopra la Pella- gra, 1'Elephantiasi de Greci, o Lepra de l'Arabi, et lo Scorbuto, ed Alcune Riflessioni Intorno la Cura, del D. Paolo Dalla Bona, Venice, 1791. Osservazioni Me- dico-pratiche formano la Storia essatta di una particular Malattia chiamata Pellagra, del Luigi Soler, Venice, 179 1. Sartago in Ephemei id. Venet. (Aneddoti Patri), No. 22, 1792. Parallelli fra la Pellagra et Alcune Ma- lattie che piu lo rassomigliano del Dot. F. Fanzago, Padua, 1792. Pellagrae Morbi inter Insubriae Austriacac Agricolas grassantes Pathalogia Auctore D. Salom. Const. Titio Lipsiae, 1792. PELLICULA MEMBRANA'CEA, (dim. of pel- lis, the skin,) any thin-membrane, as the amnios. PE'LMA, (from -zreXu, to 7noveforwards). See Pes. PELTA'LIS, (from pelta, a target). A leaf, whose stalk is inserted in the middle, and not in the margin. PELTA'TA CARTILA'GO,(from/;^c,a buckler). See Aspeka arteria. PELVIMETER. An invention of M. Coutonli to measure the different diameters of the pelvis; and an- other in the form of calipers is recommended by M. Baudelocque. Each is, however, more curious than useful, and neither is much used in this country. The form and shape of the woman shows deformities from irregularity of the brim of the pelvis, and the operator, used to the measure of his fingers, can ascertain, in touching, the distance from pubes to sacrum, as well as any irregularities of shape at the lower diameter. PE'LVlS, (from -ueXvi, a bason). A name for the inferior part of the cavity of the belly, bounded forward by the os pubis; backward by the os sacrum above, and coccygis below ; laterally by the ilia above, and ischia below. In infancy the bones are more numerous than in the adult state, and the edges of several are cartila- ginous, so that the pelvis of the child may yield a little in difficult labours. Yet the motion of the parts on each other is so inconsiderable, that no great advantage can be this way obtained. The pelvis consists of the os sacrum, os coccyx, and the ossa inominata: the latter contain the ossa ilia on Q P K i. 122 P E L '.lie sides, the pubes, branching from the front above and below; and the ossa ischia, joining the lower ramus of the pubes to the sacrum. See plate. The union of these bones is more or less perfect. In adults the sacrum is sometimes anchylosed with cither os inominatum; and, from long confinement, violent shocks, or diseases on the other hand, it is considerably loosened, so as to make walking unsteady and difficult. The os coccygis, which in adults con- sists of bones separated by cartilage, sometimes coa- lesces into one bone, and is also firmly united to the sacrum. In this process its length is diminished, and it usually turns inward, forming a very considerable im- pediment to the progress of the child. This impedi- ment is sometimes overcome by the propelling pains, and some motion between the sacrum and the coccyx is restored. Lateral motion is prevented by strong muscles and ligaments. The ossa pubis are connected in front, it is said, by a cartilage, but it is rather by a mixture of cartilage and ligament. The former belongs to each bone, and at their junction unites. It is thicker in front, from the upper to the lower part, than be- hind ; and the ligamentous fibres, mixed with it, are, of course, longer in front. In their reticulations they leave intervals, which contain small red bodies, de- scribed as resembling synovial glands; and some au- thors have mentioned a kind of capsular membrane in its back part, while the cartilages on each side seem calculated, by their separation, to admit of a small mo- tion. This cartilaginous separation is, it is said, disco- vered near the middle of the symphysis, extending a little lower behind. Other authors have denied the existence of this apparent joint; and though we have seen a cavity in the cartilage, it did not appear to be regularly organized, at least in that instance. The li- gamentous fibres, which we have described, are rein- forced by others, and by tendinous expansions from all the muscles on either side; so that if Nature designed by this structure an obscure motion, she has taken anxi- ous care to prevent its being considerable, apparently to prevent it entirely. The union of the sacrum with the ossa inominata is more close and compact; nor do we find that when the connection is loosened, that the former intimate union again takes place. The os sacrum is united to the lowest lumbar vertebra, nearly in the usual manner; but there are two little articular masses fixed in the posterior edge of the impression, by which they are mutually received into each other, which answer to si- milar substances in the vertebra. The union of the sacrum with the spine is secured also by ligamentous fibres, so that the motion is inconsiderable; but the convexity of the spine in the loins is in part lessened by the small motion which each vertebra admits; and by altering the angle at which the woman reclines, or by bending forward, we can thus often effectually change the direction of the axis of the pelvis. In midwifery the knowledge of the structure and pe- culiarities of the pelvis is an important circumstance. The brim of a well shaped pelvis represents an irregu- lar oval, or something that approaches to a triangle; if it is considered as an oval, its greatest axis is from side to side; if we consider it as a triangle, the posterior part is far longer, and the ossa pubis constitute the other two sides of the triangle; the lower circumference is formed behind by the sacrum and os coccygis, on each side by the ischium and sacro sciatic ligaments, and before by the lower part of the pubes. When the body is gently reclined, the brim of the pelvis is hori- zontal, and a line would pass from the navel through the middle of the cavity; but when a woman is in labour, or near her time, this imaginary line must fall from be- tween the navel and scrobiculus cordis; and accord- ingly we find that the head of the chp"d presses behind the anus, and gradually advances from thence up the perinaeum, until it comes to the lower part of the sym- physis of the ossa pubis. The chief use of this supposed line is to place the woman in the most favourable posi- tion during labour, that she may act more advantage- ously with her abdominal muscles, and that the child's head may fall more directly into the middle of the pel- vis. It will be a rule also to direct the forceps on the child's head, and the hand into the uterus. The obli- quity of the pelvis from behind forwards is equal to an angle of nearly 40°. In considering the pelvis, we should observe its width, the depth and form of its cavity, and the extent of its brim from the fore to the back part, which, in a well- formed pelvis, is an inch less than it is from side to side; four inches and a half from the fore to the back part; and five inches and a half from side to side. The lower circumference of the pelvis is nearly equal; but when we allow for the os coccygis being moveable, it makes a quarter of an inch more in its longer direc- tion from the os coccygis to the os pubis than from ischium to ischium. The depth of the pelvis, from the upper edge of the sacrum, where it articulates with the vertebrae lumborum, to the lower part of the os coccy- gis, is about five inches in a straight line. When the os coccygis is pressed back, it is then six inches: from the brim of the pelvis, to the lower part of the symphy- sis of the os pubis, is only two inches ;• while from the under part of the ischium it is four inches. The brim is concave internally all round. , The inferior aperture is usually, in the natural state, smaller, and of a more irregular figure than the superior, as it is not wholly formed of bone. The base is broken by the coccyx, the tuberosities of the ischia, 8cc. into dif- ferent angles, which are filled up by ligaments, forming in front what is styled the arch of the pubes, which ex- pands from an inch and a quarter to four inches in breadth in a well formed pelvis. The transverse dia- meter is largest in its natural state; but, from the yield- ing of the coccyx, is the smallest in delivery. The largest diameter also of the inferior aperture is opposed to the smallest of the superior; and from hence arises the necessity of the half turns in delivery, which we have mentioned as necessary in Parturition, q. v.;.and the greatest diameter of the superior, crosses the small- est of the inferior at an angle more or less acute. From an attention to this circumstance, we can often, with the finger alone, remove apparently insurmountable obsta- cles. The curvature of the sacrum also removes many inconveniences if attended to ; and on this account the child comes with so much facility when the face is in that hollow. This concavity also prevents pressure on the sacral nerves. The pelvis may be faulty either from too great or too small a size. In the former case the child is often too suddenly excluded, and dangerous haemorrhages arc PEL 123 PEL the consequences. In this case also the uterus is often propelled with the child, particularly when the woman has had many children; in the earliest and latest months also the child rests on the rectum or meatus urinarius, producing constipations and strangury: in the intermediate period it rests on the edge of the pelvis. The pelvis is, however, more often faulty from its narrowness. This defect is seldom conspicuous in every part of the bason, and most generally in the superior aperture. The small diameter is most commonly con- tracted, and sometimes one side only of the bony cir- cumference is pressed in. When the inferior diameter is lessened, it is usually effected by the approach of the tuberosities of the ischia. M. Baudelocque accounts for the former deformity, by attributing it to a softness of the bones in the early state; and he remarks, that the direction of the weight of the body carries the sacrum forward, and the ossa pubis backward. This is not, however, a perfectly correct view of the circumstances. The disease arises from the prominence of the abdomen, usually attendant in such cases, which renders it neces- sary to throw the shoulders back to preserve the equili- brium. In consequence, the line of pressure is upwards and backwards, instead of being upwards and a little outwards. In weak states it is common to recline on one side to relieve often the weaker leg, or to change the position. From this it arises that one ramus of the pubes is chiefly pressed in, that one of the acetabula often approaches nearer the sacrum, and that a line drawn perpendicularly from the symphysis of the pubes towards the sacrum, divides the pelvis into two very unequal parts. The inferior aperture in the same soft- ened state of the bones will be affected by the child's sitting, lolling on one side in preference to the other, or twisting the body into unnatural attitudes for the sake of present relief. The dimensions of the pelvis itself often greatly vary. In the diameter from pubes to sacrum the diminution sometimes scarcely exceeds half an inch ; in others the bones approach so near, that often scarcely an inch of aperture is discovered. A pelvis cannot, however, be considered as very narrow, unless each diameter be less than three inches and a half. M. Baudelocque informs us that he has seen pelves, where the distance from pubes to sacrum above was not more than six or eight lines; and in one which he possessed, the distance from the right acetabulum to the sacrum was only between three and four lines: in another the distance from the projection of the sacrum to the symphysis of the pubes was but fourteen lines. An increased projection of the sa- crum, from the causes assigned, viz. a swollen abdomen, in consequence of great debility, contracts the superior aperture to very small dimensions; and this projection is sometimes straight forward, sometimes to one side only. In the latter case an aperture is often left on the other side sufficient for the passage of a child. Labour will be tedious when the aperture is little more than three inches; yet the bones of the child's head, by yielding, may be moulded into an oblong form, and at last pass, and the head will soon recover its natural shape. If within three inches, the diffi- culty is greater; and when so little as two inches and a half, the mother and child are in a dangerous situa- tion. The difficulty from the diminished aperture of the superior part appears very early in labour. The pains, though strong, do not propel the child, and the woman's strength is exhausted before the child's head can pass into the pelvis. Nature, however, is all power- ful in this respect, and the head will pass through an almost impermeable strait. It is then more within reach ; and the difficulty arising from a deformity in the inferior aperture is more easily removed, as the head is often within reach of the shorter forceps. When the head comes into the cavity of the pelvis the pains for a time cease, and the head, recovering its former shape, requires the renewed action of the pro- pelling powers to protrude it beyond the second ob- struction. When the deformity is only at the inferior aperture, the symptoms of difficulty appear later, and la- bour is peculiarly difficult. The practitioner must, therefore, be cautious in his prognostic, not to promise a quick termination from a prosperous commencement, nor a particularly tedious one from difficulties in the earlier period. The middle of the pelvis is more seldom faulty than the superior or inferior diameters. The defect in this part is sometimes owing to exostosis, and more often to the direction of the sacrum, which is straight, or occa- sionally convex instead of concave. Another variety in the form of the pelvis, which ren- ders labours tedious, is the less elevation and sweep of the arch of the pubes, in fact, an approach in form to the male pelvis. A different direction of the spines of the ischium, their too great length, or an ossification of the coccyx, may have a similar effect; but the latter is not often the cause of any considerable delay. In the article on parturition we have stated that the operation of the symphysis of the pubes is no longer practised in this country, and that the separation of these bonesby an operation is calculated to gain but little space. The great question, however, which we have not yet no- ticed, is, whether all or any of the cartilages yield dur- ing labour. Should they do so, considerable space may be gained. It is contended that this separation is pos- sible ; by others that it is the effect of disease only ; by others again that it is natural, and very commonly takes place. Truth, as usual, lies between. It is certainly not common; but there is much reason to suppose that it does occasionally take place, independent of dis- ease. That the bones do sometimes separate we know, since, in consequence of the disunion, abscesses occa- sionally form in the interstices. These abscesses are formed chiefly at the union of the ossa inominata and sacrum, or at the symphysis of the pubes. The former is the less violent disease, and is often cured. The latter produces hectic fever, and the cause is often not discovered till after death. The matter sometimes bursts into the cellular substance, occasionally into the bladder; sometimes passes down'under the periosteum to the acetabulum, and from thence to the surface on the upper and inner part of the thigh. A straight pelvis will cause a difficult labour; and it is known by introducing the finger up the vagina: if you can feel the os sacrum, the pelvis is straight; or if you can touch the ossa pubes with your fore finger, and the vertebrae of the loins with your middle finger, it is considered as narrow, and vice versa. Pelvis is also the name for a cavity in the kidneys, for the cochlea of the ear, Sec.; and hencepelvis renum, Q 2 I* E M 121 P E X aurium and cerebri. See Denman, Baudelocque, and Hamilton's Midwifery. Pe'lvis. See also Cerebrum and Renes. PEMPHUiO'DES, or PEMPHINGO'DES, (from Trefvpt&a blast of wind). Fevers distinguished by fla- tulencies and inflations, in which an aerial effluvium seems to pass through the skin of the patient, and to strike on the finger. (Galen's Commentaries on 6 Epid. sect. i. aph. xvii.) Other authors give this name to a fe- ver, by the intenseness of whose heat aphthae are excited in the mouth. It is supposed, according to Foesius, to be a synochus, in which the blood vessels are inflated, and consequently called an inflated fever. PE'MPHIGUS, (from we^I, bulla, a vesicle). The vesicular fever, febris bullosa, exanthematica, serosa, morta. Dr. Cullen places it in the order exanthe- mata, defining it a contagious typhus : on the first, second, or third day of the disease, little vesicles, the size of a nut, appear on different parts of the body, continue a few days, and at last exude in the form of a thin ichor. To this he annexes the following observa- tions : " From the opinion of others, rather than my own, this character is taken; because I have seldom seen this disease, and never have observed it epidemical, or pursuing a regular course, as is here described."— With regard to the species, he says, " Since I never have seen a pemphigus which I could consider as an exanthematous fever, and have found only very few observations in the writings of physicians concern- ing a disease of this kind, almost every thing inserted in our Nosology must necessarily be taken from Sau- vages; therefore, I have followed him, though I would willingly have omitted this malady, since almost all that has been said about it appears to me doubtful, ob- scure, and ambiguous. Francis Home, however, my eminent colleague, shewed me a man slightly feverish, in whom vesicles, the size of a hazel nut, arose first on his arms, and afterwards, successively, on his whole body, which, in two or three days after, exuding a little serous humour, collapsed. But this fever discovered no peculiar disposition or type, and, being by no means contagious,soon disappeared." Synopsis Nosologia Me- thodicae, p. 148, 149. Dr. Withers remarks, that " in the case of E. P. the vesicular eruption, which was very sore and painful, was preceded and accompanied with some feverish symptoms, evidently of the low kind. It continued only for a few days, and then gradually went off." By tonics and antiseptics, he adds, that he cured two pa- tients, not long before, of the pemphigus, in which the fever was extremely putrid, with many gangrenous sloughs, of a fetid smell and most dreadful appearance, following the eruption of the blisters, attended with a low delirium for many nights, the greatest dejection of countenance, and prostration of strength. Since this time it has been noticed by different authors, though the most distinct account of the disease is given by Dr. Dickson in the Irish Transactions. From his description it appears to be a true exanthema, not constantly at- tended by fever of a given kind, but occasionally mild, though often highly putrid. The treatment is varied according to the nature of the fever; and when the pus- tules appear on the internal parts, which sometimes happens, irritation must be guarded against by opiates and demulcents. See Acta Helvetica, vol. ii. p. 260 ; Cullen's First Lines, ed. 4. vol. ii. p. 254; Edinburgh Medical Commentaries, vol. vi. p. 79 ; Withers on the Asthma: Gaitshell and Upton in the Memoirs of the Medical Society, London ; Dickson in the Transactions of the Royal Irish Academy; and Christie in the Me- dical and Physical Journal. PEMPTjE'US, (from n-cpa-xt*, the fifth). See In- termittens febris. PEN A'A SARCOCO'LLA. See Sarcocolla. PENICI'LLUS, (dim. of peniculum, a brush). A TENT, Or PLEDGET. PE'NGUIN. See Karatas. PE'NIS, (a pende7ido,from its hanging down,)eaulis, coles, mentula, priapus, is composed of three parts, viz. the two corpora cavernosa, and the corpus spongiosum urethrae. Its skin, which is thin, and without fat, is doubled at the top, forming a hood, the praeputium, which covers the glans penis, cuspis or balanos: the small ligament, by which it is tied to the under side of the glans, is called franum, canis, and filellum. The prepuce keeps the glans soft and moist, prevents exco- riation, and preserves its sensibility. The penis, where it joins the body, is connected by a small ligament, which arises a little from its root on the back part, and ties it to the upper part of the os pubis. It receives two branches of veins from the hypogastric vessels, and its arteries from the hypogastrics and pudicae; the two veins unite towards its root, and make one trunk, which runs on the back of the penis. It hath two nerves from the sacrum, several lymphatics, which pass through the inguinal glands, and three pair of muscles, viz. the erectores, acceleratores, and transversales. Cowper ob- serves, that the cuticle on the glans is villous or downy, and that the cutis is thinner on it and the scrotum than any other part. See Cowper's Observations on the Penis, Ruysch, and de Graaf. PE'NNA, (from -sreloftxt, to fly,) mentula alata. A feather. In the third volume of the London Medi- cal Observations and Inquiries, p. 7, Sec. is an account of a successful attempt to recover a fibre of a feather from the oesophagus, by means of a whalebone, with a sponge at each end. By threads loosely connected with both, the feather was entangled and brought up. If, however, it can be forced into the stomach, no incon- venience will probably arise. PENNATIFO'LIUS, (from penna, and folium). Having leaves resembling feathers. PENO-AB'SOU, pine obsou. A tree in America, whose bark is very fragrant, and whose fruit, about the size of an orange, contains from six to ten nuts, from which an oil is expressed. The fruit is poisonous, but the oil is said to cure the wounds received by poisoned arrows. Its genus is unknown. PENTADA'CTYLON, (from ™7», five, and fotx- IvXos, a finger, because it has five leaves upon each stalk). See Cataputia. PENTAGY'NIA, (from rrevre, and ywv,, a woman). The name of an order in the 5th, loth, 11th, 12th, and 13th classes of the Linnaean system, containing those plants which have five pistils in an hermaphrodite flower. PENTA'NDRIA, (from ?revle, and xwp, husband). The fifth class in the Linnaean system, comprehending those plants which have hermaphrodite flowers with five stamens. PENTANEU'RON, (mvle, and vevpov, a nerve, from its five ribbed leaves). See Plantago minor. PER 125 P E R PENTAPHA'RMACUM, (from vevle, and ionic pneumony, attended with a pulse not always hard; sometimes soft; an obtuse pain in the thorax; a con- stant difficulty of breathing, often not perceived unless in an erect posture; the face swelled, and of a purple colour; most commonly with a moist cough, and often bloody sputum. Of this he makes three divisions. 1. Simple ieliopathic peripneumony. 2. Idiopathic peripneumonies, complicated with fever, as the putrid, ardent, anel malignant peripneumony. 3. Symptomatic peripneumonies, viz. the arthritic, exanthematic, phthi- sical, hydrophobic, and rachialgic. Other authors dis- tinguish three kinds of peripneumony : the true, or in- flammation in the lungs; the spurious, or when mucus obstructs the vessels of the lungs ; the catarrhal, from a thin acrid defluxion on the lungs. The true peripneumony is produced by cold applied to the skin, mouth or stomach ; an over exertion of the lungs ; or by any of the general causes of inflammation. The disease commences with the usual symptoms of fever. The cold fit is violent, succeeded by great heat, head ach, dryness of the tongue and skin, urine of a dark or a yellowish redness, countenance full and of a purple colour. These symptoms occasionally continue for a day or two before any pain in the chest comes on, though sometimes the pain attacks on the first accession of heat. The pulse is at first hard and strong; but in the true peripneumony frequently soft, and apparently labours with a distressing load; at last it is weak, flut- tering, irregular, and indistinct. When the pain is felt, a short, dry, distressing cough soon follows, which greatly exasperates it, and continues during the whole com- plaint ; but, on its salutary decline, is freer, easier, and looser. In the beginning of the disease scarcely any sputum is discharged, but a little frothy saliva, followed by a yellow viscid gluten, and at last by a whiter softer matter if the disease proceeds favourably. The pain is occasionally in almost every part of the chest, but usually between the ribs of either side, more frequently, it is said, on the right side than the left. It is increased on laying down, and considerably more so by laying on either side, whether it be the side affected or not. It is singular that this symptom should vary so considera- bly in different cases ; nor could all the anatomical dex- terity of Morgagni, or the pathological ingenuity of Dr. Cullen, explain satisfactorily the reason of what is styled the varieties of the decubitus difficilis. The difficulty of breathing is chiefly felt on inspira- tion, but the expiration is performed frequently by a convulsive effort, and often an obscure sound. The bowels are generally constipated, though in a few in- stances a diarrhoea attends. If peripneumony proceeds favourably, the pulse be- comes slower and softer; the yellow, tenacious, and of- ten bloody, sputum is mixed with points of a whiter mat- ter, and the proportion of this more salutary expectora- tion gradually increases with the amendment of every symptom, for the cough is less violent and straining, the breathing freer, the skin more moist, and the tongue cleaner at the edges. If less favourable in its progress, the sputum becomes more dark and viscid, the pulse lower, indistinct, and often intermitting; a wandering low delirium comes on, with subsultus, and the patient dies, apparently suffocated, from the oppressed vessels no longer permitting the expansion of the lungs. Peripneumony is, in general, confounded with pleu- risy ; with inflammation of the other contents of the thorax; with rheumatic affections of the muscles of the chest; with catarrh, and asthma. It is, however, an active inflammation, which at once excludes the two latter diseases. The rheumatism in the side is attended with acute pain, but with scarcely any cough, and with a hard pulse, nor is the face full and flushed. True pleu- risy resembles, in many respects, peripneumony; but, in general, the face is less flushed, the pulse harder, the cough less violent, and without, at any period, expecto- ration. Pleurisy and peripneumony, however, are seldom wholly distinct, and the diagnosis is of less importance, as the remedies are nearly the same. (See Pleuritis.) Where cough exists, whatever be the name of the dis- ease, expectoration must be brought on, if possible. Va- rious other inflammations of the chest, as of the peri- cardium and diaphragm, are attended with similar symp- toms, but the treatment differs so little, that no injury can arise from mistake. It is necessary, however, to remark, that the seat of peripneumony is often chang- ing, that it shifts from one side to the other, to differ- ent parts of the same side, and when the lower part of the right lung is inflamed, a similar affection is commu- nicated to the liver, occasioning pain in the right epigastrium, with an expectoration yellow, copious, and frothy. See Hepatitis. Peripneumony terminates, like other inflammations, in effusion, suppuration, or gangrene. It has, however, a termination peculiar to itself, viz. haemorrhage in the lungs, from the increased vis a tergo. Effusion is the salutary termination; and when we perceive an appa- rent resolution by expectoration, some effusion always accompanies it; for after violent peripneumonies, adhe- sions are often found between the lungs and pleura, or watery effusions take place in different parts of the chest. Suppuration is known, as in other parts, by a re- mission of the pain and shivers, followed after some time by heat and increased perspiration. Throbbing pain is seldom felt, except when the seat of the disease is just within the intercostal muscles; and in that case a ful- ness, as well as pain, on pressure, point out very P E R 128 PER distinctly the part affected. Gangrene is shown by the sinking pulse, general debility, with a sunk counte- nance, and the usual placidity, or occasionally with a ghastly stare. The termination by haemorrhage is sud- den ; and it is discovered by dissection, since the lungs are found to resemble in substance the liver. If we perceive, on the fourth or fifth day, the spit- ting more free, less glutinous, whither, approaching in Mie distinct clots to a globular form, the disease is evi- dently remitting. The usual signs of a freer, slower pulse, a white sediment in the urine, and a soft clammy moisture on the surface, are equivocal, without some change in the expectoration ; for unless the sputum as- sumes the salutary appearance, should even the fever re- mit, suppuration or phthisis are frequent consequences. The suppuration, however,from peripneumony, is very different from that which constitutes consumption, and we have* in one or two instances suspected that a salu- tary termination of the former has checked a beginning hectic. On the other hand, however, inflammation of the lungs often excites a similar state in a previously in- dolent vomica,and consumption is thus the consequence of peripneumony. It has been doubted whether the sa- lutary effusion may not by absorption, perhaps by the drying power of the air, assume the purulent appear- ance ; because purulent matter is sometimes said to ap- pear independent of any abscess, or indeed of any loss of substance. This induced De Haen lo consider pus as a secreted fluid; but though we have admitted that se- cretion may take place from arteries without any glan- dular apparatus; yet, on the whole, there is no evidence, at least in this disease, that pus is secreted, or that the dried effusion assumes its semblance. (See Pus.) If pus in peripneumony appears, suppuration has preceded. A bloody sputum is often alarming, as the forerun- ner of an haemorrhage ; but such consequences seldom follow: on the contrary, we have often found it a salu- tary symptom, not differing in its effects from a topical bleeding. A diarrhoea coming on about the fifth or fiixth day is often a highly dangerous event, as it pre- vents the salutary discharge by expectoration, or if the latter has appeared, checks it, without supplying its place. A moist skin, with an improving sputum, is often advantageous ; while a dry heat, oppressed breath, with great anxiety, are alarming. To be able to lie low for a little time on either side is favourable ; but the prognosis is always peculiarly uncertain, since the dis- ease is so often exasperated unexpectedly, and changes its seat, with a new accession of fever frequently in its course. The cough is often most distressing, which we dare not mitigate, as every remedy for this purpose checks expectoration. We have not, however, found that the most incessant cough is a prognostic of a pecu- liarly dangerous state of the disease. Delirium is often a dangerous symptom ; but we have sometimes seen peripneumony alternating with delirium, and in that case the disease has yielded with little trouble. Favour- able signs appearing on the seventh clay give a proba- bility of a safe termination, should no metastasis oc- cur ; but in no disease is the strictest caution more ne- cessary, since in none are there more unexpected changes, in none is the fatal event frequently so sud- den, while our apprehensions are lulled by promising symptoms. If we pass the seventh day without any favourable change the patient seldom recovers. If the changes are not decisively salutary before the four teenth, complete recovery cannot be expected. The remote causes of peripneumony are those of in- flammatory fever in general. An inflammatory dia- thesis, by which we understand increased tone of the arterial system, is usually necessary to give the usual active form of the disease ; but we shall find that it may take place when this state is in an inconsidera- ble degree, or when it is wholly, absent. That more topical causes, as straining, obstructions, or any injuries of the lungs, may induce it, appears doubtful. They may perhaps predispose to it, or, on the accession of exciting causes, may render the subsequent complaint more violent. The effect of the causes of inflamma- tory fever directed to the lungs is the constriction of the extreme vessels, and this, with the increased vis a tergo, as explained in the article Inflammation, q. v. will explain all the symptoms. Dr. Fordyce, in the second part of his Elements, ob- serves, that nature without assistace sometimes relieves the complaint by an increased secretion of mucus from the lungs, which at first is spit up thin, and with uneasi- ness, becomes gradually thicker, of a yellowish or green- ish cast, and at last white. It is often, he adds, mixed with blood, relieving, and gradually diminishing, the symptoms, so as to remove the disease before the four- teenth day. Peripneumony is sometimes cured by an haemorrhage, or by an inflammation arising in some other part of the body. The artificial cure depends on the same principles. Expectoration, we have observed, is the only salutary evacuation, but to procure it, the inflammatory stricture must be first taken off. To these views every part of the curative plan must be directed. Indeed, in true peripneumony nature can seldom relieve without the aid of art; and in those cases in which disease has spontaneously or with little assistance yielded, it has probably been rather catarrhal than peripneumonic. Catarrh, we have seen, consists in an inflammation of the bronchial glands, and if it extends farther into the substance of the lungs becomes peripneumony, though in that case the disease is seldom of the more active, the more acute, kind. Bleeding is the only remedy for the former purpose, and it has been often employed with freedom, often with temerity. In the use, however, of this mode of relief, we must anxiously consider the patient's constitution, habits, and situation. The strong and robust; those who have lived full, and been subject to inflammatory *; diseases; the laborious rustic, who breathes the pure air of a mountainous district; will bear very large and repeated bleedings. In such cases it is often necessary to take from eighteen to twenty-four ounces at once, to repeat the operation after twelve hours, scarcely to a less extent, and again after twenty-four or thirty hours. The limits in these cases are the relief of the pain, some mitigation of the hard pulse and burning heat. We have proceeded even farther with this eva- cuation in particular circumstances; but when in the constitution we have described, the attack is violent, the discharge of blood must be considerable within a short period, and it should be taken from a large orifice.^ The appearance of the blood affords us also some cri- terion for the propriety of the repetition. If the clot is dense, of a bufly surface, contracted round the edges, PER 129 P Ell resembling in form a cup, the patient will usually bear with ease farther evacuations. The buffy appearance, however, is often seen when the texture of the clot is loose, sometimes even in the blood from scorbutic per- sons, so that the density must also be examined. A convenient method for this purpose is the pressure of any substance of a given weight, as of a key kept con- stantly in the pocket. The evacuation must be more guarded in different circumstances, and, in all, the shades from the extreme case already described to the indolent inhabitant of a crowded town, or the sedentary mechanic, exhausted by labour and poverty, our conduct must be cautiously varied. The practitioner must recollect, that this re- medy is designed to obviate the inflammatory diathesis, which is chiefly distinguished by the general firmness and vigour of the whole habit, and by the hardness of the pulse. The former is not always to be certainly ascertained, and the latter is still more equivocal. The resistance formed by the obstruction of the larger ves- sels will often give a seeming hardness where there is a slight degree only of inflammatory action, and the pulse has been denominated harsh rather than strong. In all doubtful cases, therefore, the greatest care is requisite, particularly in ascertaining distinctly the effects of the first bleeding. If these are doubtful, we should lessen the subsequent evacuation, even should symptoms ap- pear to require it. In these uncertain cases we seem to relieve pain; but the pulse, instead of becom- ling fuller and softer, is often more contracted, or more weak ; the countenance may, indeed, appear less flushed, but it is also sunk ; the difficulty of breathing is greater; and the little expectoration which might have appeared is checked. The disputes, whether blood should be taken from the side affected, or the opposite side, chiefly relate to the use of bleeding in Pleurisy, q. v., and we shall notice them under that article. When we feel doubts respecting the propriety of ge- neral bleeding, we may still evacuate blood from the part affected, by means of cupping glasses or leeches. The latter are often preferable, as they do not render the subsequent applications of blisters inconvenient. If the disease is violent, the number of leeches to the side should not be less than eight or ten; but in exhausted constitutions the less number may be more advisa- ble. If cupping glasses are applied, not more than five or six ounces should be taken, as the evacuation is more rapid. When the increased tone of the arterial system is thus in part removed, it may be farther lessened by laxatives and refrigerants. Whatever may be the inconvenience of laxatives in the advanced stage, they are highly useful in the earlier periods, and in the three first days may be freely employed : the milder saline laxatives are prefer- able. The most useful refrigerant is nitre, which may be combined with the citrat of potash, or determined more certainly to the skin by the addition of camphor, and of antimonial wine, or by a combination with the citrat or acetat of ammonia. Emetics may be given in the earliest stage; but when the violent obstruction of the vessels of the lungs has taken place, they are doubtful remedies, and the nau- seating antimonials are preferable. These, with the re- frigerants, arc the only safe and most effectual ctiapho- VOL. II. retics. Of the antimonials, the Kermes mineral has been preferred, though without any peculiar advantage. The more violent fever will be, in some degree, less- ened by these plans, and the local affection will be alle- viated by blisters. These have been objected to in the earlier period of the complaint, as danger was appre- hended from their stimulus ; but there is little founda- tion for the caution. If bleeding be necessary, it should always be premised; and in the extreme case of highly inflammatory diathesis first mentioned, two bleedings at least are required before the blister will act with ad- vantage. It should then be applied on the part affected ; nor, as we have said, are the wounds from leeches any impediment. Should cupping glasses have been applied, a little delay is necessary, before the wounds are closed by an inflammation of their lips. If blisters are applied very early, they sometimes drive the pain to another part, often to the opposite side, and it will be necessary to follow it with another blister, though, if the inflam- matory diathesis is violent, bleeding must be repeated. The cough may be alleviated by oily emulsions, by demulcents, or by inhaling the steam of warm water. Opiates, however, during the whole course of the disease, seem to be injurious; yet De Haen gave, as we have remarked, the tincture of opium, with olive oil; and other authors have occasionally employed this medi- cine ; but, except when a sudden check is necessary for a diarrhoea, we have seldom used it, and even then with disadvantage in other respects. The extract of the white poppy has been given by Dr. Saunders; but this is so slight an opiate as scarcely to militate against the gene- ral opinion; and Dr. Hamilton, of Lynn, combined it with calomel, he thought with advantage; but his practice-has not become very general. We cannot speak of this combination from our own experience. The expectorants are the chief remedies; and the most effectual of these, in the first days of the disease, are the remedies already recommended for the fever, parti- cularly the camphor, and the nauseating doses of anti- monials. When the inflammatory obstruction is in some measure removed, when the expectoration is less glutinous, and assumes a more globular form in the ba- son, with a whiter colour, a gentle stimulus on the bronchial glands is useful. The gum ammoniac is less irritating than the squills, and it was formerly combined with soap, to render, it was said, the sputum whiter. However ridiculous this language may appear, we have suspected that the effect had some foundation, and that with soap the expectorants were more effectual than in any other form. .Those who are fond of pursuing ana- logies may, from the same source, explain the little inconvenience experienced by De Haen from opium when combined with oil. After a day or two the squills maybe combined with the gum, and the dose gradually increased. When every circumstance seems, in this way to be favourable, and every symptom to assume a more salu- tary appearance, our progress is often checked by two events. The expectoration will sometimes suddenly stop; or a diarrhoea coming on will have the same effect. The expectoration stops occasionally from some irregularity, from the strength having been exhausted by previous bleeding in excess, or without our being able to trace the suppression to any cause. In this R P E H 130 P E U case, breathing the steams of vinegar, the ammonia added to the medicines, increasing the dose of the squills, or a blister to the back part of the neck, will often bring it back. Whatever is attempted must be closely followed, for the danger is imminent; nor is there any great impropriety in adopting, nearly at the same time, each means of relief, provided the closes are not so considerable as to exhaust the excitability. In this situation, also, we are advised to put blisters to •he inside of the thighs or tegs; and, though it is not easy to explain their effects on any principle but the erroneous system of revulsion, we have thought them serviceable. In reality, when nature is sinking, the obstruction often yields, and the last remedy gains the credit; so that when medicine seems to fail, if we sup- port the patient with good broths, or jellies, interposing, when necessary, a little wine, we shall often succeed. Slight emetics will be frequently of service at this time, and restore the expectoration, whose return was before hopeless: the seneka root seems to have gained repu- tation from its effects in these emergencies. A diarrhoea supervening is a more distressing event; and it is not uncommon either from some irregular and erroneous exertion of nature, or from the medicine. It has been usually attributed to the squills, but these will not produce this discharge when most wanted ; to the gum ammoniac, which is scarcely in any case laxa- tive; to the oily emulsions, the usual vehicle which contains a proportion of oil inadequate to the effect. Whatever be the cause, the event is equally distressing and dangerous. We have in emergencies interposed opium, but the expectoration is by this means more- effectually checked; and if we attempt to restore it by emetics, we incur the risk of their operating on the in- testines rather than the stomach. The seneka is liable to the same inconvenience; and the effects of vitriolated zinc and copper are too uncertain, often too violent, to be trusted in such a dangerous situation. Difficulties, so painful we have more lately endeavoured to elude; and by adding the pulvis e creta c. cum opio in the dose of about five grains, often with a drop, or more, of the oil of cinnamon to each draught, we have patiently waited the event. This plan, when a diarrhoea seems to impend, we often had reason to be better satisfied with than the more active opiate. The extract of log- wood is an useful addition, and will sometimes alone check the diarrhoea, but cannot alone be trusted. Through the whole course of the disease warm dilut- ing liquors should be freely given, the room be airy, the curtains open, avoiding equally too great heat, or a current of cold air. An erect position is generally re- commended ; but sitting up occasions fatigue, and a half erect posture, supported by pillows, is equally ad- vantageous. Bathing the feet and legs is an equivocal remedy, and should not be attempted without the greatest caution. If the water is too warm, the stimulus will be too great; if too cold, it may produce a shiver. Every means of avoiding either should be carefully guarded. Many slight remedies have been spoken of with high commendation. If such have succeeded, it is fortunate for the patient and the practitioner. We have found, however, peripneumonies so intractable and so danger- ous, with every precaution, that we have suspected vio- lent catarrhs to have been raised into importance under this more formidable title. See Baroni de Pleuro Peripneumonia ; Huxham on Fevers; Stoll Ratio Medendi, 17.76, and Aphorismi de Febribus; Morgagni de Sedibus et Causis Morborum; Baglivi Opera; Lancisi Opera; Vogel Praelectiones Academicae; De Haen Ratio Medendi, torn. ix. et xi.; Sarcone Istoria Ragionata de Mali osservati in Napoli, part ii. Peripneumonia putrida. Inflammatory peripneu- monies do not merit the appellation of an epidemical disease ; for, though frequent about the same time, they seem rather to arise from the severity of the weather than any peculiar miasmata. The putrid peri- pneumony, on the contrary, proves often a very formid- able epidemic, and its nature is that of the typhus, with which the peripneumony is accidentally combined. It is the property indeed of every epidemic fever to assi- milate each accidental disease to its own nature. The putrid forms of inflammatory diseases have not shared the attention of nosologists, because their systems would not always consistently admit them. They claim, however, particular notice, not only on account of the diagnostic, but of the very different and opposite treat- ment which they require. When lately speaking of measles, we mentioned Dr. Willan's opinion, that the supposed putrid form of the complaint was really a dif- ferent disease, the scarlatina. We then observed, that though we had not seen such a disease, from analogy its existence was highly probable; and the sheet had scarcely passed the press, when measles, in its least equivocal form, but attended with putrid fever, and every mark of debility, occurred to us. In short, it was exactly such a complaint as we supposed in that article it might be. (See Morbilli.) The putrid peripneu- mony we have had occasion to see in four distinct epidemics, and shall now shortly describe. It begins with coldness, like other peripneumonies; but the cold continues long, without being followed by heat: the depression of strength is perceived very early, and the countenance, though sometimes reddish, is usu- ally sunk. The pain of the side is highly distressing, and the cough almost incessant. The pulse has the semblance of strength, but beats with a stroke less firm and full than in the inflammatory peripneumony, and may be distinguished from the oppressed pulse late- ly described, by its being soon stopped when pressed. The rest of the scene is soon concluded. Debility has- tens rapidly on; the pulse flutters; the countenance becomes truly hippocratic; and life soon ebbs, without our having the power to recall it. Expectoration scarcely in any instance comes on, for the final scene anticipates the period of its ap- proach ; and the vessels, even when the duration of the disease is prolonged, are no longer able to propel it. Every evacuation hastens the event; nor is there often room for the mildest emetic, or the most gentle laxa- tive. The disease is usually fatal on the fourth or fifth day; and if any blood is incautiously drawn, or any laxative has a violent effect, on the third, frequently on bleeding, the patient has sunk in twenty-four hours. ., The best remedy is camphor, with the aromatic con- fection, and wine in large quantities. After a day or two the bark may be given in doses as large as in the PER 131 PE R most putrid fever; nor has it appeared to increase the difficulty of breathing. A gentle salutary moisture on the skin, the diapnoe of Chenot, is the most favourable symptom, together wijth a return of the natural charac- ter of the countenance. Should an evacuation by stool be necessary, a clyster only should be trusted. In fact, every rule in the treatment of the true peripneumony must be abandoned, and the strength by every means be supported. Dr. Cappel, a pupil of Frank, the great admirer of Brown on the continent, has described an epidemic of this kind which occurred in Dr. Frank's institution, but not so acutely putrid as it has occurred to us. Pur- gatives were useful in the early state; and where the debility was not very great, we have found them in the very earliest stages salutary, if given with caution. He enumerates also the Kermes mineral, seneka, camphor with calomel, and all the medicines which he could find had been recommended in inflammatory peripneu- mony as likely to be useful. With no little inconsis- tency also he prefers the Brunonian doctrines, though Brown speaks only of bleeding and purging as remedies for peripneumony, while bleeding, even with leeches, is pronounced fatal, and purges only admitted in the earliest periods. Such perhaps were the commands of Frank. Authors generally speak of this disease as an erysipe- latous inflammation of the lungs. See Sarcone Istoria Ragionata; Ludwig Adversaria, part i. p. 52.; Huxham de Aerc, &c. vol. i. p. 324, 326; Forestus, lib. i.; Obs. 16, 17, in scholio ; Huxham, vol. ii. p. 63 ; Baglivi Ap- pendix de Pleuritide. Peripneumonia no'tha. The spurious or bastard peripneumony; catarrhus suffbeativus of authors, may appear at any time in the year, but it usually approaches early in the spring, particularly after a very sharp win- ter. This kind of peripneumony resembles the true, but the heat, pain, and thirst, are not so considerable, and the accumulations of mucus in the lungs are more considerable. This disease is strictly and originally catarrhal, affect- ing those advanced in years, or who have weakened their constitution by any excesses. It is brought on by cold, and particularly by the north-east winds of early spring. The catarrhal accumulations are not readily thrown off, and the obstruction excites fever and inflam- mation ; but, as may be expected in such constitutions, of a languid, sluggish kind. It is said to be occasion- ally produced by drying up an old ulcer, or by a dropsi- cal disposition; but it is then apparently confounded with hydro thorax. Boerhaave observes, that the bastard peripneumony steals upon the patient with a slight weariness, weak- ness, debility of the intellectual functions, dyspnoea, and an oppression of the breast. The uneasiness it ex- cites is so small, that the heat and fever are scarcely sufficient to make the patient sensible of his disorder: altcrwards slight shiverings, returning in paroxysms, and the attacks of a gentle fever suddenly increasing the dyspnoea and debility, bring on death, without any par- ticular change in the pulse or urine. Sydenham, who first distinguished this disorder from the catarrh, gives the following account of its attack and progress. The patient is hot and cold alternately, giddy, complains of an acute pain in the head, when the cough is most troublesome. He vomits all liquids, sometimes with and at others without coughing; the urine is turbid and intensely red ; the blood taken away resembles pleuritic; the patient breathes quick and with difficulty; if ad- vised to cough, his head aches, as if it would burst; a pain is felt in the whole breast; and a wheezing is ob- served by the attendants whenever the patient coughs. To this may be added that the patient's cheeks and eyes often appear'slightly inflamed, the pulse is small, often intermitting. Lying low, or on one side, is peculiarly painful. If the strength does not return after the disease is removed, the pulse continues quick and weak, breath- ing difficult and oppressed, with at times shivers, fol- lowed by flushing in the cheeks: if the lips are dry, and the appetite defective, the patient soon sinks with suffocation. The disease is therefore in every view catarrhal, and peripneumonic only from obstruction or accidental cold. Its most frequent termination is in hydrothorax, and, indeed, in the description of every author symptoms of hydrothorax are occasionally mixed. It is undoubtedly difficult to avoid confounding diseases similar in their symptoms, and rapidly changing, to each other; nor is it of consequence, since the treatment differs so slightly. The very inconsiderable degree of inflammation which occurs in peripneumonia notha requires no very peculiar conduct. It arises from accumulation of mucus, and is relieved by lessening the load. The indications of cure will be to expel the accumu- lated mucus, and to strengthen the habit in general. The warmer expectorants, with those which gently sti- mulate the bronchial glands, are the principal remedies. The former are the balsam of Peru, and the different turpentines; the latter the gum ammoniac and the squills. Perpetual blisters to the breast are often essen- tially serviceable, and issues or blisters on the legs or thighs have been recommended, though it is not easy to ascertain the principle on which they act, or, indeed, whether they are really advantageous. If the cough is violent, opiates may be given as soon as expectoration is tolerably free; a mixture of the pil. ex opio and pil. ex aloe cum myrrha. may be safely given in such doses as circumstances may require. To keep the bowels lax is essentially necessary, and in giv- ing the opiate we must never interfere with the dis- charges by stool. The tetradynamiae are very useful as stimulant expec- torants, and the mustard whey is a common as well as a salutary drink. The seneka is often too violent in its operation, but in moderate doses may be useful, for active emetics are often injurious. Warm weather or a warm'climate are often useful auxiliaries. The strength is restored by the warm balsams, with the purer bitters; by chalybeate waters; moderate and constant exercise; by a strict attention to diet, which should be generous, without being too rich or flatulent; and by a steady moderate discharge from the bowels. For this purpose the warmer laxatives, in the form of tincture, are useful, and none are more so than the tinctures of rhubarb, senna, and jalap, in equal propor- tions. When the disease is apparently combined with hy- drothorax, or, in other words, when the mucus or water is in the cells of the lungs, the active expectorants and R 2 PER 132 PER diuretics must be joined with brisker purgatives. The squill and the gum ammoniac are the chief remedies in these circumstances, and they may be conveniently combined with a proper proportion of the extract of jalap. See Sydenham's Works, part i.; Huxham, vol. i. p. 163: Grimm on the Epidemics of Eisenach; Boer- haave's Aphorisms, with Van Swieten's Commentary. PERIPYE'MA, (from wept, and wvov, pus). A col- lection of matter surrounding any part. PERIRRHCE/A, (from -we^ip'pea, to flow from eve7-y part). A copious flow of humours from every part. PERIRRHE'XIS, (from-wept, and pttyvvfit, to break). See Hemoptysis. PERISCEPA'STRUM, (wept, and cepastrum, a wild onion ; from its encircling the head in successive folds like the coats of that bulbous root). See Fascia. PERISCYPHI'SMUS, (from -wept, and xvtpoo-, gib- bous). An incision made across the forehead, or from one temple to the other, over the coronary suture; for- merly used in considerable inflammations of the eyes. The lips of this wound were kept asunder with lint; and when the disorder abated, the denudated bone was rasped, and the wound healed. P. jEgineta, lib. vi. c. 7. PERISTA'LTICUS, (from we?i?eXXu, to contract). The vermicular motion by which the intestines protrude their contents. This motion is not apparently downwards, but the contained matter is moved backwards and forwards, though, on the whole, the tendency is to the inferior portion of the intestine. This kind of motion is evi- dently designed to expose the alimentary mass more completely to the mouths of the lymphatics. In the large intestines, where the hardened mass is moved with greater difficulty, the contractions are stronger in con- sequence of the fixed points which the plaits of the in- testine afford, and the contracted portion forms a valve to prevent regurgitation. PERISTAPHYLI'NUS EXTE'RNUS, (from wept, and g-IxQvXti, uvula). See Circumflexus palati. PERISTAPHYLI'NI INTE'RNI. See Petro-sal- tingo-staphylini. PERISTA'PHYLO-PHARYNGjET, (from wept, rlxpvXy, and 0xpvy%). Two small muscles inserted be- tween the uvula, and lower extremity of the internal ala of the apophysis pterigoidaeus, and running obliquely backward on the sides of the pharynx. They are dif- ficult to find in very lean subjects, and seem to be what Santorini calls hypero-pharyngai, or palato-pharyngai. PERISTERIUM, (from ireptsrepos, a pigeon, because pigeons are fond of it). See Verbena. PERISTRO'MA, (from wepurlpevwu, to strew about). See Intestina. PERISYSTOLE, (from weptxxm, and etfos, likeness,) re- sembling a lentil. See Oculus. PHACO'SIS, (from x- xxy\, a joint in the finger). See Liliastrum Alpinum minus. PHALANGO'SIS,(from QxXxy\, a row of soldiers). A disease in which the eye lid turns inwards, so that the hairs stimulate the eye. (P. iEgineta, lib. vi. c. 8.) The eye lid is tumefied or relaxed, proceeding either from a paralytic disorder of the musculus elevator palpebrae, or from the relaxation of the skin above. An oedematous tumour is sometimes formed in the eye lids, but this should be distinguished from the disease which proceeds from relaxation, and requires an excision of the skin. The disorder sometimes returns, notwithstanding the operation. See Hippocrat. lib. de Victu's Ratione; Cel- sus, lib. vii. c. 7. V. Ptosis. Phalango'sis tri'chia. See Trichia. PHA'LANX, (0xXxy%, an army of soldiers). The bones of the fingers, called from their regular dispo- sition. See Digitus. PHA'LARIS, Canariensis Lin. Sp. PI. 79, (from tpxXos, shining). Gramen spicatum. Canary grass. It grows amongst corn, and is found in many places besides the Canary Islands. The seeds are diuretic. See Raii Historia. PHANTA'SMA, (from tpxvl'xZp, to make appear). See Pseudoblepsis. PHARMACEI'A, (from (pxpftMxov, a medicine). A discharge from the abdomen, from the exhibition of a cathartic. PHARMACEUTICA, (from (pxpptxxeva, to exhibit medicines). Pharmaceutics constitute that branch of our art which teaches the method of rightly preparing and exhibiting medicines. Pharmaceutics, fA*xov, a drug, and xvtJLiat'-> chemistry). Pharmaceutical chemistry in contradistinction to the spagirical art, which treats of the transmutation of metals. PHARMACOPOZ'IA, (from Xe^, and pea, to flow). A HEMORRHAGE FROM A VEIN. PHLEBOTO'MIA, (from «s, light, and tpoGtu, to dread). Too great sensibility of the retina, either from inflammation, increased nervous sensibility, as in hydro- phobia, or from a disuse of light. PHO'XOS, (> turn is discharged, at others a greenish mucus, like that g&fefcr which accompanies recent colds. After a little time, $Jp¥fl* however, some spots of a more suspicious appearance ■ * are observed, and at last the spitting becomes decidedly purulent. In many cases of phthisis a caseous mat- ter is discharged very early in the complaint, which curdles in water, white round the edges of the curd pus is often conspicuous. At this time the chills, frequently observable at a very early period, are strongly marked and followed by burning heat, terminated by a copious sweat. In fact, a true hectic fever is formed. The cough is now often incessant, aggravated by the access of fever; it is in the early part of the night almost incessant. During the fever, the cheeks have a circumscribed spot of pure florid red; the lips and tubercles in the canthus of the eyes are also brighter than when in health. The fever is augmented after eating, particu- larly solids, with flushing in the face, and burning heat in the palms of the hands and soles of the feet. In the morning patients find themselves relieved, but rise languid, pale, and unrefreshed by their sleep. Though the pulse is always quicker than natural, yet there is a remission of the fever for some hours in the forenoon. The countenance now gives evident signs of wasting, the eyes are hollow and languid, the cheeks prominent, the nose sharp, the patient's flesh wastes, and the strength fails ; the breathing is short, quick, and offen- sive ; sleep tittle and disturbed; morning sweats more profuse, and the interval from fever less distinct. The spitting is more loaded with matter, brought up more eaily, and in greater quantity, sometimes a pint in twenty-four hours. The menses usually cease, when the hectic exacerbations are strongly marked. From the beginning the body is in general costive, particu- larly after the morning sweats take place; but about this time also patients, from being costive, have fre- quent motions, and soon a confirmed diarrhoea; every- thing taken into the stomach quickly running off by the bowels. The fever, heat, and cough, abate of their violence, and the morning sweats become less profuse; but if the diarrhoea is checked, these return. The strength totally fails; frequent fainting at last comes on, sometimes a slight delirium ; the sputum becomes of a dark brown colour, and sometimes sanious; the lower extremities swell, and at last death closes the scene. The distinction of consumption, particularly in its early stages is of great consequence; nor is it an object of small utility to point out its original source. At the age of about fourteen in each sex, while the genital or- gans are evolving, there is often a considerable debility and irritability. The debility in females, as we have seen (see Menses), is often formidable, and a slight cough is no uncommon attendant. At this time phthi- sis may come on, and often does so, with little suspi- cion : all the symptoms are referred to the great change that then takes place. Similar states of langour are oc- casionally observed in males, and the same mistake often occurs. In general, in such cases, if either a slight fever from cold, or an haemorrhage from the lungs, has preceded, it will lead to a suspicion of the truth ; and if it should not, the patient may find it diffi- cult to lie on one side, or on taking a deep breath a slight spasm or a cough will come on. No diagnosis can arise from the existence of fever, since in the chlo- rotic state, coldness, with occasional flushing, are not unfrequent. In general, however, the fever of phthisis attacks most pointedly in the evening; that of chlorosis in the morning : the appetite of hectic patients is best in the forenoon; of chlorotic at night; and the latter can eat meat suppers frequently with impunity. If these diagnostics fail, we must rest till each disease ap- pear more distinctly, or, in the mean time, give only the slight bitters of the purer kind, with such laxatives, generally rhubarb, as will keep the bowels free. Change of air, cheerful company, with a light easy diet, will re- lieve, if either be the disease. Syphilis at times assumes the form of phthisis ; but, in general, the chest is free, while pains are more vio- lent at night, and more frequently in the middle of the bones of either extremity, or deep seated in the head, than in the trunk. It has also seldom proceeded so far as to mislead, without showing its nature by eruptions, or by an affection of the throat. From the state of X2 P H T 164 P 11 T mind we may draw some distinction ; for cheerful hope illumines every hour of the hectic, despair darkens each moment of the syphilitic, patient. Atrophy, from induration of the mesenteric glands, or from abscess in the liver, resembles in its effects, rather than its appearance, the true phthisis. Each is attended with fever, often with regular evening exacer- bations, and in the latter we often find a dry short cough. The distinction is not, however, difficult. In the form- er, the absence of cough, the tumid abdomen, and lying with equal ease on both sides, sufficiently point out the disease: in the latter the dark yellow complexion, and the symptoms of dyspepsia. After a catarrh, a cough, with a discharge of thin acrid mucus, often threatens consumption, and our ap- prehension is only relieved by reflecting on the period of life, the absence of hectic fever, the ease with which the patient lies on either side, and, in general, the na- ture of the expectoration. Truly purulent matter is often also discharged, with such an equivocal exertion that we can scarcely pronounce it either expectoration or vomiting. In this case we have found some founda- tion of distinction from the nature of the pus. If such as is usually discharged from a common abscess, if in large quantities at once, and not attended with the gradual progress of a hectic, we have usually prophe- sied a favourable termination, and such has been the result, though in one instance the Solar Tincture, pri- vately taken gained all the credit. When we spoke above of the source of the disease, it was with a reference to the opinion of a late author, that pulmonic consumption originated in disorders of the liver. It was not an idle nor an unfounded sug- gestion ; for in many instances we have found infarc- tions of the liver to have preceded; and, when authors speak of consumption arising from a sedentary life, hard study, and distress of mind, we strongly suspect that the foundation of the disease has been laid in the liver. We have mentioned it to direct the attention of prac- titioners to the early stages of the complaint; nor was it without a view of this kind that, in doubtful cases, we mentioned as a remedy the pure bitters, with rhubarb, to which the fixed alkali may be advantageously added. Is it from this connection that the idea and the term of " a stomach cough" are derived ? Stoll has pointed out its connection with a sedentary life; and many authors have enlarged on the injuries which result from the ex- hibition of astringents in this complaint, which are pe- culiarly injurious in diseases of the liver: we can add, from observation, that coughs of this kind which have degenerated into phthisis, have been found to originate from a disease of that organ. We have limited our consideration, however, of phthisis to a consumption arising from an abscess of the lungs, and have expressed our opinion that it is such an abscess as arises from the suppuration of a strumous gland, generally distinguished by the name of tubercle, or, when in a suppurating state, of vomica. Yet the opinion of other authors must not be passed over without some consideration. As phthisis follows by haemoptysis, it has been sup- posed that the wound arising from the rupture de- generates into a foul ulcer, which heals with difficulty. If, however, the habit is not previously injured, it is not easy to say why a wound from haemoptoe should not heal as easily as one from a small sword, pistol bullet, or from the vicarious haemorrhage from suppressed menstruation. It is, therefore, more probable that the bleeding is the consequence of the contraction of the chest from tubercles, sometimes from a diminished ca- vity in consequence of deformity. Suppuration from protracted peripneumony, has also been accused, in general, with less reason. We have seen this happen in several instances, without consump- tion following. The matter has been fairly spit up; the abscess has pointed externally, and the matter been dis- charged by a wound; it has been absorbed and carried to the kidneys, within our own observation, with a fa- vourable termination. It is, therefore, probable that this cannot be a cause, except, as already hinted, when the inflammation has been communicated to an indolent.; tubercle. Peripneumony is indeed a comparatively rare disease; but our recollection does not furnish a fair in- stance of phthisis originating from it, though so fre- quently arising from a catarrh, a less degree of the same complaint. Yet even this view of the case is not without its .dif- , ficulties. Catarrh is a mild disease, originating from,^ cold, and producing only a moderate degree of inflam- mation, in a part far above that affected in consump- tion. We know, too, that catarrh has continued for a series of years without terminating in consumption. The difficulty may be reconciled in two ways. Catarrh, we believe, is never the precursor of phthisis, unless attended with fever, and the fever may be as much the exciting cause, as the inflammation of the bronchial glands; or the supposed catarrh maybe only the first symptom of the disease. The former is, we believe, the fact. Another opinion has been, that the discharge of a continued catarrh has become acrimonious, and pro- duced ulcer. This is, however, truly imaginary. We know no situation in which the discharge is so acrid as during the first inflammatory stage, and this, it is ad- mitted, does not produce consumption; and the dis- charge of a catarrh in a thin serous state has continued for many years, without a phthisis following. There is little doubt, therefore, that the true pul- monary phthisis arises from tubercles, and from these exclusively; and the enquiry will remain of what na- ture these tumours are. External causes of obstruction have been sought, and been found in the dust raised in grinding scythes, in the meal from mills, &c. Dust in innumerable instances is breathed; and were this the cause, Hyde Park, and every frequented turnpike, would in the summer be the prolific source of consumptions. We have never seen calculous concretions in either ..>* trade; but we have found them in cork-cutters, and in one instance in a delicate young lady, where the hectic was connected with cutaneous eruptions. Added to this, it must be remarked that, from the analysis of these concretions, they appear, like other calculi, to be form- ed from the animal fluids. The tubercles then are conglobate glands, enlarged in consequence of that state of the constitution which constitutes Scrofula, which we have often hinted consists in a want of irritability to propel their contents, and which we shall soon explain at some length, vide in verbo. Their original formation, and their excite- ment to action, depends on different circumstances. PHT 165 PHT They are evidently formed in contracted chests, perhaps from the pressure of the crowded parts around obstruct- ing the passage of their fluids; sometimes apparently in consequence of ah acrimony. Consumptions are not uncommon in those constitutionally subject to cu- taneous diseases from inheritance. When thrown on the surface in a sufficient proportion, the constitu- tion is safe; but where, from debility or external ap- plications, this is prevented, the internal organs suffer, and the inconvenience is particularly felt in the lym- phatic system; not that the acrimony is thrown on them, but infecting the fluids exhaled into different ca- vities, and probably separated in a more acrid state by the conglomerate glands, it is taken up by the lympha- tics, and stagnates in the conglobate. Thus we find, in similar circumstances, sometimes the conglobate glands of the lungs, sometimes those of the mesentery, and the lymphatic system in different parts, suffering from obstruction. Infirm health, with atrophy, is the constant consequence, when pulmonic affections are not induced. Damp air, acrid vapours, and various causes con- nected with the atmosphere, have been accused; but with little reason except when connected with scrofula, in which case damp situations seem to act as a predis- posing cause. Of a sedentary life, of vexation, &c. we have already spoken, and attributed their influence to their effect on the liver. It remains to consider phthisis as hereditary and in- fectous. It is useless to engage in a war of words with the partisans of Mr. Hunter respecting the real meaning of hereditary diseases. We only use the term in its common purport—are persons born of consump- tive parents particularly liable to the disease ? They undoubtedly are so, and it is the consequence of every day's experience. Yet to this there are some excep- tions. As in scrofula and other diseases the complaint pursues those children only which resemble in form, in complexion, or temperament, the parent afflicted. The others appear in no respect influenced by the hereditary taint. It is singular, however, not only that the ge- neral predisposition but-the period of life at which they are affected are the same, independent, with a few ex- ceptions, of the external causes. These exceptions are, removing into a warmer climate previous to the critical period, or in a female being in the increasing state. We nave seen the phthisical tendency constantly recurring, and as often removed by pregnancy. The unfortunate patient is, however, at last the victim of a complaint, which may be retarded, but which cannot be subdued. That phthisis is infectious the medical opinions of southern Europe incontestably show, since it is forbid- den to open those who die of the disease, and the bed- ding and clothes are burnt. We do not interfere with the practices of countries in which we have no experi- ence. In Great Britain we suspect it to be infectious, though not in a considerable degree. The physician who visits, the nurse who attends, the friend who as- sists, are in no danger. Yet to live in the same room, or to sleep in the same bed, is dangerous, if continued. We have often traced infection ; yet where the com- munication is not constant or intimate, we have thought that the communicated disease is not peculiarly violent or dangerous. Where it has appeared so it has been communicated from parents to children, and the con- trary ; but who can say that in such cases hercditan predisposition may not have had its powerful influence? Let us not deprive the sufferer of the consolations of friendship and humanity; for the disease, we must re- peat, unless in similar constitutions, is not highly in- fectious. It is sufficiently so to inspire caution with respect to too constant confinement, but not to justifv neglect. The course and the progress of the symptoms are not very readily explained. They are in the early stages too considerable for the cause, and in the latter too slight. We have mentioned, not without design, the tall stature, without a proportional expansion, which according to the explanations of the progressive evolu- tions of the body, shows some primordial defect. To which we must add, that constitutions of this kind ge- nerally show a premature expansion of the intellectual faculties, with peculiar debility of the corporeal func- tions. Deformity, a frequent attendant of each, though it sometimes precedes pulmonic affections, is by no means a necessary attendant. The first marks of indis- position, except those just mentioned, are the symptoms of impeded circulation through the lungs, followed by a slight irritation felt at the top of the epiglottis. These are generally signs of the existence of tubercles, and ought to inspire serious alarm. The former are pointed out by pain and dyspnoea on rapid motion; by a fixed, florid red on the cheeks ; by an inability to lie on one side rather than the other : the latter by a hecking cough frequently felt during the day, particularly on motion. The decubitus difficilis is constantly on the affected side; indeed so constantly, that we consider it as a dis- tinguishing mark of the complaint. The explanation, however, is difficult. It might be supposed that re- spiration would be carried on more easily by the sound lung, if not compressed; and as pain is no part of the symptoms, the pressure on the affected side would pro- duce no inconvenience. We have not pretended to ex- plain any of these appearances which respect the facility of lying on either side. With the fullest collection of the facts before us we have sometimes thought that we had found a clue, when some unfortunate well founded observation has dissipated the visionary fabric. We shall rest on the circumstance as stated, therefore, as a fact, and determine that the side on which the patient cannot lie is that which is diseased. Whether obstruction will alone produce fever is doubted ; but the debility, with the obstructions, may undoubtedly occasion an evening Hectic, q. v. The tu- bercles themselves do not admit of suppuration; and in this respect also resemble scrofulous swellings. The expectoration, we have said, is a caseous substance, fringed often with a little true pus, apparently the pro- duction of the cyst. Yet in the progress the discharge is truly purulent, and often in considerable quantities ; but in such cases the whole substance of at least one lobe of the lungs has apparently suppurated. That the respiration will be affected from such causes must be evident; yet at times it is not so, and in a few cases the patient has been able to lie with equal ease on each side. In such circumstances we have suspected that the glands at the root of the lungs are chiefly affected, but dissections have not been sufficiently numerous tr> ascertain the fact. The exceptions do not, however, contradict the general cause so frequently observed, and PHT 166 PHT so often incontestably established. The effect of the more frequent inspiration, rmd the more rapid circula- tion, is to expose the blood more frequently to the ac- cess of atmospheric air, and consequently to increase its oxygenation : hence the more florid complexion, pro- bably the stronger pulse, and of course the phlogistic diathesis. From the fever arises the increased heat after eating, which is so striking an effect of phthisis, that on its degree we have rested the determination of the digestibility of food (see Aliment) : from the fever also arises the heat on first going to bed, and the perspiration on the solution of the paroxysm. The febrile exacerbations, we have said (see Hectica), is owing to the absorption ot purulent matter ; and when this is not carried to the skin it falls on its vicarious organs, the mucous glands of the bowels, so that the perspiration and diarrhoea counterbalance each other. In the advanced stages the irritation of the cough is incessant; the heat or perspiration almost constantly distressing ; and when these are absent the life seems exhausted from debility. What then affords the cheer- ing ray of expected relief? Such, however, is afforded, for ingenuity invents every fallacious mode of eluding inquiries, and of giving the most favourable view of every symptom. The patient sinks to the grave with the constant assurances of having attained greater strength, and a relief from every dangerous symptom; with eager expectations of the events of another year, when life is limited by another day. Such we would say is the kind interposition of Providence, was the same cheerfulness found in every disease, and was not in many the gloom as distressing to the patient as the ill-founded expectation of the consumptive victim is to the well informed anxious friend. This cheerfulness is said to be owing to the absence of pain ; but pain is not always absent; and the difficulty of breathing, the in- cessant cough, the burning heats, the deluging perspira- tion would appear worse than the most poignant pain. Yet these are disregarded, represented as trifles, lessened in the report to the most inconsiderable inconvenien- ces : it is truly singular! The prognosis in hectic is always unfavourable. We this day saw a lady whose parents in a long succession have died hectic, and whose brothers have yielded to the same complaint. She feels scarcely more than a slight irritation at the epiglottis, with a delicate nervous habit. Yet the experienced eye must see in a moment her fate, when the breeding period is at an end ; for she is now pregnant, and may be again &o. Nature as- sumes her rights, and combats every disease while this important process goes on. We may find no properer place to mark the conclusion of the scene. Each suc- cessive pregnancy is attended with greater debility, and the period of suckling must each time be abridged. At last, during thewhole pregnancy, the debility is extreme: a healthy offspring, however, isoftenproduced,butwith little or no pain in the labour, and the mother dies with- out a groan within a few days. If the hectic has come on rapidly, the children are often healthy: if it has gradually approached, they soon sink from apparent de- bility only. In other respects the prognosis is influenced by the rapidity of the progress, and the degree of the symp- toms. A purulent expectoration, with considerable hectic fever rapidly hastening, leaves little hope. If the pulse in an apparently early stage, exceed in the morn ing 100, and at night 120; if at the same time the ex- pectoration is purulent and copious, the night sweats constantly repeated and violent, the debility hastening on, and the emaciation following with similar rapidity;- ;^fj much expectation of relief cannot be entertained. If in females who have already experienced a regular re- turn of the menstrual discharge this evacuation should disappear, we must equally despair. While this dis- charge however continues, while the pulse is at no pe- riod more than 90" or 95, while animal food is borne with ease, we have generally indulged a hope of relief: a • hope, alas! sometimes disappointed. Is phthisis then never cured ? Whence can arise the confident promises which every newspaper offers, which the most respectable authorities confirm ? The , .'/'& deception arises from two sources. Catarrhal com- ■• plaints are, in many instances confounded with con- • ■ ' sumptive, and the most experienced eye is occasionally deceived. In some cases also vomicae are completely v4f evacuated by expectoration, and the wound heals. So insidious is the attack of phthisis, that we have mis- taken it for catarrh; and, on the contrary, so violent is often a catarrh, that we have apprehended phthisis; nor >j has the delusion been destroyed but by the expectora- tion, rroni such errors many medicines have gained .''' credit; nor can we wonder at the decision of those whose testimony appears convincing, when we own 'i that an extensive experience of thirty five years does » not always enable us to avoid error. Confidence is, • ;flj however, the general companion of ignorance, and those ' * who know of no sources of fallacy conclude that there i are none. To say that phthisis is cured may appear -"^j equally confident and rash. We. shall perhaps be ere- .'fl dited when we claim no merit from the cure; but if J the same experience which has enabled us to decide on vi bile). A person subject to anger, or abounding with bitter bile. PI'CTONUM CO'LICA, (from Poitou, where it was endemic). See Colica. PIE'DRA DI CO'BRA. See Cobra de capello. PIE'RRE NOIRE. See Ampelitis. PIGMENTUM. The mucous, coloured substance which gives the splendid hues of the iris, and the darker matter which covers the choroid coat. See Oculus. PIG-NUT. See Bulbocastanum. PI'LA HY'STRICIS, (from pileo, to bind together). See Bezoar hystricis. Pi'la mari'na. A species of alcyonium, or a round spherical ball, found on sea coasts, among sea weeds. Lemery describes it to be about the size of a fist, lanu- ginous, of a dark colour, formed by a collection of hairs, sand, and other impurities of the sea, united by means of a glutinous fluid. It is said to kill worms; and Zwelfer tells us that, when calcined, it is useful in scrofula. PI'LEUS, (from the same). See Cucupha. In ana- tomy, the coif with which some children are born ; and then called pileolus, galea, and vitta. PILMI'CTIO, (from pilus, hair, and mingo, to dis- charge urine). A discharge of fibres, resembling hairs, with the urine. PILOSE'LLA MA'JOR, (from pilus, because its leaves are hairy. See Hieracium alpinum, and Gna- PHALIUM MONTANUM. PILO'SUS. See Capillaris. PILOTHI'SMATA. Applications which take off the hair ; Depilatoria, q. v. PI'LULA, (from pila, a ball,) catapotium, gongy- lion. Pills are a form well adapted for medicines whith operate in small doses, are offensive to the taste, or so heavy as not easily suspended in, or mixed me- chanically with, any fluid. They dissolve with diffi- culty, and produce very gradual and lasting effects. Gold and silver leaf often hinder the pills from dissolv- ing ; therefore should seldom be used. This is a term also given to several compounds, many ef which will be found under some of the principal ingredients, as pilulae e gummi. (See Asafcetida.) There is a variety of formulae of this kind in the Phar- macopoeia Chirurgica, composed of very active ingre- dients, as different preparations of quicksilver, cantha- rides, cicuta, cuprum vitriolatum, opium, turpentine, and vitriolated zinc, which may be found in that work, under the term pilulae. PI'LUS, (from wiXos, carded wool). See Capillus. We resume the subject of hair (see Capillus) to sup- ply some accidental omissions, and to add the late expe- riments of Vauquelin, which have added somewhat to our knowledge of the subject. We have already men- tioned that the hair is hollow, and that it grows from a bulbous root, resembling, in many respects, a vege- table substance. The larger extremity of the oval VOL. II. root is downwards, and the whole is connected to the skin or to the adipose membrane by small filaments, probably nervous and arterial. The root itself, next the branch, seems to be composed of very fine filaments, and a glutinous substance, probably secreted from its vessels. These filaments unite to form the stem, which is covered by an elongation of the external, somewhat elastic, coat of the bulb. The stem or hair passes usually between the papillae, and sometimes seems to penetrate a papilla; but when it emerges from the cuticle, the latter appears to closely embrace, and to be continued some way on it; this membrane is gradually lost. When the cuticle is porous, as in the scalp, the hair seems to pass out in a cylindrical form, but where less so, and particularly where the bulb is buried in fat, it passes in a serpentine direction, with great difficulty, as in the axillae, &c.; and it is then tortuous and angu- lar. It has been supposed that this is partly owing to the warmth, since the same curl is found in the hair of negroes; but the Malay, in an equally hot climate, has straight, cylindrical hair. The hair is nourished by the gluten of the root; and as this is more copious, or more fluid, it is more succulent. When in a smaller quan- tity, or more dense, the hair is dry, crisp, and soon falls off. When not carried to the extremities, these split and become brittle. The roots or bulbs of hair are found over the whole body; nor is it easy to say why they continue to vege- tate on some particular parts only. They are said to have been found also in abscesses of the abdomen, in the fluid of an ascites, in the veins, on the tongue (Amatus Lusitanus), and in the heart. We can neither confirm nor oppose these assertions; and it is not more difficult to account for such appearances than to explain why hair does not grow on the back, on the shoulders, or the neck. Hair in the ovaria is by no means un- common, and may be owing to the rudiments or remains of an imperfect conception. It has been supposed that the hair grows after death. To prove a negative is a difficult task; but, were this true, it must have been long since placed beyond dispute. The long hair found in persons, after having been buried many centuries, may have been natural. The observations of most importance on this subject may be found in Heister's Anatomy, and Camerarius' Memorabilia, iv. 47. The hair evidently partakes of the nature of the sim- ple solid, corresponding with it in firmness or softness. The bulb is nourished by arteries, and supplied with nerves; but there is no reason to suppose the hair itself nervous, and it chiefly grows by gradual additions at its extremity. The circulation through it is probably car- ried on by capillary attraction, or in the manner in which the sap of vegetables is propelled. By combing we free the fluid from those obstructions which must arise in consequence of its being bent in all directions; and, perhaps, by drawing out the hair, we straiten the canal, and render it more strictly capillary. We pro- mote, also, the circulation through the bulb, and re- lieve the head from accumulations; for though the vessels of the bulb are small, they are numerous. Long hair has always been esteemed an ornament, but it has been doubted whether it was not injurious, by the quantity of blood which it exhausted in its nutri- ment, and the consequent debility which it would pro- duce'. When very thick, it is uncomfortable from its Z PIL 178 PIL warmth, but we have never known it to be a cause of weakness, except from the perspiration which a large mass of hair must occasion. Cutting oft" the hair has, within our own knowledge, been often injurious, and attended with every appearance of local plethora. As usual, moderation is the best; and if it hang over the shoulders it is long enough, unless it grows, at the same time, thinner, and in that case it must be cut shorter. As a remedy for the headach, to cut off the hair is as ridiculous as to prevent the access of air, with the design of accelerating evaporation. Such was our knowledge on this subject when, in the autumn of last year, M. Vauquelin read to the Na- tional Institute a memoir on the nature and composi- tion of human hair. Hair was not, he found, soluble in boiling water; but when exposed to a greater tempera- ture in Papin's digester, it was readily dissolved. From a solution of black hair a black matter was deposited, found to be an oil, of the consistence of bitumen, with iron and sulphur. The last ingredient seems to point out the source of the smell of the hair in some consti- tutions, where, perhaps, it is in excess, or where it may be accidentally combined with an alkali. This idea is confirmed by the analysis of red hair, in which the odour is stronger, for it contains a much larger propor- tion of oil and sulphur, with less of iron. Alcohol ex- tracts from black hair a whitish oil, and a greyish green oil, which separates as the alcohol evaporates. It is probable, therefore, that the black matter is gummy or albuminous; and the white is said to resemble sperma- ceti in appearance, though it differs in chemical affinity. Red hair affords a white, and, instead of a greyish green, oil as red as blood. The other component parts of hair were a mucous substance, iron, oxide of manganese, phosphat and carbonat of lime, flint, and a large proportion of sul- phur. White hair contains also phosphat of magnesia, and its oil is nearly colourless. When hair becomes suddenly white, from terror, Vauquelin thinks it may be owing to the sudden extrication of an acid, as the oxymuriatic acid whitens black hair; but it may be, more probably, owing to the sulphur absorbing the oil, as in the operation of whitening woollen cloths. From some experiments made on the matter which occasions the plica polonica, he thinks that disease owing to a superfluous excretion of the fluid which nourishes the hair; but it is sometimes bloody, and, if the hair is cut off, the disease, it has been said, is fatal. To increase the growth of hair, various preparations have been employed, and each perfumer has his secret, though we know not any are particularly successful. They chiefly consist of warm, stimulating, oily sub- stances, to increase, apparently, the circulation through the bulb, and probably to check the perspiration. A fluid seems to exude through the hair, at its basis, and is probably the black matter which unites with the per- spiration, producing the scales that soon form on the scalp, if combing is neglected. Powder is useful in absorbing this matter, and preventing its concretion into flakes; but if this is not used, dark hair soon stains the comb, and proves the existence of its exudation. Of the boasted Depilatories, q. v. we have men- tioned quick lime and orpiment (see Rusma), which Spon, in his Travels through Italy, mentions as chiefly successful; but various others have been added. Kircher recommends the blood of a bat (mundus subterraneus); Laurcntini, the bulb of the hyacinth ; Morin, the exu- dations from a vine; and friction with a pumice stone has been used; but none will succeed, unless the bulb be destroyed, and extirpation is the only remedy. For increasing the hair, we find the aqua stercoris humani recommended by Schroeder; and for blackening it, the stercus hirudinum! PIME'NTO, (from pimienta, Span.). See Piper Jamaicf.nsis. PIMPERNE'LLA. See Anagallis. PI'MPILIM. See Piper longum. PIMPINE'LLA, BIPINELLA, called from the dou- ble pennate order of its leaves. Burnet saxifrage, called saxifraga, because it grows out of, and seems to break through, the rocks ; sanguisorba, pimpinella mi- nor, trugoselinum, smaller burnet saxifrage, pimpi- nella, saxifraga, x. Lin. Sp. PI. 378. A perennial umbelliferous plant, growing in dry pasture grounds. It is sometimes the name for agrimonoides; the pote- rium hybridu7n Lin. Sp. PI. 1412. Pimpine'lla a'lba germano'rum, pimpinella saxi- fraga major, gypsophyton. Greater white burnet saxifrage ; p. saxifraga Lin. Sp. PI. 378, /3. y. fo Some of its leaves are deeply cut; the odd one.into three sections; common in Germany, but rarely met with in England. The roots have a hot, pungent, but not durable, taste. When fresh, they affect the eyes liko mustard and horse radish. In drying they lose all their volatility ; and water partially extracts their virtue, but spirit completely. When distilled with water, they afford a small portion of oil, which is highly acrid. These roots are warm, stimulating, aperient, and diuretic. Bergius considers them also to be diaphoretic and sto- machic ; and they are often recommended, where pitui- tous humours are supposed to prevail," as in asthmas, catarrhal coughs, in what has been called angina serosa; by Hoffman in chlorosis: it has also been employed by way of gargle, for dissolving viscid mucus, and to sti- mulate the tongue, when paralytic. Its dose in powder is 9 i. in infusion 3 ij- The species called nigra grows wild in Germany and Switzerland, and yields a bluish oil. Whatever has been said of the value of these, as medicines, by Stahl and others, they are not used in the present practice. Pimpine'lla ani'sum, Lin. Sp. PI. 379, anise, which furnishes the aniseeds of the shops. See Anisum. Pimpine'lla italica, of some foreign pharmaco- poeiae, is the sanguisorba officinalis Lin. Sp. PI. 169. It is not used in this country. Like the other species of pimpinellae, it is a stimulant only. PINASTE'LLUM. See Peucedanum. PINEA'LIS GLA'NDULA, (from pinea, a pine apple), to which it hath some resemblance. The pineal gland. See Cerebrum. PINE'US PU'RGANS. See Cataputia minor. PINGUEDINO'SA MEMBRA'NA, (from pin- guedo, fat). That portion of the cellular membrane which contains the oily matter or fat. See Cellulosa Membrana. PINGUE'DO. See Adeps. PINGUI'CULA, (from pinguis, fat, because its leaves are oily to the touch). See Sanicula ebor. PINHO'NES. See Cataputia minor. PI'NNA, (wmx, a wing). The lateral and inferior PIP 179 PIP parts of the nose are called pinna and ale nasi: the su- perior broad parts of the ears are also called pinnae. See Auricula. PINNA'CULUM FO'RNICIS GUTTURA'LIS, (from its resembling in shape pinna, a wing). See Uvula. PINNA'TUS, (from pinna, a wing). The epithet of a leaf composed of many smaller leaves growing on the side of the footstalk, like the feathers of a wing. PI'NON. See Bryton. PI'NUS, (from wtlvs, the pine tree,) peuce, pinus pinea Lin. Sp. PI. 1419; differs from the fir tree by its leaves standing in pairs, while those of the fir are soli- tary. The pine abounds with a resinous juice similar to that of the fir tree. The cones are agreeable to the taste, similar in quality to the sweet almonds; and used chiefly as demulcents. The frankincense, which has been supposed the production of a species of pine, is from a species of juniper, or, more probably, of the amyris. See Thus. The bark of all the pine trees is astringent, and the tops are antiscorbutic; but their virtues chiefly depend on the turpentine they contain. Raii Historia. See Abies. Pi'nus In'dica, Nu'cleo purga'nte. See Grana tiglia, under Cataputia minor. PI'PER, (from wemu; because it assists digestion,) Pepper, arum moschatum, piper nigrum Lin. Sp. PI. 40, p. aromaticum of La Marck, is the small round aromatic seed of a trailing plant, which grows in Su- matra, Java, and Malabar. When ripe and decorticated it is styled white pepper, supposed formerly to be a different species, and called leuco piper. It has been sain", however, that there is a variety of the plant which produces the white seeds, which is much superior to th 3 factitious; but we can find no sufficient authority for the fact. The white pepper brought to us is inferior in pungency, as well as in fla- vour, to the black. The pepper is externally corrugated by drying in the sun,but the ripest, fullest seeds have the fewest wrinkles, and are the best. Pepper appears to be a more general and permanent stimulus than other spices of equal pungency on the palate; and its stimulus does not reside in the volatile parts or essential oil, but in a resi- nous substance which does not rise in the heat of boil- ing water. Pepper infused in water impregnates it very strongly with its flavour, but not with its taste ; by a slight boiling more of its pungent matter is ex- tracted, and its flavour dissipated. Distilled with water, a light, mild, limpid oil is obtained, which excites only on the tongue a grateful moderate warmth. Rectified spirit completely extracts the pungent part of the pep- per ; and when the tincture is evaporated a still more fiery extract is left behind. The quantity of extract is nearly the same from the white pepper, but it is less pungent. Peppers, particularly black, have been used as stimulants and aromatics in vertigo, paralytic and gouty disorders: in large doses it has cured inter- mittents, though in some instances it has produced fatal consequences from its stimulus. In ulcerated throats, biting constantly pepper corns is an excellent remedy, equal to the capsicum gargle of the West Indies. For its dietetic use see Condimenta. Pi'per I'ndicum, capsicum, lada chilli; vallia capo molago, solanu7n urens, siliquastrum Plinii, piper his- panicu7n, lusitanicum,turcicum, brasilianum, guineense, calecuticum, guinea pepper, capsicum annuum Lin. Sp. PI. 270, is in long roundish taper pods, divided into two or three cells full of small whitish seeds; a native of the East and West Indies. When this fruit is fresh it hath a penetrating acrid smell: to the taste it is highly pungent and acrid, producing a painful burning in the mouth like that from arum root. Rectified spirit dis- solves its pungency, and the extract is excessively fiery. This kind of pepper is given in small quantities as a most active stimulus in cold, phlegmatic temperaments, in some paralytic cases, in relaxations and insensibility of the stomach, for promoting the efficacy of aloetic medicines, and the deobstruent gums in uterine dis- orders. When dry it is without odour or particular flavour, and so readily diffusible that it joins agreeably and conveniently with any sauce. It promotes diges- tion ; but much of its pungency is lost on the palate unless given in pills, and it seems not to be an active stimulus to the arterial system. Bergius has often seen long protracted intermittents cured by the following powder, without any relapse. Six grains of Indian pepper and two scruples of bay berries, in powder, divided into three portions, one of which was given on the approach of the first rigor, another the day follow- ing at the same hour, and the last on the third day. (Cullen's Materia Medica). In climates of which cap- sicum is a native, we are told that its use is salutary, that it strengthens the stomach, assists digestion, and corrects the putrescency so common in hot climates: as a stimulant of the most acrid kind it may be found ef- ficacious in some paralytic and gouty cases, or to pro- mote excitement where the functions are languid and torpid. In the cynanche maligna it has been suc- cessfully exhibited in a gargle; and in the cachexia Africana, considered as the most frequent and fatal pre- disposition to disease among negroes, in a dose from six to eight grains it is often useful. (Mackittrick.) A species of this plant called in the West Indies bird pepper, is the basis of a powder brought from thence under the name of Cayenne, or Cayan pepper. The four species of this pepper, which grow in Guinea, are the chilchotcs, chilterpin, tenalchiles, and chillpelagua ; that which grows in Peru is called agy. Pi'per Jamaicense, piper caryophyllatum, cocculi Indi aromatici; piper chiape ; amomwn; caryophyllus aromaticus A7nericanus ; pimento ; piper odoratum Ja- maicense ; allspice and Jamaica pepper is the dried unripe aromatic berry of a large tree, growing on the mountains of Jamaica ; myrtuspimento Lin. Sp. PI. 676. It is moderately warm, of an agreeable flavour, somewhat resembling a mixture of cloves, cinnamon, and nutmegs, consequently called allspice. On distil- lation it yields an elegant essential oil, which sinks in water; and is moderately pungent, in smell and flavour approaching to oil of cloves, or rather a mixture of those of cloves and nutmegs. The remaining decoc- tion, inspissated, leaves an unpleasant extract, not pun- gent, and the berry itself is wholly deprived of its taste as well as flavour. Rectified spirit extracts all its virtue,but yieldsnothingondistillation. The spirituous extract consequently possesses its whole virtue, viz. a pungent warmth, less fiery than that of the black and white peppers. Z 2 PIS 180 PIT A distilled water, from half a pound of this pepper to three gallons of proof spirit, is substituted for the aqua aromatica, and the aqua mirabilis of former dis- pensatories. The London College order a water to be made from half a pound of the berries of pimento bruis- ed, put into a sufficient quantity of water to avoid an empyreuma; from which, after maceration for twenty- four hours, one gallon is to be distilled, aqua pimento. Ph. Lond. 1788. The oil of Jamaica pepper is sometimes substituted for the oil of cloves, and is very little inferior to the oil of nutmegs. Pi'per lo'ngum, macropiper, acapatli, catu-tripali, pimpilim, long pepper, piper longum Lin. Sp. PI. 41, is brought from the East Indies. The pods are round, about an inch long, containing numerous minute seeds. These are hotter and more pungent than the other pep- pers ; but in pharmaceutic properties the same, though in Dr. Cullen's opinion weaker. The black pepper is most agreeable to the palate, and chiefly employed as a condiment; the long is most used in medicine; the white is seldom employed in either. When astringents have failed, a diarrhoea hath been cured by j) i. of pepper with 3 ss. of diacodium, twice a day. Pi'per lo'ngum folio'rum nervis, Sec. See Betle. Pi'per mona'rdi. See Buyo buyo. Pi'per mura'le. See Sedum. The other species of peppers are of little value in medicine. See Neumann's Chemical Works. Lewis's Materia Medica. Pi'per caryophylla'tum. See Piper Jamai- oense. Pi'per cauda'tum, and Cupeba cubebs. See Nhandu, and Cubeb.s. Pi'per chia'paj. See Piper Jamaicense. Pi'per tavasei. See Cassia caryophyllata. PIPERI'TIS, (from its biting taste). See Lepi- DIUM. PIRAMIDA'LIA CO'RPORA. The small emi- nences on the lower part of the Medulla oblongata, q. v. PISCA'TOR RE'GIS, (piscor,tofish). See Al- OEDO. PISIFO'RME, OS, (from pisum and forma). See Lenticulare, and Carpus. PISSjE'UM I'NDICUM. See Petroleum Bar- badense. PISSASPHA'LTOS, (from wto-o-x,pitch, andxrpxx- t«s, bitumen). See Bitumen. PISSASPHA'LTUM. See Mumia. PISSELJL'UM, (from wto-a-x, pitch, and eXxiov, oil). Oil of pitch, bitumen Barbadense, is. prepared by boiling pitch, over which wool is suspended. When it is soaked with the rising vapour, it is said to be wrung into a vessel, and this is repeated as long as the pitch is boiling. The common method of distilling to obtain essential oil is more probably used. See Pix LIQUIDA. PISSI'NUM O'LEUM. See Brutia. PISTA'CHIA LENTISCUS. See Lentiscus. PISTA'CHIUM, PISTA'CIA, terebinthus Indica Theophrasti. The pistachio nut tree. Pistachio nuts are oblong and pointed, about the size and shape of a filbert, including a kernel of a pale greenish colour, covered with a yellow or a red skin. They are brought from the Levant. The kernels are agreeable to the taste, sweetish and unctuous, resem- bling in their nature almonds. See Raii Historia. PISTI'LLUM, (from pinso, to bruise). A nestle. In botany, a pistil, or pointal, that column or set of columns which occupies the centre of the flower, rising on the top of the embryo, generally surrounded with the chives. They are supposed by Linnaeus to be a continuation of the medulla or pith ; and differ greatly in their form, for in some flowers they are roundish, in others triangular, oval, or square. The pistillum is the female part of generation, whose office is to receive and convey the pollen to the fruit. It consists of Ger- men, Stylus, and Stigma. PISTOLO'CHIA, (from wta-ros faithful, and Xoxtix',' parturition ; because it was thought to promote deli- very). See Serpentaria Virginiana. PI'SUM, (from wttros, a garden; because it was a garden vegetable). The pea. Of these there are various species, but they are not medicinal; they are less nutrient and less flatulent than the bean, and generally more tender; the sweeter and more mucilaginous kinds are the more nutritive. See Aliment. Pi'sum arbore'scens. See Cajan. PITUTTA, (from wyrvx, coagulum, from its con- sistence). Pituita. This term strictly means the thin lymph which distils from the nose, and from the Schneiderian membrane in all its extent; but it is most frequently confined to de- fluctions from the nose, and accumulations in the sto- mach. Pathologists have, hoVever, seized on the term as a convenient appellation for fevers of a particular kind; and much confusion has arisen from the extensive in- discriminate use of the word. We are ashamed to say how much labour has been employed to collect in a comprehensive view what authors have said on the sub- ject; but though we have mispent our own, we shall respect our reader's time. The original meaning of the word was a defluction from the head, and it was supposed to pass from thebrain through the foramina of the cribriform bone into the nose. It is amusing to see the difficulties which the ancient pathologists felt in finding a passage for it; but we are gravely told by some authors that it passes down in the form of vapour; and it is plainly hinted that it is con- densed by cold, or rather a cold. In fact, it was synony- mous to rheum; but in its condensation by cold, it was gravely asked how the brain escaped being frozen. The great point in dispute, seems to have been whe- ther the pituita was an excrementitious fluid, and whe- ther generated in the brain, or drawn to it as to an alembic from the stomach or liver. It is useless to follow the disquisition; but we may add, that it was at last determined not to be an excrementitious fluid, not to be generated in, or derived from, the fourth ventricle of the brain, nor from the liver. In fact, it is the mu- cus of the whole pituitary or Schneiderian membrane; and more generally considered, when exceeding in quantity or morbid in quality, to be a disease of the stomach. Thus, when Horace says, " Nisi cum pituita molesta est," he does not refer to catarrh; though Baxter PIT 181 PIT gravely tells us that bilious constitutions are subject to catarrhs, but to his habitual weakness of the stomach, for he observes in another place, ■ Stomacho que tumultum Lenta feret pituita. The humoral pathologists, catching at the language of Galen, supposed that a pituita sometimes abounded in the blood, and was secreted in the stomach, and occasionally the cause of fevers. In the usual progress of epidemics, when the inflammatory form, more com- mon in spring, has yielded, and the bilious constitution of autumn has not come on, the pituitary fevers are said to take place (Grant on Fevers); that is, fevers of no peculiar distinct kind. Not the slightest evidence of a mucous fluid in the blood has, however, been ad- duced ; and still less of its power to produce fevers. We have found mucus or pituita discharged in excess, and with altered qualities, in coryza; in the throat (see Angina) ; in the stomach (see Dyspepsia) ; in the intestines (vide C which proved that a large portion truly belonged to the foetus, led to an inquiry whether the apparently uniform cake might not be composed of two parts, one belonging to the foetus, the other to the parent. The result was, that almost the whole of the placenta was truly foetal, that the maternal portion was inconsidera- ble, and that the blood of the parent was deposited in cells; from which it was seemingly taken up by ab- sorbing vessels, probably red veins. In this view the apparently mamellated structure of the uterus, at the point of union between it and the placenta, was the whole that belonged to the maternal system, except the deci- dua. Even the decidua reflexa is supposed to belong to the foetus; but on this subject physiologists are not perfectly decided. The circulation thus carried on by absorption, and the deficiency of any nerves passing from the mother to the uterus, led pathologists into some difficulty to explain the effects of fright, apprehension, or fever, on the foetus ; and was still more embarrassing to the phy- siologist in explaining the source of the naevi materni. The present structure is perfectly consistent with the doctrines we have attempted to establish respecting the primordial germ, which admits not of any consider- able distention beyond its adult state; and it will be necessary to examine shortly the mode of communica- tion, since a remote connection is at least evident; for the child is certainly influenced by diseases which affect both the circulating and nervous systems of the parent. There can be little doubt but that the extreme vessels in the maternal part of the placenta possess the pecu- liar irritability and sympathetic associations which dis- tinguish these extremities of the arterial system on the surface. • Their sympathy is also more extensive; and fever or terror, which affects the latter, with spasm or insensibility, will equally disorder the former. The want of a supply is consequently felt, and uneasiness must follow. Violent evacuations will often do little injury; for in that case the supply, though diminished, is not wholly stopped. Though there is, however, no immediate communication between the two systems, by means of nerves, it does not follow that the proximity of the minute nervous fibres, when their nonconducting coats are deposited, may not have some influence. If there is any foundation in the doctrine we have endea- voured to establish on that subject, it is probable that the vibrations of an elastic fluid, on one side, may have some influence on the nerves contiguous to them from PL A 184 PLA the other. We have indeed contended that divided nerves do not unite, so as again to communicate the nervous influence from the brain, or sensations from their extremities; but this apparently arises from their uniting in the usual way, by accretion and effusion, in short, by an inorganic substance, as is represented in the plates of Fontana. Nor is this nervous influence by approximation wholly without examples, were it pro- per at this time to engage in the subject. Some doubts have arisen whether the maternal blood is conveyed, without a change, through the vessels of the placenta; or whether some separation, perhaps some secretion, may not take place. The difficulty has arisen from its being observed that infectious diseases are not communicated to the foetus, or, at least, not readily and certainly, and from the suspiciun that the azotized blood of the mother might, in the earlier periods, be injurious to it. It is now, we believe, ad- mitted that fevers have not their origin in the blood; and it will be obvious that the foetus can suffer only from the disturbance of the balance of the circulation. Even putrid fevers, in a high degree, have been found not to affect the child in utero; and we know, from the experiments of Parmentier and Deyeux, that in these cases the vital fluid is very little altered; though we should, a priori, have suspected that the gelatinous fluids of the foetus were not very susceptible of putre- factive fermentation. Where poisons are more decid- edly present in the blood of the mother, the child is sometimes affected. The small pox has certainly been conveyed to the foetus, and it has been affected from the time the pustules have begun to dry into scabs, at the period when the maternal blood is most full. The lues, it is said, is not communicated; and it has been sup- posed, that when the child is affected, the communica- tion of the virus takes place in passing through the vagina. We have given some reasons for supposing this not to be the case (vide Lues); and may add, that, were it so, the local disease would probably show itself more frequently in the head than in the genital system, since the head is first, and for a longer continuance, exposed-to the contact of the virus. We must, from every view, admit of a communication; but some means are found for lessening the deleterious acrimony of the poison, often of destroying it altogether. It is not impossible that with the blood a milder portion of albuminous matter is secreted; perhaps the fluids of the foetus may not be susceptible of taint; or the poi- son be soon carried to the surface: a determination favoured by its being constantly bathed in water. The nervous communications we must leave among the numerous arcana of physiology, unless the commu- nication by the approximation of the ultimate uncoated fibrils on each side be admitted. We were, at one time, inclined to adopt the existence of a nervous aura com- municated to some distance; but found that the differ- ent facts would by no means support its existence, and that, in the present case, it would be inapplicable. We soon perceived, also, that the admission of this princi- ple would lead to numerous inconsistencies and impro- babilities. The influence of the mother in producing the nacvi, called from thence 7natemi, may be very shortly discussed, by denying it altogether. We have already given our reasons for it. The placenta is often diseased. It sometimes ac- cretes to the uterus, as observed by Morgagni, Steelier, and Gooch; becoming a firm tendinous mass, or, ac- cording to the last author, with beginning ossifications. It is often so closely attached, that no power which we can safely use will separate it; and the whole gradually sloughs away in succeeding menstruations. It some- times degenerates into cysts, or, probably, hydatids; of both we have instances in Bauer, Haller, Ruysch, and Valisnieri. Of its attachment to the os uteri we have already spoken; and in our plate we have preferred a case of this kind as the general attachment might be better understood from the appearances in this case, than the latter from a representation of the former kind. Tfie placenta was-, in general, removed soon after de- livery ; but within about thirty years, we believe chiefly from the recommendation of Dr. Hunter, it has become usual to delay the extraction; and it has been delayed for many days. We perceive in the older authors various and opposite opinions on this subject. Some contend that it should be immediately extracted, and that any delay is dangerous or fatal; others, that weeks and months may be suffered to elapse without making any attempt to deliver it. More attentive observation has preserved the medium. The extraction is not hurried; but seldom more than a day or two is suffered to elapse without attempting to bring it away, if nature should not perform the office. When the cord is broken, a little longer delay is occasionally necessary, that a partial separation may take place and give advantage to the operator. The inconveniences of suffering it to remain are a constant drain which de- bilitates the constitution; a mind unsatisfied and un- easy ; often putrid discharges: those of too rapid ex- traction are, pain; violent floodings; often inflamma- tion ; and sometimes, from rashness, inversion of the uterus. The most ridiculous and absurd medicines are re- commended to expel it. Myrrh, the skin of a hare, the dung of different animals, arid the testiculi equi, are among these. If myrrh has any effect, as we have suspected, of bringing on haemorrhage, it may be use- ful, but should it have such a power there is scarcely time for its action. In general, therefore, we should wait for some hours after delivery to see if nature will produce the separa- tion, which will be shown by fresh pains recurring, bearing down, and the cord, elongating when gently drawn. It hath long since been observed, that hastening the placenta was one cause of the difficulty in delivering it; and the most eminent practitioners agree that a flooding only can justify its speedy separation. When necessity obliges the accoucheur to introduce a hand into the uterus, the back of it should be toward the uterus, and the palm as close to the placenta as pos- sible, that the womb may not be injured in separat- ing it. PLACI'TIS, (from wXx%, a crust). See Cadmia. PLA'CTULjE. See Morpiones. PLADAROTIS, (from wXxfoipos, fiaccid). A fun- gous tubercle in the inside of the eye lid. PLA'GJl, (from wXittu, to strike). Solutions of PL A 185 PLA continuity, as wounds; though stripes, blows, S;c. are generally included. PLA'NCUS, (from wXx^a, to turn aside). See Lei- Oi'ODES. PLANIPE'TALUS, a plant which has plain, flat petals. PLA'NTA, (from planus, fiat). The sole of the foot, also a plant or vegetable, because it originally included only vegetables on the surface of the ground, which are trodden under foot. We have often remarked the difficulty of discrimi- nating even -the largest groups of animated nature, in consequence of the imperceptible shades by which one class of bodies passes into another. Even the animal and vegetable kingdoms can scarcely be dis- tinguished with accuracy from this cause. A plant may, however, be defined a living organized body, with- out feeling or spontaneous motion; which has the fa- culty of reproduction ; which grows and is nourished by intus-susception, through the medium of other bodies to which it adheres by some of its parts. Plants approach animals by an organized structure ; perhaps by a power of preserving a greater temperature than the elements which surround them, by a degree of sensibility and irritability: they approach minerals by not possessing a locomotive power, by having no con- taining vessels ; and, in many cases, by the function of nutrition being in part carried on by apposition. The anatomy of a plant, if fully detailed, would carry us to disquisitions of a disproportioned extent. It is sufficient to remark that every vegetable isfibrous; and its bulk, like that of animals, formed by an inorganic substance intersposed between the fibres. When these admit of no farther distention the tree dies, and at first on the top, where the impelling force is soonest exhausted. The nourishment is conveyed by vessels which pass through the bark, and from it the woody fibres are deposited. The wood gives firmness and solidity, but the tree will live and put forth shoots though the wood be destroyed, should the bark be unin- jured; at least in its whole circumference. It has been disputed whether the vessels of a vegetable are canals conveying a fluid within them; or whether the nourishment is conveyed along the fibres. Many authors have pretended to have seen canals in different species of vegetables, and have described them ; but future observers have not been equally fortunate, and on the whole it seems clear that the nutritious fluid passes along the fibres, which, by their juxta position, may be supposed to form canals. The most convincing argument in favour of the existence of vessels is, that if the plant is placed in ink, some parts will be coloured and others remain of their natural hue, which at least shows some affinity to different fluids in different parts of the vegetable. Those who admit of vessels distinguish the vasa pro- pria externa disposed in small bundles under the bark, forming a net work with large meshes ; the vasa pro- pria interna, found particularly in the oak and the pine, appearing to convey a fluid, which, on cutting the chelidonium majus transversely, may be seen to pass out; the vasa propria intima, found in the inner bark, and sometimes in the wood, which can scarcely be de- monstrated, but which Dr. Hill is said to have separated in the piscidia erythrina, after a long maceration; and vol. ii. the vasa propria, perhaps the only vessels cleari) demonstrated. These are large and numerous, par- ticularly near the surface, convey a viscid coloured fluid, and communicate with the utriculi. They are supposed to receive the sap from the lymphatic vessels, and to prepare the appropriate fluids of the plant. The lymphaticvessels are numerous, and pass from the roots to every part of the vegetable, conveying the nou- rishment absorbed from the earth. Those who contend for a circulation of fluids in vegetables, suppose them to arise through these, and descend through the vasa pro- pria, between the wood and the bark. Hill has de- scribed them as consisting of little cells included in each other,forming a hollow cylinder; but this author's fancy was often too predominant; and these appear- ances have not been seen by other observers. There are probably also inhalent and exhalent vessels, which are found in the leaves; a part analogous to the lungs of animals. The utriculi are described as vessels composed of ve- sicles slightly contracted at equal distances,but preserv- ing a free communication in the whole length of the canal. They appear, however, to be a mere cellular substance, communicating with the vasa propria, the lymphatic vessels, and the medulla. When the leaf of a plant, as an iris for instance, is broken transversely, and the parts slowly separated, small fibres are drawn out, which appear as if they had formed a vessel by spiral circumvolutions. These have been styled air vessels, or trachea; but with littlereason, for they sometimes appear to contain a coloured fluid. They are found in the minutest parts of the plant, even it is said in the stamina ; but later vegetable physiolo- gists suspect that these tracheae are peculiar only to the more adult state. Hedwig and Reichel thought them primordial ; other authors have supposed them irritable organs, the source of the motion of the sap; and Des- fontaines the rudiments of fibres. Nothing, however, is decided on the subject; but as they are found in the organs most completely developed, we should rather suspect them to be expanded fibres than primordial ones. Were they the latter, as Senebier has justly observed, we might discover them in a state of progress to the fibrous form. M.irbel, in his late work on the Anatomy of Plants, admits of five species of tubes, which supply the office formerly attributed to the vessels described by authors, viz. simple and porous tubes which contain the appropri- ate juices (succi proprii); the tracheae and pseudo tra- cheae, which he considers as tubes without assigning their use ; and the small tubes which form the bands and the ligneous strata. Independent of these vessels, Mirbel calls the regular and symmetrical vacancies of a soft texture, formerly by tearing themembranes,lacuna. The tubes and lacunae he supposes to be formed of a membranous substance, which is the primordial basis of vegetables. The former are without pores, which are numerous in the other. These pores are insensible, longitudinal, or glandular, according to the parts or species of plants in which they are found. The epidermis is composed of longitudinal fibres in the greater number of plants ; and in some, as the cherry tree, of transverse ones. The external laminae are sometimes inorganic; the internal frequently con- sist of distinct strata. The epidermis of the trunk and A a P L A 186 PL A branches is regenerated if destroyed; that of the fruits and leaves is never restored. It is evidently composed of a net work, or of numerous reticulated laminae, re- sembling spiders' webs; and perforated by the pores of numerous vessels. It enjoys life equally with the plant, and is not wholly a crust formed by the vegetable secretions. The glands of the epidermis of the leaves are called the transparent miliary glands by Guettard ; and they are of the colour of the parenchyma, separat- ing in the day oxygen, and in the night carbonic acid gas. The parenchyma, or the cellular texture, is discovered on raising the epidermis, and is a net work formed by fibres or transparent vessels filled with a green fluid, anastomosing at their meeting, and swollen at the inter- vals between their anastomoses. It is formed by con- tiguous vesicles, connected horizontally at right angles with the longitudinal fibres. In this part the ultimate elaboration of the fluids takes place, and the different gases are separated. Senebier thinks the colour owing to the remaining carbon, but the green matter is a re- sinous substance, and consequently does not contain carbon exclusively. The decomposition of the water, the cause of the ultimate change, is owing to the action of the solar light. The bark, or vegetable cutis, has been lately styled cortical strata, formed of a cellular substance, with closer meshes than those of the parenchyma. In the flattened net work we perceive transverse and longitu- dinal fibres, which communicate with the tubes and cells of the parenchyma. These are the fibres which in flax and hemp are employed to make linen and ropes, ulti- mately paper, either white or brown. The liber is the inner part of the bark composed of reticulated laminae with still smaller meshes, adhering so loosely as to be easily separated, and giving the idea of the leaves of a book, from whence its name is taken. The tracheae are very numerous in this portion of the bark. When there is a solution of continuity in the wood with loss of substance, the liber insinuates itself into the wound, and in a few years fills it with a woody substance. Du Hamel compared it to the periosteum of the hones, led by a false analogy, and erroneous ideas of the nature and formation of a callus. Between the bark and the wood we find strata of what is styled the alburnum, differing from the bark by the white colour and greater density. The vascular and tubular portions are more closely compacted, less nu- merous, and less sensible than in the bark. Some of the species of salix, when macerated, show this part most distinctly. It seems to be the wood in its progress to the ligneous state. This is, however, no part of the bark, but a primordial portion of the vegetable de- veloped to receive the fluid, which is to become wood. It is at first almost wholly albuminous, but from the influence of light becomes resinous; for etiolated plants are never woody. When the bark is removed, the ligneous state is sooner brought on ; and it is said to be advantageous to bark the oak one year before it is felled. The alburnum then becomes hard, the wood less perishable and less accessible to the at- tacks of the teredo navalis. The wood, is the hardest portion, and its laminae are very compact, containing, instead of fluids, a carbon, as bones contain between their fibres phosphat of lime. The lymphatic vessels are more numerous than in other parts, and convey the sevum, which, when in excess, is evacuated in drops, styled tears. These do not arise from the bark or the alburnum ; for lo procure it, as in separating sugar from a species of maple, the wood must be penetrated. It is an erroneous idea that the number of ligneous strata show the age of a tree. Those of two successive years are sometimes con- founded ; and in some years two are deposited, so that the stratum of spring and autumn may be distinguished. Ligneous strata should therefore be banished from the vocabulary of the vegetable system ; for in every part of animated nature we find, in the successive growth, only successive developments of primordial parts. The last portion is the medulla, confined to the centre of the dicotyledinous plants, and disseminated through every part of the monocotyledinous ones, according to Desfontaines. It is composed of loose vessels and utriculi, which are spongy and long in drying ; resem- bles the parenchyma, varying like it in density, accord- ing to the plant which contains it. The medullary canal is parallel to the longitudinal fibres, in the middle of which it is placed, and commu- nicates by its cells and vessels with the cellular texture. The fluids of these two parts differ only in colour; those of the latter being green from the access of solar light. Some medullary productions pass through the wood, and are gradually lost in the bark, or are spread through every part of the vegetable like the nerves of the spine. The appendices medullarcs differ only in extent, scarcely reaching beyond the innermost fibres of the wood. The medulla is in greatest quantity in young plants, and is then green, but the colour is fainter in proportion as the wood excludes the light. The medullary productions which reach the bark are sometimes green, but the appendices always white. In old trees neither of these are found; and it is said that they then produce fruit without kernels. The ancients uniformly supposed the kernel to be a produc- tion of the medulla, and deprived their trees artificially of it to procure fruits without a kernel, which were supposed to be more highly flavoured and succulent (Geoponica, lib. xx.); but Du Hamel was unsuccessful in his experiment, though he did not follow^with accu- racy the ancient process. Perhaps it is impossible to separate every portion of the medulla. The more of this substance they contain, the more easily are they propagated by buds and layers. Linnaeus supposed that the medulla had a considerable connection with the sexual parts of plants, and thought that the pistil was derived from it. Hales considered it as the most essen- tial organ to the nutrition of plants; but, as Senebier remarks, the old willows which still flourish without a medulla, refute this opinion. Columb, by boring trees at different depths, found the serum most abund- ant when the auger reached the medulla, and supposed that through it the juices mounted; and Plenck thought that it was a reservoir of nourishment in dry seasons (Physiologia and Pathologia Plantarum) ; but in such seasons the medulla is as dry as the rest of the plant. It is indeed probable that the medulla contains the nu- tritious juice of young plants, supplying the milk and the albumen of the cotyledons. At a more advanced period, this appropriate nourishment is unnecessary, and the medulla gradually disappears. PL A 187 PL A We have mentioned the important distinction of Desfontaines respecting the want of the medulla in the monocotyledinous trees, which, like the palm, are cylin- drical from the top to the bottom. He, therefore, divides trees into those which have cylindrical and those which have conical trunks: a division founded in nature, and of the utmost consequence to be kept in view. The more minute distinctions, and the growth of the branches, would lead us too far, so that we shall speak shortly of some other parts of vegetables before we treat of their physiology and pathology. The knots of vegetables are protuberances, formed by buds gradually distending. As this process takes place in the liber, the descending sap is arrested in its course, and forced into the bud. The fibres in this part are less strong, and slightly brittle. The knots are, however, the hardest parts of the wood, from the fibres being compressed by the expanding bud. Successive layers of wood cover them, but they are never effaced. Articulations are a species of knots proper to her- baceous and woody plants, which usually produce branches. The knots or articulations of reeds, examin- ed in a microscope, present a regularly formed tissue consisting of hexagons, mixed with small round bodies of a finer texture. The knots of a sugar cane form rings about five lines in breadth, whose surface contains five ranges of semitransparent points, arranged in a quincunx. The articulations are richer in juice than the other parts. There is much analogy between branches and knots, respecting their reproduction; for the roots usu- ally proceed from the knots in solaniferous plants, as well as in those multiplied by buds and layers. Buds and suckers are plants in embryo : they are but- tons, with the leaves imperfectly formed, and a year is often required before they can assume the name of a bud: the first appearance of a bud is called an eye; and, previous to this, in its first state of dilatation, it resembles in form a reversed cone. The most favourable moment for the evolution of buds is when the leaves begin to fall, as they then attract the fluids, both from within and without, and begin to enjoy an active life. Suckers are only buds which grow accidentally in consequence of a wound, which, interrupting the course of the sap, evolves a bud. Thorns have been supposed abortive branches, because they occasionally become branches. They seem, however, to be constant in the same species, and to have an active office, that of de- fence, in the infancy of the vegetable. In those mon- strous productions, from excess of nourishment, the thorns certainly sometimes become branches; but they are never fertile. To this we may add, that they are always directed to the earth; or, if apparently horizon- tal, inclined in a gentle angle to the ground, while the branches rise upwards. Thorns are in the first year covered with a bark, in the second the bark disappears, and after the third they usually die like an inorganic body. They have no power of absorption. If an an- nular incision is made round the branch below them, and the leaves above are taken off, they die the first year. Comparetti found them to originate from a bulb like the hair, and the bulb of the sting of a nettle was found to contain the acrid fluid which distils from its extremity. Thorny plants are stronger, drier, and more compact than others; and when the thorns are lost, it seems to arise from greater care and a more sue culent food. The flower is not only the ornament but the most essential part of the plant; for it contains the organs by which the species are continued. The sexual system is now established, and the stamina are allowed to be the organs which distinguish the male, the pistils those of the female, flowers. They are sometimes on distinct plants, more frequently indistinct flowers on the same plant; but most commonly the male and female organs are on the same flower, which is consequently called an hermaphrodite. It has been already shown (see Bo- tany) that the arrangement of Linnaeus is founded on the sexes of plants, and it will not now be soon dis- turbed. The flower in all its splendour is said to be only an ex- pansion of the other parts of the vegetable. The calyx has been derived from the bark, the petals from the liber, the stamina from the wood, and the pistil from the medulla. This, we believe, from the experiments and observations of Grew, Malpighi, and Desfontaines, is now rendered highly probable; and if, as has been con- jectured, coloured is only attenuated light, we can attain some knowledge of the source of colour which adorns the parterre. The sight is, however, pleased at the ex- pense of the health; for flowers exhale a deleterious gas, often highly injurious to delicate nervous constitutions. The double flowers are the monsters of the vegetable kingdom; for they are produced by an excess of nourish- ment, and the additional petals are the stamina which assume that form from excess. Like other monsters they are barren, and produce no fertile seeds. The stamina are the organs least known: those of the tulip are swollen at the lower part, and hollowed, according to Senebier, in irregular tubes through their whole length The tops are generally crowned by two ovoid capsules seen in the microscope, which are sepa- rated by a membranous septum. Spiral vessels are found in the stamina, particularly in those which are irritable, viz. of the barberry and opuntia; and it has been said that these vessels are the seat of their irrita- bility. Others, without deciding on the cause or the seat, attribute this irritability to the stamina of every plant; and Tessier seems to have proved that in all the ccrealia, the stamina at the rising of the sun turn to- wards the pistils, throwing with some force the pollen from the antherae. The opinion of Desfontaines, just mentioned, that the irritability is seated in the spiral vessels, seems to be supported by the experiments of Comparetti on the filament of the urtica and parietaria. Dr. Smith places the seat of the irritability at the base of the fila- ments, and indeed the joints seem the usual seat of this principle in every vegetable. Other botanists have sup- posed that the motion is mechanical, depending on the dilatation or contraction of the fluids in the vessels, by different degrees of temperature; but the existence of these vessels has been doubted. The antherae, placed at the top of the stamina, con- tain the true vegetable semen, which seems to preserve its prolific power for a long time, since we know that it may be conveyed by the air, and impregnate the fe- male flowers of dioicous plants at a great distance. The globules, which the microscope discovers, are A a 2 P L A 188 PL A apparently not the ultimate form of the pollen; for, when placed in water, they burst, and throw out with considerable force some smaller globules, or a sensible aura. Tessier found the pollen the most animalized of all vegetable substances, next to the gluten of farina: it afforded ammonia in the ultimate analysis, and appeared naturally of a resinous nature. The number of the pistils, the female organs, is the same with that of the seeds, and of the stigmata with that of the cells. On a general view, when the seeds are numerous the pistil appears single; but, on minuter examination, it is composed of as many pieces as there are seeds. Its lower part passes into the ovarium, and its surface is without any epidermis, covered usually with a viscid fluid. It is not yet decided whether the pistil is tubular. Bonnet saw in the orange, lily, and the linden tree apertures at the extremity of the stigma, continued through the pistil to the ovary, large enough to admit the fecundating pollen. It is supposed that in the moment of impregnation these apertures open to con- vey the pollen, and again close when the orgasm is at an end. Linnaeus suspected a similar contrivance, and Spa- lanzani saw an opening, but could follow it no farther than the middle of the style: in some plants he could not discover the smallest aperture. Hill declared that he saw it through the whole track; but Adanson, who only traced it in some species, supposes that the pollen is conveyed through the tracheae, when the pistil is not tubular. These, however, have not been proved to be pervious tubes. It is probable, as Linnaeus supposes, that the aperture is too small to be discovered; and when we consider the minute division of the pollen, it is scarcely probable that it could be brought within the reach of even the best assisted sight. May not the fe- cundation of the seeds be affected by a seminal aura, as was formerly supposed to occasion impregnation ? The whole analogy of animated nature, and the means of reproduction, oppose this opinion, and we were lately unwilling to admit it where its existence and influence were most probable, viz. in the connection between the mother and foetus. We have spoken of irritability, and given instances of its existence, though many more striking ones remain to be mentioned; yet no organs in which it is accu- mulated have been discovered, no source of this prin- ciple has been pointed out. The solar light decomposes the water, and its oxygen is exhaled, while the hy- drogen remains to form the oils and the green resinous matter of the leaves; nor is it improbable that azote is absorbed from the atmosphere. This process is un- doubtedly calculated to assist the circulation of the fluids through the lower parts of the vegetable, but by no means accounts for the motions certainly connected with irritability. An anonymous author has endeavoured to show that in meteorological phenomena the decom- position of water is attended with a separation of the electrical fluid, and in this way accounts for the posi- tive electricity of the atmosphere. (Exeter Essays, 372, &c.) If this be the case, may not the electrical fluid be the source of irritability, and may not the medulla be its great reservoir ? The pistil, the most certainly ir- ritable organ, is apparently derived from it; but if this be denied, the use of the tracheae has not yet been disco- vered, and the structure of these, calculated greatly to extend the surface, adapts it for the same purpose. This is, however, conjecture only ; nor is the present work a place to render it probable, though various facts occur to us which we think would rescue it from the oppro- brium of an hypothesis. The two great powers which convey the fluids of the vegetable through its vessels, or along its fibres, are the capillary attraction at the roots, and the decomposed wa- ter in the leaves, if we are not permitted to add the electricity evolved in the latter process. The sap in the early spring rises in waves, falling during the night, and again rising by clay, sometimes like the undulations of the ocean, sinking below its former rise, but still, on the whole, progressive. In the early periods the milky and albuminous fluid of the seeds supplies the young plant, as the maternal fluids in the placenta supply thy foetus. While the plumula has yet no power to expand its own leaves, nature has provided the rudiments of this organ in an appropriate form, styled the seed leaves; but its own soon expand, and the plant acquires an independent existence. In the progress of its exis- tence it annually extends in height, and increases in bulk. The wood is deposited from the bark, forming in its intermediate state the alburnum, either from the ascending, or, according to Mr. Knight's very ingenious experiments, in the descending vessels. The former, from the experiments with coloured fluids, seem to sur- round the medulla; but the minutiae of the vegetable physiology must not detain us. Thus we find, as in the animal body, the principal parts of the vegetable pre-exist in the germ. Every ad- ditional organic part is developed, and inorganic matter only added. We see in the peduncle of the pear the fibres which form the fruit, and can trace them gradually expanding to a determinate bulk; and the flower we can often trace to the bark, the wood, and the medulla. If we compare an animal with a vegetable, we must take one of the lowest rank as an example, for instance the polypus. The last appears to be a congeries of animals, and the vegetable seems also to combine in one body numerous individuals. Each may be propa- gated by buds; but they differ in one essential respect, that the food is. taken into a cavity before it is distri- buted to the parts around. We know not a single in- stance to the contrary, unless it occurs, as some authors have suspected, in the lower orders of marine vermes, the asterias, and some others. Irritability and sensibility, which distinguish animal creation, have been lately attributed to vegetables. We have pointed out a possible source in the electricity se- parated by the decomposition of water; but its opera- tion or its instruments have not been ascertained. The contraction of the sensitive plant is well known; but in others, particularly the hedysarum gyrans, cactus opuntia, cistus helianthemum, the amarillis formosis- s4ma, &c. the motions are regular, though not" spon- taneous, and apparently the result of organization rather than volition. It seems to reside in every part of the vegetable, since, when plunged into cold water, every part seems to contract, and the motions of the mimosa are said to be checked by watering it with a solution of opium. The irritability of plants is inter- mitted during the night, which shows its connection with the light, and almost every vegetable closes its P L A 189 PL A leaves towards the evening; some in the most striking, remarkable manner. Light, however, is not the only cause; for different flowers open and close at various times, and the convolvulus, for instance, soon after the sun has attained its meridian height. Linnaeus, from the opening of plants at different hours, has collected what he fancifully styles hoxologium flora, a botanical clock, viz. the flowers which show in this way the successive hours of the day. If by sensibility we understand the power of feeling, and being affected by external bodies without judging of their effect, plants may probably possess this quality. When a plant bends towards the light, or throws out unusually long roots, to penetrate a barren rock, and reach a more genial soil, we cannot deny it some share of sensibility. The same conclu- sion must follow when we find plants differently affected by the same nourishment or the same aspects. In this view they often show more sensibility than some of the lower animals, as the polypus, the stella marina, echi- nus, 8cc. Perceptivity implies some judgment of the effects of sensations, and this quality has been liberally bestowed on plants. Philosophy would appear to put on her most repulsive garb were she to deny what has given interest to an elegant and pleasing poem (Botanic Garden), and some entertaining speculations (Percival's Essays). It is necessary, however, to add, that not the slightest evidence has been adduced of the existence of this quality. Respiration is a function common to both animals and vegetables, though not carried on with regularity and constancy. Oxygen gas is separated, and carbonic acid air, perhaps azote, absorbed. It has been supposed that azote is also separated in the lungs; but we suspect that it is rather received, since many plants which grow in water alone decidedly show traces of this principle, particularly the tetradynamiae. Circulation, in the sense of an animal function, is not found in plants. The fluids rise and fall: we have said that no tubular vessels have been discovered, and probably none exist. Digestion and nutrition in the vegetable kingdom are simple functions. Water is the great source of aliment, indeed, many vegetables are nourished wholly by it; and this fluid, when decomposed, furnishes, as we have seen, the hydrogen to form the oils and resins, as well as the other secreted fluids, white the carbonic acid, perhaps the azote from the air, contribute to the forma- tion of" the wood, probably the seeds. Vegetable physio- logists have supposed that the fluids either absorbed by the leaves or the roots are carried to the utriculi, and there digested; but not the slighest evidence of this process has been given : at the same time there is ap- parently an inherent power in the plant, to separate those principles from the air and water which form its appropriate and distinguishing fluids. Pease and cres- ses will grow in distilled water, exposed to the same air, and yet contain very different principles. This pe- culiar power has not yet been ascertained, and probably will never be understood. M. Braconnot has, indeed, very lately examined this subject with more than usual attention; and his labours, which we have just received in the Annates de Chimie, vol. Ixi. may with advantage detain us for a short time. He examined chemically a rich mould, and found that it contained nothing soluble in water; but that its chief characteristic was a power of retaining moisture. He found in it the usual substances, which are nearly the component parts of vegetables deprived of the oxygen, and a proportion of hydrogen. M. Braconnot repeated the experiments of Tillet and Van Helmont, and found that plants would germinate in substances which could impart nothing to them, as litharge, flower of mustard, well washed sea sand, and even lead shot, though weakly in the latter, from its not retaining the water ; and the products were very nearly the usual ones which are found when they grow in the best mould. Radishes in river sand, well washed, produced rather a larger quantity of ashes than in common earth, with a greater proportion of potash. Where then can plants obtain their carbon ? It has been said, from the open air, but they will grow in air deprived of its carbon, and even in an exhausted receiver. We are, however, by no means satisfied with the author's reasons for rejecting Senebier's experiment with lime, since he h&s only proved that lime is volatile when joined with water or alcohol; and in the experiment it was suspended in the bottle where the vegetable grew. He has, however, sufficiently shown that the quantity of carbon is far greater than the air can impart. This principle must be, therefore, derived from the water, and very proba- bly, as he supposes, by the medium of light. The only principle which can in any respect supply the place of light is hydrogen; and our author suspects some affinity between hydrogen and light. Hydrogen is certainly contained in charcoal, and the diamond, which have been supposed to be carbon in the purest forms. While we thus speak of the food of plants, we may mention the suspicion that a part of their excrementi- tious fluids are discharged from the roots. A noxious excretion from the roots is evident, in M. Braconnot's opinion, from the unctuous and dark appearance of the earth round them. In several of the euphorbia and cicoraceous plants it is milky; and in the plants which grow in water the roots are, after some time covered with a glutinous substance. This subject, however, re- quires father examination. The more nutritious food of vegetables is manure. They may be divided, like animal stimuli, into the more steady and permanent, and the more active and diffusible. The former are animal or putrifying vege- table substances, probably in part azotic, but generally containing carbonic acid gas. Quick lime or marl may appear an exception to this idea; but it must be recol- lected that they are not used alone, and are mixed with other substances before they are applied. The calcina- tion renders them more easily divisible, and the remain- ing causticity seems of service in dividing the too ad- hesive clods. The more diffusive stimuli are salts of all kinds, particularly the oxygenated ones, which seem to exhaust the irritability; for they push on vegetation with such rapidity, that the plant soon dies. Light may be equally dangerous in excess, if water is freely sup- plied. Metals, metallic vapours, and metallic salts, are said to be poisonous to plants; but from some late ex- periments it seems that at least the latter have been usually injurious from their excess: in smaller propor- tions they seem to be useful, realizing the canon of Lin- naeus in the vegetable kingdom also, " Alimenta a toxicis non natura sed dosis distinguit." Reproduction is the last effort of all organized bo- dies, and the nearer they approach their end, the more P L A 190 P L A earnest does nature seem to supply successors. In the vegetable kingdom this is particularly striking; for to make a plant produce flowers and seeds no plan is more effectual than to confine, mangle, or weaken it. Of seeds and the early embryo we have spoken sufficiently; and of buds, shoots, or layers, it is enough to repeat, that a plant is a congeries of organized bodies. Sepa- rate one of these from the parent plant, and it is itself an independent active being. Light, we have seen, is the great stimulus of vegeta- ble motion. It is not, indeed, essential to vegetable life; for Humboldt found plants in the shafts of mines, where no light penetrates. We know, however, that vegetables have a strong affinity to light; and if it is a component part of bodies, which, from late observations, we have reason to think, it is not impossible that they may derive some portion of this principle, in dark situations, from surrounding substances. One singular fact merits notice, that, when deprived of light, well known plants appear in disguise from an altered shape of the leaves. They are more round, as if the points were elongated by the discharge of gas; for at the points it is chiefly emitted. Plants confined in dark- ness lose their colour, and are blanched, or, as it is called, etiolated: they lose also their peculiar taste and their acrimony, as is the case with the endive, the chi- coreum, &c. The reason, from what has been said, is obvious. The gases in large proportions, are destructive to vegetables : with oxygenous, azotic, and carbonic acid gas, a plant dies. With equal parts of carbonic acid gas and atmospheric air it dies also: with T2oS5 of this gas they languish; with eight they thrive vigorously. The most active vegetation goes on when a plant is wa- tered with a solution of carbonic acid gas, in an atmo- sphere with about -j1^ of the same. Buds take root most certainly in this way, if the light be excluded, or admitted moderately. It is often sufficient, by exclud- ing the external air, to confine the gas which arises from moistened ground; but it is safer to add a portion through an aperture, which may be again closed. Various other vapours are injurious to vegetation. We have mentioned quicksilver rising in the toricellian vacuum; but it appears, from some experiments of the Dutch chemists, that it may exhale even under the pressure of the atmosphere. Plants covered with a jar, immersed in water, in which a bottle of mercury was suspended, were covered on the third day with black spots, and on the fifth or sixth were quite black. In the experiments of Senebier the vapour of sulphuric ether prevented germination, without changing the qua- lity of the air. Camphor, oil of turpentine, asafoetida, vinegar, and ammonia, have a similar effect, if inclosed with growing or germinating plants. Vegetables exposed to impure exhalations of every kind flourish better than in the open air. Even the branches of a tree on the side of a dunghill are greener and more vigorous than on the opposite side, and such plants exhale more copious streams of oxygenous gas. Salts, as we have said, are the most powerful stimuli; but we cannot think the poudrette of the French (pul- verized stercus humanum) useful only on account of its salts. The azote seems to claim some share, as well in this manure as in the fumes of the neighbouring dunghill. Odoriferous, and even fetid substances, if mixed in a considerable proportion with the earth, im part their odour, and sometimes an unpleasant taste. The effects of the vegetable functions are increased temperature. It is, we believe, generally allowed tint the vegetable is warmer than the surrounding air, and resists for a long time the effects of frost, if not succu- lent, or peculiarly full of fluids. It has been said that this is owing to the high refracting power of the resins, by which they admit of the combination of a greater de- gree of heat; to the carbon being a bad conductor of heat, which confines it more effectually, as it abounds in the bark ; and to the heat of the earth, conveyed to the vegetable by its fluids. Each reason is, however, confuted, by the buds of the tallest trees resisting the effects of cold in winter, when no sap ascends, and no leaves are expanded. If the heat of animals be not a property of life, as there is much reason to suspect, the cause of vegetable heat may be the following. During the summer the combination of light seems, as usual, to separate heat; but as is does not appear at any time in a considerable degree, it probably enters into a new combination with some of the vegetable matter, from which, during the winter, it is slowly evolved. The temperature of vegetables appears to be uniform in the heat of summer and the cold of winter, so that there is, probably, some reservoir for its excess, though, in the present state of our knowledge, it cannot be pointed out. The great line of distinction between organized and inorganized bodies is, that the latter increase by juxta position of particles externally; the former by an intus- susception of the nourishment, and its application from within. Organized bodies include animals and vege- tables, and it would not be improper to compare the functions of vegetables with those of animals of the lower classes, to show more closely the concurring and discordant appearances, but that it would lead us into too extensive discussions. Some observations have led naturalists to consider different supposed vegetables to be the nidi of animals, and these we must shortly notice. The tremellae, which have been usually considered as plants, have neither roots, leaves, nor flowers: they wholly consist of a gelatinous substance, and seem, in reality the nostoch only. The latter, in stony ground, may be seen to assume in part the form of the tremella lichenoides, and in part to retain its own. In fact, the nostoch successively passes into the lichen gelatinosus, crispus, rupestris, and fascicularis, as well as the tre- mella verucosa; and these again change to other plants, the lichen crispus assuming the form of the lichen gra- nulans. From these observations, for which we are indebted to Carradori, whose memoir is analyzed in the Annates de Chimie, the tremellae must probably be ba- nished from the vegetable kingdom. In addition, we may observe that Adanson has seen the threads of the nostoch contract and dilate ; Fontana has shown that its filaments, like those of the ergot, were truly animals which die and revive by the action of water only; Corti and Scherer have seen the animals escape from the cen- tre to the borders; and the nostoch, in a chemical ana- lysis, yields ammonia. The last, indeed, is not a deci- sive argument, for many vegetables afford the same principle; but these have such decided marks of a ve-, getable nature that no error can arise. It is with less success that late authors have attempted PL A 191 PL A to raise the confervas to the rank of animals. It is contended that winged insects are seen to escape from them, and that when these no longer appear the green mantling on the water does not increase. This may be true; but the confervae expire oxygen. The nature of mushrooms has also been rendered doubtful, because electricity, which hastens the germination of vegetable seeds, and kills the ova of animals, not only prevents the germination of mushrooms, but even destroys those beginning to expand. Mushrooms, however, from their structure, must belong to the vegetable kingdom. If we thus partly limit the empire of Flora, the latest microscopical observations have greatly added to it. The spots, the rust, the mould, on various plants are true parasitic, organized vegetables, which have each peculiar distinct forms and appropriate habitations; but these belong to the pathology of the vegetable king- dom, lo which we hasten. The diseases of plants are chiefly external. There is nothing analogous to the nervous diseases of animals, but exhausted irritability from excess of stimuli, or its defect from too great succulence. Wounds are com- mon, and cured like those of animals, by excluding the air. Ulcers, in different parts, and of all the various kinds found in animals, are also common. They chiefly arise from lacerated or neglected wounds. Fi-actures and clefts are also frequent, and easily understood. De- curtation is the. death of the upper branches from debi- lity, either in consequence of a barren soil or a severe winter. As soon as the extent of the tree's power is seen, the branches should be cut off close to the living part, and this should not be too long delayed; for nu- merous vigorous lateral shoots seem to be thrown out by no more exertion than would push the sap to a very short distance in the dead part. Exostoses sometimes occur in consequence of an excess of nourishment; but often of its deviation from the true direction, induced by some weakness of the bark. On the contrary, the bark is sometimes too firm, and binds the tree so close as to prevent the circulation. This disease is styled hide bound, and it is necessary to cut down to the wood, in a longitudinal direction, from the first divarication of the branches to the earth. The bark, on the con- trary, sometimes exfoliates; and it is necessary not only give the contained viscera a smooth surface, and to confine an halitus secreted by the extremities of the ar- teries : the mediastinum keeps the heart more fixed in the centre of the body, and prevents wounds of one side the thorax from affecting the other. The pleura is of a firm texture, with many blood vessels and nerves in- terspersed; subject to inflammation and abscess. See Pleuritis and Abscessus. PLEURI'TICA. A pain in the side. PLEURI'TIS, (from wXevpx). A pleurisy or in- flammation OF THE PLEURA. Three kinds of pleurisies are described; the true or inflammatory, the false and the spasmodic or flatulent. In Dr. Cullen's system it is a species of pneumonia, and he defines it a pleuritic pneumonia, attended with a hard pulse; a pungent pain, for the most part, of the side, increased particularly in inspiration; a difficulty in lying down on the side affected; a very painful cough, dry in the beginning, afterwards moist, and often bloody. He distinguishes four varieties. 1. Pleuritides idiopathica simplices. 2. Pleuritides complicate. 3. Pleuritides symptomatice. 4. Pleuritides falsa. The true pleurisy is an inflammation of the pleura, with pain and fever, in its strictest sense on that side of the membrane which lines the ribs, though frequently communicated to the portion of the membrane contigu- ous, which covers the lungs. The pulse is remarkably hard, vibrating, and strong; but the pleurisy is principally known to be present by the pain in the side, with a high fever, a difficulty of breathing, and a short cough. The pain is usually just above the short ribs, increased by inspiration, and less on expiration; the breathing is consequently difficult, and the inspirations are short. The cough is short, sup- pressed, and in true pleurisy dry ; but a mucus is some- times spit up from the lungs, at first thin, but gradually puriform and bloody. When we have reason to think that the inflammation has extended to the lungs, and the disease has become, in the language of pathologists, the pleuro-peripneumonia. The existence, indeed, of a pleurisy without some de- gree of peripneumony has, however, been doubted by Bonetus, and many of the ablest practitioners. The descriptions of almost every author combine apparently the symptoms of each, and it is by no means an easy, perhaps a possible, task to separate them. We shall add, therefore, the distinctions which have, we think, occurred to us at the bed side. Pleurisy differs from peripneumony by the pulse being stronger and harder, the pain more acute, the in- spirations shorter, and more apparently spasmodic. The face is seldom flushed; the head lies low without increas- ing the dyspnoea; the cough is short and quick, without any expectoration. We think also that pleurisy does not commonly leave the side to affect the biliary system, though we have suspected its translation to the pericar- dium. Because there is a bastard peripneumony, au- thors have supposed that there is a bastard pleurisy ; but, in their descriptions, wc see only the rheumatic affection of the muscles of the thorax. The distinction between the pleurisy and the in- flammation of the mediastinum, or of the diaphragm, is sufficiently easy from the seat of the pain; and, in the latter case, from the painful constriction, around, on breathing. Rheumatism of the muscles undoubtedly assumes at times every genuine mark of pleurisy; but B b 2 PL E 196 P L E the distinction is of little importance, as the remedies are the same. Rheumatism, however, often shifts its seat to the joints, and the fever is sometimes diminished by general remedies, without any relief of the topical pain. In almost every instance also, in rheumatism, the partis sore to the toucii. We find some traces in authors of a putrid pleurisy. We cannot indeed deny the existence of such a disease ; but from its general nature we think it improbable. Putrid fevers often attack with topical pains; and if these should be in the side, those practitioners who are fond of multiplying diseases may readily suppose that they have discovered a new one. To this error we must probably attribute the observation, that bleeding is sometimes injurious in pleurisy. Pleurisy terminates, like other inflammations, in effusion, suppuration, and gangrene. The first is the most common; the last is peculiarly rare. Suppura- tion is most commonly the effect of that inflammation which arises from external violence; and in every in- stance, if we carefully attend, a fluctuation may be felt between the ribs, and the matter evacuated by a punc- ture or even a caustic. If the abscess bursts internally, an empyema is the consequence ; so that, if symptoms of suppuration come on, the part affected should be examin- ed with care, to solicit by poultices, or by a caustic, the evacuation of the matter through the skin. Suppura- tion is known to have come on by the cessation of pain, with the usual symptoms of shivering, throbbing, Sec. The causes of pleurisy are those of internal inflam- mation in general, viz. cold when the body is heated, particularly when partially applied. External blows and injuries undoubtedly bring it on, but a disease from these can scarcely be considered as true pleurisy, except when attended with general fever'; and numerous sti- mulating bodies accidentally swallowed are supposed to bring on inflammation of this membrane. These causes do not, however, vary the regulations necessary for the .elief of the disease. The bad symptoms enumerated by authors are those of debility, with a livid colour in the countenance, breathing shorter though with less pain ; in short those which show that a gangrene has taken place. When the pain remits, and shivers come on, we known that a suppuration is advancing; but in this case we can only attend, as we have said, with care, and solicit the pus to the surface. When this is perceived, a blister, an issue, or a caustic, will contribute to assist the ex- ternal discharge. The mode we have found most ef- fectual is, to cut between the ribs, somewhat below the point, till we form an issue, nearly through the inter- costal muscles, large enough to hold a horse bean. This, covered with the blister ointment, excites a discharge in a day or two, and the matter soon passes through the wound, which, after some time, heals readily. If there be no scrofulous faint in the constitution we have never found any difficulty in completing the cure, though the case is sometimes tedious: country air, a milk diet, anodynes, and tonics, greatly contribute to the salutary event. When we speak of the cure of pleurisy, we must be understood as meaning to treat of the pure disease, unconnected with inflammation of the lungs, an event which indeed seldom occurs; but as it sometimes hap- pens, it is necessary to consider it separately. At the end we shall state those circumstances of the coinci- dence of the two diseases which must modify our con- duct. Bleeding, in pleurisy, is so obvious a remedy, that it has been common-in every age; and the measure of the evacuation required is such that, when excessive bleeding is recommended, so great as in pleurisy is mentioned as the standard. The disease was apparent- ly more common and more violent in former ages than at present; for even the Botallista, as they are called, the followers of Botallus, are not reprehended as employing bleeding in too great a degree. The medical world were for more than eight hundred years divided in the dispute, whether the blood should be drawn from the arm of the side affected or the opposite one; and the authority, not of a college but of an emperor (Charles IX.) was called on to decide it. This singular deter- mination, which was to quiet the minds of physicians, was prevented by an unfortunate accident; for the em- peror died of a pleurisy, in consequence of being bled on.the wrong side, and his successor was too much en- gaged in his political views to assume the office of a medical dictator. The curiosity of a subject, now almost forgotten, has led us to look into it, and our enquiries have not only been a source of some amuse- ment but of- advantage to ourselves. We shall add a short abstract of the whole. The ancient authors, down to the era of Actuarius, where we limited the term, seem to have employed bleeding as the only remedy, even without adding the assistance of purgatives; and the blood was, in almost every instance, directed to be drawn from the arm of the side affected. The Arabians, on the contrary, seduced apparently by the Galenic doctrines of revulsion, direct- ed the blood to be taken from the opposite side, some- times from the vena saphaena; and they applied, for similar reasons, the cupping glasses to the legs. Yet when the violence of the disease was quieted, they cer- tainly admitted of bleeding from the side affected. Sub- sequent to the revival of learning in Europe, the re- commendations of practitioners have varied, but, in general, they have followed Hippocrates. We think we perceive one circumstance which ren- dered the Arabian practice to be less effectual: They bled frequently, and in small quantities ; for it is express- ly observed, that much blood must not be taken from the opposite side, lest there should be none left to sup- ply its place, and, of course, no revulsion could follow. The reason for bleeding in the vena saphaena, in cases where suppressed menstruation or haemorrhoidal dis- charge was supposed to be the cause, originated in the idea that this evacuation would prevent the morbid matter from rising upwards. Mercurialis and Caesalpi- nus have endeavoured to reconcile the opposite opinions of these different sects, but it is unnecessary to enlarge on their reasons, which are futile and unsatisfactory; nor could better arguments be drawn respecting the latter's ignorance of the circulation of the blood than from this part of his works. ,It may be worth remark- ing, that, in these authors, e directo et xxt t\tv, mean on the same side. A circumstance suggested by Vesalius during this controversy merits some notice. In every pleurisy, whether on the right or left side, he contended that blood should be taken from the right basilic vein PLE 197 PLE Since the arteries on both sides of the ribs, except the third superior, pour their blood into the azygos, and this vein inclines to the right, it is more readily, he thinks, emptied by opening a vein in the right arm ; but when the upper ribs arc affected, the blood, he observes, should be taken from the left, because these vessels arc connected with the left intercostal. It is singular how much this idea caught the fancy of many cotem- porary and succeeding physicians, especially when the" valves of the intercostal were discovered. Ematus, Salceus, Fallopius, and many others, modified, opposed, or confirmed the opinion of Vcsulius, which we now know to have little real foundation. In the course of this enquiry we have found much reason to conclude that many of the reputed pleurisies were really rheumatic affections, since the pain was felt at the origin and insertion of the muscles of the thorax ; an error, however, of little consequence. We have found also several traces of a putrid pleurisy, though not described with sufficient accuracy to enable us to judge whether it was really inflammation of the pleura with a putrid fever, a severe typhus with flying pains, or a pu- trid peripneumony. Wierus seems to describe the last, since it attended a malignant catarrh ; Gesner the se- cond kind, since it was relieved by a gentle diaphoresis. The obscure account of Cardon seems rather to refer to mediastina or carditis. But it is time to return more directly to the subject. We now know that bleeding is chiefly useful by its general depletion, and its diminishing the tone of the arterial system. In violent cases of pleurisy it is there- fore useful lo take off a large quantity of blood from a large orifice, and, in general, to bleed in a horizontal posture, that fainting may not interrupt the discharge. Less than eighteen or twenty ounces in a robust young man should not be taken at the first operation; and if the pain or the hardness of the pulse be not lessened, nearly as much may be drawn within the next eighteen hours. It frequently happens that it must be again re- peated. Incredible arc the quantities sometimes taken, with only a slight relief for a very few hours; and these very large evacuations are in strong inflammatory habits essentially necessary. Topical bleedings, with leeches or cupping glasses, are also necessary, if the pulse grows soft without any considerable diminution of the pain; but while the pulse continues hard and strong, the general bleeding must not be remitted. Blisters are also indispensable remedies; but they should not be employed early, nor until it is found that topical bleeding will be no longer necessary. They may be placed on the part where the leeches have bit with safety; but on the wounds with the scarificator they have been applied more cautiously, lest the absorp- tion of the cantharides should produce inflammation of the bladder. After a short time, however, a little swelling comes on in the lips of the wounds, and then they may be employed with little disadvantage. Such, however, is the violence and the rapidity of the com- plaint, that there is often little room for hesitation or delay. Purgatives^ are spoken of by authors in terms so vague that it is not easy to ascertain their real advan- tage. We have not seen them produce any striking good effect; and we should suspect that they were not remedies well adapted to this disease. To avoid irritation from the intestinal canal is always neces- sary. Diaphoretics have not been employed, we suspect, with sufficient attention ; and, from the analogy of this inflammation to rheumatism, as well as the little danger to be apprehended from checking expectoration, the powder of Dover, with probably camphor and nitre, may- be useful. If the seneka root is highly useful in this disease, as has been alleged, the advantages must arise from its united powers of an emetic, a purgative, and a diapho- retic : but emetics alone are not essentially useful; and as the seneka has gradually lost its credit, it is pro- bably by no means so highly advantageous as has been supposed. In this simple view of the cure of pleurisy it is evi- dent that we do not include any degree of inflammation of the lungs themselves, or even of their investing membrane. In peripneumony, though bleeding is use- ful, and often necessary, we can neither evacuate so largely nor so repeatedly as in pleurisy, for the truly salutary discharge is by expectoration; and if the strength is too far reduced, the sputum is prevented. We may repeat that the fulness and redness of the face often distinguishes peripneumony. If this be observed; if the patient cannot breathe but in nearly an upright posture; if the cough is constant and harsh, with a slight frothy, glairy, or bloody expectoration; we may conclude that the membrane of the lungs, or the sub- stance of the organ itself, is affected; and white we lessen the general inflammation by bleeding, we must cautiously diminish also that of the bronchial glands, and endeavour to bring on a salutary expec- toration. The bastard pleurisy is the disease, we suspect, often confounded with true pleurisy. It consists of a rheu- matic inflammation of the intercostal muscles, often of the other muscles of the thorax or abdomen. The dis- ease is distinguished by external soreness, and is re- lieved by bleeding and blistering. In this complaint the seneka is of no service. See Peripneumonia ; Sydenham's Works; Hoff- mann's Med. Rat. Syst.; Fordyce's Elem. part ii.; Cul- len's First Lines, vol. i. p. 311; Triller de Pleuritide. Pleuri'tis hepa'tica. A variety of pleurisy, com- plicated with an inflammation of the liver. See Hepa- titis and Peripneumonia. Pleuri'tis spu'ria. See Rheumatismus. Pleu'ritis sple'nica. See Splenis inflamma- tio. PLEURO'DYNE, (from wXevpx, and ofojv*, pain). Pains in the pleura. See Rheumatismus. Pleuro'dyne fu'gax. See Crampus. Pleuro'dyne rheumatica. See Rheumatismus. PLEUROPNEUMO'NIA, (from wXevpov, and wvev- (mvix, an infla7nmation of the lungs). A pleurisy com- bined with peripneumony. PLEURORTHOPNCE'A, (from wXevpov, oplos, up- right, and irveu, to breathe). A pleurisy in which the patient cannot breathe without keeping his neck erect. Blanc hard. PLEUROSTHO'TONOS, (from wXevpov, the side, and retva, to stretch). See Tetanus. PLI 198 PL U PLE'XUS, (from plecto, to weave together,) in ana- tomy, a net work, or a reticulated complication of ves- sels or nerves. See Ganglion. Ple'xus cardia'cus, or pulmona'ris, is formed of the ramifications of both trunks of the eighth pair, and their mutual communications with the filaments of the intercostal or great sympathetic nerve. It is situated above the lungs, on the fore side of the bronchiae, and distributes nerves to the pericardium, &c. See Nervi. Ple'xus cHOROi'DES,/;/e.rtt« reticularis, or retiformis. When the fornix is cut off, and removed, we see a vas- cular web, called the plexus choroidcs, with several eminences which it covers. The two first are called corpora striata, and the other thala7ni nervorum optico- rum. The first small eminences are united; the ante- rior are called nates, and the posterior testes. Le Dran explains the plexus choroides to be a folding of the carotid artery in the brain. See Cerebrum. Ple'xus pampimifo'rmis. See Spermatica chorda. PLl'CA POLO'NICA, (from plico, to knit together). Plaited hair. Gehena helotis, kolto, rhopalosis, the trichoma of Cullen, in the class cachexia, and order impetigines; a contagious disease, in which the hairs are thicker than usual, and so entangled, that it is im- possible to extricate them. This disorder is endemic only in Poland and Lithuania, and consists of several blood vessels apparently running from the head into some of the hairs, which arc greatly enlarged, elongat- ed, and closely convoluted. When the disease impends,- porrigo, phthiriasis, profuse discharges of sweat from the head, often hae- micrania, violent pains in the neck, back, shoulders, loins, and the extremities, sometimes even resembling gout, are felt. In some instances, swellings, ulcers, and exostoses, not unlike syphylitic or scrofulous ap- pearances precede; the sight is often dim, and the nails fall off. In other cases, palpitations of the heart, delirium, mania, fevers of different kinds and types, with tingling in the ears, and even deafness, are the precursors of plica. All these symptoms disappear in a single night, and the plica comes on. In females, the predisposition to the disease sometimes appears by a large flow of the menses, and a shooting pain under the sternum. When it does not attack at once, a few locks, on the hinder part of the head, appear matted, and inclining to the thickened state. The hairs on other parts of the body are said also to be occasionally affected. The disease is attributed to salt or bituminous water; to air confined by forests, and occasionally keen by the blasts from the Carpathian mountains; to dirtiness, or neglect of combing; to viscid or more acrid food. In no other country, however, do similar causes induce the disease. From the history given, it is evidently a cri- tical discharge, which no other can apparently supply ; and if checked, the complaint will probably return. It is said, and appearances confirm the probability of the event, that fatal haemorrhages have been the con- sequence of cutting off the hair; though other authors contend that this may be done with safety. The disease is said to be contagious, by wearing the clothes, or using the bed linen of those affected: no stranger suffers from it, unless by the most immediate contact of one labouring under the disease, even though he has lived long in Poland. The French army, lately in that 'country, is said to have experienced it; and from them some information may at a future period be drawn, which we shall take an opportunity to avail ourselves of. The cure consists in discharging the miasma by the safest outlets. As the bulbs of the hair are the organs which nature points out for its evacuation, the discharge from thence should be assisted. Warm fomentations to the head are consequently commended; and the decoc- tions of lycopodium, in water or beer, are said to be peculiarly efficacious. Erndtell, by a curious error, mis- takes the branca ursina for the lycopodium. The warm- er diaphoretics, with camphor, assisted by blisters to the back of the neck, are said to be useful; but active purgatives, emetics, and sudorifics, have been found to exasperate the disease. Though cutting off the hair is injurious, yet the spontaneous separation of the matted locks is attended with no danger. (Sennertus; Acta Na- turae Curiosorum, iii. 102. Acta Vratislaviensia, xiv. 103). Sulphur has also been strongly recommended. See Erndetelii Warsovia Illustrata, p. 153, kc.; Coxe's Travels; Primitiae Physio Medicae ab iis que in Polonia and extra earn Medicinam faciunt collectae i. 168 and 188; Philosophical Transactions, No. 256, 417, 483; Commercium Norimbergense, 1733. Tabul. iv. Fig. 4; Miscellanea Naturae Curiosorum, Dec. i. An. 6 and 7, p. 197; Hoffmann. Epist. ad Bonlokoe de Plica Polonica Vicat Memoires sur la Plique Polonaise Lausanne, 1775. PLICA'RIA, (from plico, to entangle; because its leaves are entangled together into one mass). See Ly- copodium. PLICA'TIO. A violent shock and bending of a long bone wtithout fracture. PLI'NTHIUS LA'QUEUS, (from wXtvhos). See Circus quadruplex. PLUMBA'GO, (from plumbum, lead). Plumbago; fer carbure Haiiy, iv. 98. Black lead. It is used for pencils, and not a medicinal substance. See Chemia. Plumbago in the vegetable kingdom, is leadwort, or French dittander, because its leaves are covered with lead coloured spots. Lepidiu7n dentillaria dictum; plumbago Europaa Lin. Sp. PI. 215, is a plant whose root is fibrous, pungent, and perennial; the leaves al- ternate and entire; the calyx hairy; the flower mono- petalous, placed on spikes. It resembles the parietaria, and may be a proper substitute for it. PLU'MBUM, (from palumba, because its colour re- sembles that of a dove). Lead. Saturnus, aabam, abartamen, accib, allabor, alomba, alracas, capricornus, molybdos. Greek writers often use the same name for lead and tin; and Latin translators interpret xxrnrepas by each term. Lead is of a bluish white colour, but easily loses its lustre, gradually contracting a dark tinge, and at last a whiter hue. When rubbed, it has a peculiar smell, though without taste, and tinges the fingers or paper of a blue colour. Its specific gravity is 11.35, and its hardness 5±; but neither are increased by hammering, like other metals. It is very malleable, though but slightly ductile, and not very tenacious. It melts in a heat of about 590°, and at a higher degree the metal boils and evaporates. Its crystals, when slowly cooled, PLU 199 PLU seem to be polyhedra, with 32 sides, formed by six quadrangular prisms. Water does not dissolve lead, but facilitates its oxydation by the air, and the oxyd itself is not soluble. It combines with oxygen in dif- ferent degrees, and the successive oxydations are of a grey, white or yellow, red or brown colour. Lead melted in an open vessel soon affords the grey oxyd, and, if this be scraped off as soon as formed, the whole of the metal may be converted into it; but its true co- lour is only obtained by a gentle heat, with a slight agi- tation. If this oxyd is exposed for a long time to a greater heat, it becomes yellow, and is then styled mas- sicot. It is singular that the white lead, obtained by corroding plates of lead by the vapour of vinegar, or precipitating nitrat of lead by potash, contains the same proportion of oxygen as the massicot, viz. 0.07. The yellow oxyd, ground to a fine powder, exposed to heat and to flame, with constant agitation, is styled mi- nium, or red lead, and contains 0.09 of oxygen. Nitric acid dissolves 185 parts of this oxyd, leaving 15 of a deep brown powder, or, when properly prepared, of a brilliant flea colour, containing 0.21 of oxygen. When heated, it becomes yellow, and vitrifies, emitting oxy- gen gas ; inflames sulphur, when triturated with it, and is reduced by melting on burning coals. All the oxyds of lead vitrify easily, and, in that state, combine with all metals except gold, platina, and silver, so that it is employed in separating these from the baser kinds. The separation takes place in a cup, made of the earth of bones, called a cupcll, through which the vitrified lead sinks, and is recovered again in brilliant reddish scales, called Litharge, q. v. Lead combines neither with carbon, hydrogen, nor azote; but readily with sul- phur and phosphorus, and most of the metals, particu- larly gold, platina, silver, mercury, copper, and tin. It also admits of an union with oils, see Nutritum and Emplastrum. The acids unite in general with lead, but the salts have not been carefully examined. They are, in gene- ral, insoluble in water, without an excess of acid; but the solutions of those which are soluble are transparent. All have a sweetish and somewhat astringent taste ; and the lead is precipitated by sulphurated hydrogen and the hydrosulphuret of potash, in a black, but by the gallic acid in a white, powder. A plate of zinc, in a solution of lead, is covered with the precipitate in its metallic state. All its oxyds do not combine with acids : the white, however, unites with every acid; the brown apparently with the greater number, but its combinations have not been sufficiently considered. The union of lead with the mineral acids is not easy nor rapid; and the salts are not used in medicine. The phosphat, the fluat, the arseniat, the molybdat, and chromat of lead are equally strangers in the medical world. The carbonat of lead is'formed by the union of the carbonic acid with its oxyd; most readily by precipitating the calx from the nitrat of lead, by car- bonated alkalis. It occurs, native, in large quantities, and it is the state in which the lead appears, when a white powder is formed in leaden cisterns which con- tain water, at the surface where it is contiguous to the metal: it contains about 15 of acid and 85 of oxyd, and is wholly insoluble in water. The acetous acid does not attack lead in close ves- 0els, and only oxydates it when in contact with the acid and the air ; but the oxyd is immediately dissolved as it is formed. This is the sugar of lead, the extract of saturn, and Gowlard's extract, as at present prepared. It is usually in the form of small needlelike crystals, which are four sided prisms, terminated by dihedral summits, sparingly soluble in water, unless with an ex- cess of acid; decomposed by heat, the sulphuric, phos- phoric, muriatic, fluoric, oxalic, malic, and tartarous acids, which form a salt nearly insoluble in water. The malat of lead is, however, soluble in the acetous, and weak nitric acids. The lactat of lead is soluble in water; and the sebat soluble in water and the acetous acid. Neumann asserts, that the acetite of lead is sus- ceptible of fermentation, and that in consequence of it a spirit is produced. The oxyds of lead are employed in coarse earthen ware, as glazing, from their power of sinking into the body of the ware, consequently being less subject to scale. We know of no experiments made on this oxyd. We once kept vinegar on a dish of this kind for twenty-four hours, in summer, without being' able to distinguish, by the nicest tests, any saturnine im- pregnation. Sand is often mixed with the calx of lead, which probably preserves the metal from the action of the acid. Lead, taken in any quantity internally, is highly de- leterious to every animal: externally it is sedative, dis- cutient, perhaps astringent. It destroys irritability, probably sensibility, and is on this account highly use- ful in external inflammations, in bruises, and those irritable sores which are highly painful and distressing. Internally the preparations of lead lessen the irritability of the arterial system, relieve internal haemorrhages and spasms. Its effects, however, on the intestinal canal prevent its free and unlimited use; for by de- stroying irritability it produces what is termed the dry colic, or the colic of Poitou, terminated by nervous spasms, convulsions, and death. From the period when sir George Baker discovered lead in the Devonshire cider every benevolent heart caught the alarm, and so numerous were the ways by which they supposed lead might be taken, that we could scarcely eat or drink from apprehension. It would fill several pages to de tail all the terrors of authors; but we shall add a speci- men of their observations, with some remarks. The diseases in the bowels, followed by palsy, which attack smelters, and the various manufacturers in works where preparations of lead are employed, plumbers, painters, and printers, are known to arise from lead; and wines, or cider, when acid and rendered mellow by the saccharine quality of the metal, may undoubtedly be injurious. It is said that the leaden dishes in which apples are pressed in making cider, communicate to the liquor a saturnine impregnation, and the consequence cannot be denied ; but it is comparatively rare. If the carbonat of lead was soluble in water, or a weak spirit, we could easily imagine that the oxyd formed in the dish of a pound might be carried into the vessel, and dissolved by the carbonic acid formed during fermenta- tion : it remains, however, to be proved whether super- carbonated lead may not be soluble in cider. Yet this ii very improbable, for cider colics are rare even in De- vonshire, almost exclusively confined to those who drink the harsh cider made from unripe fruit; and we know that such cider will produce the Devonshire colic P LU 200 P L I vhen no lead is employed in the pounds. If a salt of lead is formed in the dishes, it must be a carbonate or a malat of lead. The carbonate is wholly insoluble in water, and the malat insoluble, except in the acetous acid. Such salts, meeting with the acid of a sour apple, may undoubtedly be dissolved in cider; and if such colics arise from lead, they are produced in this way; but the various coincidences which must take place to render the cause efficacious, will show that the effect mbst be rare, and it is truly so. It is asserted also, by many authors of credit, that saturnine applications to wounds have produced the most violent colics, and we cannot deny it, but must add, that, by some singular fatality, surgeons of the most extensive experience in a large hospital, and no inconsiderable circle of private practice, have never met with a single case of this kind. To the effects of lead on the bowels, these benevolent and timid practitioners have added cardialgia, vomiting, dyspepsia, pains in the limbs, resembling rheumatism, haemoptysis, terminated by a suppuration of the lungs, a metastasis of morbid matter from the hands to the breasts, in females, palpitation, anxiety, fainting, con- vulsions, epilepsy, gangrene, atrophy, and death. It is singular that they have not added one effect which we have often seen, viz. bilious accumulations, in conse- quence of costiveness. In reality, colic pains, with such accumulations, obstinate costiveness and palsy of the hands, the latter preceded often by pains in the arms, and nervous debility, are the only symptoms of this poison. Undoubtedly the vapours of lead from the smelting houses are injurious, not only to vegetable but animal life, within the reach of its noxious effluvia; but it re- quires a strong faith to believe that birds of almost every kind have died from drinking water out of a dish glazed with litharge. Dogs may undoubtedly lick up the oxyd of lead from dishes of that metal, where water has long stood, but they will scarcely lick it from clothes; nor will doves suffer from eating particles of lead, chickens from drinking milk from a leaden vessel, or birds from picking seal-wax. In the human body it is equally absurd to speak of the danger of leaden pumps, leaden cisterns, the tinning by which copper vessels are covered, which contains a portion of lead or of pewter. The oxyd produced, if such vessels con- tain water, we know to be insoluble, and in no instance are they, we believe, employed to hold vinegar, except the tinned copper vessels, which contain lead only in the solder, and so intimately combined with bismuth as not to be affected by the acid. Milk, suffered to become sour in leaden vessels, is, we suspect, a rare occur- rence; and butter in such vessels rather grows rancid than acid. Sour milk is the acetous acid, and the solu- bility of a lactate in water docs not apply to it: we have seen, also, that even the acetous acid, when the access of air is prevented, will not dissolve lead. The distillation of spirits through leaden tubes, and even lining the chamber which receives the oil of vitriol, when sulphur is burnt, or the lead which the ores of the white vitriol may contain, we know, from the more correct chemistry of modern times, can produce no effect on the human body, as lead will not combine with either. The metal itself has been swallowed with impunity, nor can it meet with a menstruum in the stomach, which, without the access of atmospheric air5 can dissolve it. Wc once heard a medical gentleman assert, that the coagulated fat which swam on the gravy of roasted mutton, on a pewter dish, contained lead, and should be taken off; and Dr. Hardy, from mis- understanding a passage of Pliny, has gravely observed that boiling cabbage in a tinned vessel would dissolve the lead in it. Such are the absurdities detailed when all the terrors are alive. It is undoubtedly necessary to guard against the poison of lead with more anxious care, as its noxious quality is not betrayed by the taste like that of copper ; but the properties of its salts, and the relation of'the metal to the different acids, which we have anxiously- pointed out, will show the folly of supposing that it can be introduced into the system in the greater number of ways described. The mode of discovering it, pointed out by ancient authors, is equally ridiculous, viz. a whiteness and sweetness in the water. The oxyd is indeed insoluble; and if suspended may render water turbid, but its specific gravity will soon precipitate it. Sweetness it cannot impart, unless combined with the acetous acid, which either in wells or in the atmosphere it cannot meet with. The water which arises from the springs in the neighbourhood of Edinburgh, after rains, used to be white and sweetish, without the slightest suspicion of lead. The Bristol waters are soft, approach- ing to sweetness, without any such impregnation. The best tests of lead are, however, the hepar sulphuris; the hepar antimonii; or the hepar sulphuris arsenicale, dis- solved either in water or spirit. They should be used soon after their preparation, or a portion of the sulphur is deposited; and the darker fluids, as wine, should be diluted previous to the experiment. If the liquor to be tried contain chalk, or tartar, the precipitate will afford an uncertain conclusion; and the colouring mat- ter of wines, if such has been used, will often give the appearances supposed to arise from lead only. The liquor probatorius fortior of Hahneman is the most certain test, and we shall add the process for prepar- ing it. Two ounces of acid of tartar are to be dissolved in sixteen ounces of warm water, adding two drachms of calcareous liver of sulphur, very dry,and finely powder- ed. These must be shaken together in a bottle for ten minutes ; and after half an hour the clear fluid decanted into another bottle, which contains about half an ounce of the acid of tartar. The whole must be shaken to- gether, and, after standing one night, decanted into small bottles, to be very carefully stopped. The means of relieving diseases which arise from the unsuspected introduction of lead properly belongs to the head of poisons ; but since they sometimes hap- pen from using it as a remedy, it will probably be more convenient to speak of it in this place. In what manner the lead is dissolved which is handled only we cannot say. Its absorption is assisted by heat, and it is not injurious unless from constant employ- ment, and then only in particular constitutions. Nu- merous are the printers, glaziers, and painters, who have never suffered from the saturnine colic, and there are in reality few who ever experience it. The state of the metal, when it colours the hands, is not known. It seems to be an imperfect oxydation, with which wc are not acquainted, similar perhaps to that state of mer- cury when it assumes the appearance of a black powder. PL U 201 PL L1 Is it an union of the metal with the electric fluid ? The means of preventing it are simple and obvious. When glaziers' lead is flatted in a mill it comes out warm, and this part of his business should be always performed in gloves: indeed these should be constantly worn in every part of his work which will admit of them. The printer cannot employ gloves; but if he feels any incon- venience, it will be a sufficient preservative to wash his hands with soap and water whenever he leaves his work for his meals, and perhaps to smear them slightly with oil when he begins. The painter should have water always at hand, and wash off immediately every atom- of paint which accidentally falls on it. Each will find fat meat, particularly fat bacon, in a morning use- ful ; and occasionally, if costive, a dose of castor oil, or two ounces of olive oil, may be taken. By these sim- ple means we have preserved the health of many who have been constantly employed in either business, and experienced repeated attacks of a colic. When symptoms of a saturnine colic, the first effect of lead, come on, oils, mucilages, diluents, and warm water impregnated with hepatic gas, are recommended ; while stools are to be procured by cathartics, particularly castor oil. Without meaning to impeach the propriety of these directions, which are sanctioned by the first names in medicine, we would only contrast the empi- rical practice of the Devonshire farmer, which we have known to be successful, viz. equal parts of brandy and oil of turpentine. If indeed the irritability of an organ be destroyed, an active stimulus is apparently the best means of restoring it; and if restored, milder purgatives will more certainly succeed. We have never found the oleum ricihi sufficiently powerful without the aid of large doses of calomel; though the most active pur- gatives which have been recommended are the oil, magnesia, the bitter purging salt, and soda phosphorata (see Colica.) We forgot to mention, when speaking of the colica Pictonum (the colic of the Picts, as Dr. Wallis wisely translated it, who added that the Picts were subject to it,) that the abdomen is usually re- tracted ; and we lately found this symptom an import- ant one, in distinguishing the lead colic of a glazier from a common bilious one, during an highly bilious constitution. Lead is now almost banished from the practice of medicine as an internal remedy, and the courage of Dr. Reynolds has been spoken of with warm commend- ation when he ventured to order a single grain of ace- tated lead. We know, from experience, that it is by no means the hazardous remedy which it is generally sup- posed ; and have given five grains two or three times a day without any disadvantage, interposing only a dose of the oleum ricini every two or three days. It was for- merly given in headachs in a much larger dose, and then certainly brought on the dry colic. We strongly ..uspect, however, that our apprehensions have pre- cluded us from an active remedy, though we would not recommend its use, except under the immediate inspec- tion of an experienced, attentive practitioner. Lead in its metallic form is rarely used, except some- times in probes to keep wotmds or perforations from dosing. The ancients, however, recommended laminae of lead to be applied to the loins in nocturnal pollutions, to discuss scrofulous glands, and scirrhi, threatening VOL. II. cancer, as well as to give a support to weak joints, and to compress wounded arteries. Malouin (Chimie Me- dicinale, vol. ii.) and Fernelius mention the practice of some quacks who have given small scales of lead to cure leucorrhoea, haemorrhages, syphilis, and even gout. Van Helmont recommended small bullets in ileus, a practice which Naudeau imitated with success. We shall, as in our former articles on metals, first speak of the more usual preparations, and then shortly notice the forgotten formulae of ancient pharmaceutists. Ceru'ssa, or White lead ; dulcedo saturni, aboit, affidra, arsiora, blanca, effides, psym7nithion, psilothrum, is, as we have said, the first degree of oxydation, and usually prepared by exposing plates to the fumes of wine or vinegar, assisted by the heat of a dunghill. It is used as a cosmetic, but destroys the colour and the smoothness of the skin, injures the teeth and the constitution. It is adulterated with chalk and lime, so that the flaky masses called flake lead should be chosen. The weight will discover the adul- teration, or the anuriatic acid dissolve what chalk it may contain. If this test be not satisfactory, the lead itself may be reduced by calcining four parts of ceruse with two of fixed alkali and one of charcoal dust, and its proportion will show the purity of the suspected oxyd. This preparation was used in school of the Asclepiadae at Rhodes, and recommended by Diosco- rides, externally to destroy slight excresenccs, to heai wounds, ulcers, and excoriations, and to relieve pruratus. It has been also employed in erysipelas, in discharges from behind the ears, and to check the fetid perspira- tion of the feet; but in each case the most fatal effects are said to have followed. Pulvis e cerussa compositus, collyrium stccum, pulvis cerussae, is prepared by adding to five ounces of cerussa one ounce and a half of sarcocolla, and half an ounce of tragacanth. (Ph. Lond. 1788.) An improvement of the white troches of Rhazes, and used in inflammations of the eyes. Vinegar of litharge is made by digesting four ounces of litharge, in a pint of the strongest vinegar, in a sand heat for three days, shaking the mixture occa- sionally. It is not essentially different from a solution of cerussa acetata, though seldom pure, as the litharge generally contains a portion of copper. When this vinegar of lead is diluted with a large proportion of water, it relieves external inflammations from burns, bruises, &c.; itching and other uneasiness in cancerous ulcers; and, before Goulard recommended it, was used for bathing inflammations of scirrhous tuin.ours to pre- vent their becoming cancerous. The acetum lythargyri was also used as a secret remedy to stop bleedings, and cure scirrhous tumours. It is said even to have cured cancers, and to have pre vented impending gangrenes. Mi'nium; Red lead; acastum; alumboti. The state of the lead in this form has been already explained. Its preparation is a distinct business, and its makers melt large quantities of lead at once upon the bottom of a revcrberatory furnace built for the purpose, so that the flame acts upon a large surface of the metal, which is continually changed by raking it backward and for- ward until the fluidity of the lead is destroyed; the calyx is afterwards only occasionally turned. Red lead C c PLU 202 PLU is often adulterated with red oker, which is discovered by melting it as directed for discovering adulterations in white lead, omitting the alkali. Saccharum saturni; cerussa acetata; sal, dulcor, mel et magisterium saturni. Take of ceruse, a pound; dis- tilled vinegar, one gallon and a half; boil the ceruse with the vinegar until the latter is saturated; then filter through paper; and after proper evaporation set it aside to crystallize. (Pharm. Lond. 1788.) Repeat the evapo- ration and crystallization until no more crystals are formed. The ceruse should be finely powdered before the vinegar is added; and during the boiling it should be frequently stirred with a wooden spatula. The strong acid which remains after distilling vinegar is the most useful. If the heat is considerable, the acid will be dissipated before it combines with the lead. It will be sufficient that the vinegar be hot. When the solu- tion is exhaled for crystallization, a small quantity of rectified spirit of wine may be added. In all the intentions of the aqua lithargyri acetati, the sugar of lead may be used; and of all the preparations of lead for external use, cerussa acetata is perhaps su- perior to any, for we are much more certain of the strength of this preparation than of any other. The best mode of applying it is prescribed by Mr. Bell, in his Treatise on Ulcers, edit. 3. p. 43. Whether this salt be employed in solution, with eight parts of water, as usually directed ; or with oil of turpentine, which becomes red, styled by Crollius bal- samum plumbi; with olive oil of camomile and water, or other liniments, it is useful in every complaint for which the preparations of lead have been recom- mended. The various inflammations, even the erysipe- latous ones, have been, it is said, relieved by this remedy, externally applied. What comes near to this external application is its use in inflammations of the throat; and in aphthae, applied by means of a camel hair pencil; warmly recommended by Raulin and others, though not supported by more judicious practitioners. In gonorrhoea and leucorrhoea it is used as an injection when dissolved in water, sometimes with camphor; and after a little time with vitriolated zinc. Girtanner employs it, adding to each ounce of the solution thirty drops of the spiritus nitri dulcis, in which from three to eight grains of opium have been previously combined. In Ophthalmia, q. v. its use it well known. In swelled testicles it is a very advantageous applica- tion ; and in scorbutic ulcers, combined with opium and the white of an egg. It is highly commended in cancers ; in foul ulcers; in haemorrhages; in hysterical attacks, applied on wet rags to the abdomen; in diarr- hoeas, added to clysters; and in excess of lust, applied to the pubes. As an internal medicine it has been warmly corns mended, and as eagerly decried; nor need we stay to enumerate the authorities on either side, since the ge- neral opinion has decided on its danger. It has been generally used in haemorrhages, and all increased evacu- ations; in hectics; in gonorrhoeas: in night sweats; in intermittents; in internal inflammations ; in furor uteri- nus; mania; melancholia; hypochondriasis ; headach; dropsies; diseases of the spleen ; and more lately in America in chorea hysteria; epilepsies, &c. Various have been its combinations for these different complaints, and various its doses, from a quarter of a grain to half a drachm. To detail them minutely would be useless, since we cannot recommend the imitation. Extractum saturni, aqua lithargyri acetati, is pre- pared by gently boiling equal parts of litharge and vinegar for an hour and a quarter. If boiled longer after its separation from the mass, it is styled an extract. The London college call it aqua lithargyri acetati, and order two pounds four ounces of litharge to be mixed with one gallon of distilled vinegar, boiled to six pints, constantly stirring, then to be set aside; and after the faeces have subsided to be strained. Pharm. Lond. 1788. Of this a cataplasm is made by adding 5 i. of the water to one pint of rain water, and a sufficient quan- tity of bread crumbs to form a poultice. It is applied in local inflammation ; commended in cancerous and scrofulous cases; for improving the state of unhealthy sores; and in milk tumours of the breast. Of this acetated litharge the cremor lithargyri acetati is formed, by adding one drachm of the water of acetated litharge to one ounce of cream; of service in external ophthal- mia, applied upon linen rags. It is powerfully sedative, and useful in burns or scalds from the great degree of cold attending its application. Cerussa injectio composita. Rj. Pulv. Ceruss. comp. 9 i. zinci vitriolati gr. vi. aq. rosae 5 iv. m.; an useful injection in the inflammatory stages of gonorrhoea. Cerussa linimentum cum sapone. R. Solutionissaponis ? ij. aquae lithargyri acetati %i. m. ; a good application for diseased joints, and for bruises with deep seated ' inflammation. Aqua saturni, is called by Goulard the vegeto mineral water. He makes it by dropping into a quart of pure water an hundred drops of the extract of saturn, adding four tea spoonfuls of brandy. This is his specific in external inflammations, particularly of the eye, for wash- ing ulcers, cancers, scrofulous tumours, contusions, ^JM phlegmons, erysipelas, piles, chilblains, tetters, gan- '" j grenes, &c. A solution of the cerussa acetata will pro-1 bably have the same effect. * Ceratum saponis was introduced into practice by Mr. 'j| Pott, and is made by boiling gently together a pound of litharge finely levigated ; a gallon of vinegar; and eight ounces of soap, till all the moisture is evaporated. To this must be added a pound of yellow wax, and a pint of olive oil, previously mixed by melting, and the whole must be assiduously stirred from the beginning. It is a convenient and useful dressing for fractures and ulcers; and is nearly the same as Marshall's cerate, *£! though we shall approach nearer to it in another pre- paration. From the proofs of the fondness of the ancients for the preparations of lead already given, it'will be expected .'J that the ancient formulae, particularly the external ones, will be numerous. We were indeed surprised at the ^ extent of our list, but shall abridge our account so far ;, as will be consistent with a sufficiently exact and com- * prehensive view of the subject; and for the sake of 1 perspicuity shall divide those, not already noticed, into '1 oxyds, salts, solutions, plasters, and ointments. j Oxyds. The magisterium plumbi vel saturni is the ^% white calyx, precipitated from the saccharum by spirit '<" of wine, more frequently by potash. When vitriolic ., acid is employed it forms a vitriolated lead; when the PLU 203 PLU muriatic, a muriated lead, then styled lac plumbi. Each is recommended in phthisis, in stomach complaints; even in iliac passion and scirrhus of the liver : but at present both are neglected. Precipitatum saturni is only the lead precipitated from the extract by dilution. It is used as a cosmetic, parti- cularly in the little eruptions on the eyelids. Plumbum ustum is prepared by adding a sixth part of sulphur to the lead, and calcining them together. It contains consequently some portion of the vitriolic acid ; is of a grey colour, and was used in the age of Dioscorides. The plumbi cinercs which have often the same appella- tion, and are used in a saturnine plaster, are prepared by merely roasting lead, without any addition. The scoria argenti contain chiefly lead, and are used with the same intention as the other calces of this metal. Salts. Extractu7n saturni is only the vegeto-mineral water, deprived of all its fluid. The spiritus saturni, or as sometimes called, olemn satur7ii, is the vinegar ex- pelled from acetated lead by the strongest force of fire. It first comes over in a thinner, afterwards in an oily, form ; at first yellow, and next of a darker colour. It seems to possess only the virtues of a very strong-vinegar. It was formerly recommended in lepra, scabies, lues, and melancholia; but has apparently no peculiar virtue. Crollius gave three drops of the oil, mixed with wine, in colic. Nitrum saturninu7n is prepared by dissolving three parts of nitre with two of acetated lead, and crystallizing the solution. It seems to be an astringent; is re- commended in haemorrhages, and by Schroeder in asthma. There is apparently little reason to suspect any decomposition, and the salts seem to crystallize to- gether. If a double elective attraction takes place, the result will be nitrat of lead and acetated postash. If the preparation is so highly astringent as its admirers represent, this may be the case. Solutions. Acetated lead in a fluid form* occurs under different titles. The acetum saturni, in old phar- maceutical authors, has sometimes a small proportion of nitrous acid added; and, combined with a little of the camphorated spirit, has been recommended as a clyster in diarrhoea. The acetum cerusse, and acetum minii, some- times called tinctura minii, are similar preparations. The latter is ordered by Salchow in a dose of four drops, four times a day, in a case of gonorrhoea, while the vegeto-mineral water was constantly applied to the testicle, which at the same time was swollen. The extractum saturni of Janin is made by evaporat- ing the acetum lythargyri to the consistence of a paste. Two parts of this extract are then diluted with sixteen parts of warm water, and the whole kept in well stopped phials. It is supposed to be superior to Goulard's ex- tract in inflammations of the eyes; and when used, four drops of the extract, with three of camphorated spirit of wine, are added to an ounce of water. Goulard's extract is also an inspissated vinegar of lead, again reduced to a fluid form by the affusion of water. It is only used in this state, except when the author seems to have applied it of a thicker consistence, ap- proaching that of a plaster, to an inflamed tumour of the breast. The extract is employed in all cases where the acetated cerussa has been recommended ; and when joined wilh one third of oil of turpentine, one half of axunge (of a hare), and one forty-eighth of petroleum, has been applied with success to scrofulous swellings. Added to the extracts of hemlock, henbane, and opium, it is said to have relieved swelled testicles. Bell has recommended it in prolapsus of the iris, as well as in scrofulous, spongy, and torpid ulcers. An anonymous German author speaks of it in terms of commendation, when joined with soap, and applied to cancers; and with aromatics to tumours of the arm. In fomentations, with warm astringent decoctions, it is said to relieve incontinence of urine from a debility of the sphincters, phymosis, paraphymosis, ulcers of the penis, and bubos. The vegeto-mineral water of Goulard is only the diluted extract, with a double quantity of spirit jof wine, that is, double the quantity of the extract. It is recom- mended in almost every disease already mentioned, and many others, particularly in erysipelas from an external cause; burns of every kind; the bites of insects; gun shot wounds; prolapsus of the rectum; incarcerated hernia; venereal complaints; sinous ulcers; ozaena; fistula lachrymalis; and tumours either glandular or oi the joints. Other authors confirm, in part, the various virtues of this fluid; and Salchow adds, that pains in the teeth are relieved by rinsing the mouth with a diluted solution of it, and even gouty pains alleviated. Goulard recommends from twelve to fifteen drops, diluted with a measure of water, in heat of urine, an involuntary dis- charge of semen, gonorrhoea benigna, and even dysentery. The lac virginis is the same as the lac plumbi, former- ly mentioned, viz. the acetum plumbi, from which the lead is precipitated by means of alum, or common salt. The psoricum Galeni, whose use is known from its title, is a solution of lead with double its weight of chalchitis, a vitriolated iron, or an oxyd of iron, in vinegar. The oleum saturni is made by dissolving the saccharum sa- turni again in vinegar, crystallizing it, and suffering the crystals to deliquesce in the air. The tinctura antiphysica was not long ago in an Edinburgh dispensatory, but de- servedly neglected. It is an useful astringent, but owes its virtue to the salt of iron, for the lead is almost com- pletely precipitated. Plasters. These are uncommonly numerous, for preparations of lead have been added to plasters of al- most every kind, since the time of Dioscorides. A list of the titles only would be unsatisfactory, and to describe the formulae would be tedious, for near eighty different plasters have been enumerated. We shall omit them also for another reason. In the form of a plaster the lead is so intimately involved with the wax and oil, that it scarcely exerts its peculiar powers; and by far the greater number owe their utility to the other ingre- dients.. The ointments, including the cerats, exceed forty, but we shall only enumerate a few of the most important. The unguentum £ cerussa acetata, the nutritum, and the ceratum sapo7iis, have been already noticed. The unguentum ad ambusta of Juncken contains cerussa, camphor, powder of olibanum, and oil of roses, with the white of an egg; but that of Jurine is more neat and effectual. A drachm of litharge is dissolved in an ounce of olive oil, to which is added an ounce of wax, and a scruple of opium. In lax, spongy ulcers, the proportion of litharge is increased ; and in case of violent pains that of opium is larger. The unguentum apostolorum of the Wirtemburg pharmacopoeia con- tains turpentines, with a numerous host of resins and C c 2 PLU J04 PNE gum resins of a tendency opposite to that of lead. Bar- bette's unguentum ad cancrum ulceratum is rather an as- tringent preparation than a saturnine. The union of the lapis calantinaris with lead is not uncommon; and the unguentum e lapide ca/i;«/narf of the Swedish, the desicca- tivum rubrum of the new dispensatory, unguentum de tutia of Juncken, unguentum fuscum of Wurtzius, and griseum of Juncken; are of this kind. The unguen- tum hamorroidale noricum, as well as that of Wedelius, each contain camphor added to the calces of lead; and in the former is also a proportion of opium. The un- guentum e 7ninio camphoratum of the Wirtemburg dis- pensatory is a similar formula, but containing a larger proportion of lead in different forms; very nearly resembling Marshall's cerate. The unguentu7nmundi- ficans of Stahl is made by amalgamating lead with quick- silver in equal parts, to which is added the terra tri- politana, and the unguentum album camphoratum. The unguentum ad ophthalmiam siccam of Senertus con- tains litharge, camphor, and aloes: it is applied on the eyelids, chiefly in ophthalmia tarsi. Numerous are the unguenta ad scabiem which contain lead. In that of the Wirtemburgh dispensatory we find also styrax, oil of laurel, and mercurius precipitatus albus; in that of Schroeder, turpentine, common salt, and sulphur; in Juncken's turpentine, styrax, common salt, and juice of lemons. The cerats, as the name implies, arc of a greater con- sistence than the ointments, and for the reasons before assigned probably less useful. The ceratum e minio, however, of the Wirtemburgh pharmacopoeia, contains camphor; and is said to be highly useful in burns, in inflammations, and in the troublesome suppurations which sometimes arise from blisters. The ceratum sa- turninum of Goulard contains one part of his extract, four parts of yellow wax, and four parts of expressed oil. If a portion of the zincum ustum be added it is said to be more efficacious, and the most fetid ulcers to have been cured by it; taking internally small doses of muriated mercury, or drinking freely of an infusion of malt. Cerated linen spread with a plaster composed of extract of lead, camphor, and wax, are said to be useful in rheumatic and gouty pains ; as well as in tumours of the head, from external violence, buboes, and chilblains. From the very extensive list of saturnine applications employed from the time of Galen to the present mo- ment a fair inference may be drawn, that the external application of lead is not injurious to the constitution in general. Dr. Percival, Stoll, and some others, contend, that it has been occasionally so; and Tode, with a long list of authors on the opposite side, with the consent of the experience of more than 2000 years, declare their innocence. When we add the reflections already sug- gested, that, even applied to the stomach and bowels, it is less deleterious than has been generally supposed, perhaps imaginary terrors respecting its application will cease. We may now enlarge a little more fully on its action. All the metals, we have said, are tonics, though we have reluctantly excepted lead. Yet when we consi- der the various tonics which we employ, we shall find room for suspecting them to contain a narcotic quality. The Portland powder, which was long continued, showed a strong narcotic power; and all bitters, if not occasionally remitted, seem to impair the tone they were intended to restore. May not then tonics act chiefly by repressing irritability; for though irritability originates in weakness, its continuance leads to its ex- haustion ? If lead then checks irritability, it may be con- sidered as possessing, in one view, a tonic power; and of course not to differ from the other metals. If then, as we have said, iron is a tonic possessing an inflam- matory stimulus, lead, on the other hand, may be such, combining also a power purely sedative. The discus- sion we must, however, resume, vide Toxica. Can then its tonic power be obtained without its sedative ? or can its sedative effects be procured with- out endangering the destruction of irritability in the in- testinal canal ? These are questions which we dare not answer fully, lest we should lead to dangerous, un- warrantable experiments. In the course, however, of this enquiry we have been led, from occasional facts re- corded or incidentally mentioned, to think that the com- bination of mercury, perhaps of iron, may counteract its sedative power; and, from our own experience,' we know the interposition of oily medicines will probably preserve the intestinal canal from injury. The stimulus of many spices are confined to the alimentary canal only; and these interposed may perhaps prevent injury from lead. Such reflections may lead to a cautious trial; for a medicine so active, and which, with proper manage- ment, might prove so salutary, should not be neglected from imaginary apprehensions, or resigned till it clearly appears that no corrector can be discovered. « See Numann's Chemistry; Cullen's and Lewis's Materia Medica; Goulard's Treatise on the Effects and Various Preparations of Lead; Aitken's Observations on the External Use of Preparations of Lead; Bell on Ulcers, edit. 3. p. 36; London Medical Transactions, vol. i. p. 257. Plu'mbum ni'grum. Black lead ; fabrilis nigrica; ochra nigra; wadt. It hath none of the properties of common lead, except that of colouring in drawing lines. It is not now used in medicine, though formerly reck- oned drying and repellent. Strictly speaking, in modern mineralogical language, it is phosphorated lead; but Plumbago, q. v. is really meant. Plu'mbum candidum. See Stannum. Plu'mbum cinereum. See Bismuthum. Plu'mbum rubrum. See Adrop and Plumbum. PLUMME'RI PI'LUL^E. Plummer's pills. Levi- gate calomel, and the precipitated sulphur of anti- mony, of each two drachms, together; add three drachms of the gum, and one drachm of the resin of guaiacum; mix them well, and make them into a mass, with the bal- sam capivi. These pills, Dr. Plummer, in the Edinburgh Medical Essays, recommends in spots, pimples, and flushing in the face, virulent gonorrhoea, sciatica, rheumatism, lues venerea, ulcers with pains and swellings in the feet, scrofulous disorders, &c. The combination is un- doubtedly an useful one ; but too long continued triture renders the calomel less active. The ingredients should be rubbed slightly together; and we have sometimes directed the calomel to be beat in after the mass was made. Indeed their uses are the same as those of the uErHioPiCiE piLULiE ; q. v. PLU'MULA. A little feather; (a dim.ofpluma, a feather). See Corculum. PNE'UMA, (from wvea, to breathe). Spirit, air, PNE 205 PNE vapour, or the breath. (See Anhelatio.) It is also the appellation of a water called scythicus latex. PNEUMATICA. When the existence of an air, peculiarly pure, adapted to preserve life and flame for a much longer period than the atmospheric, was dis- covered, it was at once supposed that the universal me- dicine, so long sought, was found; and the sanguine expectations of physicians were still farther raised, when it was shown that it combined with the blood in respi- ration, giving it a more brilliant hue. Oxygen gas was consequently soon employed in various cases, particu- larly in hectics; but it was generally injurious, and ap- peared to increase the florid complexion, and the fever- ish heats, with all their distressing consequences. In fact it was soon found that this portion of the atmo- sphere, though necessary to support life, required to be lowered in its powers to prevent its too great stimulus; and we have at last discovered that the azote, the sup- posed injurious part of our atmosphere, contributes to some important functions, already hinted at, viz. the animalization of the nourishment taken in. Yet the prospect was too fascinating to be relinquish- ed, and the rapid discovery of various other gases kept expectation alive, and fed with delusive hopes the anxious expectations of the sufferers, and th,eir sympa- thizing friends. We fear that the injudicious eager- ness of some practitioners has contributed to render the disappointment still more painful, and the interested m selfishness of others has prevented the discovery of the truth, by withholding the different facts necessary for its development. From the present state of our know- ledge, little can be expected in medicine from the em- ployment of factitious airs. We shall, however, shortly notice what experience has fairly shown, and point out those cases where expectations may still be fairly enter- tained. The oxygen gas is highly stimulant, and, when fre- quently breathed, increases the irritability of the arte- rial system, often its tone. In still larger quantities it exhausts irritability, and acts like all stimuli in excess. Yet perhaps it has not been sufficiently tried in com- ^ bination with air of a lower quality, particularly with carbonic acid gas, or in cases where the irritability of the system is too much diminished, as in chlorosis, Br scurvy, the cutaneous diseases of old age, in scrofula, 8cc. In some of these diseases the oxygenated salts WKKtf appear to be useful medicines; and somewhat may be expected from breathing oxygenous gas, since dry ele- vated situations are often adapted to such complaints. Oxygen gas should be diluted with perhaps twenty times its quantity of common air, even in cases of di- minished irritability, and with twice as much in others. Carbonic acid gas has not been found efficacious in complaints for which pneumatic medicine has been em- ployed, we mean in phthisis; nor has the air in the neighbourhood of lime kilns appeared particularly salu- tary, where this gas is copiously mixed with the air of the atmosphere. In other forms it has been found use- ful. From fermenting poultices it has acted apparently as a powerful antiseptic; thrown on foul ulcers, and oc- casionally on cancers, it seems to correct the foetor and amend the appearance of the discharge; and similar effects have followed from washing them with water - impregnated with this gas. Internally, in the form of yeast, it is said to correct putrid acrimony in the bowels. The effects of the super-carbonated mineral waters in strengthening the stomach, and correcting symptoms of dyspepsia, have been frequently noticed. The hydrocarbonate is prepared by decomposing wa- ter by means of hot charcoal. Its immediate effects are to produce vertigo, and it should be diluted previous to its exhibition, by about thirty times its quantity of com- mon air. It renders a strong pulse more weak; but if the pulse be previously weak from disease, it will after some time render it slower and firmer, should its effects be salutary. It is said to be useful in hectics; but has not, we suspect, been tried in other complaints. It appears to be in general sedative, and occasionally nar- cotic ; nor are its effects in hectics very different from those of digitalis. We are sorry to be obliged to add that we have never found it peculiarly advantageous. Hydrogenous gas. The inflammable air of former authors, has had no fair trial as a medicine. Air of a lower temperature, and near marshes, where this pecu- liar gas appears to reside, is found useful sometimes in hectics, occasionally in asthmas. It has not probably been used in medicine, because it could not be breathed with safety, unless combined with oxygen; and in that state would be subject to explode. We do not recol- lect this union having been mentioned but by one au- thor, who, speaking of the want of medical enterprise, observed, that if by the electrical spark such explosions were produced within the body, he knew " not what would be the consequence." In this opinion we cor- dially acquiesce. Azotic gas. The mephitic air has been considered as so inimical to life, that we believe it has not been tried: but this gas, with a small proportion of oxygen, forms the nitrous oxide, which is said to act as a most pleas- ing stimulant, whose effects arise almost to intoxication without any subsequent languor. This air has not, how- ever, been the subject of any experiments as a medi- cinal substance, so far as our information extends. On the whole, perhaps, physicians were too much elated by the first discovery and the prospects it held out, and too soon disappointed by want of success. Much still remains in this department of medicine for a cautious trial. Yet we fear expectation may be again frustrated; for hitherto we have gained little by pneu- matic medicine. It may be useful to add that Mr. Watt has contrived convenient portable apparatuses for these purposes, and has added suitable directions for using the different gases. See Aer. See Cavallo, on Factitious Air; Dr. Beddoes' Works; and Dr. Thornton's Communications on Pneumatic Me- dicine, in the Medical and Physical Journal, passim. PNEUMATOCELE, (from wttvfut, wind, and xyM, a tumour,) hernia flatulent a and ventosa ; pneumatosis. A FLATULENT HERNIA, Or WINDY RUPTURE, Contains wind only in the herniary sac; but it is very rare. In some putrid fevers, in the small pox, and gangrenes, some parts of the skin frequently crackle like parch- ment under the finger; and in a very corrupted state of the fluids pneumatocele may be formed. Mr. Bell observes that the term is sometimes confined to a dis- tention of the scrotum by a collection of air. This hath been described by ancient writers as frequent; but all the tumours they describe as containing air were watery or true hernias. That species of hernia to which young children are liable is commonly termed v wind POD 206 POL rupture, as well as the collections of water in the scro- tum of new born infants. In wounds of the lungs, air is sometimes txtravasatcd into the surrounding cellular substance, passing into the scrotum, and over thewhole body; and in highly putrid diseases air may be sepa- rated from the blood, so as to distend the cellular sub- stance of the scrotum, as well as of other parts; but a real pneumatocele has never, probably, existed as a mere local affection of the scrotum. In the case of air diffused into the cellular substance, in consequence of a wound of the lungs, small punctures with the point of a lancet are found to be sufficient for evacuating it. But whenever the disease is induced by such a degree of putrescency as will separate air from the blood, a plentiful use of antiseptics and corroborants is indicated; but the disease will scarcely yield to them. Mr. Pott positively asserts that there is no tumour of this kind, and in this situation, in a living animal: it is indeed particularly described by many writers, both ancient and modern; but the complaint is either a true intestinal hernia, or a species of hydrocele, frequently a tumour produced by a small quantity of fluid remaining in the lower part of the tunica vaginalis, after its com- munication above with the cavity of the belly is closed; and a true, but a small, intestinal hernia. Some late writers mistake the encysted hydrocele of the tunica communis, which connects the spermatic vessels for the wind rupture; though it differs from the wind rupture in its situation : but if the encysted hy- drocele of the tunica communis is accompanied with an hydrocele of the tunica vaginalis, or with a true hernia, the Case is with difficulty ascertained. See Bell's System of Surgery, vol. i. p. 496; Parcy's Works, vii. 16, 17; Pott's Chirurgical Works, quarto edit.; Cullen's First Lines, vol. iv.; Morgagni de Sedi- bus, See. xliii. 35. PNEUMATO'SIS, (from mtvfutro*, to inflate,) is considered as a genus of disease including complaints which arise from air in any cavity. It contains the pneumatosis spontanea,-which arises without any evident cause, but usually from the separation of air in conse- quence of putrefaction; the p. traumatica, from a wound in the lungs, which suffers the air to escape into every part of the cellular substance; p. venenata, from poisons (see Venenum); and p. hysterica, when the air is con- fined in the stomach and intestines. See Emphysema, Pneumatocele, and Gastrodynia. PNEUMATO'MPHALOS, (from wvevfuc, and aj»- ipxXos, the navel). See Hernia umbilicalis. PNEUMO'NIA, (from wvevf^uv, the lungs). An in- flammation of the lungs, or its containing membranes. Dr. Cullen places this disease among the phlegmasia ; defining it a febrile affection, attended with pain in some part of the breast, difficulty of breathing, and cough. The species are, Pneumo'nia peripneumonia. See Peripneumo- nia. Pneumo'nia pleuritis. See Pleuritis. PNEUMO'NICA, (from the same). A sense of weight, or a load on the chest. PODA'GRA, (from was, afoot, and xfpx,pain). See Arthritis. PO'DEX, (a pedendo, from breaking wind). The fundament. See Anus and Prurigo podicis. PODOPHY'LLUM PELTA'TUM, (from wovs, a foot, and tpvXXov, a leaf, from its shape). See Anapodo- PHYLLUM. PODOTHE'CA, (from wovs, and n6^i,pono). See Chirotheca. POEGE'REBA. See Cortex pogereb*. PO'HUN WATERS. See Spa* aquje. POINCIA'NA, flower fence, poinciana bijuga Lin. Sp. PI. 544; frutex pavoninus ; crista pavonis; acacia orbis American, &c. grows in the east and West Indies: its seed pods, infused with galls, afford the best black ink; but no part of the plant is medicinal. See Raii Historia. POLE'NTA, (from pollen, flower). See Alphiton, PO'LGAHA. See Palma coccifera. PO'LIUM, (woXtos, white, from its white capilla- ments). Teucriu7n Lin. The two following have been noted in medicine. Po'LIUM MONTA'NUM LUTE'UM, SMALL UPRIGHT FOLEY mountain; teucrium polium Lin. Sp". PI. 792, x, is a small plant, with square stalks, oblong woolly leaves set in pairs, and labiatcd flowers. Po'lium cre'ticum, rosmarinum stachadis facie; teucriumfrutescens; t. creticum Lin. Sp. PI, 788; tree germander ; poley of Candia. The leaves are set on short pedicles, not indented ; the flowers stand in loose clusters, each on separate foot stalks. The leaves and tops of each have a moderately strong aromatic smell, and disagreeable bitter taste. Distilled with water, they yield a small quantity of yellow essen- « tial oil; and the extract is very bitter. The leaves and tops are said to be corroborant, aperient, and antispas- modic. See Lewis's Materia Medica. PO'LLEX, thumb; quod vi polleat, because in power and strength it is superior to the other fingers. See Digitus. Po'llex pe'dis. The great toe. POLLINI'CIO. See Condio. POLYADE'LPHIA,(from woXvs, many, and xfoxQos, brother). The name of the eighteenth class in the Lin- naean system ; comprehending those plants which bear hermaphrodite flowers, with three or more sets of united stamens. POLYA'NDRIA, (from ttoXvs, and xvr.p, a husband). The name of the thirteenth' class of the Linnaean sys- tem, comprehending those plants which bear herma- phrodite flowers, with many stamens, from twenty to a thousand, growing single on the receptacle. The num- ber of the stamens distinguishes this from the first eleven classes; their situation on the receptacle sepa- rates it from the twelfth class, icosandria; and their simplicity avoids all confusion with the sixteenth and eighteenth classes, 7nonadelphia and polyadelphia. POLYCHRE'STUS, (fromTreAvs, much, and xzi""7^* useful). An epithet of several medicines, assigned to them for their extensive utility. POLYCHRE'STUM, (from ttoXvs, and x?*™<> uae' ful). See Guaiacum. Polychre'stum sal. Salt of many virtues. See NlTRUM. POLYDI'PSIA, (from ttoXvs, and fo^x, thirst). See SlTIS. POLYGA'LA, (ttoXvs, and yxXx, 7nilk, from the quantity of its milky juice,) ambarvalisfios; amarella; polygala lutea Lin. Sp. PI. 990, common blue milk- wort, is a small perennial plant, with the leaves POL 207 POL dtcrnatc, uncut, and those on the upper parts of the stalk larger than those on the lower: the flowers are irregu- lar, tubulous, tripetalous, labiated, set in loose spikes on the tops, the cup composed of five leaves, the two larger of which continue after the flower hath fallen, and embrace, like wings, a flat bicellular seed vessel. The stalks of this common sort are procumbent; the lower leaves are roundish, the upper oblong, narrow, or pointed; the flowers are blue, purplish, or red; sometimes white, with a kind of fringed appendix on the lower lip ; the roots are slender and hard. It grows wild in dry pastures, and flowers in July. The roots are similar in taste to the seneka, and said to have, in a less degree, the same effect in pleurisy. Polyga'la se'nega, and marila'ndica. See Senega. Polyga'la I'ndica mi'nor. See Colinil. Polyga'la vera, poly gala major massiliotica ; colu- tea caule genista fungoso ; poly gala vulgaris Lin. Sp. PI. 986, x. Milk-vetch, used in infusion for increasing the milk. Polyga'la amara, Lin. Sp. PI. 987, is a narcotic bitter, and, like many others of this class, has been em- ployed in phthisis pulmonalis, but with the usual suc- cess. POLYGA'MIA, (from woXvs, and yxpos, nuptia). The twenty-third class in the Linnaean system, com- prehending those plants which bear hermaphrodite flowers, together with male or female flowers, or both. This term, applied to a single flower, regards the inter- communication of its flosculi, as in the first, second, third, and fourth orders of the class syngenesia. Polyga'mia frustra'nea, (from frusta, to no pur- pose). The third order in the class syngenesia, com- prehending such of the compound flowers as have per- fect florets in the disk, producing seed, but imperfect ones in the ray, which are barren. Polyga'mia super'flua. The second order in the class syngc7iesia, in which the florets of the disk are hermaphrodite, and fertile; those of the ray, though female only, fertile. POLYGONA'TUM, (woXvs, and yow, a joint; from its numerous knots or joints.) Sigillum Solomonis; C07ivallaria polygonatum, Lin. Sp. PI. 451, is a plant with unbranched stalks, oval, narrow leaves, ribbed like those of plantain, generally all on one side; on the other side hang oblong monopetalous white flowers, two or more together, on long pedicles, followed each by a black berry; the root, the part used, is white, thick, fleshy, with several joints, and some flat circular de- pressions, supposed to resemble the stamp of a seal. It is perennial, grows in woods, and flowers in May. The roots are said to be astringent, incrassant, and cor- roborant ; if bruised and applied as a poultice, it dissi- pates the black colour from contusions. See Raii Hist. POLY'GONUM,'(from the same). Knotgrass; calligonum, centinodia, carcinethron, corrigiola ; poly- gonum aviculare Lin. Sp. PI. 519. The root is creep- ing and fibrous; the stalk and branches full of joints'; the stalks recline towards the earth, are smooth, finely channelled, slender, and branched, full of knots or joints, from which grow long, oval, sharp pointed leaves. The root is cooling, astringent, and hath been used against internal haemorrhages; externally against in- flammations. See Raii Historia. Poly'gonum bistorta. See Bistorta. Poly'gonum persicaria. See Persicaria. Poly'gonum minus. See Herniaria. POLYGY'NIA, (from woXvs, many, and ywn,~ a wo- ma7i). A class of plants, in whose fructification there are many pistils, the female organs of generation. POLYMERI'SMA, (from woXvs, and pe^os, a mem- ber). Supernumerary limbs or parts. POLYMO'RPHOS, (from woXvs, and fupipn, a shape). Multiform. See Sphenoides os. POLYNEU'RON, (from woXvs, and vevpov, a string). See Plantago. POLYO'STEON, (from woXvs, and os-leov, a bone). The metatarsus, which consists of many bones. POLYPE'TALUS, (from woXvs, and welxXov, a flower leaf). Many leaved. See Petala. POLYPHA'RMACOS, (woXvs, and tpxppMxov, a medi cine; from its various uses). See Polychrestos. POLYPHY'LLUS, (from woXvs, and tpvXXov, a leaf). Having many leaves. POLY'PODES, (from woXvs, and wovs, afoot). See ASELLI. POLYPO'DIUM, (from the same; on account of its numerous ramifications resembling a polypus. Poly- pody. Polypodium vulgare Lin. Sp. PI. 1544, x, is a fern with long leaves issuing from the root, divided or. both sides, down to the rib, into a number of oblong segments, broadest at the base; it hath no stalk or ma- nifest flower; the seeds are a fine dust, lying on the backs of the leaves, in roundish specks, disposed in rows parallel to the rib; the roots are long and slender, of a reddish brown colour on the outside, greenish within, full of small tubercles, supposed to resemble the feet of an insect. It is an evergreen, grows in the clefts of old walls, rocks, and decayed trees. That produced on the oak is usually preferred, though not superior to the other sorts. It yields its virtue both to water and spi- rit; but the spirituous tincture is the sweetest, though the spirituous extract is only astringent. The leaves have a weak, ungrateful smell, a nauseous sweet taste, a roughness, and a slight acrimony. Its virtues are those of the fern; but it has been lately given in mania, though with little success, and is frequently used in the catarrhs of old people, as, like the fern, it unites a slight astringency with its demulcent qualities. The ancients supposed it to be a purgative, and peculiarly fitted to discharge pituita. They therefore depended on it in cases of melancholia. Polypo'dium te'nerum mi'nus, filix querna repens, polypodium dryopteris Lin. Sp. PI. 1555, oak fern ; grows in marshy places. If the root is bruised, and applied to the skin, while sweating, it is said to take off the hair. Polypo'dium fi'lix fcemi'nea. See Filix fs, and x°'Pes > m Latin, sus and scrofa. Pork is not easy of digestion, and considered by Sanc- torius and others to have the strongest tendency to re- tard perspiration; consequently it has been considered as unwholesome. The Jews, who were generally affect- ed with lepra, were perhaps on this account forbidden to eat it. As this animal is generally extremely fat, it is consi- dered as highly nutritious to such constitutions as can digest it easily; nor is it, as has been supposed, indi- gestible when in its younger state. When salted in the form, of ham or bacon it is less easily assimilated; but its stimulus renders it in small quantities sometimes acceptable to weak stomachs. The name porcus, and porcellus, is given to some fish, particularly the dolphin, because they are said to root up the earth, like swine, with their snouts. Por- cus also, from the Greek word #oes,-is a name for the pudendum muliebre. PO'RI, (from weipu, to pass through). The pores of Dd2 POR 212 P o s the skin are described by Lewenhoeck as so small, that one grain of sand will cover one hundred and twenty- five thousand: but this was apparently an optical de- ception ; for no future observer has discovered them. The extremities of the exhalents undoubtedly open un-' der the cuticle; but their orifices are not visible. PORRI'GO, (d porrigendo). See Pityriasis and Furfurosi. PO'RRUM, (from wpxa, to burn, because of its hot taste. Common leek, is similar to garlick, but weaker. It is carminative, and diuretic. The juice of leeks has sometimes succeeded in dropsy, when other medicines have failed. PO'RRUS. See Sarcoma. PO'RTjE VENA, vel PORTARUM VE'NA,(from porta, door, or entrance). The splenic, mesenteric, and mesocolic veins, uniting at the root of the mesen- tery, form the vena portae, janitrix, or ramalis vena. It may be considered as two veins joined at their trunks, one of which is ramified in the liver, the other in the viscera of the belly: the former may be called hepatica superior, or minor; the latter ventralis inferior, or ma- jor. The trunk of the vena portae hepatica is called its sinus, from which five principal branches are divided and spread through the whole substance of the liver, ending apparently in thick, villous folliculi. In these the bile is secreted, and collected by as many vessels of another kind, whose apertures are called pori biliarii, which again unite in one common trunk, ductus hepa- ticus. The vena portae ventralis is situated under the lower or concave side of the liver, between the middle and right extremity of that sinus; from thence it runs down from right to left under the trunk of the hepatic artery, bending.behind the beginning of the duodenum, and under the head^-the pancreas ; its length exceeds three inches. At the head of the pancreas it divides into the meseraica major and minor, and the splenica. See Winslow's Anatomy. PORTAI'GUILLE. See Acutenaculum. PO'RTIO DURA, MOLLIS. See Nervi, and Nervus auditorius. PORTLAND POWDER. A medicine celebrated for the cure of gout, and at one time highly fashionable, from the relief which a duke of Portland was supposed to have derived from it. This powder was composed of equal parts of germander, ground pine, gentian, and centaury, and a drachm of these powders, well mixed, was to be taken in a glass of wine and water, broth, or tea, every morning fasting, and nothing was to be taken for an hour and half afterwards. This course must be continued for three months; three-fourths of a drachm taken for three months longer; then half a drachm for six months. After the first year half a drachm may be taken every other day only for one year longer. It is recommended also in rheumatism, if not habitual. This is an old remedy, traced by Dr. Clephane from Galen down to almost our own times; but he remarks, that the ancients were cautious in employing it, pointing out the danger of its inducing dropsy, pleurisy, and peripneu- mony, from its constant use, and from its great danger in particular, if the gout has become habitual. Modern experience has confirmed these cautions, and the medi- cine is now neglected. See Clephane in the Medical Observations and Inquiries, vol. i. Vide Arthritis. PORTORA'RIUM, (the door, or entrance into tht intestines). The duodenum or the pylorus. PORTULA'CA, (from porta, to bring, and lac, milk, because it is supposed to increase its secretion,) an- drachne ; allium Gallicum, portulaca oleracea Lin. Sp. PI. 638. Purple or garden purslane, a culinary plant; but the seeds and leaves are supposed to be cooling, antiscorbutic, and moderately astringent. Portulaca maritima. See Halimus. PO'RUS BILIA'RIUS,(from wopos, a passage.) The beginning bile duct. See Jecur, and Pori\e vena. Po'rus o'pticus. The point of the retina where the optic nerve enters, which is insensible. Po'rus reticula'tus. See Eschara. PO'SCA. Vinegar and water mixed. POSOLOGIA. (See Dosis.) The doses of me- dicines are chiefly learnt from experience; but some guide is necessary for the young practitioner, and for this reason we shall subjoin a posological table, rather as a general guide than one to be implicitly trusted in every case. The minuter regulations of the dose may be more readily understood from the remarks in the particular article, or under the disease for which it is prescribed. For many reasons, though we shall give the highest and the lowest doses, the latter will be ra- ther beneath than above the standard. Doses distinguish, we have said, medicines from poi- sons; and, on the other hand, aliment from remedies. Minute attention is, however, requisite in many cases, since it is not improbable that the specific action of re- medies depends on their doses. Our experience with mineral waters shows that some medicines, in a small and minutely divided quantity, are more effectual than in larger doses, and in a more concentrated state. We cannot imitate in any other way the tonic effects of iron, or the laxative powers of neutral salts in propor- tions so small; and it is highly probable that if we ever find the exhibition of factitious airs highly beneficial, it will be in much smaller quantities than have been hi- therto exhibited. Injudicious, particularly young, eager, practitioners having once learnt that a remedy has a peculiar power, think that power will be necessarily augmented with the dose; and if they are capable of distinguishing, a faculty not quite so general as~ may be reasonably supposed, they soon perceive their error. Camphor, for instance, in a dose of five or six grains is a mild sedative, and often a diaphoretic, in fevers; in a dose of twenty grains it frequently produces nausea, increases the heat, and proves highly injurious. Opium in too large doses prevents instead of promoting sleep, and acts rather as a stimulus on the bowels than a narcotic. The laudanum purgans of an old pharmaco- poeia owes its laxative virtue rather to the dose than the addition which it receives, calculated chiefly to prevent its being rejected by vomiting. In fact, every medicine beyond its proper dose is usually the source of consi- derable inconvenience, promoting generally increased or irregular action. POS 2L3 POS TABULA POSOLOGICA Simplicia. vbsynthium Abrotanum Acetum Acidum vitriolicum - Aconiti extractum Acetosae succus Acorus radix -firugo ... Aloe succotrina Altheae radix Alium - Alumen - Ammoniacum Anethi semen A nisi semen Anguslurae cortex Antimonium praeparatum Arabicum gummi Aristolochia tenuis Arnica ... Arsenicum Arum ... Artemisia Asarum - Asafcetida Aurantiorum cortex - ------------folia ----------- succus Bardanae radix Balsamum canadense ---------copaibae Dos minim. gileadense Peruvianum tolutanum Benzoin gum - Bistortae radix - Borax - Cajeput oleum - Camphora ... Cahella .... Cancrorum chelae vel oculi - Cantharides - Cardamines flores Cardamomi minoris semen - Carduus benedictus Carui semen - Caryophylli aromatici Cascarilla - Casia fistularis ... ---- lignea - - . - Castoreum ... Centaurii minoris summitates Cepa - Cera alba - Cerussa acetata - Chaelidonium Chamaedrys - Chamaepitys Chamemaeli flores Chinae radix (decoct.) Cicutae folia arida & semen succus inspissatus gtt. xx. Cinarae succus Cinnabar nativum Cinnamomi cortex Citri cortex Coccinellae - Colchicum Colocynthis Columbae radix Contrayervae radix Coriandri semina Cornu cervi Cortex Peruvianus Cotula foetida Cremor tartari - Creta - Crocus - Cubebae - Cumini semen - Cuprum ammoniacale -------vitriolatum Curcuma - Cuscuta - Cydoniorum semina - Daucus creticus & sylvestris Dictamnus albus & creticus Digitalis folia arida Dolichos setae gr. x. XX. Ebuli cortex & semina gr. xv. 3i Elaterium - gr. x. 3ss. Enula campestris Eruca - gtt. iij. xii. Eryngium - gr. v. 9i- Erysimi semen & radix gr. vi. xii. Eupatorium (succus recens.) 9i- 3i- Eupatorii extractum gr. ss. nj. di- 3i- Ferrum - gr. vi. 9i- Filix mas. radix gr. xv. 3i- Foeniculi dulcis semina di- 3i- Fuligo ligni gr. iij. 5ss. Fumaria - gr. x. XXX. ?ss. Iij- Galanga - - -» di- 5i- Galbanum gr. v. di- Gallae - di- 3i- Gutta gamba 9i- 3i- Genista (in decocto) 9i- 3ss. Genistae semen gr. 1. vi. Gentianae radix 9i- 3ss. Di- 3i- gr. i. gr. v. gr. v. gr. x. gr. x. gr. xxv £l: 3i- 9ss. 9i. 3ss. 31. POS 214 POS Geoffroeae radix Ginseng - Glycerrhizae radix Granati cortex Gratiola - Guaiacum gummi Haematites ... Hedera terrestris(in infuso) Helleborus albus Helleborus niger Hordeum (in decocto) Hyoscyami folia arida & semen Hypericum, flores Jalapae radix - Ipecacuanha - Iris florida. succus Juniperi baccae Juglans. cortex Kino, gummi Dos minim. - gr. v. - gr. xv. - 5ss. - 9i- - gr- x. - gr. x. - gr. x. - gr. vi. - gr. v. gr. 1. gr. v. gr. xv. gr. x. 3SS- gr. x. 3i- maxima. gr. xv. 3ss. 3"- 3ss. 9i. 5ss. 3ss. 5iv. gr. xv. x. 5vi. gr. iij. gr- x. 9ij- 3ss. 5ss. 9ij- 3U- gr. x. 9i. 5m ■ 9i- Labdanum. gummi - - - gr Lapathum acutum & aquaticum. suc- cus .... Lavendulae flores ... Laureola foemina (mezereon) in de cocto .... Laurus vulgaris, oleum Lichen islandicus (in decocto) Lignum campechense. Extractum Lilium album ... Limoniorum succus -----------cortex Lini semen (in infuso) Linum catharticum folia Lobeliae radix (in decoct.) libra una quotidie xv. 3SS- 5"»- Macis - Magnesia Majorana (in infuso) Malva (in decocto) Manna ... Mastich Matricaria Mechoacanna Mel Melissa (in infuso) Mentha viridis 8c piperita Mezereon; vide Laureola Millefolium Millepedes Moschus - Myrrha - Nasturtium succus Nicotiana (in infuso) Nitrum - Nux moschata Nymphfiea alba, in decocto Oleum olivarum gr. x. 3ss. gr. x. gss. §iij. Bvi. ad libitum. ^ss. ^ij. 3ss. Jij. 3SS. gr- x. di- 9i- 3ij- - ad libitum. di- di'i- 3i- 5U- gr. v. 9i. gr. x. 3ss. 3SS- 3^- gr. v. 9i. gr. v. gr. xv. ad libitum. Oleum ricini ... ------terebinthinae Olibanum - Opium .... Opoponax ... Origanum in infuso Ostrearum testae Pareira brava - Petroleum - Pimpinella saxifraga Pimenta - Piper indicum ... -----nigrum & album Pistaceae nuces Pix liquida in infuso Pulsatillas extractum Quercus cortex Radix Indica Lopeziana Raphani rusticani radix Rhabarbarum Rhaponticum ... Rhamni radix - Rhododendron - Ricini semen - - - Rosa rubra, petala Rosmarini flores Rubia tinctorum Rutae folia ... Sabinae folia ... Sagapenum ... Sal ammoniacum crudum ---cornu cervi ... ---marinus- ... Salix cortex - Salvia in infuso - Sambuci baccarum succus Sanguis draconis Sapo .... Santalum rubrum -------- album Et citrinum Santonici summitates Sarsae radix ... Saxifragae lignum (in decoct) Scammonium ... Scilla recens ... —— exciccata - Scordium ... Senae folia - Seneka. radix Serpentariae radix Serpyllum in decocto Simaruba. cortex Sinapi. semen - Sium. succus ... Solanum dulcamara, in decocto Spermaceti - Stannum - Staechas Stramonium ... Styrax - Dos minim. maxima - 5"j- P- - gtt. X. gtt. XXV - gr. x. 3i- - gr. i. gr. iij - gr. xv. 3ss. - ad libitum. - gr. x. 3ss. - 9i- 3i- - gtt. X. gtt. xx\ - di- 3ij- - gr. v. gr. xv. - gr. v. gr. xv. - gr. vi. 9i- 5iv. gvi. - gr. v. 9i - 9i- 3i- - 3ss. 3ij. - di- diy - gr. xv. 5i- . - 3ss. 3i. - 3i- Siij- - gr. v. gr. x. - gr. ij. gr. iij. - 9i. 3»j- - gr. x. Bij- - di- 9U- - 9ss. 3i- - gr. xv. 9ij- - gr. x. 9i. - 9i. 3ss. - gr. v. gr. xv. - 9ij- 3U- - 3ss. 3ij- - ad libitum. - 3'tj. oss- - gr. x. Bij. - 9i- zss. - coloris ergo - ad libitum. - 3SS- 3ii. - 9i. 31- " 1UJ 5vi. - gr. v. gr. xv. " gr- v. 3ss. - gr. i. gr. v. - 3ss. 3i- - di- Si- - 9i- Si- - 9ss. 3ss. - ad libitum. - gr. x. 3ss. ■ 5i- Iss. " ly- quotidie. - 5iss. 5^'. " 9i. fry - gr- x 9ij - gr. i. »j - 9ss. 3ss. POS 215 Succinum - Sulphur .... Tamarindus ... Tanacetum - Taraxaci succus Terebinthina chia Terra japonica - Thus..... Thymus in infuso Tormentillae radix Trichomanes in infuso Trifolium palustre in decocto Tussilaginis folia, in decocto Dos minim, maxima. Extractum cicutae ----------cinconae POS Dos minim. - gr. v. - 91. corticis elentheriae - 'Ai. colocynthidis compositum gr. iij. gentianae - - Si- ad libitum. d'\. 3ss- ad libitum. ad libitum. — glycerrhizae — hellepori nigri — haematoxyli — hyoscyami — jalapii — papaveris albi — rutae — sabinae - - ad libitum maxima. xv. 9U- 3ss. XV. 3ss. Ulini cortex interior in decoct, quotidie. libra una. Uva ursi.....ji. gss. Valeriana sylvestris - - ftj. zj. Vitriolum album gr. i. pro emetico gr. v.—x. ---------coeruleum. See Cuprum vitriolatum. ---------viride - - - . g-r# v# gr> x Winteranus cortex Zedoaria Zincum ustum Zinziber gr.x. 9i. gr.x. 5i. gr. i. gr. gr. v. gr. v. xv. PR^EPARATA. Acetum scillae -------colchicum .(Ether vitriolicus velnitrosus Aqua calcis Aqua ammoniae ---------------purae - ---------------acetatae Aquae simplices' ------spirituosae gtt. xx. gtt. xxx. gtt. xx. xxx. gtt. xx. xl. libra una quotidie. gtt. xxv. lx. gtt. viii. xvi. 3vi. 3»j- Ii 3i Coagulum aluminosum libra una quotidie. Confectio aromatica ... jjgg. Confectio opiata - - - gr. v. Conservae .... ^j, Conserva ari - - - ^i. ---------scillae - - - - gr. xv. 3U- gr. xxv. 3ss. Decoctum commune pro clystere ■- pectorale Decoctum cinconae —--------cornu cervi -------— hellebori albi ---------- sarsaparillae -----■--------------compositum Electarium casiae -----------senae olim lenitivum e scammonio Elixir aloes - -----vitriolicum acidum Essentia limonum Extractum aconiti ————— cacuminis genistae §iv. Jfciss. ad libitum. giss. Jiij. Jfei tfeij. quotidie. Ibiss. quotidie. ffji. quotidie. ffei. quotide. 3»- 3U- 9i- 3vi. 3u- gtt. xx. lxxx. gtt. x. xl. gtt. i. gtt. v. gr. i. v. gr. x. xxv. Infusum gentianae compositum --------senae - --------senae tartarizatum - --------rosae ... Julepum e camphora ---------- creta Lac ammoniacum Mel acetatum Mel rosae ... ----scillae Mercurius dulcis sublimatus --->------muriatus ----------vitriolatus Oleum amygdalae ------lini --.. -------jecoris aselli - ' ------- ricini ... -------anisi - ------- carui ... ■ cinnamomi -------juniperi - -------lavendulae ------menthae piperitidis -------origani ... ——— pulegii ... -------roris marini sassafrae ... -------terebinthinae Oxymel colchici ■ scillitici ... Pillulae aromaticae -------aloes compositae -------aloes cum myrrha -------galbani compositae -------hydrargyri -------opii ... -------scillae - Pulvis aloes cum canella —-----------— guaiaco —-----------■—■ ferro ----aromaticus ----asari compositus ----cretae compositus 3i- 3 iii- ad libitum. ad libitum. 3ss. 5i. gr. i. x. gr. i gr. ij. gr. ij. gr. x. gtt. vi. gtt. iij. gtt. xxv. gtt. vi. gtt. xv. gtt. x. gtt. xii. gtt. viii. gtt. xii. chelarum cancri c. cum opio gtt. x. gtt. xxx dn- 3*- 3»- 3ij- gr. xv 3ss. gr. vn 9i. gr. xv. gr. xxv. 9ss. 9i. gr. v. gr. xv. gr. iv. X. gr- x. 9i. gr. v. gr. x. gr. vm . XV. gr.x. 9i- gr.x. gr. xxv. gr. v. Vlll. gr. x. XXV. gr. v. gr. xv. gr-x. 9i- POS 216 POS Dc Pulvis contrayervae c. ----ipecacuanhae c. —— myrrhae c. - ----opiatus ' - —— scammonii c. - - ------------cum aloe ----------------calomel -----senae c. ... ----tragacanthae c. - - Sal catharticus glauberi -------------amarus — cornu cervi - — diureticus - — martis - — succini - — tartari (kali vel soda) Spiritus ammoniae compositus 1 - succinatus ----------------foetidus ■ anisi c. carui c. ■ cinnamomi ■ juniperi ■ lavendulae c. ■ menthae piperitidis sativae ■ nuclei fructus myristicae ■ pimento - ■pulegii raphani c. ----— rorismarini Stannum. pulvis Succus graminis Succi scorbutici Sulphur auratum antimonii Syrupus papaveris albi ,,------------erratici ■ rosarum solutivus ■ scilliticus ■ spinae cervinae tolutanus minim. gr- x. gr.x. 9i. gr x. gr. v. gr. v. gr- v. 3ss. gr. xv. 3»j- 3^- gr. v. 9i. gr. v. ?)iaxima. 3ss. 3ss. 3i- xii. 9i- xv. 3i- 3SS- ^iss. giss. xv. 9ij- gr. xv. Dos minim. gr. viii. 3ss. gr. vi. 9i. gtt. x. xxx. gtt. viii. xxv. gtt. xx. xl. Iss. Iij. gtt. xx. lx. gtt. xv. xl. 5ss. 5ij. Tartarum emeticum - In this estimate of the doses of medicines, we can- not expect to meet the sentiments of every practitioner, nor perhaps always to be minutely and accurately cor- rect. As we have already remarked, this table is in- tended rather as hints to conduct the practitioner in his own observations than as a guide to be blindly follow- ed ; for many are the varieties which will result from age and sex; from temperament and idiosyncracy. They are, indeed, so numerous that we engaged in the task with hesitation and reluctance; nor are we certain that we may not have done more injury by assisting empi- ricism than service to the younger practitioner. • In the table of preparations we have followed the London pharmacopoeia almost exclusively ; not that we confine to it exclusive excellence, for both the Dublin and Edinburgh pharmacopoeias merit peculiar attention We soon found, however, that to include these would not only extend the catalogue beyond its proper limits, but by names similar, yet different, by formulae vary- Tinctura aloes assoe fcetidae aurantii corticis balsami peruviani balsami tolutani cantharidis cardamomi composita cascarillae castore'i catechu chinconae -----— ammoniata ------composita cinnamomi composita ■ columbae ■ ferri ammoniacalis ----muriati - galbani - gentianae c. - guaiaci - hellebori nigri - jalap ii - myrrhae - - opii camphorata rhabarbari • sabinae c. • scillae senae serpentariae Valerianae zinziberis ammoniata xxx. )V1. Vinum aloes ------antimonii ------antimonii tartarizat. ------ferri ------ipecacuanhae ------rhabarbari ing often rather in appearance than in their nature, we should require endless explanations to guard against confusion. We gave up the attempt the more readily, as in Dr. Duncan's very valuable dispensatory they may be readily compared. In the tables annexed to that work we find a comparative view of the doses of the more important medicines, according to each dis- pensatory, with which we shall conclude the present article. Tables, showing the proportion of antimony, opium, and quicksilver, contained in some compound medicines. Tartrite of antimo7iy.—Wine of tartrite of antimony contains two grains of tartrite of antimony, or tartar- emetic, in the ounce. Ed. Opiu7n.—Opiate confection contains one grain of opium in thirty six grains. Lond. Opiate or thebaic electuary contains in each drachm about a grain and a half of opium. Edin. Electuary of catechu, or japonic confection, contains POS 217 POS in each ounce about two grains and a half of opium; for one grain of opium is contained in one hundred ;tnd ninety-three grains. Ed. Compound powder of chalk with opium contains one grain of opium in about forty-three grains. Lond. Compound powder of ipecacuan contains one grain of opium in ten grains. Lond. Powder of ipecacuan and opium contains six grains of opium in each drachm, or one grain in ten. Ed. Opiate powder contains one grain of opium in ten. Lond. Pills of opium contain one grain of opium in five. Lond. Opiate or thebaic pills contain six grains of opium in each drachm, or five grains contains half a grain of opium. Ed. Tincture of opium or liquid laudanum is made with two scruples of opium in each ounce of the liquid, or with five grains in each drachm. But a drachm of the tincture appears, by evaporation, to contain about three grains and a half of opium. Ed. Ammoniated tincture of opium, or paregoric elixir, is made with about eight grains in each ounce of the liquid, or with about one grain in the drachm. Ed. Tincture of soap and opium, formerly called opiate liniment, anodyne balsam, is made with one scruple of opium in each ounce of the liquid. Ed. Troches of liquorice with opium contain about one grain of opium in each drachm. Ed. Quicksilver.—Quicksilver pills contain five grains of quicksilver in each drachm. Each pill contains one grain of quicksilver. Ed. Quicksilver pills contain four grains of quicksilver in twelve grains. Lond. Quicksilver ointment contains twelve grains of quick- silver in each drachm ; made with double quicksilver, each drachm contains twenty-four grains. Ed. Stronger quicksilver ointment contains one drachm of quicksilver in two drachms. Lond. Weaker quicksilver ointment contains one drachm of quicksilver in six drachms. Quicksilver plaster contains about sixteen grains of quicksilver in each drachm. Ed. Plaster of litharge with quicksilver contains about one ounce of quicksilver in five ounces. Lond. Plaster of ammoniac with quicksilver contains about one ounce of quicksilver in five ounces. Lond. Powder of scammony with calomel contains one grain of calomel in four grains. Lond. Ointment of nitrated quicksilver contains twelve grains of nitrated quicksilver in one drachm. Lond. Stronger ointment of nitrat of quicksilver contains in each drachm four grains of quicksilver, and eight of nitrous acid. Ed. Milder ointment of nitrat of quicksilver contains in each scruple half a grain of quicksilver, and one grain of nitrous acid. Ed. Ointment of white calx of quicksilver contains in each drachm about four grains and a half of the calx. Lond. OR, One grain of tartrite of antimony is contained in Wine of tartrite of antimony. Ed. - grs. 240 Wine of antimoniated tartar. Dub. - 120 Wine of tartarized antimony. Lond. - 120 Wine of antimony. Lond. - - uncertain. VOL. II. One grain of precipitated sulphuret of antimony is contained in Compound pills of antimony. Dub. grs. 2.7 One grain of opium is contained in Opiate confection. Lond. - - grs. 36 Opiate electuary. Ed. - - - 43 Electuary of catechu. Ed. - - 193 Compound electuary of catechu. Dub. - 199 Troches of liquorice with opium. Ed. - 75 Compound troches of liquorice. Dub. - 60 Pills of opium. Lond. ... 5 Opiate pills. Ed. - - - 10 Opiate powder. Lond. - - - 10 Compound powder of chalk with opium. Lond. 43 Compound powder of ipecacuan. Lond. Dub. 10 Powder of ipecacuan and opium. Ed. - 10 Tincture of opium. Ed. Lond. Dub. - 12 Camphorated tincture of opium. Lond. 244 Ditto ditto Dub. 196 Ammoniated tincture of opium. Ed. - 68 Tincture of soap and opium. Ed. - - 31.5 One grain of quicksilver is contained in Quicksilver pills. Lond. ... grs. 3 Ditto Dub. - - 2.5 Ditto Ed. - - - 4 Stronger quicksilver ointment. Lond. Dub. 2 Weaker quicksilver ointment. Lond. Dub. 6 Quicksilver ointment. Ed. 5 Quicksilver plaster. Ed. - 5.5 Litharge plaster with quicksilver. Lond. 5 Ammoniac plaster with quicksilver. Lond. 5 One grain of calomel is contained in Powder of scammony with calomel. Lond. grs. 4 Compound antimonial pills. Dub. - - 2.7 One grain of the grey oxyd of quicksilver is con- tained in Ointment of the grey oxyd of quicksilver. Ed. grs. 4 One grain of the red oxyd of quicksilver is contained in Ointment of red oxyd of quicksilver. Ed. grs. 9 One grain of submuriat of quicksilver and ammonia is contained in Ointment of white calx of quicksilver. Lond. grs. 13 One grain of nitrat of mercury is contained in Stronger ointment of nitrat of mercury. Ed. grs. 5 Ointment of nitrated quicksilver. Lond. Dub. 5 Milder ointment of nitrat of quicksilver. Ed. 13 In many instances these proportions are only to be considered as approximations to the truth, as they are calculated from the quantities of the ingredients taken to form the preparation, not from the quantities which exist in it after it is formed. The nitrat of mercury, for example, in the different ointments into which it enters, is estimated as equal to the whole quantity of mercury and nitrous acid employed to form it, although, from the very nature of the preparation, it cannot be so much. In the solutions of opium, the opium is esti- mated as equal to the whole quantity employed, al- though not above two-thirds of it be dissolved. Lastly, no allowance is made for the loss by evaporation; and hence, notwithstanding the difference by calculation, the Edinburgh troches of liquorice with opium contain probably as much opium as those of Dublin; for the former, being made with syrup, will lose more in dry- ing than the latter, which are made with the extract of liquorice. Ee P O T 218 P R M POSSETUM. Posset. Milk curdled with wine, treacle, or cider, by foreigners reckoned peculiar to the English. The serum of a posset, called posset drink differs from the whey of milk by the addition of the fluid employed to curdle it. POSTBRACIIIA'LE, (from post, after, and bra- chium, the arm). See Metacarpus. POSTE'RIOR ANNULARIS; an external inter- osseous muscle of the hand, which draws the ring fin- ger inwards. Poste'rior Indicus; a similar muscle, which ex- tends the fore finger and draws it outward. Poste'rior medii, extends the middle finger and draws it outward. Poste'rior mu'sculus au'ris. See ABnucTOR AURIS. POS'THE, (quasi, wposOe, from wportBtiftt, to place before). See PrjEputium. POSTPOSITIO, (from post, and pono, to place). When the paroxysm of a fever comes on later than is expected, the paroxysm is said to be postponed; when it begins sooner, to be anticipated. POTA'SSA. We have, in the articles Alkali and Chemia, q. v. given every information apparently ne- cessary on this subject; yet, as in some cases the kali is required to be peculiarly pure, we mean chiefly when employed as a re-agent in detecting poisonous impreg- nations, it may be, perhaps, useful to describe shortly the methods of preparing it without any remaining im- purity. Two have been employed; and we shall.first mention that of Bouillon la Grange, from the Annates de Chymie. To water, heated nearly to boiling, some highly caus- tic lime must be added, which will bring on ebullition; and, when slaked, an equal quantity of potash of com- merce. The water must be in such a quantity as will bring the whole to a thick liquid. In boxes, whose bot- tom is covered with well washed river sand, and then with a stratum of finer sand, on a cloth sprinkled with wood ashes, this mixture must be cautiously poured, and covered very gently with water, which, passing through the cloth and sand, is conveyed into vessels by a hole in the bottom of the box. The fluid in the vessels must be guarded from atmospheric air, and water added till its saline taste begins to grow weak. The superfluous fluid must be carried off by a quick ebullition, and any impurity will then separate. To obtain it perfectly pure, it must be evaporated to dryness, and dissolved in alcohol, which takes up the pure potash only, leaving whatever salt contains any carbonic acid. Lowitz advises the lixivium of potash, freed from the carbonic acid in the usual manner, to be evaporated to a thin pellicle. After cooling, the foreign salt is to be separated, and the evaporation continued in an iron pot, during which the carbonate of potash rises in a pellicle, which must be constantly separated. WThen no more pellicles are formed, and it ceases to boil, it must be taken from the fire and suffered to cool, continually stirring it till cold. It must then be dissolved in dou- ble the quantity of cold water, the solution filtered, and evaporated in a glass retort till it begins to deposit regular crystals. After the formation of a sufficient quantity of these, the brown fluid must be decanted, and the drained crystals redissolved in the same quantity of water. The decanted fluid, become clear by subsiding. must be again decanted, and crystallized. These opera- tions arc repeated till the crystals afford, with the least quantity of water, solutions perfectly limpid. We know that alkalis are, in general, the product of fire ; but in many cases they exist formally in the plant, though often united with an acid in the form of a neu- tral. Recent discoveries, however, which we shall soon notice (see Sal and Soda), have lately opened an ample field for speculation. See Clavellati ci- POTENTI'LLA RE'PTANS, (a potentia, from its efficacy). See Quinquefolium. POTE'RIUM, a cup, (from the shape of its flower). Sanguisorba. See Pimpinella. POTIO, (from poto, to drink). A potion : a liquid form of medicine, to be taken at once, a term usually confined to laxatives. POUPA'RTH LIGAME'NTUM. See Fallopii ligamentum. PR^CIPITA'NTIA, (from pracipito, to cast down). Medicines which moderate the motion and heat of the blood, by precipitating, as was supposed, its acid. PRjECIPITA'TIO. Precipitation; the separation of substances dissolved in a fluid, by the addition of a third body, by the abstraction of caloric, or of the quan- tity of the menstruum. The first is, however, strictly speaking, true chemical precipitation, and it takes place when the added substance combines with the men- struum, rendering it no longer able to hold the first in solution; or where the third body unites with that in solution, forming a substance no longer soluble. The substance separated is called the precipitate, if it sink, cream, if it swim. Some caution is necessary in these experiments, for in some cases the precipitate is again soluble; but this depends on chemical affinities and the minuter doctrines of chemistry. See Chemia. When the matter to be precipitated falls to the bot- tom of the vessel, the fluid is poured off, or filtered, and what remains behind is to be dried like levigated powders. PR^ECO'CIA, (from their early ripening). See Ar- menia ca mala. PRjECO'RDIA, (pra, and cor, the heart,) a general appellation of the bowels, generally of the contents of the chest. Fernelius, lib. iv. de Febribus, comprehends under this term the region above the stomach, the dia- phragm, the liver and biliary ducts, the pancreas, the stomach, particularly its upper orifice. This name has been also given to the metatarsus. PRjEPARA'NTIA MEDICAME'NTA are medi- cines supposed to prepare the morbid humours for se- paration, and their consequent discharge. Pr^para'ntia va'sa are the vessels of the spermatic cord, in which it was supposed that the seed was pre- pared. See SPERMATICA CHORDA. PRtEPARA'TA VE'NA. See Frontalis vena. PRtEPU'TIUM, (from praputo, to lop off before). The prepuce or foreskin, epigogion, posthe. When this is wanting the person is called leipodermos, when lost, lipodermos. See Penis. PRJLSA'GIA, (from pra, before, and sagio, to per- ceive). Presages. Fred. Hoffman observes, that three things are requisite to a right presage, viz. 1st, That from due observation we be able to trace and in- vestigate the origin and causes of disorders in order to PRE 219 PRE oppose them in the beginning by proper remedies, or give salutary directions. 2dly, That we accurately know the various natures of diseases, and their differ- ences in different constitutions, that we may be better able to give medicines which shall remove them. 3d, That we be able to form a right judgment of the ope- ration of medicines, and the event of disorders. See Prognostica. PR.fiSENTA'TIO, (from prasento, to offer). In midwifery it is the manner in which a child offers it- self in its passage into the world; and the different pre- sentations are denominated according to that part of the child which is perceived at the mouth of the womb, when a woman begins to be in labour. In preternatural presentations the membranes pro- trude, for the most part, in a lengthened form; and when the pain declines, no part of the child can be per- ceived, but the membranes only, as in the beginning of labour; after some time, from the quantity of water, the membranes have a round form ; but they have not the usual effect of dilating the os tincae. If the head presents, it is distinguished by bringing the finger round so as to take in a large portion of it; we then feel an uniform hard substance, and often discover a suture. When a shoulder or a hip presents, they have not that uniform hard feel which is observed when the head of- fers. If the back presents, the vertebrae are felt; if the belly, the funis umbilicalis discovers it. The breast presenting is known by feeling the ribs; the breech by the private parts, and the discharge of the meconium at each pain; the hand, or foot, by the absence or pre- sence of the heel. See Parturitio. PRA'NDIUM, (from prandeo, to dine). Ariston. DINNER. PRA'SIUM A'LBUM, (from wpxe-tx, a square bor- der). See Marrubium album. PREGNANCY. When, from the previous connec- tion, the foetus is animated, (see Generatio,) it soon escapes into the uterus, if the Fallopian tubes are not obstructed. Its minuteness at that period prevents us from determining with precision the time of its pas- sage ; but as it is probably conveyed to the tube at the moment of animation, since an extraordinary action is required to raise the fimbriae, it probably is not long delayed in its progress. Every part of the uterus is ap- parently adapted for its attachment, since, wherever the placenta is fixed, we there find its maternal part; the cotyledons of ruminant animals. The early appearances are those only of a slight inflammation, the constant concomitant of increased action, or of evolution, with usually a small proportion of mucus; and, for some time it is only a small body, covered apparently with a tight down. See Foztus. The mother for a time feels no alteration, and, indeed, so slight are often the early symptoms, that a woman sometimes does not know that she has conceived till she feels the motion of the child. More frequently, how- ever, symptoms of general irritability and peculiar sen- sibility come on early. The fancies are singular, the appetite capricious, the features sharp, the complexion pale, but clear; till about six weeks after impregnation, a sickness of the stomach comes on, chiefly in the morning, and most commonly on rising from bed. After the stomach has been freely discharged, some women are frequently easy and cheerful through the whole day; but many suffer from constant sickness for four months; some during the whole period. We have known women who have never been able to eat or drink without the bason near, in which it was con- stantly returned, seemingly unaltered in appearance and quantity, and have yet borne healthy children. In most instances, however, the sickness is confined to the first four or five months, though the capricious appetite frequently continues during the whole time. In the early period, the abdomen is said to be some- what flatter than usual: "it is at least not fuller; but between the fourth and fifth month the uterus rises above the pubes, like a round ball, occasionally on the right or left of the symphysis, and gradually extends, till at the ninth month it reaches the scrobiculus cordis, protruding in its progress the navel. At a very early period, often within the first two or three weeks, the breasts grow fuller, and pricking pains are felt in them; the areola round the nipple extends, and is brown, often verging to a blackish hue, which continues to enlarge till the moment of delivery. About the fifth or sixth month, sometimes earlier, a little whit- ish serum can be pressed from them, which at last ap- proaches more nearly the appearance of milk. The catamenia, as is well known, are very commonly sup- pressed during pregnancy; but in some women they flow with their usual regularity through the whole pe- riod of gestation. In delicate females, who use little exercise, it is not uncommon to have one discharge re- gular in time, but not in quantity or duration, after im- pregnation ; and this slight appearance will recur at irregular intervals during the whole time. If not at- tended with pain, or flowing copiously, we have never found it dangerous or threatening abortion. The most unequivocal symptom occurs nearly be- tween the fourth and fifth month, styled the quickening, when the motion of the child is first perceived. This sometimes induces a little faintness, which soon passes away ; but the commencement is occasionally so slight as to be unobserved. It first resembles a flatulency; and flatus has sometimes deceived even the most ex- perienced matrons; but it soon becomes more distinct, with a somewhat more rapid motion, resembling the fluttering of a bird; and at last it affords so strong a re- sistance as to raise the clothes, and be obvious to the eye at some distance. The period of quickening is pretty accurately about the twentieth week, and will generally correct any erroneous reckoning from the dis- appearance of the menses. These symptoms arise from the peculiar state of the uterus, with which the stomach, the mammae, and the appetite sympathize. The final cause of the vomiting it is not easy to assign. We have considered it, in another place, as useful to guard against plethora in the earlier months; and it is certain, that the children of those women who have been scarcely free from vomiting, have not been extenuated, or apparently deprived of their proper nourishment. To determine whether impregnation has taken place requires often very minute attention; and the most ex- perienced practitioners are occasionally deceived. If a young married woman wishes for children, she will catch at every probable appearance, and magnify every accidental symptom. It is necessary to watch the changes already detailed, and to pursue them in their PRE 220 PR E progress. We have mentioned the principal circum- stances in different articles, particularly under Ascites; and suspected pregnancy, in the article Medicina fo- rensis. After three or four months the situation may be more clearly ascertained by the touch ; and in the sixth or seventh month pretty certainly determined. We shall shortly describe the successive changes in the cervix uteri and os tincae during pregnancy, to enable the younger practitioner to determine the question by this means; and we shall copy the very comprehensive and judicious description of Dr. Hamilton, in his " Out- lines of Midwifery." " For the first three months the os tincae feels smooth and even, and its orifice is nearly as small as in the unimpregnated state. When any difference can be perceived, it consists in the increased length of the pro- jecting tubercle of the uterus, and the shortening of the vagina, from the descent of the fundus uteri through the pelvis. This change in the position of the uterus, by which the projecting tubercle appears to be length- ened, and the vagina proportionally shortened, chiefly happens from the third to the fifth month. From this period the cervix begins to stretch, and be distended, first in the upper part; and then the os tincae begins also to suffer considerable changes in its figure and ap- pearance. The tubercle shortens, and the orifice ex- pands; but during the whole term of gestation the mouth of the uterus is strongly sealed up with a ropy mucus, which lines it and the cervix, and begins to be discharged on the approach of labour. In the last weeks, when the cervix uteri is completely distended, the ute- rine orifice begins to form an elliptical tube instead of a fissure; and sometimes, especially when the parietes of the abdomen are relaxed by repeated pregnancies, dis- appears entirely, and is without the reach of the finger in touching. Hence the os uteri is not placed in the direction of the axis of the womb, as has been generally supposed." To this we can only add, that about the fifth or sixth months, the weight of the uterus is sensible on raising it by pressure on the os tincae or cervix, and that in the later months the distended cervix is so thin that the head of the child, when it presents, can be often felt through it. The diseases of early pregnancy are numerous and troublesome, arising chiefly from the excess of ir- ritability just mentioned, and the plethora, which usually occurs in the early months. We must consider them in an inverted order. Plethora. The diseases arising from plethora are, chiefly, flushing of the face, fulness, pain of the loins, load in the head, vertigo, and drowsiness. The women whose stomachs are most irritable suffer less from these complaints; but, when they come on, they require par- ticular attention. It has been usual to direct small bleedings, and such pregnant women bear with ease, and even advantage. Yet the habit is soon established, and they become necessary in future pregnancies, when the plethora is less common. We have endeavoured, therefore, to avoid them, and we think we have succeed- ed by cool, free air, by gentle laxatives, and a mode- rately cooling diet; above all, by perfect rest and tran- quillity both of mind and body. The swelling and pains of the breasts arise in part from this cause. They should not be confined by ligatures and lacing ; nor must it be forgotten, that, in the present apparently free and easy costume of the ancient Grecians, they suffer as much by pressure from the sides and below as they formerly did by the iron stays. Every thing must now project forward, but it is not on this account a more easy dress when the breasts are swollen. The greater number of diseases arises, however, from irritability ; and among these we may reckon the dis- tressing stomach complaints. The morning sickness is one of the most painful feelings attendant on this state; and it is one of these which medicine most commonly fails in relieving. A cup of camomile or peppermint tea, taken on first waking, and suffering the patient to lie still for an hour, will sometimes alleviate the dis- tressing sickness; but should it recur during the day, these means will scarcely succeed any farther. Slight emetics will occasionally relieve, but as often fail. Magnesia and columbo root, sometimes with the kali purum, sometimes with the ammonia pura, occasionally with the aromatic tincture, or a slight proportion of the tinctura opii, will be for a time useful; but the sickness will not wholly yield till the uterus begins to rise above the pelvis and freely expand. Dr. Vaughan, in the London Medical Journal, employed nourishing clysters, with anodyne liniments, to the pit of the stomach. We have already observed, that the intention of nature in exciting vomiting seems to be the prevention of plethora, which is often far more dangerous than the increased action of the stomach. If this be true, it will prevent the introduction of nutriment: and the apparent anxiety of nature in every instance to preserve life, particularly in the reproduction of the species, would lead us to be cautious of interfering in an object where her own plans are usually so beneficial. We may alleviate trouble- some symptoms, but should not strongly interfere. It is peculiarly rare, we believe it has scarcely ever happened without the suspicion of some fixed organic complaint, that a woman has sunk or miscarried from inanition. Cardialgia and diarrhea are troublesome symptoms, but not dangerous. They are generally relieved by magnesia, the compound powder of chalk, with occa- sionally a few drops of the aqua ammoniae purae, some- times with the tincture of opium. They arise from ir- regularity in the digestive process, in consequence of the increased irritability of the stomach, and disappear usually about the fourth month. They are increased by acescents rather than by acids, for vinegar can be often taken with less inconvenience than pastry. Paintings and hysteric affections are the consequences of peculiar irritability of the system. Low spirits are among the early symptoms, and almost every pregnant woman thinks her state a fatal one; but while such is her language, her conduct contradicts it, and indeed, in the intervals of sickness and pain, the spirits of a preg- nant woman are often free and cheerful. Despondency is only in her words. The common hysteric remedies, keeping the bowels free, above all a little variety of scene, and the cheerful conversation of a sensible wo- man, who has already passed the same ordeal repeatedly with success, will lessen every unpleasant symptom of this kind. The diseases of advanced pregnancy are often more serious. They arise from the pressure or the change of position of the gravid uterus; and though often only inconvenient, are sometimes dangerous. The diseases which arise from pressure are variou3> PRE 221 P R E swellings of the veins of the leg, oedema of the lower extremities, Sec. costiveness, piles, and dyspnoea. These are relieved by the common remedies; but white the cause remains cannot be cured. In weak habits the cedema sometimes arises to general dropsy, which con- tinues after parturition. More serious diseases from the pressure of the uterus are various spasmodic complaints, rising from slight cramps in the legs to violent epileptic paroxysms. The immediate causes are irritation from the pressure on the sacro sciatic nerves, communicated to the brain when the convulsions are more general. Sometimes they seem to arise from the motion of the foetus, and are more common in a first pregnancy than at any future one. The slight spasms are alleviated by opium ; but the epileptic fits are highly dangerous, and in a large proportion of cases are fatal. We have already mentioned this disease, vide Convulsions ; but must now more fully enlarge on it. Puerperal co7ivulsions are sometimes relieved by co- pious bleedings ; but the event often leads us to regret the loss of that strength which the patient is thus de- prived of. They seldom occur with any violence till about the seventh month ; but, in general, attack near the full period. It is first necessary to empty the rectum by an active clyster, which will also, in many cases, bring on labour. The next step is to give a large dose of opium, and inject also no inconsiderable one into the rectum. Forty drops of the tincture of opium may be given, and repeated every hour, or oftener if the fits are violent; and at least two drachms should be given in a clyster. If the fits produce any tendency to labour, the relaxation occasioned by the opium will produce some yielding in the os tincae; and when it is open, though very slightly, labour may be expedited by introducing the finger, and enlarging it, till we can rupture the membranes. In general, during a pain, the convulsions remit, which is a strong argument in favour of expediting the labour. If the os tincae does not yield, some practitioners have attempted its dilatation by force; a practice by no means to be recommended, though we have not seen it followed, as has been pre- dicted, by inflammation of the uterus. In general it is safer to give large doses of opium till the relaxation which it occasions, joined with the debility naturally produced by the repetition of the paroxysms, brings on labour. We must be cautious, however, not to carry our expectations of labour coming on too far, as the woman may die undelivered, a circumstance peculiarly dreaded by females; and, in emergencies, the forcible dilatation of the os tincae, however dangerous, is the safer alternative. By this plan more than half of those entrusted to our care have recovered, while the usual calculations of the successful cases offer a considerably less proportion. Before the seventh month, however, we must trust to the opiates and the operations of nature. Other plans have been recommended. Dr. Denman advises dashing cold water in the face; Dr. Hamilton the digitalis; and other practitioners large doses of camphor given by the mouth and by clysters. The former we have found useless; the digitalis we have not had an opportunity of trying; and we should ap- prehend that there was not sufficient time for its ope- ration, unless the dose was hurried on with a rapidity that would be dangerous. The camphor, recommended in the Memoires dc Medicine, we have tried; but in each case it brought on an alarming stupor, which has prevented us from repeating it, though given in a far less dose than was recommended. Sometimes the convulsions follow delivery, and generally arise from fright or from terror. This is hardly apart of the present subject, but it is so closely connected that we could not avoid mentioning it, and it will not detain us, since the usual remedies just men- tioned will relieve the complaint, if it admit of relief. In general these convulsions are not so frequently fatal as those which precede labour, though always dangerous. Ischuria and frequent micturitio7i are complaints which depend partly on pressure, and in part on irrita- tion. Either is an inconvenience which maybe alleviated by a slight opiate; but frequent inclination to make water produces considerable irritation, if not gratified; and the pregnant woman should avoid crowded rooms, long journeys, and every situation where this desire cannot be quickly indulged. Should the bladder be greatly distended, the urine will be permanently re- tained, and the worst consequences follow, particularly the retroversion of the uterus, which, but for this con- nection, should have been noticed more early. Retroversion of the uterus usually occurs about the latter end of the third month, when the womb, if pre- vented by distention of the urinary bladder, or violent fatigue, from rising above the pelvis, falls backward be- tween the vagina and rectum, pulling the os tincae back- ward and upward. Obstinate costiveness has been ac- cused of producing this change in the situation of the womb, but will more probably prevent it, for the posterior part of the pelvis must be spacious and empty to admit of the uterus falling backwards. In this case a tumour is felt in the perinaeum, bearing down like a child's head, with forcing pains, tenesmus, a retention of the stools and urine. The finger passed into the vagina is soon stopped without reaching the os tincae; and in the rectum a round hard tumour may be felt. In this situa- tion the uterus enlarges, and increases all the symptoms. The forcing pains are violent; the retention of the urine and faeces obstinate; the load and oppression are com- municated to the brain; and coma, or delirium, with fever, come on, often accompanied by convulsions. The reduction of the tumour affords the only prospect of relief. We must endeavour then, for this purpose, to evacuate the bladder and rectum; but the weight of the uterus draws back the meatus urinarius, and the bulk prevents the passage of clysters or faeces. A finger introduced into the vagina, and another into the rectum, will assist the reduction, while the patient on her hands and knees, bent forward, contributes by her posture to facilitate the return of the uterus. Perhaps if laying on her back, with her nates raised to half a right angle, the reduction might be still more easy. Dr. Cheston, we find, in the second volume of the Medical Communications, succeeded in a case of this kind, by puncturing the bladder at the pubes ; and a more des- perate proposal has been made to puncture the uterus through the rectum to procure abortion. The attempt. is, however, truly absurd, for the puncture of the uterus would not restore the situation of the womb ; PR E 222 P IJ E and if abortion could thus be procured, the foetus must pass through the wound. The caprices of pregnant women are numerous and troublesome. They are not wholly fanciful, for the most firm and sensible women, who conceal them, ac- knowledge the pain and difficulty they feel by the effort. On the contrary, they increase by indulgence, and often become injurious. In speaking of the pecu- liarities of the Fcetus, q. v., we showed, at some length, that a change in its structure or appearance from any mental affection of the mother was highly im- probable; but to deny any reasonable gratification often produces uneasiness and irritation both of mind and body, with loss of sleep, and an increase of the hysteric symptoms. A man will also commiserate the state to which the most lovely and tender part of the creation is thus reduced, and be led by every kindness and at- tention to alleviate it. Yet the same affection will set limits to indulgence; for the craving truly grows by what it feeds on, and at last may require impossibilities. The refusal will then be doubly distressing. To grant every reasonable request, to sooth, to persuade, and to expostulate, when these requests verge to what is fanci- ful, what is not easily practicable, or what may become injurious, will gradually place these fancies more under the controul of reason, and the months in which their influence is strongest will gradually pass away. It is singular, however, that the most eccentric caprices of appetite are rarely injurious ; and the most unlimited indulgence is often borne not only with impunity but with advantage. Even the heartburn is not increased by large quantities of fruit, if eagerly longed for ; and the rest is often calm and refreshing after food appa- rently the most indigestible. May not then these ap- parently capricious fancies be often the dictates of na- ture, the cravings of somewhat salutary to the constitu- tions by means of which we are ignorant ? PREHE'NSIO, (from prehendo, to take by surprise). See Catalepsis. PRE'MNON. See Oculus. PREPARATIONS, (from preparo), a term applied often to compound medicines, but more commonly, at present, confined to those parts of the human body which are artificially preserved from the usual changes in consequence of putrefaction, or prepared to display their structure. Preparations are either wet or dry. Dry preparations should be always finished with expedition that the natural colour may be preserved, and great care should be taken that they are not soiled by dust or handling. The fat should be carefully removed; and the prepa- ration may be slightly washed over by some colourless aqua kali puri, and again with water, to dissolve what may remain. If the part is not very thin, this may be repeated; but in general it injures the texture of the preparation, and such subjects should be chosen as have least fat. Objects preserved in this way should be dried in the shade, with a free current of air; but when the danger of putrefaction is considerable, artifi- cial heat, in a degree not to melt the injection which is previously thrown into the vessels. If they are distended with air, small apertures should be made to prevent the rarefied air from bursting them. Dry membranes may be extended by pins on a fiat board, with a paper slightly oiled beneath to prevent their sticking. Hollow sub stances are best preserved on stands under glass bells. In drying, fly blows and insects may be kept off by- washing the preparation with a solution of hydrargyrus muriatus, in alcohol, in the proportion of a drachm to six ounces. Preparations are sometimes distended, for drying, with wool, cotton, hair, quicksilver, tallow, or plaster of Paris, besides air. The last, however, is preferable, as more uniform ; but is apt to escape by minute fora- mina, which are with difficulty closed. Where the pa- rietes are thick, as dropsical ovaries, uteri, or aneurisms, hair, or wool very slightly oiled, are necessary. Plaster of Paris is chiefly used where the distending substance is suffered to remain, where tortuous canals prevent the use of hair or wool, or where the membrane is so thin as to require an equable distention. Thin injected pre- parations are also conveniently displayed on plaster. The penis and the internal organs of generation, as well as the lymphatics, are most conveniently filled with quick- silver ; the heart with tallow, which may be melted and drained off with a heat less than will melt the injection of the coronaries. The lungs are preserved dry, in small portions, by distending the air vessels with quick- silver; in large portions, by filling them with oil of turpentine. When dry, each fluid may be discharged by an even, longitudinal section. Dry preparations are varnished to preserve them from mould, to prevent their destruction by insects, and to increase their transparency. The white spirit varnish of the shops is well adapted for large masses; but is too friable when applied on thin membranes. For the latter purpose the oil varnish of the shops is preferable. It is necessary to separate every particle of fat or grease; and in using the spirit varnish to dry the preparation carefully. Externally both are properly laid on with a brush, and repeated coats are applied. In hollow pre- parations the varnish is poured in and shaken around; in corroded ones poured on them. Another kind of dry preparation is styled corroded, since, after injection, the substance of the containing vessels is destroyed by immersing the whole in a fluid containing three parts of muriatic acid and one of water. From about three to six weeks is necessary for the cor- rosion. It is then to be placed in a bason; and at first a gentle, afterwards a stronger stream of fresh water is allowed to pass through it. The little adhering pulp in the smaller interstices may be washed away, by direct- ing a current of water through a small syringe to the part. The preparation must then be dried; and should be carefully suspended by a tape, as a cord will pro- bably cut through the wax. If the vessels are not large enough to admit of its being suspended safely, it must be placed on cotton, over which a woollen cloth is spread. It must be supported on a stand, by means of plaster poured into the cavity, in which the trunk rests. Wet preparations are preserved in spirits; and the peculiar art which raised the credit of Ruysch so high seems to be in part lost. Cotemporary authors speak with rapture of the pellucidity of his fluids, and the brilliancy of his injections. A little boy was so artificially preserved that the Czar Peter, it is said, ran and kissed it. Albinus succeeded well, though less PR E 223 PRO happily than Ruysch. Yet attentive anatomists have re- marked, that the parts preserved in his glasses were peculiarly minute. Various fluids have been tried, but with little success; and we must now explain the me- thods of the most experienced dissectors. When a part is to be preserved in spirits, it should be previously macerated in water, continually changing it, to prevent putrefaction, till it passes off pellucid. Every particle of fat and cellular membrane should then be separated, the hollow parts and cavities distended with hair; and the ducts, or more important blood vessels, pointed out by the introduction of bristles, quills, or bougies. If then put into alcohol, it will soon acquire firmness enough to admit of the removal of the stuffing. Every object does not require spirits of the same strength. Those which are thick and massy require pure alcohol: those which are less so, proof spirit; and the membranous objects, one part of spirit, and two of water. The spirits and water should be previously mixed and filtered. Immersing some preparations in pure colourless oil of turpentine gives them transpa- rency, and shows the internal organization and arrange- ment of the blood vessels very perfectly; but is adapted only to those which are to be dried. At first the spirits should be frequently changed. Dr. Monro adds a proportion of vitriolic or nitrous acid to the spirit; and this mixture neither changes the colour nor consistence of the parts, except they contain mucus or serum. The brain of a young child, the crystalline and vitreous humours of the eye, become so firm in this fluid as to admit of handling. The serum and the semen are coagulated in it; and the red injection is rendered more conspicuous. For the more tender albuminous parts, two drachms of spirit of nitre must be added to a pound of spirit of wine. For other parts twenty or thirty drops are sufficient; and this fluid, itis said, comes very near the spirit employed by Ruysch. To secure preparations and prevent the evaporation of the spirit requires many minute contrivances, scarcely within our scope to develope. The best method is to have the top of the glass accurately ground and polish- ed, on which a piece of plate glass of the same size is to be laid. On the edge of the vessel a drop or two of gum water is placed, and the piece of plate glass laid gently on. The gum water will then, by capillary at- traction, run round the rim, closing the little interstices which the polisher may have left. A piece of tin foil should then be moulded over the cover and the edge of the jar, and the whole secured by a wet bladder reach- ine: below the tin foil, covered by a leather closely tied to the neck of the jar, well varnished, especially round the cord. The glass should be thick and free from any irregularities, so as to magnify the preparation without any distortion. With every precaution, however, spirit gradually evaporates. The best way of suspending light bodies is by a floating glass globe; larger ones by a stick fixed across, for a thread continued to the edge of the jar conducts the spirit, and assists evaporation. PRE'SBYT&, (from T^ec-Svs, old). See Amblyopia, and Oculvs. PRESERVATI'VAA'QUA,(from/?reserz;o,;o/27r- vent). See Antivenerealis aq.ca. PRESU'RA, (from npeSu, to infia7ne). Inflamma- tion of the ends of the fingers from cold; the phlogosis '-rythema of Cullen. PRIAP.,E'IA. See Nicotiana minor. PRIAPI'SMUS, (from Priapus, the heathen god). A priapism ; an erection of the penis without any- lascivious idea or inclination, with violent pain, is a spasmodic contraction of the erectores penis, wholly unconnected with the state of fullness of the vesiculae seminales; and the disease of advanced life. Priapis- mus affords a striking instance of spasm arising from debility. Camphor and opium at night, with bark and warm aromatics in the day time, are the best remedies ; but we can in general only palliate : the disease is sel- dom removed. See Impotentia. PRI'MjE WVJL. The first passages; that is, the stomach and duodenum. PRIMULA VE'RIS, (from primus). See Para- lysis. Primu'la odorata. See Auricula ursi. PRI'NCEPS ALEXIPHARMICO'RUM. See An- gelica. PRINCI'PIA, (from princeps). The principles or elements. In science it is the appellation of rudiments, or of those leading propositions on which the whole depends ; thus, to mark the extremes of the scales, we have the principia philosophie, and principia medicine. In analysis, the principles of bodies are those ultimate results beyond which we cannot proceed. According, therefore, to the progress of science, we have rested at different points, returning lately, with Aristotle, to earth, air, fire, and water. Yet air and water are cer- tainly not elements, for water can be decomposed ; and when we speak of air, we know it to be a compound, though we are unacquainted with its different bases. In fact, the only elements we can now recognize are earth and fire : yet of the common principle of the different earths we are still ignorant. Principles and elements are, therefore, words which ought to be ef- faced from chemical nomenclature; or, at least, they ought not to be used but as an expression denoting the last term of our analytical results; and it is al- ways in this sense that the true philosopher uses the word. PRIOR ANNULARIS INDICIS and MEDII. Interosseous muscles of the hand, moving these respect- tive fingers. PRIVATI'VI, (from privo). Privations, or de- fect of powers ; synonymous with dysesthesia and dysorexia in Cullen's Nosology. PROBE, (from probo, to try). A surgical instrument, employed in examining the condition of a wound; the direction of a sinus ; or the state of a bone. It is usu- ally of silver, rounded at one end, and triangularly sharp at the other. PRO'BOLE, (from tt^oSxXXu, to project). See Apo- physis. PRO'BANG. A flexible piece of whalebone, with sponge fixed to the end. See Deglutitio. PROCA'RDION,(from vpo, before and xx?foov, the sto7nach). The pit of the stomach. PROCATA'RCTICA CAUSA. The procat- arctic causes, (from TTpoxxTxpxotA.xt, to precede). The pre-existent cause. See Causa. PROCE'SSUS. A process (from procedo, to start out). In chemistry, the operation in which a new sub- stance is produced. PRO 224 PRO In anatomy, it is a protuberance or eminence of a bone. If the process projects in a roundish ball it is called caput, and the narrow part cervix; when oblong, and unequally rounded, a condyle; when rough and un- equal, a tuberosity. Processes which terminate in a sharp point are denominated coronoid; those which form a longitudinal ridge, spina, sometimes crista; the labia are each side of a broad spine; and brims of cavities are named supercilia. The use of processes is to assist motion, by allowing a greater surface for the origin, larger attachment, and more advantage- ous direction of muscles. See Apophysis, and Epi- physis. Proce'ssus cilia'ris. See Ciliare ligamen- tum. Proce'ssus mamilla'res. See Olfactorii NERVI. Proce'ssus vermiformis. An appendage to the coecum, resembling a worm, terminating in a point. Its use is unknown. See Appendicula vermifor- mis. PROCIDENTIA, (from procido, to fall down). See Prolapsus. Procidentia a'ni ; prolapsus, and exitus ani, cxania; the falling down of the fundament, is a re- laxation of the sphincter, admitting the inversion of the internal villous coat of the intestine, with a proportional tumour. The causes are, weakness, aggravated by costiveness, piles, diarrhoeas, or tenesmus. It is induced also by every cause of violent forcing, as hard labour, or a stone in the bladder; and every cause of paralysis in the levatores and sphincter ani. Hoffman attributes it to a relaxation of the ligaments of the intestines. In- fants are the most frequent subjects of this disorder, in consequence of debility. The tumour, which is of a fleshy colour, sometimes wrinkled, at others smooth and shining, accompanied with an uneasiness, and an ineffectual desire to go to stool, sufficiently distinguishes the complaint, which is sometimes mistaken for the piles. A ligature hath been applied about the prolapsed anus, in order to ex- tirpate the supposed haemorrhoid. When costiveness, a stone in the bladder, or labour, occasion this complaint, the cure is sometimes effected : when a diarrhoea follows it is more difficult; if the haemorrhoids supervene we rarely succeed. If the disease, as sometimes happens, should proceed from acrid matter, the cause is distinguished by a sharp, pungent pain after every motion, and the relief is effected sometimes by chalk and mucilages; by muci- laginous clysters retained by opium ; more frequently by equal parts of wax and soap, with a small proportion of the Theban extract. If the tenesmus is violent, the mucilaginous clysters, with a large proportion of opium, will be necessary, and the latter should be in a solid form. Should it proceed from costiveness, the mildest laxatives, particularly the castor oil, will be most useful. Rhubarb and aloes are highly injurious, and recom- mended only by in discriminating empyrics. If the prolapsed intestine be swelled, then cold as- tringent applications are necessary, and by supporting the tumour with the palm of one hand, the fingers of the other will gradually replace the fallen intestine. We must, however, not violently persevere, but act only during the relaxation of the spincter. After the reduc- tion the part may be suspended by the T bandage. When the prolapsed intestine is contracted by the sphincter ani, and cannot readily be returned, Mr. Pott advises bleeding, opium, fomentations, and an anodyne and emollient poultice to the part, to procure the ne- cessary relaxation for the reduction. If extirpation proves necessary, it is best performed by ligature, for the haemorrhage which would follow excision must be highly dangerous. If the prolapsus is large, a strong needle, double threaded, may be passed through the intestine, tied above on one side, and below on the other. If the prolapsus is small, a double ligature should be passed round its whole diameter; and in both cases be left to drop off. The pain is allayed by- poultices, opium, See. The sphincter afterwards per- forms its office. If a gangrene affects the intestinal fold, the dis- coloured part, slightly scarified, should be repeatedly fomented with warm brandy, applying in the intervals the cataplasmae cumino. When the prolapsed part cannot be easily retain ed ingrown people, Cheselden recommends taking away a piece of the prolapsed gut lengthways, for, after the cicatrix is formed, it will never descend; a practice which Pott disapproves. See Gooch's Cases and Remarks; Pott's Works; Turner's, Wiseman's and Heister's Surgery ; Bell's Surgery, vol. ii. p. 268; White's Surgery, p. 380. Procide'ntia o'culi. See Malum. Procide'ntia u'teri, 7netroproptosis, ecptoma, hys- teroptosis. Different degrees of this disorder are: 1. Relaxatio; a bearing down of the womb ; when the womb descends down to the middle of the vagina; 2. Procidentia, when it descends to the labia; 3. Prolap- sus, when it falls through the labia pudendi. Inversio, and Retroversio, q. v. are different complaints. See also Pregnancy. The lesser degrees of this complaint are discovered by the touch, the greater by the eye. If the woman stands upright, a finger introduced into the vagina will dis- cover the disease; and if the os tincae be felt, the case is distinguished from a descent of the vagina, though the distinction is sometimes difficult. If the disease happens during pregnancy, the weight pressing down renders walking difficult and painful; micturition diffi- cult; costiveness; and a numbness in the legs and thighs. The pain is usually felt near the insertion of the broad ligaments, though these do not seem to support the womb; and the cause seems rather to be a relaxa- tion of the vagina, which really supports it. Girls are sometimes the subjects of this disease; but it most frequently happens to women who have experi- enced repeated hard labours; who have exerted them- selves too soon after delivery ; and are of a weak re- laxed habit. Leucorrhoea consequently predisposes to this disease, and it often arises from straining, lifting heavy weights, and whatever produces a strong action of the abdominal viscera. If neglected, the disease becomes painful, obstinate, and inconvenient; sometimes inflammation, ulcers, or a cancer, are said to be the consequences. It is necessary, therefore, for women to guard, with PRO 225 PRO great care, against the first feelings of the complaint, and to indulge themselves with rest, as well as to brace the constitution by tonics, cold bathing, and astringent injections. The bowels should be kept free, and every active exertion avoided. If the water be suppressed by the descent of the uterus, the tumour must be replaced, and the patient laid in bed, with her head lower than the trunk; and in making water the tumour maybe supported. Should this plan fail, the catheter must be introduced. The prolapsed uterus sometimes ulcerates, from the access, it is said, of the air, or the acrimony of the urine, but in reatity from the strangulation of the upper part; and the uterus should be replaced without attending to this circumstance. In general the cure is only palliative, and consists of replacing the womb, rest, and introducing a pessary into the vagina, to prevent the uterus from falling lower. This sometimes produces a radical cure, and the relaxed parts recover their tone. In lesser degrees of this dis- order, the usual confinement in bed during the next lying-in hath effected a cure; and when it occurs in early pregnancy, it disappears when the womb has en- larged so much as to rest on the pubes. A pessary should be introduced as soon as convenient after de- livery, and worn for some time after the woman walks abroad. A round pessary is preferable; and it should be so large as to occasion some uneasiness in passing it, since it will otherwise be apt to fall down. See Pes- sarium. If a lacerated perinaeum is the cause, a cushion may be placed with its convex side to the os externum, and secured by the T bandage; and if the prolapsus hath been neglected, and a swelling with inflammation has come on, bleeding, cooling laxatives, fomentations, and poultices, are necessary: if a mortification appear, the bark with astringent ones. A pessary must be applied as soon as the patient can bear it. Whenever a gan- grene or a cancer appear, reduction increases the symp- toms, or produces, new and fatal ones; but if there are ulcers, the part should be restored with all convenient speed, without waiting for their healing. When the uterus not only descends, but is turned inside outward, it is styled inversio uteri. This only happens immediately after delivery, when the os tincae is nearly as large as the fundus; and the funis is forci- bly pulled to bring away the placenta. Whatever be the cause, the womb must immediately be restored, or the consequence will soon be fatal; for its orifice will contract, and prevent the necessary relief. After emptying the bladder, lay the patient on her back with her hips raised, and with the hand restore the inversion and gently return the uterus, retaining it till a contrac- tion takes place, and afterwards supporting it as in case of prolapsus. Dr. Leak advises, after the parts are reduced, the fre- quent use of the following astringent injection. R Aluminiset vitriol, alb. aa 3 i- aq, bullient. Jfe i. solve et cola. At the same time we.must endeavour to strengthen the whole system by nourishing diet, chalybeate waters, and the bark. If no internal' disease forbid, the cold bath will give great relief. Should the descent of the tumour prevent the patient from walking, a fine sponge wrung out of alum water may be dried in a compressed state, cut into any con- venient form, and introduced as high as possible. It VOL. II. will act by its astringency, and by its pressure in a gen- tle and uniform manner; and during the use of this ap- plication the astringent injection may be used twice a day ; and the sponge tent should be made gradually smaller as the vagina contracts. In the Edinburgh Medical Commentaries, vol. ii. p 43, we are told that a woman of singular fortitude, about fifty years of age, was much afflicted with pro- lapsus uteri. After trying many remedies in vain, she at length cut into the substance of the uterus with a common kitchen knife. A considerable haemorrhage ensued; but the uterus gradually contracted, and she had no return of the prolapsus, nor any bad symptom. Having boasted of her success, many women in the neighbourhood afflicted with the same complaint ap- plied for her assistance, and, by a similar operation. were effectually cured. In the prolapsus vaginae the same method of cure is still more strongly recommended; and this peculiar case has suggested the idea that scarifications may be sometimes useful. See Ruysch's Observations, N° 1, 7, 9, 10. and Saviard. London Medical Observations and Inquiries. vol. iii. p. 1. vol. iv. p. 388—400; Medical Museum, vol. i. p. 227—230 ; Heister's Surgery ; Hamilton's Midwifery, edit. 5 ; Edinburgh Medical Commentaries, vol. ii. p. 43 ; London Medical Journal, vol. vi. p. 387 ; White's Surgery, p. 460; Leak's Medical Instructions, edit. 5. Procide'ntia u'vuljE. See Hypostaphyle. Procide'ntia vagi'nje; colpoptosis. The degrees of this disease are different; but when the whole vagina or a part appears through the pudendum, it may be called a prolapsus; when it descends to thelab'iaa procidentia; and when not so far a relaxatio. Widemanus relates a case of this kind which had all the appearance of a prolapsus uteri, but not properly distinguished until it was too late to afford any relief; but generally the dis- ease is known by observing the os tincae, which dis- tinguishes the prolapsed womb from all other cases of descent, and from the inversio, which only happens after labour. When the whole vagina is prolapsed it appears like crude bloody flesh ; and if it swells violently, attend- ed with inflammation, a sphacelus will soon come on; but if the swelling be slight, without inflammation, the tumour will neither be troublesome nor dangerous. This disorder should be distinguished from a tumour, a fungus, a sarcoma, &c. of the vagina. The part may be restored with the fingers, and the patient should rest in bed for some days, using an injec- tion of warm vinegar and water; red wine and water; or a solution of cerussa acetata. In most cases the first object seems to be ablution, then reduction, and after- wards corroborants, such as the bark, vitriolic acid, cold bathing, and avoiding all violent exercise. If* these fail, the T bandage must be worn. See Heister's Surgery ; Hamilton's Midwifery, edit. 2, p. 247; Edinburgh Medical Commentaries, vol. ii. p. 46. Procide'ntia ve'sic^e urina'rlk. The inversion of the uterus never happens without carrying the bladder with it into the perinaeum, together forming a tumour. The bladder in this position is no longer exposed to the pressure of the abdominal muscles, and not having force enough in this posture to contract, the Ff PRO 226 PRO patient is compelled to squeeze the bladder with her hands, or between her thighs. The catheter if intro- duced must not be thrust inward, but downward, the fundus of the bladder being below the meatus urinarius. See London Medical Observations and Inquiries, vol. iii. p. 1. PROCO'NDYLUS, (from wpo, before, and xovfojXes, finger). The first joint of each finger next the meta- carpus, ante internodium. PROCTALGIA, ¥ROCTrTlS,(fromw?axlos,anus, and xXyos, pain,) clu7iesia, cyssotis. Inflammation of the anus. A variety of the phlogosis in Dr. Cul- len's system. It is discovered by a hot and acutely painful tumour at the anus, irritated by pressure, ob- stinate costiveness, and fever. The causes are, riding; violent blows; acrid applications; piles, Sec. The disease yields with difficulty, often terminates in abscess, and is sometimes succeeded by fistula. See Inflammatio, Abscessus in ano, and Fistula in ano. PROCTOLEUCORRHCE'A, (from w?uxlos, anus, Xevxos, white, and peu, to flow). A white mucous dis- charge from the anus. PROCTORRHOZ/A. A yellowish or sanious discharge from the rectum, accompanied with heat and itching about the anus. Whether, however, the discharge is white, yellow, or streaked with blood, the disease is the same, and consists of increased mucous discharge from the rectum, either from cold or irritation. It scarcely differs, except in its seat, from CxXXos, a stringed instrument, and etfos, likeness. See Cerebrum. PSALTERIUM,(Latin, a harp,) lyra, the medullary substance that unites the posterior crura of the fornix of the brain, resembling in its striae the strings of a harp. PSELLI'SMUS, and PSELLO'TIS,(from ^eXXi&, to stammer). Stammering, or a faulty articulation. Dr. Cullen places this local disease in the order dyscinc- sia, defining it a defect in pronouncing words. The species are, 1. Psellismus hesitans; battarismus; isch- nophonia, when there is difficulty to pronounce the first syllable or word. 2. P. ringens; blesitas; traulotis; and rottacismus, when there is a fault in pronouncing the letter R, which is always aspirated, and as if dou- bled. 3. P. lallans; lambdacis7nus; when the letter L is sounded improperly, or in the place of the letter R. 4. P. emolliens; traulotes; when the harsh letters are ex- pressed too soft, as the tetter S is too frequently sounded. 5. P. balbutiens; aranula; when from a large tongue the labial letters are too much heard, and are often sounded instead of others. 6. P. acheilos; 7nogilalia; when the labial letters are difficultly if at all sounded. 7. P. tagos- tomatum; cocatismus; when, from a division in the palate, the guttural letters are not well pronounced. Neither complaint is ever the object of medical practice; pronouncing carefully, under the direction of a nice ear. is the only means of relief. PSEU'DES, false or bastard. Hence is de- rived the word pseudo, with which many names begin. PSEU'DO A'CORUS. See Iris palustris. Pseu'do a'sthma. An asthma excited by an ab- scess, or a vomica in the lungs. Pseu'do ble'psis, phantasma, suffusio. False sight ; or seeing in imagination what does not exist, or existing things differently from the perceptions of others. Dr. Cullen places this disease in the order dysesthesie, distinguishing two species. 1. Pseudo blepsis imaginaria. For a variety of this, see Marma- rygjE. 2. Pseudo blepsis mutans; as when an existing object appears changed. See Diplopia. Pseu'do bu'nias. See Barbarea. Pseu'do bu'nium. See Bunias. Pseu'do ca'ssia. See Folium. Pseu'do chi'na. See China occidentalis, and Supposita. Pseu'do cora'llium. See Corallium ni- grum. Pseu'do co'stus. See Pastinaca olusatra. Pseu'do dicta'mnos. Bastard dittany, gnapha lium,veterum marrubium pseudo dictamnus Lin. Sp. PI. 817, is a plant which resembles the horehound in its virtues, but is not used at present. Pseu'do helle'borus. See Calendula palus- tris. Pseu'do i'ris. See Iris palustris. Pseu'do li'enes. Some glands which Ruysch ob- served near the spleen. Pseu'do lo'tus. See Guajacana. Pseu'do mela'nthium. See Nigellastrum. G g 2 P so 236 PSO Pseu'do mo'la. See Mola. Pseu'do narci'ssus anglicus. See Narcissus lu- TEUS SYLVESTRIS. Pseu'do na'rdus. See Lavendula lata and angus- TIFOLIA. Pseu'do pla'tanus. See Acer. Pseu'do pyre'thrum. See Ptarmica. Pseu'do sa'ntalum. See Brasilium lignum. Pseu'do seli'num. See Caucalis. Pseu'do se'nna. See Colutea. Pseu'do sycomo'rus. See Azedarach. PSI'DA, or PSI'DIUM. See Guaiava. PSILOTHRA, (from ^iXoa, to denudate). See De- PILATORIUM. PSILOTHRUM, (from the same; because it was used in depilatories). See Bryonia alba. PSIMMY'THION, (from ^ta, to smooth; because it was used in cosmetics). See Plumbum. PSO'jE, (from i^oxi, the loins,) alopeces; nephrome- tra; neurometeres. The names of two pair of muscles in the loins. PSO'AS; lumbalis, lumbaris internus,psoas magnus; a thick strong muscle placed obliquely on the sides of the vertebrae, running under Poupart's ligament to each thigh. It rises fleshy from the sides of the last vertebrae dorsi, and those of the upper vertebrae lumborum, and, from the upper surfaces of their transverse processes ; and is joined under Poupart's ligament by the iliacus in- ternus, which lies upon the concave part of the ilium, and takes its origin from the anterior edge of the bone. It runs down before the psoas, and makes one mass with it: together they run over the head of the bone, and pass upwards to be inserted, tendinous, into the little trochanter, and fleshy into the bone a little below that process. Between this tendon and the ischium is a large bursa mucosa; and at its origin it is slightly connected with the diaphragm and quadratus lumborum. Its office is to bend the femur, by bringing it for- wards, partly to rotate it, and to turn the toes out. The kidneys often press upon this muscle, and over it runs a nerve. Those, therefore, who have stones in the kidneys often feel a numbness in the thigh of that side. Pso'as, seu lumbo'rum, absce'ssus. Psoadic, or lumbar abscess, has been considered as a species of Arthropuosis, q. v. and we have admitted it inadver- tently among the synonyms. The seat, the nature of the complaint, and the remedies are, however, very dif- ferent. It consists in an inflammation of the muscle itself, and consequent suppuration. Mr. Pott hastily transferred it to the lymphatic glands; because he found the vertebrae in the neighbourhood usually cari- ous ; and Mr. Justamond thinks the disease wholly ow- ing to caries of the vertebrae. Mr. Abernethy supposes that the cellular substance interposed between the peritonaeum and the loins is the common seat of these abscesses, since this substance is in greater quantity at the sides, where it connects that membrane to the psoas and quadratus lumborum muscles, than in the middle, where it forms an attach- ment to the spine. Where this substance is most abundant, the abscesses are most frequently formed; and for this reason we"find them usually limited to either side of the vertebrae, and seldom extending across them. If matter was formed in the middle, opposite to the oodies of the vertebrae, its gravity and the want of resistance would, however, determine the descent to either side As the peritonaeum would readily yield to the protrusion of the matter collected behind it, from the separation of the cellular substance connecting it to the vertebrae, it is improbable that a caries of the bones should be the consequence of an ordinary lumbar abscess. Dr. Huntei observes, that matter is sometimes lodged in this part at the crisis of afever,and he hath seen instances of matter proceeding from the liver into this situation, after making its way through the peritonaeum. As the muscle with the cellular substance and integuments forms a thick mass, the matter seldom points outwardly on the back, bur running down between the fibres, makes its way into the groin, thigh, ham, the inner condyle of the os femoris, Sec. When on the right side, it may penetrate the co- lon which lies upon it, and thereby occasion a large discharge of matter by a stool, and possibly a fistulous sore. Of this possible event we have not seen or been able to discover a single instance in any author. The disease invades insidiously; the pains are situated in the back, rather lower than the region of the kidneys, and usually so slight as to be mistaken for a rheumatic affection or a slight strain. It consequently proceeds with little check ; for were it more early distinguished, the abscess might be often prevented by bleeding, purg- ing, and the medicines proper for inflammations, aided by the necessary local applications. After the abscess is formed, the pain often increases, and the matter may be discharged into the cavity of the abdomen, where it would be soon fatal. It more usually, however, follows the course of the psoas muscle, and points externally a little lower than the inguinal glands, or it may pass down the thigh, dissecting the muscles, and forming sinuous abscesses. Sometimes, though rarely, the matter passes through the muscles of the back, and is discharged in the loins, or it may fall into the cavity of the back part of the pelvis. This abscess is, therefore, highly dangerous; since in the most fortunate circumstances it is so long in pointing out at the back, that the patient sinks under the early hectic, or from the subsequent discharge, and in the event of the other terminations the lengthened sinuses can scarcely ever be brought to heal. Usually, the first symptom that the patient feels in cases of the psoas abscess is«not where the disease . originates, but a pain in the lower part of the thigh of the side affected; he stands on his toes, and does not complain of the part for some time : but by attending to the circumstances from the beginning, and laying the person affected on his back, lifting up his thigh, then, between inspiration and expiration, carefully exa- mining the part, a tumour may be often felt near or in the region where the disease originates. The leg of the affected side seems to be shorter than the other, but it is not so. In other cases the disease proceeds rapidly, sometimes very slowly; and at length appears in the groin, on the affected side ; the muscles of the thigh become exceedingly emaciated, and the whole body wastes. When it proceeds thus far, the patiently rarely, if ever, recovers; the symptomatic fever that generally attends closes the scene. In some cases the patient feels in an early period a slight pain in the back, so inconsi- derable that he scarcely notices it; and when questioned PSO 237 PSO itt a later period of the disease, often does not recollect it. If at this time he is desired to bend his body, and to raise either leg, turning out at the same time the toe, he feels a sharp pain in the middle of the back; and these symptoms occur previous to the formation of matter, ascertained by the symptoms just described. At this time there is no fever, nor any circumstance to discriminate the case : for a pain in the back, on stoop- ing, is common; and perhaps the pain felt on turning out the toe is the only diagnostic. This disease is often confounded with the abscess of the hip joint, yet they are very distinct and different in their origin, seat, and progress. The psoas abscess originates sometimes, perhaps, in the lymphatic glands near the receptaculum chyli, and the vertebrae in the neighbourhood are occasionally diseased and carious; in other instances in or about the loins, if not higher in the abdomen; but, in general, it seems to be a true inflammation of the psoas muscle, and the affection of the glands, as wrell as the caries, to be the conse- quences. We know that the matter may be long re- tained without any ill consequences, if the air is ex- cluded, and this is the foundation of Mr. Abernethy's method of cure. The symptoms mentioned above con- tinue for some time ; but at length the disease appears externally ; the limbs and the whole body waste. The hip joint abscess originates in the hip joint; when it attends, the leg of the affected side is shorter than the other; the pain begins in the part where the disease originates, and about the great trochanter. The most frequent situation of the psoas abscess is before or by the sides of the psoas muscles, from whence the fluid collected sometimes extends itself laterally, making its way between the three strata of abdominal muscles, and presents itself beneath Poupart's ligament, elevat- ing the fascia of the thigh. If the patient be laid on his back, the tumour of a psoas abscess may be pressed into the cavity of the belly; but in an external one no alteration takes place, and if there be two lumbar ab- scesses, the compression of one will fill the other. A stone in the kidneys hath been taken for this disease; but in the former the pain is very acute, the stomach often affected with vomiting, and stony concretions, occasionally blood with the urine, have sometimes passed. See Abscessus ischiaticus. If an absorption take place before the abscess hath burst externally, the patient often dies; and if a fetid ichor is discharged, or the bones are affected, little or no hope remains. A symptomatic fever generally closes the scene; but in general the fever does not come on while the matter is confined, nor to any great degree for forty-eight hours after it is discharged: a circumstance probably owing to the admission of the air. This disease, whilst in its inflammatory state, is ge- nerally neglected or mistaken, otherwise it might be easily cured, perhaps by bleeding. We recollect an ano- nymous communication, in which it was said that very copious and repeated bleedings were a certain cure, and farther information was promised, though never re- reived. It was probably, therefore, one successful in- stance, exaggerated in the eagerness of youth, and of early confidence. It is not difficult to see why the early practice has been so unsuccessful. The inflammation is of that torpid kind which arises sometimes in the liver, sometimes from the brain in Concussion, q. v. Ft proceeds without any alarming symptom, or exciting any increased activity of the circulation, till it has ai ready attained that degree which disposes to suppura- tion, often till suppuration has come on. From hence it has been styled strumous, lymphatic, caries of the bones, Sec. while it is merely languid inflammation of a muscle constantly in action, constantly irritated. Dr. Fordyce observes, that this disorder should be treated in the same manner as inflammation of the liver, except for the situation, both in the state of inflammation and suppuration; but we know of no peculiar treatment of hepatitis, except blisters, purgatives, and calomel; neither of which succeed in the present disease. Wc have tried every variety of plan in vain. We have bled copiously; we have emptied the bowels freely; deter- mined copiously to the surface by the sudorific powder of Dover, without being able to prevent the consequent suppuration. We have been told of the success of others; but when we have been able to ascertain the facts, we have found them common rheumatisms, or abscesses not deeply seated. We have seen persons recover; but there was reason to attribute it rather to the efforts of nature than the utility of medicine : and in general, keeping up the patient's strength sufficiently to enable him to undergo the discharge, by a nourishing diet and clear air, the bark, the dilute acid of vitriol, is the most promising plan ; to which we would add ab- solute rest, and the occasional use of laxatives. Other practitioners, particularly Mr. Bell, advises evacuation as soon as the matter is formed, lest the bones should be injured. Dangerous as this complaint always is, and fatal as it is generally supposed, Mr. Abernethy has supplied some cases where success has attended his endeavours. He observes, that whilst the condensed cellular substance, which forms the cyst of an abscess, remains entire, it continues free from inflammation, and the contained pus is not altered; but whenever the abscess is opened, either by ulceration or the hand of the surgeon, a sudden and generally considerable in- flammation extends itself over the whole cyst, followed by a copious discharge of pus, frequently fetid. If, however, he adds, when we evacuate fluids from cavi- ties, we immediately close the aperture, we prevent the inflammation which would otherwise ensue. If, also, the matter of an abscess is discharged, its cavity be- comes much diminished by the contraction of the cyst: a contraction greater in a chronic lumbar abscess than in those of a more inflammatory nature. These consi- derations led him to evacuate the fluids in part, and im- mediately close the aperture, repeating, after some time, the operation. The practice founded on these principles seems to have answered the intention, and it is pursued on the following plan. The pus is discharg- ed by introducing a lancet through the integuments, then passing it obliquely, for a small distance, between the skin and the fascia, and by depressing the point of the lancet there puncturing the cyst. The matter should be drawn off in an uninterrupted current, if pos- sible, and the abscess completely evacuated. The aper- ture should then be immediately and exactly closed, by dressing the orifice with lint, and bringing the edges into close contact with sticking plaster. In aid of this plan, Mr. Abernethy gives vomits of vitriolated zinc and copper, passes gentle electrical shocks through the abscess, and keeps up the action of the external vessels by rubbing the surface with a solution of tartarized anti- mony. The second discharge of the pus has generally PSO 238 PSO been postponed for a fortnight; but if the cavity soon fills again, and the newly heated punctures are irritated by the pressure of the contained fluid, there is an abso- lute necessity for evacuating the contents of the ab- scess at an earlier period. In this second operation, he is less anxious about the obliquity of this aperture, as coagula are found in the matter, which it is necessary to discharge; and he generally delays it till the tumour is so large that on opening it there is no danger of in- juring the vessels below. He sometimes thought an injection of opium useful. In this mode the matter is to be evacuated from time to time, until the abscess be- comes so superficial as to be treated in the method common on such occasions. Elements of the Practice of Physic, part ii. by G. Fordyce; Cheston's Pathological Inquiries; Aberne- thy on Lumbar Abscess; De Haen Ratio Medendi, pars iv.; Penciz Acta et Observationes Medicinales; Medical Observations and Inquiries, v. 193. Pso'as pa'rvus. A little psoas is found on the ante- rior part of the great, where it exists. It arises fleshy ^rom the upper vertebrae of the loins laterally; is in- serted, by a long, flat, thin tendon, into that part of the os pubis where it joins the ilium. From this tendon many fibres are sent off to form a thin fascia, which covers part of the psoas magnus, and iliacus internus, gradually losing itself .on the fore part of the thigh. Its use is to assist the recti abdominis in drawing the os pubis upwards, as in raising ourselves from a decum- bent posture. PSO'PHOS, (]>o ircumstances. If the disease is in the upper part of the body, and the critical evacuation is to be expected from above, the pulsus dicrotus occurs, which he styles pulsus superior. If the complaint is in the breast, and the discharge is expected from that part, the pulse will be soft, flowing, and equable : if in the throat, some- what harder and quicker, approaching the " cephalic pulse," which is still more hard, quick, and strong ; truly a rebounding pulse. The pulsus inferior has un- equal intervals, and is not seldom an intermittent one, joined with subsultus. It will portend vomiting, if at the same time hard and unequal; evacuations from the intestines, if more unequal, almost intermitting, and mixed with subsultus. A pulse presaging haemorrhoids is rebounding, hard, frequent, and less unequal. The whole, however, is a superstructure raised on the founda- tion of Solano; but it is certainly, in a great degree, imaginary, and we find, from De Haen's Epistle to Haller, that Bordeu himself trusted little to it. The doctrine is at least inapplicable to the artificial cure of fevers by emetics and cathartics. It may be asked if this is an improvement ? We can reply most certainly ; for, instead of a treatise on fevers being, as was said of Hippocrates' epidemics," a meditation on death," febrile complaints are seldom dangerous. A critical jaundice is a certain proof that the proper alvine discharges had been neglected. Some other minute peculiarities of little importance have been noticed respecting the pulse; but we have sufficiently enlarged on that subject, farther perhaps than its application to more rational practice will war- rant. See Galeni Tractatus varii de Pulsus in Operum, vol. iv.; Massaria de Urinis et Pulsibus; Bellini de Urinis et Pulsibus; Solani Lapis Lydius Apollinis, folio, abridged and republished in 12mo. in 1737, and again at Vienna in 1753; De Haen Ratio Medendi, Pars ix. and xii.; Nihel on the Pulse; Hoffman Dissertatio de Pul- suum Natura et Praxi; Stahl de Differentia Pulsus Ceteris et Frequentis; Floyer's Pulse Watch; Boer- haavii Institutiones cum Commentario Halleri. PU'LVINAR,(from pulvis, dust,or chaff, with which they are filled). See Epithema. PULVINA'RIA. Cushions, or pillows, made with chaff, mixed with medical ingredients coarsely powdered. Those made with hops are said to be effi- cacious in producing rest; an apparently idle fancy, rendered famous from the rank of the patient on whom it was tried. PU'LVIS, (from pello, to drive about, because it is easily agitated). A powder is composed only of such materials as may be reduced to this form, and kept in it without any loss of virtue, or which, from their levity, will not increase the bulk, or by their taste render the medicine nauseous. Bitters, fetids, acrid medicines, alkaline salts, and gums, are generally improper for keeping in this form. The dose of powders should not exceed d ij 5 and if light, 3 ss. Compound powders were formerly called species. Pu'lvis aloe'ticus. See Hiera picra. Pu'lvis antily'ssus. See Lichen cinereus. Pu'lvis antimonialis. See Antimonium. Pu'lvis Jacobi. The powder of Dr. James. An antimonial preparation, of which werfound various prototypes in our enumeration of the older antimo- nials (see Antimonium). It was originally prepared by himself, but has since descended to the rank of a quack medicine; though, from the ingenuity of Dr. Pearson, we now approach very near it in the London Pharmacopoeia. I i 2 PUN 252 P U II It is supposed that, in the first preparations, calomel was added, and it has been said that Dr. James did not trust to it for the cure of fevers, but used it only as an eyacuant previous to the use of the bark; and that he did not originally design to keep it a secret. It has, however, been anxiously employed since his time, and atone period the quantity exported was immense. This may probably continue. The specification is worded with all the ambiguity of an ancient oracle, nor can it be prepared by the process described. Its succedaneum also, from many circum- stances, is uncertain in its result. Dr. Pearson dis- covered that this celebrated powder consisted of the earth of bones, and the antimonial calx, forming a double compound, in the proportion of fifty-seven parts of the calx to forty-three parts of the earthy salt. It was doubtful, however, whether the ingredients of the earth of bones were not united with the antimony in an intimate chemical union, forming a triple compound. A little calx of iron appeared to be an accidental impreg- nation. The chemical state of the calx is, however, peculiar. About three-fourths may be dissolved in mu- riatic acid, and will afford the powder of algaroth. The remainder is insoluble in this acid, and is seemingly vitri- fied. If the bone ashes (phosphorated lime) are calcin- ed in the above proportions, with the calx of anti- mony, and then exposed to a white heat, the result very nearly resembles James' powder. The uncertainty of the medicine apparently depends on the last part of the process. With the utmost care we have not been able to prepare it twice exactly alike. In a medical view, James' powder is less active than its imitation. It affects the bowels and stomach very slightly, and passes off more readily by perspiration. In general, however, the difference is so inconsiderable, that we need scarcely regret the want of the real re- ceipt of the inventor. We have thought that by unit- ing two grains of the pulvis opiatus with three of the antimonial powder, we imitated very nearly the effects of Dr. James' preparation. The opiate, however, cer- tainly forms no part of the medicine sold. See Dr. Pearson in the Philosophical Transactions. Pu'lvis febri'fugus cr- upper extremity, and easily dislocate it, if this ligament was not to take off the force of the shock. The fibula is also so called. RA'DIX, (from pxfo%, a lower branch). A root, that part of a plant by which it receives nourishment. Some roots are fleshy, others fibrous, others woody. Linnae- us divides them into fibrous, bulbous, and tuberous, which are again subdivided, chiefly in the following manner: Ra'dix asphode'li, composed of several oblong fleshy knobs, as the king's spear, and the day lily. Ra'dix bulbo'sa, composed of several coats, involv- ing, or of several scales lying over, one another. The first of these is called tunicated, as the onion; the last, squamous, as the lily. Ra'dix carno'sa. Fleshy or esculent root, as the carrot. Ra'dix fistula'ris. Tap root, or that part which runs perpendicularly deep into the ground. In taking up trees, it should be neither cut nor broken; and in planting them, a hole should be made proper for its re- ception. Ra'dix fibro'sa, consists only of small fibres, like hairs, as those of grass and corn. Ra'dix granulo'sa, consists of many small fleshy knobs, which resemble grains of corn, as the white saxifrage. Ra'dix grumo'sa, usually a pendulous root, consists of many oblong fleshy knobs, joined to one centre at the top, as that of the ranunculus. Ra'dix palma'ta, a tuberous root divided apparently into several fingers, so as to resemble a hand, as the handed orchis. Ra'dix testicula'ta, a double tuberous root, consist- ing of two knobs, resembling the testicles, as in the or- chis. Roots are sometimes styled comosa, which send out fibres from the top, at a knot between the trunk and thicker part of the root; fusiformes, when they gradu- ally lessen to a point; entire, as in liquorish, and parted, as in St. John's wort. Perennial roots are styled radi- ces fruticosa. Ra'dix tubero'sa, consists of an uniform fleshy substance, and is generally roundish, as that of the potatoe. Ra'dix Brasilie^nsis. See Ipecacuanha. Ra'dix dulcis. See Glycyrrhiza. Ra'dix I'ndica Lopeziana. Radix serpentum ophi- orriza 7nungos Lin. Sp. PI. Pharmacopoeiae Edin- burgensis; Gaubii Adversar. cap. vi. The root of an unknown tree, growing at Goa, or Malacca, and brought to Batavia. The pieces are sometimes of two inches diameter. The woody part is whitish and very light, sofler, more spongy, and whiter next the bark, including a denser, somewhat reddish, medullary part. The bark is rough, wrinkled, brown, soft, woolly, pretty thick, covered with a thin paler cuticle, without any remarkable smell or taste, or any appearance of resinous matter. When boiled in water it has no smell, and the strained liquor, of a yellow hue, is almost insipid, impressing the tongue with a very light bitterishness, RAN 269 R A N without viscidity. The tincture is brown and equally insipid. The extract obtained by evaporating the de- coction is equally void of sensible activity. After draw- ing off the spirit from the tincture a balsamic matter remains, which bubbles and flames in the fire, with a bitterish taste, like that of opium. This root is regarded in the East Indies as a medicine of extraordinary efficacy in diarrhoeas. Gaubius found it effectual in abating colliquative diarrhoeas, particu- larly those attending the last stage of consumptions. It seems to be a narcotic bitter not unlike the simaruba, but in Gaubius' opinion more efficacious. The powder is given in doses from fifteen to thirty grains, repeated three or four times a day. A tincture made with com- mon spirit is said to be equally effectual with the root; and its dose was a tea spoonful three times a day: a dose somewhat disproportioned to that of the root and to its sensible qualities. Lewis's Materia Medica, edit. 3. Ra'dix rho'dia. See Rhedia. Ra'dix ru'bra. See Rubia. RAI'JIS DE MOSAMBIQUE. See Columbo. RAMA'LIS VE'NA, (from its minute branches). See Porta ven^. RA'MENTA. Shreds or filings. RA'MEX, (ramus, a branch, from its protruding for- ward like a bud). See Hernia. Ra'mex varico'sus. See Cirsocele. RA'MUS, (quod radice manet). A branch, the sub- division of a stem of a tree. Ra'mus infe'rior. See Maxillaris inferior ner- vus. Ra'mus supe'rior. See Frontalis nervus. RA'NA, (Hebrew, ranah, to croak). The Frog, or puddock. The spawn of frogs was formerly used as a refrigerant, but now wholly neglected. See Ranula. Ra'na esculen'ta. The hind legs of the frogs are only eaten. They resemble delicate veal, and are much less luscious than the tortoise. Ra'na rube'ta. See Bufo. RA'NGIFER, (from ramus, a branch, and fero, to bear, named from its branching horns). See Cervus rangifer. RANI'NjE ARTE'RIiE and VE'NiE. (Quia ni- gra sunt instar ranularum). See Sublingualis. RA'NULA, (a dim. of rana, a frog). Batrachos, hypoglossus, rana. An indolent tumour under the tongue, named from its situation in the venae raninae,or perhaps from its altering the voice of the patient. This tumour is formed in the salivary glands, and is seated on either side of the fraenum : it is often of a scrofulous kind, defined by Vogel a folliculous tumour, containing a thick or tofaceous matter ; but the nature of the mat- ter varies, and it is sometimes like the white of an egg, at others more solid, and even sandy, purulent, or dif- fering from each. It has been styled a hydatid, and is said by Siebold to be an expansion of Wharton's duct. When it grows suddenly, both the speech and swallow- ing are impeded with much pain; but it generally in- creases gradually, and its effects are not violent. In- stances, it is said, have occurred of these tumours de- generating into cancers ; but this is highly improbable, for they are with great difficulty dispersed or brought to suppuration, and generally require the knife for their removal. The actual cautery has sometimes been employed, and the oil of hypericum recommended. If a tumour of this kind is seated where the salival ducts enter into the mouth, incisions must never be attempt- ed, because of the danger of wounding these ducts, and we must wait till nature discharges the contents. If seated on either side, great care is required, lest the nerves or the blood vessels should be injured; but if we hold up the tongue, and make an incision trans- versely into the tumour, the matter will be safely discharged. The wound must be dressed with honey of roses acidulated with spirit of vitriol, that the cyst may also be destroyed, to prevent a return of the disease. Mr. Justamond relieved a patient who would not sub- mit to an operation, by rubbing it daily with a strong solution of alum. See Heister's Surgery; Bell's Surgery, vol. iv. p. 325 ; White's Surgery, p. 275. RANUNCULOI'DESPRATE'NSIS,(ran«ncw/«s, and etfos, likeness). See Calendula pratensis. RANU'NCULUS, (because found in marshy places where frogs abound). Crow foot, is a plant with perennial, pentapetalous, rosaceous flowers, set in five leaved cups, and followed each by a round cluster of naked seeds. A name also for the myosuros. Ranu'nculus bulbo'sus, Lin. Sp. PI. 778, tuberosus major, round rooted or bulbous crow foot, hath a round tuberous root, the size of an olive; the leaves are divided commonly into three segments, and further subdivided; the stalks are erect, the flowers of a bright glossy yellow, their cups turned downwards; common in pasture grounds, and flowers in May. This is one of the caustic species. Ranu'nculus longifo'lius palu'stris minor; ra- nunculus fiammula Lin. Sp. PI. 772. citrinula, spear WORT, Or SMALLER WATER CROW FOOT, with fibrOUS roots, long narrow leaves, accumulated at both ends, leaning on procumbent stalks; growing in watery places or moist meadows, and flowering in June. The roots and leaves have no smell, but an acrid fiery taste. Internally they appear to be deleterious, even when boiled in water so long as to discover no pungency to the palate. The effluvia of the less acrid species, or varieties culti- vated in gardens, when freely inspired, have occasioned headachs, anxiety, vomitings, and spasms. The leaves and roots applied externally blister the part, and destroy it. For this purpose they are used in Mrs. Plunket's re- medy for cancers. Indeed all the species are highly acrid, exciting itching, inflammation, blisters, and ulceration on the tongue or on the surface. In the stomach they have all the effects of an acrid poison. The most viru- lent species are the r. bulbosus, sceleratus,acris arven- 8is,thora, and illyricus; but the acrimony resides, some- times in the roots, occasionally in the stalks, lea\es, or flowers. The acrimony of the ranunculus alpestris, ac- cording to Haller, is most considerable ; but no medi- cine will counteract the virulence of this tribe. The wild plants are more acrid than the cultivated ones; their pungency is diminished by drying, and destroyed by long keeping. See Raii Historia; Lewis's Materia Medica; Kraft Experimenta de nonnullorum Ranunculorum Ve- nenata Qualitate, Vien. 1766; Mayr de Venenata Ra- nunculorum indole corumque usu, Viennae, 1783. Ranu'nculus vi'ridis. The name of a species of frog: the term ranunculus is also given to several other of the vegetable class, viz. RAP 270 R AP Ranu'nculus itca'ria and ve'rnus. See Chf.le- DONIUM MINUS. Ranu'nculus nemero'sus. See Moschatel lina. Ranu'nculus phragmi'tis. See Anemonoi- des. Ranu'nculus tridenta'tus ve'rnus. See Hepati- ca nobilis. RAPA, (from the Arabic term rapagh, to germinate). The turnip, or round rooted turnip, rapum, a plant with jagged leaves, yellow flowers, with small round, smooth, reddish or blackish seeds, in long pods. The garden turnip is supposed to be a variety produced by culture from the smaller sort, which grows wild in sandy grounds in some parts of England. It is bien- nial. Turnips are to many an agreeable food; but watery and flatulent; in weak stomachs inconvenient. They are said to be detergent, laxative and diuretic; are mild rather than sweet, but contain no sugar, and very little amylaceous matter. The yellow turnip has a sweeter and more mucilaginous taste, and is therefore apparent- ly the most nutritious. (Cullen's Materia Medica.) The liquor pressed from them, after boiling, and some- times from the raw root, is taken medicinally in coughs and disorders of the breast; and applied to the mouth in aphthae, the seeds are styled alexipharmic, diapho- retic, and diuretic; they have no smell, but to the taste are mildly acrid. The female turnip is of a less rounded shape, and preferred. See Raii Historia; Lewis's Materia Medica. See Rapistrum. RAPHA'NIA, (a disease supposed to arise from eat- ing the bastard radish. Raphanus raphanistrum Lin.). Convulsio soloniensis; eclampsia typhodes; ne- crosis ustilaginea; kriebel, krankheit; is defined " a spastic contraction of the limbs or joints, attended with convulsions and excruciating periodical pain." Rothman observes that it had been frequently epi- demical in Sweden, though considered as a new disease, and he has traced it in the works of different authors from the year 1596 to 1727, so that it has been com- mon in other parts of Europe. He adds, that this dreadful distemper sometimes continued for three or four weeks, and that it terminated fatally from a diarr- hoea or convulsions. The poorer people were the chief subjects of this complaint, and were usually attacked in autumn, soon after eating, bread made of new corn. The lollium temulentum, and the disease of corn styled ergot, by which the end of the seed is elongated like, a horn, have been accused, as well as the charlock (ra- pistrum), of producing the disease; but it most proba- bly proceeds from the ergot. Valerian, castor, camphor, and other similar antispas- modics, were given with little advantage. Camphor has been sometimes combined with vinegar, and the animal oil of Dippell, with scarifications, blisters, and emetics, have been repeatedly employed with no de- cided success. See Pulteney's View of the Writings of Linnaeus; Memoires de la Societe Royale de Medecine, at Paris, Annee 1776, 1786; Rothman's Dissertatio de Raphania; Amoenitates Academicae, vol. v.; Rosen- stein de Morbo Convulsivo Spasmodico; Tissot Epistolae Medico-practicae; Marcard von Einerder Kriebelkrank- heit. RAPHANI'STRUM, (from raphanus, in conse- quence of its likeness to the raphanus minor). It agrees with this plant also in its medical virtues ; and i* sometimes the appellation of miagrum. RA'PHANUS, (wxpx t« pxfoas (pxtverSxt, from its rapid germination). The radish. RA'PHANUS AQUA'TICUS. See Sisymbrium aquaticum. Ra'phanus horten'sis, radicula, raifort; rapha- nus sativus Lin. Sp. PI. 935; common garden radish. The root is attenuating, occasionally carmi- native ; and all the parts of the plant arc antiscorbutic. The roots are more acrid after drying than when fresh, but this acrimony is soon dissipated by boiling. It is commonly eaten raw with its cortical part, in which its acrimony consists; and this rather serves as a condiment to its acescent substance, and which therefore seldom proves flatulent. It is, however, in weak stomachs in- digestible. Ra'phanus rustica'nus, mari'nus, and sylve'stris. Horse radish, cochlearia armo7-acia Lin. Sp. PI. 904. The leaves are large, long, and indented about the edges. It is found wild about the sides of ditches and rivulets, but for medicinal and culinary purposes cul- tivated in gardens; perennial, flowering in June. It rarely perfects its seeds, but is propagated by trans- verse cuttings of the roots. The smell and taste of the roots are quick and pene- trating; but they contain also a sweet juice, which sometimes exudes in little drops upon the surface. Its pungent matter is very volatile, dissipated in drying, and carried off in distillation, both by water and spirit. As the pungency exhales, the sweet matter, though partly dissipated, becomes more sensible. It impreg- nates both water and spirit by infusion or distillation very richly with its acrimony, and in distillation with water yields a small quantity of essential oil, exceedingly penetrating and pungent. This root differs from mustard seed in the volatility of its pungent matter, and its solubility in spirit. It is properly employed as a condiment with animal food, as it stimulates the stomach and promotes digestion. Externally applied, it is an useful rubefacient in palsy and rheumatism. Its infusion often cures hoarseness, when it depends on the interrupted secretion of mucus; and it readily proves emetic, when taken in infusion, or assists the action of other emetics. Infused in wine, it stimulates the whole nervous system, and is useful in palsy; but employed in large quantity it is often injurious by the excess of heat which it excites, though on this account useful in chronic rheumatism. Cut down into very small pieces, without bruising, and swallowed without chewing, ac- cording to Bergius, it has been extremely useful in arthri- tic cases, perhaps of the rheumatic kind. Its pungency passes to the kidneys, and often proves a powerful diu- retic ; and by promoting urine and perspiration, it has long been known as a powerful antiscorbutic. Held in the mouth it proves a certain and good sialagogue. The syrup of horse radish is made by infusing one drachm of the root in four ounces of water, and forming that into a syrup, in a moderate heat, with sugar. An infusion of it with bruised mustard seed, either in wine or boil- ing water, acts as a stimulant and diuretic, and is often prescribed with success in dropsical and paralytic com- plaints. An infusion of this root in milk is also one of the safest and best cosmetics. If the root be kept in a cool place, and buried in dry R A U 271 R E C sand its virtues are long retained. Dr. Alston thinks that it may be dried and powdered without losing any considerable portion of its virtue. The London college directs the following compound spirit, spiritus rapha7ii compositus, to be kept. Horse radish root fresh, the exterior rind of Seville orange dried, of each two pounds; fresh garden scurvy grass, four pounds ; bruised nutmegs, an ounce ; are added to proof spirit of wine, two gallons, with water, a sufficient quantity to avoid an empyreuma : distil two gallons. Pharmacopoeia Londinensis, 1788. See Neu- mann's Chemistry; Lewis's and Cullen's Materia Me- dica. Ra'phanus sylve'stris. See Lepidium. RAPHE, (from pxtpn, a suture). The longitudinal eminence which divides the scrotum, passing through the perinaeum to the anus. Raphe cerebri. The longitudinal eminence which divides the corpus callosum. RAPHONTICOI'DES LU'TEA. See Behen al- bum. RAPI'STRUM, (from the resemblance of its leaves to those of the turnip). Rapa la7npsana, miagra, sinapi arvense pracox semine nigro, charlock, chadlock, kedlock, or wild mustard; a plant said to be antiscor- butic, but never employed in practice. RAPOCAULIS,(from rapa,and caulis,the cabbage). See Brassica congvlodes. RAPU'NCULUS, RAPUNTIUM, (from rapa). Plants which much resemble the campanula in external appearance. See Cervicaria. RASH. A familiar name for any papular eruption. RASPATO'RIUM, (from rado, to scrape). A Sur- geon's RASP. RAUCE'DO, RAU'CITAS, (from raucus, hoarse). A hoarseness, a diminution of the voice, sometimes attended with a preternatural asperity or roughness of the parts affected, the aspera arteria, and particularly the larynx. It is generally a symptom of catarrh, but sometimes a species of Paraphonia, q. v. It is chiefly occasioned by an inflammation, some- times a want of tone in the nerves of the part; for whether the whole larynx acts as a wind, or its ligaments bring it nearer to a stringed, instrument, a due activity of the nerves is necessary. In the first case it is a symp- tom of cold, or it may arise from swallowing acrid pow- ders. When it occurs also from measles, small pox or repelled eruptions, it is probably owing to the same cause. It is, however, often a symptom of hysteria, and then is probably owing to an altered state of the recur- rent nerve; for the voice involuntarily changes from an acute to a grave tone, goes off, and returns suddenly. Sometimes hoarseness comes on from swallowing dele- terious substances, as in the instance recorded by Plater, where a beetle swallowed produced it; sometimes it is said to be a symptom of pregnancy. Its most common causes are, however, fixed organic diseases of the trachea and neighbouring parts, often from syphilis. An ossification of the thyroid and cri- coid cartilages; a thickening of the first ring of the trachea (Fantonus) ; an erosion of the epiglottis (Hal- ter); an ulcerated larynx (Wathen's Memoirs of the Medical Society, London, vol. i.); and an erosion of the uvula (Lentilius), are all said to have produced the disease. Substances fixed in the oesophagus are said, in the Memoirs of the Academy of Surgery, to have had the same effect. Various are the remedies prescribed for the com- plaint, not always with a rational view of its cause. If Plenck found the arnica, the bark, and the aqua vui- neraria useful, it must have been in a case of debility. The erysimum and horse radix often given in the form of a syrup, must have succeeded on the same principle. Breathing watery vapours, bleeding, whey, cold water, and demulcents could only be of service in the inflammatory disease; the seton of Hildanus, when it arose from a topical complaint; and mercury when it was a symptom of the venereal disease. RAU'CITAS. See Branchus and Raucedo. REA'LGAR, arlada, auripigmentum rubrum, arseni- cum rubrum factitium, and abessi. A composition of sulphur, orpiment, and unquenched lime; of a red co- lour, always glossy, but not always transparent. See Arsenicum album. RE'BIS, abessi, azoth. The alvine sordes, in old au- thors; or the hair of choleric or plethoric men. Amongst alchymists it means the seed from whence gold is ge- nerated ; and it has obtained the barbarous name rebis, because its first two ingredients, by long coction, be- come one in species and number. For a similar reason the mercurius duplicatus philosophicus, consisting of sulphur and mercury, is called rebis. RECEPTA'CULUM CHY'LI, vel PECQUETI, (from recipio, to receive,) diversorium, sacculus chylife- rus, the receptacle of the chyle, first demonstrated by Pecquet at Paris, 1651, 1652, though Eustachius and Asellius were in some degree acquainted with it. It lies on the right side of the aorta, at the union of the last vertebra of the back with the first of the loins, and is in reality the union only of the different lymphatics somewhat enlarged; but by no means a sac in the hu- man body, as it is sometimes described. The upper por- tion lies between the aorta and the vena azygos, and forms a particular canal which runs up through the tho- rax, called the Ductus THORACicus^q. v. See Mon- ro's Osteology. Recepta'culum. A receptacle, by Ray called sedes; by Boerhaave, placento; and by Vaillant, thala- mus, is the basis upon which the other six parts of fructification are fixed.— 1. Receptaculum commune, connecting many flosculi. 2. R.fioris, a basis to which are fixed the parts of the flower exclusive of the ger- men. 3. J?, fructificationis, common to the flower and fruit. 4. R. fructus, a basis for the fruit only. 5. R. proprium, belonging to the fructification only. 6. R. seminum, the basis on which the seeds are fixed within the pericarpium. RE'CIPE. Take. It is usually placed at the be- ginning of prescriptions, and is generally wrote thus, R. or R. or with the character for tin, %. As this is the astronomical character for Jupiter, it has been ridicu- lously supposed an invocation for success. See R. RECLINA'TIO, (from reclino). An inactive state of the muscles; in botany a leaf which bends down, and whose top is lower than its base. RECTIFICA'TIO, (from rectifico, to make clear) See Depuratio. RE'CTOR SPI'RITUS. See Spiritcs. RE'CTUM INTESTFNUM, (from rectus strait,} RE C 272 REC apeuthysmenos, longanon, archos, cyssaros. This last of the large intestines is every where covered by longitu- dinal muscular fibres, and hath strong circular ones for expelling the faeces. It is not furnished with bands like the colon, nor covered with the peritonaeum, as the other intestines. At the lower extremity of the rectum are cryptae, supposed to be the seat of worms, and vas- cular ridges between the cryptae, the seat of haemorr- hoids, apparently raised by the fat between the mem- branous and muscular coats, interspersed with little glandular follicles, which separate mucus. The folds near the extremity are longitudinal, forming little la- cunae of a semicircular form, turned upward towards the intestine. This gut is a continuation of the last convo- lution of the colon, which, having passed below the lowest vertebra of the loins to the inside of the os sa- crum, is bent backward in the concave side, to which it is connected ; and having reached the os coccygis it runs in the same direction, bending a little forward, terminating beyond its extremity. The arteries are from the haemorrhoidalis interna, the last branch of the mesenterica inferior, which communicate with the hypogastrica, and particularly with the haemorr- hoidalis externa. The veins are branches from the mesaraica minor, or haemorrhoidalis interna, which communicate with the hypogastrica. The nerves are from the plexus mesentericus inferior and the plexus hypogastricus. Sometimes hard, scirrhous lumps, without pain, are seated near the anus, which are thrust out at every effort to void the faeces, and are then slightly painful; but at no other time, unless handled. If they have a small basis, Mr. Pott advises their speedy removal; for otherwise they certainly prove fatal. The early symp- toms do not elucidate their nature: the first sensation is that of wanting to void a large stool, but without effect. This unavailing inclination frequently returns, and on trying a clyster, the pipe is obstructed by a hard sub- stance. The nature of the case is often discovered; but we can in general only palliate. A tumour perhaps of this kind was apparently dissolved by the external ap- plication of the beladonna. Medical Commentaries, i. 464. Another disease of this gut is a general relaxed state of its whole substance. When extruded through the anus, it is bound by the sphincter muscle, and resem- bles a fungus with a narrow basis ; a true fungus is, however, uniform, and the finger may pass round it; it is soft to the touch, yet from irritation may be as pain- ful as a cancerous one. It is, therefore, proper to dis- tinguish them with accuracy, as the first may be cured, but the latter cannot. The cancerous fungus within the rectum is seldom uniform, but generally unequal, spreading from a large basis, and discharging an offen- sive ichor or gleet. Another disease of the rectum is a scirrhous contrac- tion. It occurs usually about an inch or two above the anus, and the first symptoms are obstinate costiveness, alternated by a watery diarrhoea, of a short continuance. The faeces are usually retained. Hemlock, and all the variety of medicines, have been tried with little suc- cess. The cure is palliative only. The existence of the disease can often be ascertained with accuracy, as it is within the reach of the finger. The anus is sometimes contracted by haemorrhoids, sometimes by venereal tubercles; and in the Memoirs of the Academy of Surgery, vol. i. and iii. there are in- stances of an abscess formed in this part, in consequence of swallowing some foreign bodies, or of substances forced into the gut. In the Medical Commentaries of Edinburgh, a case occurs of a calculus formed in it. Palsy and gangrene, sometimes cancers, of this part are said to have followed the abuse of drastics; and ulcers of the rectum are endemic in the Brazils. They are always with difficulty cured, though Dr. Rowley boasts of his success with antimonials and salts. Set Fistula. Siebold Dissertatio de Morbis Intestini Recti; Wris- bergde Preternaturali, Intestini Recti cum Vesica Coa- litu ; Rowley's Seventy-four Cases; Memoirs of the Medical Society, London, vol. ii. art. 2 and 25 ; Edin- burgh Commentaries, ii. 373. RE'CTUS. Strait. The name of several muscles, denominated from the rectilinear direction of their fibres. Re'ctus abdo'minis. The recti muscles of the belly arise from the os pubis, are inserted into the ster- num, and are expanded upon the cartilages of the fifth, sixth, seventh, and sometimes of the eighth ribs, having expanded into a thin aponeurosis, which passes under the pectoral muscle, and is said sometimes to ex- tend far up the sternum. In their course they are divid- ed into four or five portions, by tendinous intersections, most apparent on the anterior surface. They lie on the fore part of the belly, immediately under the integu- ments ; and the vessels which pass underneath the up- per parts are the mammary artery descending, and its vein ascending; those of the lower part are the epigas- tric artery ascending, and its vein descending. In this muscle certain white lines and impressions are perceptible, called by Vesalius perigrapha. Its use is to compress the abdomen, and to assist in raising the body. Re'ctus ante'rior. See Rectus cruris. Re'ctus a'nticus bre'vis. See Rectus internus minor. Re'ctus a'nticus lo'ngus. See Rectus internus MAJOR. Re'ctus atto'llens. See Genio hyoid-eus. Re'ctus oru'ris ; rectus femoris, rectus a7iterior, or gracilis anterior, rises by a strong tendon from the an- terior and superior process of the ileum, and from the cartilaginous tip of the acetablum, and is inserted into the upper part of the patella. Re'ctus de'primens, et infe'rior o'culi. See Depressor oculi. Re'ctus exte'rnus o'culi. See Abductor oculi. Re'ctus inte'rnus ; gracilis internus, rises close to the edge of the os pubis, where it joins to the ischium, and runs to the internal condyle. It serves to bend the thigh forward. Re'ctus inte'rnus ma'jor; rectus anticus longus, flexor capitis, lies before the rectus internus minor; rises commonly by as many tendons from the transverse processes of the fifth, fourth, third, and second cervical vertebrae, and is inserted into the anterior part of the cuneiform process of the os occipitis, bending the neck forward. Re'ctus inte'rnus mi'nor, a'nnuens : rectus R EF d ~" f 2i o R E M interus minor of Cowper; rectus anticus brevis of Win- slow ; is also named renuens. It rises from the root of the transverse process of the atlas, and is inserted into the cuneiform process of the os occipitis, just behind the groove where the lateral sinus forms the beginning of the internal jugular. This muscle gives the head a lateral motion upon the atlas. Re'ctus inte'rnus o'culi, rises from the bottom of the socket near the hole by which the optic nerve enters the orbit, passes on the side of the globe next the nose, and is inserted into the sclerotica. It draws the eye towards the nose. See Abductor oculi. Re'ctus latera'lis, rises from the transverse pro- cess of the atlas, and is inserted into the os occipitis and os temporis, near the mastoid process. It bends the head to one side. Re'ctus ma'jor; rectus capitis posticus major, rises from the upper part of the spinal process of the den- tata; runs upwards and outwards, and is inserted by a flat tendon, near where the os occipitis is joined to the os temporis, serving to bring the head backwards. It istin part a rotator of the head, and, though styled rectus, is in reality an oblique muscle. Re'ctus mi'nor ; rectus capitis posticus minor, rises from the knob which answers to the spinal process of the atlas, and passes thence to the head. It can only move the head upon the atlas. Re'ctus supe'rior o'culi. See Elevator oculi. RECU'RRENS, (from recurro, to return). The re- current nerve. See Par vagum, and Nervus. REDDLE. An argillaceous ocre, formerly used as a tonic, and externally as an astringent. RE'DUC,vel RE'DUX, (from reduco,to bring back). A flux, or a powder by which oxyds are reduced to a metallic form. Fluxes are generally either of the vitreous or the saline kind : by the former are meant all those that are, or readily assume a glassy form in the fire ; the chief of which are the glass of lead, or of an- timony, and borax: by the latter those composed of salts. There are fluxes of a yet cheaper kind ; such as dried wine tees, dried cow dung, dried horse dung, dried river mud, fuller's earth, iron filings, &c.; and a variety of compound fluxes, some of which are chiefly adapted for particular ores : indeed almost every opera- tor has his favourites. For the common black flux, see Calcinatio. REFECTFVA, (from reficio). See Cardiaca. REFRIGERANTIA, (from refrigero, to cool). A class of medicines of peculiar utility in all cases of in- creased tone or action of the sanguiferous system. As increased action of the vessels produces increased heat, so, on the other hand, different causes of the latter in- fluence the former. If it were necessary to make any distinction in a class of medicines so simple, we should say, that they are adapted either for a sudden or a permanent effect. Of the former kind, cold is the principal remedy; of the latter, a diet of weak alimentary powers, or, more strictly, every means of lessening the proportion of the gluten in the circulating mass. Cold is administered in the form of cold air, cold water, or the different fluids which attract caloric. The more temporary effect of cold produces, we have seen, reaction, so that the continuance of its application is VOL. II. necessary. The neutral and earthy salts are, in different degrees, refrigerant; and nitre is perhaps the most powerful, or a combination of nitre with crude sal ammoniac. The acid fruits and the native acids ap- pear to be refrigerant from the same principle, though they have some influence, when long continued, as weak aliments. Sedatives, however, repress inordinate circulation by an action apparently chemical, and hold a middle rank between cold and the diminution of the denser parts of the blood. Emetics in nauseating doses are of this kind ; probably the acid products of fermentation; more cer- tainly the preparations of lead. Avoiding all stimuli must be also a comparative cause of diminished action. The great source, however, of the change intended by this class of medicines is the diminution of the denser parts of the blood. Thus all evacuations of blood are permanently refrigerant; for though watery fluids are quickly supplied to fill the vessels, the gluten and red globules are of slower production. Low diet is a remedy of the same kind; and when we consider the effects of vinegar in reducing the bulk, we are tempted to believe that it may have some effect on the digestive process, and added to its sedative quality, obvious in the mouth and on the lips, may also lessen the proportion of gluten in the blood. The great utility of refrigerants is chiefly seen in all inflammatory affections, and in all the pyrexiae of Dr. Cullen, which depend on increased action, particularly haemorrhages and inflammations. In these cases the diminution of the symptoms only affix the limits ; but in the continued action of refrigerants of every kind we have reason to dread the most permanent chronic de- bility. The greatest caution is consequently necessary, in their employment. REFRIGERA'TIO. See Horror. REFRIGERATO'RIUM, (from refrigero). A re- frigeratory; the vessel filled with water, through which the worm passes in distillations, to condense the vapours as they pass through it. RE'GIA AQUA. See Nitrum. RE'GIMEN, (from rego, to govern). The regimen, or the regulation of the diet with a view to preserve or to restore health. See Di^eta; (Stahl de Regimine). In chemistry it is the regulation of fires. REGIONA'LIS MO'RBUS, (from regio, a country). See Endemius. REGI'STERES, (from rego). Registers, or open- ings, in different parts of furnaces, to be shut occasion- ally. By their means the fire may be regulated, for the heat is increased or diminished in proportion to the ac- cess of air. These holes should be from two to four inches wide, if the internal diameter of the furnace does not exceed a foot. RE'GULIS BARBADE'NSIS, vel JAMAICE'N- SIS. See Palma nobilis. RE'GULUS. A metal in its metallic form; from rex, because the alchemists expected to find gold in the metal. RELAXA'TIO, (from relaxo,) chalasis. See Pro- cidentia uteri, and Atonia. REME'DIUM, (from re, and 7nedeor, to heal,) a remedy ; boethe/na ; a medicine by which any illness 1^ cured. See Materia medica. M m REM 274 REN PEMITTE'NTES, (from remitto, to abate). Re- mitting diseases are fevers in which the paroxysm abates without wholly receding. As we have spoken so fully of intermittents, diseases of a similar nature with remittents, we have less temptation to enlarge on the present subject. Some considerations were, however, referred to this article. We have seen that the true regular intermittent has but one paroxysm in twenty-four hours. When a re- mittent first assumes the form of an intermittent fever, the remission is regularly more distinct; the sweat comes on, and the urine drops a more copious sediment. This remission becomes, by degrees, more perfect, and after the sweat there is some interval of apyrexia. The disease then soon becomes an inter- mittent. When the contrary change takes place, the paroxysm is prolonged, and its crisis is less complete. It is seldom prolonged to the period of the next attack; but the fever remains in a less degree, and its violence is gradually increased in each interval till the remissions are indistinct. In general, every fever begins with exacerbations and remissions, but the exacerbations of the true remittent are, on the alternate days of the continued fever, every evening, and more slightly every day about eleven or twelve. Every fever approaches, however, the tertian type. Remittents generally show it very strikingly, and the most continued fevers have, as already observed, their more remarkable changes on alternate days, down to the fourteenth; the period, independent of accidental circumstances, of every continued fever. With respect to remittents, however, this is perceived most strikingly, for twenty tertian remitting epidemics are described for one quartan or quotidian remittent. In examining the symptoms of different epidemics, the succession of the paroxysms may appear to oppose this opinion, and quo- tidian remittents to be more common than we have re- presented. On a closer examination, however, these apparent amphimerinae are in reality double tertians. Stahl has pointed out numerous instances of this kind in his dissertation De Tertiana, Febris genium univer- sum manifestante. It is a principle which should be always kept in view, in every consideration relating to the progress of fever. We found it difficult to explain why, after a com- plete solution of the paroxysm of an intermittent, the same series should recur. With respect to remittents there is little difficulty, for almost every epidemic of this kind is attended with asthenic symptoms, or rather with the most extreme debility. At the conclusion of the paroxysm, the sensorial energy is not restored : the fomes remains, till the returning evening exacerbation, or, more often, the returning tertian tendency renews the train of symptoms. These considerations render it highly probable that the true reason of the renewal of intermitting paroxysms is the imperfect restoration of the sensorial energy by the former fit; a cause already suggested, and which the remaining languor in the in- tervals strongly supports. This reasoning acquires more force when we find that all the febres comitatae of Torti are remittents, and that the accompanying symptoms are chiefly those of debility. As we may suppose the nosology of Dr. Cullen to be generally known, it is suf- ficient to refer to his enumerations of the tertianae comitatae of Torti, page 53, vol. ii. 1780. To this we may add the various accounts of the yellow fever of the West Indies and America; the epidemics observed by Sarcone at Naples; and the different publications re- specting camp fevers, and those occurring in long voy- ages, especially in transports conveying large bodies ol troops. It is easy to say with our predecessors in this work, that we must " empty the bowels and throw in the bark." It is the language of inexperience and ignorance; but we need not enlarge on the more difficult parts of the treatment, as we have already noticed them in our account of the yellow fever. The asthenic remittents of warm climates are the diseases in which cold applications are found chiefly useful; and the account which sir John Chardin gives of the treatment of the fever which he experienced at Gombron is a good example of the practice. It con- sisted in cold drinks and cold applications. Cold affu- sions are too violent repellents of the blood from the surface; and sponging the body with cold water and vinegar is all that can be allowed in this line. The bark may assist recovery, but there is seldom any proper period for its use during the fever. RE'MORA ARA'TRI, (from remoror). See Ano- NIS. REN, (a kidney,) nephros. See Renes. RENA'LES ARTE'RIjE, (from renes, the kidneys,) e7nulgentes arteria, are generally two in number, and go out on each side from the lower descending aorta, im- mediately under the mesenterica superior. The right is situated more backward, and is longer than the left, because the vena cava lies on the right side between the aorta and the kidney. They run commonly without division, almost horizontally to the kidneys, into the depressions of which they enter by several branches which form arches in the inner substance of the viscera. From these arches many small branches go out toward the circumference, or surface of the kidneys. Some- times two arteries go inlo one kidney. Generally the right renal artery passes behind the vena cava, and the renal vein in the other side; and the left artery first be- hind, and then before the vein. Sometimes they send branches to the glandulae renales, membrana adiposa of the kidneys, and even to the diaphragm. Rena'les ven^, emulgentes vena, spring from the inferior cava, when it arrives at the kidneys, into which these branches are sent. They are the largest veins connected with the vena cava, between the liver and the bifurcation. The right emulgent is the shortest, the left the longest; for it crosses the trunk of the aorta. Usually the left emulgent vein receives the left spermatic vein. RENE'LIUS. See Rhencos. RE'NES, (x-tto ra petv, from the flow of urine). The kidneys are two oblong flattened bodies, extending from the eleventh and twelfth ribs to the fourth lumbar vertebra. The right kidney lies under the great lobe of the liver, and is lower than the left, which is situated under the spleen. They resemble in shape a large bean, of which the concave side is towards the vertebrae. Their length is double their breadth, and the latter double their thickness. The upper extremity is broader and more incurvated than the lower, and the depression REN 275 R E P in the concave side is oblong, surrounded by small tu- bercles. The kidneys themselves are covered chiefly with a cellular substance; for the peritonaeum is ex- tended only over the upper and fore side, so that, when the kidney adheres to the muscles, matter and even stones may be discharged through an abscess, without danger from access of air to the cavity of the abdomen. The aorta descendens, and the vena cava inferior, lie between the kidneys, pretty close to the bodies of the vertebrae. (See Renales arteri.e and ven^e.) Each artery is surrounded by a nervous net work, from which the nerves enter with the arteries. The kidneys are covered on one side by the peritonaeum, and the whole substance is invested by a capsule, composed of two la- minae, connected together by cellular substance. The external lamina is thin and smooth, rendering the kid- ney uniform, and passing by numerous elongations into its substance. In children, the convex part is divided into little lobules; a form sometimes continued in adults. The substance of the kidney is divided into the external or cortical, and the internal, tubular, or mammillary portion, the latter of which is made up of a number of pyramidal bodies, about twelve in each kidney, whose points are received into the pelvis, so that the cortical part not only lies round the outer surface of the kidney, but its processes pass into the interstices. The corti- cal part is wholly vascular, but in minute injections, certain appendages, called corpora lobosa, are observ- able. These are natural cells, where the small arteries seem to be expanded. Ruysch thinks them only con- voluted arteries. In the veins no cryptae are seen, so that they are not extravasations; they are also uniform, and confined to the cortical part. The ramifications of the blood vessels are peculiar; for in their ultimate branches they resemble stars, and in this form are lost on the proper membrane of the kid- neys. The medullary, the striated, and the mammil- lary portions, are apparently continuations of the same substance, differing only in the proportion of red ves- sels. Every anatomist has refined in his observations on the structure of the kidneys; but these refinements are sometimes doubtful, and scarcely in any instance applicable to physiology. Each mammilla lies in a kind of membranous calyx, or infundibulum, which opens into a common membranous cavity, called the pelvis. After the infundibula have contracted into a conical form round the apices of the mammillae, each forms a small short tube, which, uniting at different distances along the bottom of the sinus of the kidney, constitute three large tubes, passing from the sinus obliquely downwards, and uniting into one trunk called the ure- ter. This excretory duct runs down obliquely on each side, with a small degree of inflection, to the lateral parts of the inner side of the os sacrum, and passing between the rectum and bladder, terminates in the latter at its inferior part, near thevesiculae sentinales. The ureters perforate each coat distinctiv in a slanting manner; so that their oblique insertion answers the purpose of a valve, when the bladder is distended. The internal liga- mentary membrane of each ureter does not end with its passage into, the bladder, but is continued toward the prostate gland, where it seems to be inserted; keeping the lower part of the bladder from too great distention, and the ureters fixed. The artery is in the upper part of the sinus of the kidney, and partly before the vein; the vein is about the middle, and between the artery and the ureter, which is in the lower part, a little behind the vein, and partly surrounded by a branch of the ar- tery. Nephrotomy therefore appears impossible; and the operation, however represented, is only opening an abscess in the loin, when, from inflammation, a con- cretion between the kidney and peritonaeum has taken place. See Nephrotomia. One kidney is occasionally absent (Stoll Ratio Me- dendi, ii. 386), sometimes of a monstrous size, from calculus or from purulent matter : it has been found to weigh thirty-five pounds. (Histoire de l'Academie des Sciences, an. 1732, and Halter de Renibus Monstrosis.) When one has decayed, the other has been enlarged. (Morgagni de Sedibus, &c. ep. xl. 14.) The most fre- quent changes are, however, a depraved substance and a diminished bulk. It has been found by Warton (Adenographia, p. 96.) so small as not to weigh more than a drachm; to be gangrenous; eroded; full of hy- datids, or tubercles; and ossified. (Fearon in the Me- dical Communications, i. 27.) The principal complaint is, however, ulceration, of which we have numerous instances in the works of physicians of every age from the time of Hippocrates. (See Nephritis.) Worms have been sometimes found in the kidneys; but rarely in the human kidney, except when ulcerated or con- sumed. Wounds in the kidneys are sometimes healed (Haller Pathologia Obs. 69.); but frequently fatal. Haller, in the Gottingen Commentaries, describes a case in which it was displaced, and also degenerated; and, in his Opuscula Minora, iii. 40, is an instance of the two kidneys coalescing. See also Calculus. Re'nes succenturia'ti, (from succenturio, to sup- ply or fill up). These supplementary kidneys are sometimes peculiarly large, sometimes wanting, and oc- casionally double, without any peculiar affection of the function, and their use is little known. See CapsuljE ATRAIULIARI^E. RENI'SUS, (from rcnitor, to resist). Resistence, properly belongs to hardness, which resists impressions, or to perfect elasticity, if such existed. The renitentes corporis dispositiones are those powers of the body which resist the effects of morbific miasma, or conta- gion. Galen, and Vander Linden. RENOVA'TIO, (from renovo, to renew). Renova- tion, or the restoration of a mineral body from an im- perfect to a perfect state. RENU'ENS MU'SCULUS, (renuo, because it throws back the head). See Rectus internus mi- nor. RENUNCIA'TIO, (from renmicio, to declai-e open- ly,) elogium, an opinion or judgment given by a physi- cian or surgeon to a magistrate or judge with respect to the mortality of a wound; of poison being taken, &c. See Ambrosius Paraeus, Tractatus annexus Chirurgiae de Renunciationibus. REPELLE'NTIA, (from repello, to drive back). Repellent medicines; those which prevent such an afflux of a fluid to any part as would excite tumour or inflammation. These are chiefly astringents and sti- mulants. See Discutientia and Inflammatio. RE'PENS, (from repo, to creep). The epithet of a plant which creeps on the ground. REPRODUCTIO,(from reproduco, to reproduce,or renew). Regeneratio, resurrectio. This function has M m 2 RES 276 RE 8 been considered as more extensive and important in its operation than sound observation will support. In the lower orders of animals, composed like vegetables of a congeries of buds, each part can hecome a living ani- mal, and this power is greater in proportion to the sim- plicity ot the structure; but we have remarked, that fibrous, primordial parts are not reproduced in their ori- ginal organized forms. We greatly doubt of the repro- duction of the glans penis, recorded in the Medical Essays of Edinburgh, for this reason, that even the sensation is said not to have been injured; and totally disbelieve the Ephemerides Naturae Curiosorum, where veins and the tongue are said to have been regenerated. If either could happen, it would not occur in solitary instances. See Reunio. Ambrose Parey Opera Chirurgica, lib. xxii.; Domier de Viribus Naturae in Reparandis Partibus, &c.; Gold- hagen de Reproductione Partium. REPU'LSIO, (from repello, to drive back). Repul- sion, an action of bodies opposed to attraction : a prin- ciple of the most extensive application in chemistry, indeed equally with attraction. It is supposed to de- pend on a polarity in the particles of bodies, analogous, if not similar, to that observed in magnetism. This is, however, explaining ignotum per ignotius; for we know little of the causes of magnetic phenomena. Repulsion, however, we know to be connected in general with ca- loric ; but as antagonizing attraction it apparently acts independent of caloric. The French philosophers often confound it with resistance and elasticity. RES NATURA'LES. According to Boerhaave these are life, the cause of life, and its effects, which remain in some degree, whatever may be the disease. See Circumstantia. RE'SEDA, (from resedo, to appease; from its allay- ing inflammation). See Barrarea. RESINiE, (from pea, because it flows from vegetable substances). Resins are the productions of the vegeta- ble kingdom, and sometimes exude spontaneously from -trees, and at others are separated by chemical art. Ex- cept when they spontaneously exude, they are usually mixed with extractive matter and with gum. From the first they may be separated by sulphuric ether, and from the latter by alcohol. Yet in each case the resin is sel- dom wholly pure. Resins are usually in some degree transparent, and their taste is sometimes pungent, though this vegetable substance is more frequently tasteless. Its colour is yellow or brown; its specific gravity about 1.10, and it is an electric. It is insoluble in water, soluble in alco- hol, ether, and volatile oils; easily melts; burns with a white flame, much smoke, and a strong smell. When distilled it yields a large proportion of volatile oil, with a very inconsiderable one of acid: the latter is some- times absent. When its solutions in alcohol, ether, or oils, are evaporated, the resin remains unchanged, with a smooth shining surface, styled a varnish. It is scarcely acted on by alkalis or acids, and, distilled in > close vessels, furnishes some acid, and a large propor- tion of empyreumatic oil. From these facts it might be supposed that resin is another form of oil; and, in fact, if volatile oils are ex- posed to oxygen, they become resins, forming in their change a little water, so that they probably lose a por- tion of hydrogen. If we wish to discover whether any vegetable substance contains resin, we should pour on it sulphuric ether, and expose it to the light; when the resin, if any exist, will become of a brown colour. Re- sin has, therefore, apparently the same analogy to vola- tile which wax has to fixed oils. Resins appear to be of almost infinite variety, andr indeed, every difference in the taste and flavour of the essential oils influences the sensible qualities of the re- sins derived from them. The principal resins are, Chio turpentine, from the pistacea terebinthus Lin.; the Ve- nice turpentine, commonly employed in medicine ; the Strasburg turpentine, from the common fir; pitch, from the pinus picea; elenii, from the amyris elemifera; mastich, from the pistachia lentiscus; guaiacum, from the guaiacum officinale; ladanum, from the cislus la- daniferus; dragon's blood, from the dracena draco; balsam of Mecca, from the amyris opobalsamum ; bal- sam of copaiba, from the copaifera officinalis. Benzoin, the balsams of Peru and Tolu, and the storax, contain resin joined with the benzoic acid. See Balsamum. All vegetable extractive matters, by an union with oxygen, seem to be in part changed to resin ; so that the London college has properly directed decoctions of bark to be boiled only for a short time in close vessels. There are a variety of gum resins used in medicine, of which the principal are the fetid gums, aloes and opium. The acrid resins exhibited by themselves often ad- here to the coats of the intestines, irritating and inflam- ing them. These inconveniences are remedied by al- kaline salts, by soap, and in a great degree by sugar, if previously triturated with the resin. Essential oils are said to correct resins; but the oil soon separates in the stomach, and the resin is equally active with the added stimulus of the oil. The action of these medicines is extended beyond the primae viae, as is evident from the children being purged by the milk of those nurses who take them. See Neumann's Chemical Works; Aikin's Dictionary of Chemistry. RE'SINA A'NIME. See Anime. Re'sina fla'va remains after the distillation of oil of turpentine, and is the common resin of the shops, chiefly employed in external applications. It forms part of the composition of several plasters, and gives a name to one ointment, unguentum resina fiava. (See Basi ■ licon.) Lewis says, in taste it is considerably bitter, and sometimes given as a corroborant and diuretic, in preference to the turpentine, as containing less of its stimulating qualities. On trial we could not find any remarkable medicinal virtue in it, even in large doses. Materia Medica. See Abies. Re'sina lutea Australasia. The yellow resin of New Holland, is produced from a low herbaceous plant, which bears its fructification at the end of a long hol- low reed. The resin seems to exude from different parts of the plant; but is fi^und in the earth after the tears have separated, and may be obtained in large quantities. Its most powerful menstrua are alcohol and ether; but it is wholly soluble in the water of pure kali. It seems to be slightly tonic and antispasmodic, to which pectoral qualities have been liberally added;. but does not promise to be an important addition to the materia medica. Re/sina ru'bra Australasia- The red resin o% R E S 277 RES New Holland, is a production of the eucalyptus resini- fera of Wildenow, ii. 977, and Linnaean Transactions, iii. 84. It resembles in every respect the gum kino ; nor is it in a medical view superior. Re'sina to'sta, fricta, nigra. See Colophonia. Re'sina flava unguentum. See Basilicon flavum. RESPIRA'TIO, (from respiro, to take breath). Breathing, anapneusis, the action of taking in and discharging the air from the lungs, including, therefore, inspiration and expiration. This function is of the most extensive importance, since there are few animated beings to whose circulat- ing fluids the occasional access of air is not essentially necessary, either in its gaseous state, or as combined with water. In general the weight of the air is alone sufficient for its impulse, and it is necessary only to make some vacuum to admit either air or water. In the amphibia, and in fish, the aperture of the mouth, and the action of the jaws propels the fluid, either air or water, into the lungs or over the gills, that the blood may partake its salutary influence. In insects we find no apparatus to assist its action, though some such ap- parently exists, since the spiracula lead to canals which pass through the whole body, anastomosing freely with each other. The numerous spiracles seem to show, independent of these anastomoses, some separate in- fluence, since by varnishing them in succession, so as to prevent the access of the air, the parts become succes- sively paralytic; but the animal does not die till the upper apertures are closed. In the human body air is received into the lungs in consequence of a vacuum formed by the elevation of the ribs. With their action the diaphragm seems to correspond; and from a convex form towards the cavity of the thorax, it becomes nearly straight. It has been represented as becoming concave; but this is wholly inconsistent with the phenomena of muscular action. When the action of the intercostals is remitted, the chest falls in consequence of the elasticity of its liga- ments, and relaxation is a constant alternating state with contraction in every muscle, unless when diseased. This statement is now generally acknowledged to be correct; nor need we enlarge on the very different opinions which have been offered on the subject, or at- tempt to elucidate the difficulties, which, on other views, have been felt. The only remaining difference of opinion relates to the respective share of the dia- phragm and intercostals in this function. The latter are said by some late authors to fix the ribs only, and that the enlargement of the chest is chiefly effected by the contraction of the diaphragm. Each, however, produces some effect, though the chief agent is un- doubtedly the diaphragm. In women the intercostals seem to have a greater share in enlarging the thorax than in men, from the greater arches of the ribs, and the final cause is to assist respiration, when the motion ot the diaphragm is impeded by the enlarged uterus. Wc have said, that all the ribs are raised, and this is perhaps strictly true, though Sabatier contends that the lower ribs descend. (Memoires del'Academie Royale, annee 1773.) Other physiologists have, however, drawn different conclusions, both from the structure of the parts, and from observation. It has been contended also, that as the external and internal intercostals cross each other obliquely, their action must be different, and even opposite; but this has been fully contradicted by an experiment of Haller. In this experiment, it was also found, that in inspiration the ribs did not approach, but rather receded, and the space was, in part, gained by their protruding the sternum. If, as we find in pregnant women, near the time of delivery, the intercostals carry on the function of re- spiration almost exclusively, so at other times it is chiefly, if not wnolly, effected by the diaphragm. The union of the ribs with the sternum has been anchylosed sometimes with little injury to respiration, though more often with dyspnoea. When, from various causes, re- spiration is difficult, or, in other words, when water, inflammation, or other causes prevent the access of the air, or the elevation of the ribs, different neigh- bouring muscles are brought to the assistance of the usual agents, particularly those of the thorax in inspiration, and those of the abdomen in expiration. To give a more fixed point to the former, the ele- vatores scapulae are exerted, and the shoulders are raised. In the whole of this function, the lungs are passive. Contiguous to the pleura, or at least separated only by an halitus, they are in contact with that part of the membrane which lines the ribs, both in inspiration and expiration, following in each the motions of the chest. The apparent object in this function is to expose every particle of blood, in succession to the air. The circu- lation seems to stagnate through serpentine vessels during expiration, and to flow freely when these are distended by the distention of the lungs. This, though apparently obvious, has been denied, chiefly on the principle, that the regular return of blood irritates the heart to regular contraction. Yet, when the lobules are distended, the canals of the vessels are necessarily straiter, and when respiration is more frequent, the pulse is quickened. Whatever be the state of this function, there is always sufficient blood carried back, to stimu- late the heart to regular action. The blood vessels, we have seen, dispersed freely on the cellules into which the extremities of the bronchiae terminate, and the containing coats are there so thin, that the wax of the injection exudes. Whether air can pass or repass has been the subject of some controversy ; and however dis- cordant the calculation respecting the extent of surface to which the blood is exposed, physiologists have gene- rally agreed that it exceeds considerably the whole sur- face of the body. The capacity of the thorax, the quantity of air taken in at each inspiration, and that remaining after com- plete expiration, has been differently estimated. Dr. Goodwyn, Mr. Coleman, Dr. Menzies, Mr. Kite, and Mr. Davy, by different experiments, have endeavoured to determine these questions ; but the results have greatly differed. The subject does not appear to us one of considerable importance, so that, without any exten- sive disquisition, we shall adopt the conclusions of Dr. Bostock, in his late Essay on Respiration. He thinks, that about forty cubic inches, of air are taken in, at each inspiration; that the lungs, in their natural condition, contain about 280 cubic inches ; and that about 109 cubic inches are left after an ordinary expiration. Were we inclined to be critically minute, we think we could show that each number is somewhat too high; though, on the whole, these conclusions arc supported by tht RES 278 R ES best physiologists. According to this calculation, how- ever, about one seventh of the contents of the lungs are discharged by an ordinary, and somewhat more than half by a violent, expiration. A bulk of air nearly equal to three times the contents of the lungs will be thus dis- charged in a minute, and about 4114 times their bulk in twenty-four hours. The uses of respiration were for a long time unknown ; and imaginary effects were imputed to this function, particularly a more intimate mixture of the blood, by its fancied rapidity through the lungs. The whole mass of blood was supposed to pass through the lungs in the same time that it did through the rest of the body, and, of course, it was thought that its course must be more rapid, though it would be apparently obvious, that if the circuit was shorter, the celerity need not be so great. There is, however, no evidence, except the most uncertain calculation, that the whole mass does pass through the lungs in a corresponding period with its circulation through the whole system : nearly the same quantity is returned in the same time; but if we can measure, or at least approximate, the capacity of the vessels of the lungs, we are unacquainted with the extent of the vessels of the general, or as it may be styled., the aortic system. The nerves, in their passage through the diaphragm and the liver, from the com- pression of this muscle, were supposed to be affected; and the alternate contraction and relaxation of the dia- phragm, as well as of the heart, were attributed to it. The nerves in general, however, pass through the more tendinous portion ; and, as the diaphragm in its contrac- tion is only less concave, the pressure on the liver cannot be considerable. The concurring actions of the sto- mach and abdominal muscles are the only powers which seem to emulge the biliary ducts. The influence of respiration on the course of the chyle in the thoracic duct is wholly imaginary; for pressure would only be useful if there were valves in it; but there are none; and, in experiments on living animals, the chyle is seen to move in the duct, though respiration be impeded or prevented. The necessity of a supply of fresh air in respiration must have been known from the earliest periods; but the source of this necessity was little understood, till Boyle found the respired air loaded with aqueous va- pour, and diminished in bulk. Mayow, whose fair fame has lately been rescued from oblivion, showed that some principle, which he called a volatile ethereal spirit, was imbibed from the air, and Dr. Black found that air respired contained carbonic acid gas. In this view of the subject, the unfitness of the air for the continuance of life was attributed to its diminished elasticity; for it was only suspected that carbonic acid gas was not fit for the continuance of this function. At last, after a period of more than twenty years, the constitution of the atmosphere was taught by Scheele and Lavoisier. They found that the apparently homo- geneous atmosphere was composed of two gases of different properties, the oxygenous and the azotic, in the proportions, if bulk be considered, of 22 to 78, if the weight, of 26 to 74. This proportion of a fluid unfit for respiration, in air essentially necessary to life, was at first astonishing, till it was found that oxygen, like ardent spirit, was poisonous, by its destroying, from excessive stimulus, the excitability, and that, like it, to be innocuous, it must be lowered. Late experiments, however, seem to show that the azote is not wholly use- less. In explaining the process of animalization, wc found the necessity of some principle, which could re- duce the newly absorbed nutriment to an animal nature, and this appears to be azote. Yet the idea is encumbered with difficulties. Azote is an excrementitious fluid ; and the changes produced in the blood, from its circulation through the lungs, are apparently those from oxygen only. It is not, however, a very absurd idea that a prin- ciple, at first necessary, may in the end be injurious from excess. In fact, Mr. Davy, in some very accurate ex- periments, found a remarkable deficiency of azote, amounting in twenty-four hours to about four ounces and a half. The changes, produced in the atmospheric air, from respiration, are found chiefly to affect its oxygenous por- tion : this is diminished; and water, in the state of vapour, with carbonic acid gas, are substituted. It is not certain whether the latter gas is separated, or that its basis, carbone, with the oxygenous gas inspired, are its ingre- dients. The latter is more probable; and, though air contains a small portion of this gas (about 0.01) natu- rally, its proportion in expired air is very considerable. The oxygenous portion is undoubtedly that part most essential to life in general; and,from the highest order of animals to the lowest, the great difference seems to be, that in the latter the oxygen is more slowly and more completely separated. A man dies while the air still retains a comparatively large proportion of oxygen ; snails separate the whole completely (Vauquelin An- nates de Chymie xii. 278; Spallanzani on Respiration). In general, the greater the heat, the larger proportion of oxygen is necessary: birds, in general, die when two thirds of this principle are exhausted. In the human body the greater the.rapidity of the circulation, whether from increased temperature, muscular action or fever, the larger proportion of oxygen is required. From a hundred parts of oxygenous gas, were lost in respiration, during an hour and quarter, when the animal breathed with great difficulty, three and a half cubic inches; and of the remainder sixteen and a half were absorbed by potash. In another experiment, the proportions lost and absorbed were somewhat greater; and it seems probable that the purer the air, the greater is the propor- tion of carbonic acid gas, as if at least a portion of the oxygen was converted into it. The quantity of oxygen, consumed by a man in twenty-four hours, is nearly 46.000 cubic inches, or about two pounds eight ounces troy ; and the quantity of carbonic gas formed probably exceeds three pounds troy. The diminution of the bulk of air by one respiration is about ?lT of the whole. Mr. Abernethy supposed, that in common respirations the bulk of air was actually increased. It must un- doubtedly be expanded by the heat of the body, a cir- cumstance perhaps not sufficiently taken into the calcu- lation ; but he supposed also, that the carbonic acid gas was a superadded portion by exhalation from the vesi- cles of the lungs, while the diminution,, apparent when an animal was long confined in air, arose, in his opinion, from its absorption. The quantity of moisture which is discharged has been differently estimated. It appears to have varied from 11180.57 to 13704 grains in twenty- four hours: the average is 12442; but perhaps the quantity of watery fluid, discharged at different times, varies. It is supposed, by Lavoisier, that this water is formed by the union of the oxygen with hydrogen. RES 279 RES Other physiologists have attributed it to a common exhalation; but, when the quantity of oxygenous gas which disappears is accurately examined, it will be found greater than can be accounted for, if we even admit portions to be employed in forming the water and the carbonic acid gas. It is highly probable, there- fore, that it is in part absorbed. It is not, however, equally probable, that the water arises from the union of the oxygen with hydrogen. In general, the union of these gases is effected with some difficulty, and we suspect that, in every instance, the co-operation of the electric fluid is requisite. This fluid is generally found free, in the atmosphere, and may become an intermede in the present process. In the change also from a ve- getable to an animal nature, hydrogen is generally lost; so that, though some of the water in expired air arises from exhalation and evaporation, some perhaps may be formed. - The changes produced on the blood by respiration are now more clearly understood than in the time of Boerhaave and Haller. Blood which has passed through the lungs is of a brighter colour than the venal blood, and has a greater capacity of heat. The colour we now know to be owing to the influence of the oxygenous gas, and the darker colour of venal blood to carbone. Blood, stagnating without the access of air, becomes of the nature and colour of venal blood : it assumes the same appearances, when exposed to any of the unre- spirable gases. When we considered (see Digestion) the different nature of the alimentary substances taken in, which are generally in part vegetable, we found an accumulating portion of carbone, and sometimes of hydrogen, while in ihe animal fluid these in part disappeared, and the predominating principle was azote. We can detect the source of the carbone in the blood, in conformity to this idea, from the thoracic duct, and we perceive that the newly formed aliment is anxiously conveyed, imme- diately on its reaching the blood vessels, to the lungs. The oxygenous gas is there united with it, and carbonic acid gas immediately formed, which is carried off by the air. At the same time probably a portion of hydrogen becomes water, while the azote taken in more com- pletely animalizes this new fluid, and adapts it for fur- nishing the different secreted fluids. In the course, however, of the circulation, the oxygen more completely unites with the remaining carbone, so as to form an oxide, which thus assumes a dark colour, and requires a new supply of oxygenous gas, to change it to carbonic acid air, and fit it for its discharge. The change thus induced by the circulation is chiefly chemical, since it may be imitated out of the body, and the successive variations, from the florid colour to the darker hue, and the contrary, may be effected by con- finement from air, and again restoring the blood to the access of oxygen. The oxygen, in this instance, will have its effect through a small bladder, or indeed any vessel of the body, if the cellular substance be removed. The effect, therefore, will be more certain and speedy through the thin vessels of the lungs, whose diameters admit but a small proportion of the blood. It acts also through the serum, and, as Mr. Davy supposes, by its previous solution in this fluid. The reason of the more striking change to the florid hue we do not, however, understand, as we are so little acquainted with the na- ture of the red globules. Their colour is found from some late experiments to be owing to phosphorated iron, with perhaps some uncombined oxide of the same metal. That the oxygen and hydrogen may form this acid, which immediately unites with the uncom- bined oxide, is not an improbable, though an unsup- ported suggestion; but we are apparently on the eve of obtaining more satisfactory information. The azote ab- sorbed in this function contributes to form the gluten of the blood, which probably differs, in this respect only, from albumen; and, in an increased proportion, the fibrin. Whether this last principle can supply any waste or destruction of the truly fibrous parts of the body is doubtful. We have never been able to detect any such supply, nor has, in any instance, a truly orga- nic portion of the body been reproduced, within our observation or recollection. Where organs are repro- duced, it is not probably in a single animal, but in a congeries of animals propagated, analogously to vege- tables, from buds. One effect of respiration has been already considered, viz. the heat of animals. (See Calidum innatum.) We again introduce the subject to remark, that were this the effect of the chemical changes which take place in the lungs, this part of the body should be warmer than any other, which is by no means true. It is probable, therefore, that if wholly owing to a che- mical change, it is produced by the gradual incorpora- tion of the oxygen with the carbone, during the circu- lation, an opinion first suggested many years since by Dr. Duncan. The increase of heat which actually takes place in the lungs, from the play of affinities, is appa- rently compensated by the cold produced by the eva- poration of the moisture. With respect to other gases, the hydrocarbonate is the only one decidedly injurious from powers certainly sedative; for nitrous, vitriolic acid, and alkaline airs, are only these substances in a gaseous form. The carbonic acid air cannot be breathed for any considerable time, even when diluted, without pain ; and hydrogen and azote appear to be only "injurious inasmuch as they exclude oxygenous gas. Carbonic acid air, unmixed, produces an immediate spasm on the lungs, and cannot be taken into them. The last experiments of Lavoisier (Memoires de l'Academie des Sciences, 1789,) we per- ceive, afford great room for doubt whether the last is capable of any great advantage or injury, unless from constant use. Annates de Chymie, vols. iv. v. vii. ix. xii. xxi. xxiv. xxix. xxxiv. xxxvi. xliii. ; Journal de Physique, vols. xxv. xxviii. xliii. xlvi. xlvii. Iii.; Memoires de PAca- demie des Sciences, pour 1739, 1724, 1729, i777, 1778, 1780, 1789, 1790; Memoires de la Societe Royale de Medecine, annee 1782-3 ; Philosophical Transactions, 1776,1779,1797; Hales' Statical Essays ; Richerand's Physiology; Blumenbach's Institutiones Physiologic : Fourcroy Medecine Eclairee par les Sciences ; Davy's Researches; Dela Rive de Galore Animali; Goodwin on the Connection of Life with Respiration; Kite's and Abernethy's Essays; Menzies and Coleman on Re- spiration; Lavoisier's Elements; Higgin's Minutes; Thompson's Chemistry ; Bostock on Respiration ; Spal- lanzani on Respiration. RE'STA BO'VIS, (because it hinders the plough\ Rest harrow. See Anonis. RES 2S-j ia, to destroy, because of its thorns). Spina cervina, solutiva, purgatrix, infectoria, cervi; hippophaes. Buckthorn and purging thorn, rhamnus catharticus Lin. Sp. PI. 279, is a prickly bush, or a low tree, common in hedges, having pointed leaves; producing small green flowers in June, and in the be- ginning of October black berries, which contain a dark green juice, with four seeds in each. It is usual to find these berries mixed, with the ber- ries of the black elder, and of the dog berry tree; but the juice of the buckthorn berries is green; and the buckthorn berry hath four seeds. These berries have a faint unpleasant smell, a bitterish, acrid, nauseous taste; operate briskly by stool, and have frequently been employed as hydragogues. They occasion dry- ness in the mouth and throat, with thirst, and pain in the bowels, unless warm liquoris frequently drank dur- ing the operation. Twenty of the fresh berries; forty or sixty in decoction ; a drachm or a drachm and a half of the dried berries : an ounce of the expressed juice, or half an ounce of the rob, or extract, are the usual doses: but the juice made into a syrup is generally- preferred by physicians, though it is rarely prescribed alone. If the berries are not pressed, the juice is more pleasant, and also more active as a purgative. The in- ner bark of the tree is said to be a strong purgative, and to occasion vomiting. The London College order the syrup of buckthorn to be made in the following manner: take of the juice of the berries of buckthorn, ripe, and fresh gathered, one gallon ; ginger bruised, one ounce; pimento in powder, one ounce and a half; sugar, seven pounds. Strain the juice after it has stood some days to subside ; and in a pint of it macerate the ginger and pimento for four hours, and strain. Boil the remaining juice to three pints; add that part in which the ginger and pimento has been macerated, and make the whole with sugar into syrup. (Pharm. Lond. 1788.) From one to two ounces are given for a dose, but it is rarely used, on ac- count of its nauseous taste, and sometimes its violent operation. When the berries, however, are not pressed, its taste is pleasing. See Cullen's and Lewis's Materia Medica; Neumann's Chemistry. A name also for the paliurus, hippophaes, alnus, ni- gra, and frangula. Rha'mnus zi'ziphus. See Jujuba. RHAPO'NTICUM, (the Rha of Pontus). Rhapon tic, rheum; rheum ponticum; rhaverum antiquorum, rheum Dioscoridis; rhaponticum Alpini; rhabarbarum Dioscoridis; English rhubarb ; rheum raponticum Lin. Sp. PI. 531. Leaves smooth and roundish, pedi- cles somewhat channelled : grows wild on the moun- tains of Thrace, whence Alpinus brought it into Europe about the year 1610; and it bears the hardest winters in our climate. The roots are often mixed with those of the true rhubarb, but are detected by their mucila- ginous taste when chewed, and not tingeing the saliva of the bright yellow of the true rhubarb. The rhapon- tic when cut through appears regularly marbled in a radiated manner; is dusky on its surface, and of a loose spongy texture ; more astringent than the rheum pal- matum, and less purgative; requiring for the latter pur- pose two or three drachms. See Raii Historia ; Tour- nefort's Materia Medica. Rhapo'nticum vulga're, rhaponticum folio heleni incano,centaurium maju8,centaurium magnum. Great centaury, common rhapontic ; centaurea rhapontica Lin. Sp. PI. 1294, is a large plant with leaves composed of oblong serrated segments set in pairs on a middle rib, edged in the intermediate spaces with a serrated margin ; the stalk divides towards the upper part into several branches, which bear on their tops, round, soft, scaly heads, from which arise bluish flosculi, followed N n 2 R HE 284 RH E by down, inclosing the seeds. It is perennial, a native of the southern parts of Europe, and raised in our gar- dens. The root is of a dark black colour on the out- side, internally reddish, yielding, when fresh, a juice of a deep red; with a slight, not disagreeable, smell, and in taste viscid, with sweetness, roughness, and some degree of acrimony. It is considered as an aperient and corroborant, and supposed to be particularly use- ful in diarrhoeas; but very much inferior to the true rhapontic. See Raii Historia ; Tournefort's Materia Medica. RHATANIA, a native of South America, not yet introduced into any botanical system. This root is about the size of a crow quill, and the cortical part is very thick, the ligneous very fibrous. When recent it is succulent, and full of extractive matter, which, when pressed out and evaporated, furnishes what has been styled the American extract of bark, and an as- tringent, coloured, ingredient for the red wines of Por- tugal. The extract mixes readily with water ; and the powder resembles that of the pale bark. It precipi- tates a greater proportion of tanin than the Peruvian bark, is more pleasing, it is said, to the taste, and sits easier in the stomach. Half a drachm of the extract makes a turbid solution in eight ounces of water, said to equal in virtue the same quantity of a strong decoc- tion of the Peruvian bark. RHE'NCHOS, (from ptyx*>> to snore). Rhochmos ; ronchus; stertor, snoring; a sound supposed to be made betwixt the palate and nostrils by persons asleep. Independent of steep, this noisy respiration is a symp- tom of apoplexy, in which the mucus from the-fauces is forced through the nostrils. Slevoght attributes it in some instances to the premature healing of the paro- tid ulcers of children. See Halleri Dissertationes, ii. 4 3.; and Alberti de Rhoncho Dormientium. Cerchon or cerchnos is that rattling noise made in re- spiration, from the larynx, or the aspera arteria, when the air passes through an accumulated fluid, in cases of asthma, or the last struggles of exhausted nature. RHE'ON, and RIIE'UM. See Rhaponticum Rha- barbarum. RHENOPHO'NIA, (from %evoy stimu- lants after the phlogistic diathesis has been removed by bleeding. Rheumatism, therefore, appears in every view of the R H E 286 RH E subject to consist in inflammatory action of the arterial system, and probably inflammation of the coats of the arteries themselves. This idea will meet every cir- cumstance of its appearance, and connect the various remedies of the most experienced practical physicians. We certainly see rheumatism distinctly only in the vo- luntary muscles; but if these opinions have any weight, there is no reason why the internal organs should not suffer in the same way. Authors have spoke of rheu- matism having affected the heart, the diaphragm, the liver, the intestines (Eyerel), and other organs, when transferred from the limbs. In cases of metastasis only the nature of the inflammation can be exactly per- ceived ; for if these parts are originally attacked, the symptoms will not differ from common inflammation. The remote causes are cold applied when the body is heated, or indeed any cause of the true inflamma- tory fever may be occasionally attended with rheuma- tism. It has been sometimes described as epidemic, and it may appear so in weather unusually cold and uncertain; but we suspect that these epidemic rheuma- tisms are truly synochi, which are often at first attended with irregular wandering pains in the limbs. The re- mark of Plencis is of more importance, that rheuma- tisms are influenced by the nature of the reigning epi- demic. Acta etObservata Medica, 94. Rheumatism is seldom fatal; but it is often a disease of peculiar obstinacy, and, in a more or less acute form, sometimes continues for many months. In these cases the phlogistic diathesis of the vessels continues, while the strength in general decays, and prevents the most salutary discharge by bleeding. The pain continues with a violence somewhat remitted, but with severe occasional exacerbations; the limb wastes; the strength, and the colour of the countenance, decline ; the face sinks, and the patient often continues in this exhausted state for many months, sometimes for years. But to the disease in this chronic form we shall return, and now only add, that rheumatic patients are subject to relapses; and,as mother inflammations, the vessels,by repeated increased action, become more irritable, and more subject to spasmodic contraction. The experience of many ages has established the utility of bleeding in acute rheumatism; and blood must be drawn from a large orifice, in a considerable quantity, frequently repeated. The severity of this eva- cuation, described under the article Pleuritis, q. v. is not too great for the present complaint, if the patient be robust and strong. The usual guide is a more soft and slow pulse, a diminished heat, and a moist skin. We are always cautioned, however, that if we carry this evacuation too far, we may lessen the strength, and in- duce the disease in its more chronic form. There is probably a foundation for this caution, since, if we di- minish the vis vitae so far as to prevent the evacuation, next in point of advantage, that by the skin, we have no means of taking off the phlogistic diathesis but a repetition of the bleeding, which the strength will not bear. In general, then, when the hardness of the pulse remits, the bleedings should be stopped, and we must apply to other means of perfecting the cure. ' Topical bleedings would appear highly advantageous; but we gain little from them while there is any re- maining fever. The disease continues, and the affection of the limb is only a symptom ; for by bleeding topi- cally in an early stage of rheumatism we often occasion a metastasis to some other part. Another reason which seems to render topic al bleeding less advantageous is, that the pain is often let in the joint when the disease is in the whole muscle,for the reasons already assigned, so that the remedy is only in appcarace topical. Though cathartics generally diminish phlogistic dia- thesis considerably, yet they do not greatly relieve rheu- matic pains ; and the reason will be obvious, if our idea be correct, that rheumatism is an inflammation of the arteriai system. Purging is also highly inconvenient, from the trouble anu pain of moving the body ; yet, on the whole, we have thought that interposing occasion- ally active laxatives, which contain a considerable pro- portion of calomel, have been useful in shortening the disease, though they have not greatly mitigated the pain. The neutral salts have been sometimes prefer- red ; but they have not appeared to us so effectual. The chief remedy are the diaphoretics, and the ad- vantages of this evacuation must be obvious on the principles iaid down. When the heat and fever are considerable, the more cooling kinds, as nitre, saline draughts, with camphor, are preferable. But the crude sal ammoniac, with the acetated ammonia, may be soon employed, and with each class the antimonials may be advantageously combined. The chief remedy we owe, however, to the sagacity or the lucky combination of Dr. Dover, his sudorific sweating powder, viz. the pulvis ipecacuanhae compositus of the last London Phar- macopoeia. The principle of this combination we have already explained (see Diaphoretica) ; and scarcely inferior to this is the sweating powder of Ward, which contains the white hellebore instead of the ipecacuanha. We have sometimes thought it su- perior. These remedies relax the skin so completely that we can often venture to add some stimulant, as the acetated ammonia; sometimes, as recommended by Dr. Hamilton and Dr. Riedly,calomel; and, in general, in- fusions of our own aromatic vegetables. It is particu- larly remarked by Dr. Cullen, though unaccountably overlooked by some late practitioners of eminence, that the sweating, when once begun, should not be inter- mitted, and when it has relieved, should be suffered very gradually to decline. The warm bath is an incon- venient remedy, as it requires painful muscular exertion: it would be otherwise more frequently used in this com- plaint, as with moderate heat it is well adapted to its relief. The vapour bath, from its superior temperature, is better adapted to the chronic form. The other diaphoretics of a gentler power, which re- quire a longer continuance, are chiefly adapted to the disease, when its acute form is in some degree conquered. Of this kind are the mezereon, the seneka, the bardana, and guaiacum. In the period of the disease just men- tioned each is sometimes useful, and in general some ammoniacal salt, or the ammonia itself, may be com- bined with the decoctions of either. The volatile tincture of guaiacum, if employed too early, has been sometimes injurious. Narcotics have been often used to relieve pain ; but opium alone, unless directed to the skin, by relax- ing sudorifics, seems injurious. This circumstance has been the chief support of the opinion, that opium stimulates; but in this disease a very essential discharge is the perspiration, and if this be not produced RHE 287 R II E every medicine appears injurious. Other narcotics which have been employed we may mention in this place, though they have chiefly been employed in chro- nic rheumatism, viz. the rhododendron, which seems to combine a sudorific power; hyoscyamus, dulcamara, hemlock, and aconite. Each seems occasionally to les- sen pain and procure sleep. We have not considered mercurials under the head of diaphoretics ; because it would appear as if we wished to bend every thing to a system. We, therefore, have preferred selecting the facts. The practice of Dr. Ha- milton, who found calomel with opium useful, (Edin- burgh Medical Commentaries,) we have already men- tioned; and by different authors, who are, however, chiefly army physicians, the sublimate mercurial fric- tion, and calomel, have been recommended. We sus- pect, however, that these medicines have been chiefly useful when the inflammatory stage has, at least in part, disappeared. We have remarked, that we thought the purgatives which contained calomel were more effectual than others; but dare not say that any part of the relief was owing to the mercurial. The remissions, and in some cases the intermissions, of this disease, have suggested the use of the bark; and this medicine has been highly commended. It has not been our fortune to have seen it beneficial; but we cannot deny our confidence to the assertions of practi- tioners of the highest respectability. The utility of arnica, recommended in the first volume of the Berlin Transactions, may rest on a similar principle. Of the external re7nedies, we have already mentioned topical bleedings, and the next in point of utility are blisters. These are of little service while the general inflammatory state continues; and we have found, that to render them useful in acute rheumatism, bleeding, in a quantity proportioned to the strength, should be premised. We had adopted the practice of bleeding previous to the fresh application of each blister, for the blisters must be frequently repeated, long before we en- tertained the ideas now suggested respecting the nature of the disease. All external applications, if employed too early, remove the pain from the part then affected, but drive it to another limb. The tartar emetic ointment is by some practitioners employed as an external stimulus, since it is supposed to produce a more permanent effect. This may un- doubtedly be the case; but the little foul ulcers which it produces soon impede its use, and other stimulants cannot afterwards be employed. Baldinger has recom- mended ginger, over which alcohol has been burnt, and others the spirit of turpentine, joined with ammonia. The actual cautery has been applied, and the burning with moxa is no uncommon remedy in the east. Blis- ters, however, and topical bleeding, are almost the only external remedies employed in the acute stage. Rheumatismus chronicus, arthrodynia. The grad- ual change from the acute to the chronic state of this disease admits not of any accurate limits, except, per- haps, the state of fever. Yet in rheumatisms strictly chronic there are evening exacerbations, which seem to destroy this distinction. In general, however, the fever is slight and almost imperceptible; the limb cold, almost immovable, dry, or covered only with a cold clammy sweat; the pain acute, especially on changes of weather, or when heat is withdrawn; and the whole system highly debilitated. This form of the disease often continues for a long time, with little vari- atibn; nor does it sometimes terminate, except with life. The lumbago and the sciatica are frequently of this kind, and the knee is very often the part affected. There can be little doubt of the state of the parts in this form of the disease. It is evident that the circu- lation is carried on imperfectly, from a debilitated state of the vessels, which occasions the frequent recurrence of spasm, especially when external heat, or internal stimuli, do not contribute to assist their action. As this atony affects the arteries exclusively, it must evi- dently arise from the previous inflammation; but if this inflammation was not of a peculiar kind, we should find a similar consequence after other phlegmasiae. It is highly probable, therefore, that the disease is in the coats of the arteries themselves. Conformably to this idea practitioners have found every internal and external stimulus of the highest ser- vice. Cantharides, the mineral acids, camphor, am- monia, the essential oils, particularly those of turpen- tine, cajeput and amber, flour of mustard, and the juice of horseradish, have been used singly, or combined in various forms, often with opium. Electricity and gal- vanism have had their advocates, though they have of late been seldom employed. In a more solid form the cummin seeds, the mustard, and ammonia, have been made into a cataplasm, with black soap, or into a plaster with euphorbium. All these are useful stimulants, and often successful. Warm bathing, and warm pumping, are, however, remedies of greater utility; and the waters of Bath, combining probably a stimulant power, are often pecu- liarly useful. The application of sea salt or brine is often serviceable, and the tepid baths of our sea coasts have in many instances cured, when employed from about 86° to 92°. When the system is not greatly de- bilitated, even sea bathing is used with success; but the reaction in the part affected must be generally as- sisted by friction, and the most stimulating liniments. Issues and setons near the part have been proposed, but have seldom been found useful, as they are chiefly adapted to inflammation deeply seated. The internal medicines are the more active stimu- lants, and those tonics which determine to the surface. The internal stimulants which have been most success- ful are the arum, the seneka, the mezereon, the guaia- cum, and the turpentine. The arum, in the form of a conserve, with an equal part of sugar, is often highly useful. The seneka and mezereon are exhibited in de- coction, often with mercurials. The guaiacum in this form is inert, and the gum is employed with more suc- cess. The greater number of medicines has yielded, however, to Dr. Dawson's remedy, the ammoniated tincture of guaiacum, given in a dose of two or three drachms, sometimes extending to half an ounce: it is much more effectual when combined with opium, or a small portion of Dover's powder. We have tried various combinations of ammonia, gum guaiacum, and opium, in a solid form, but by no means with equal success. A very general and active stimulus is the ethereal oil of turpentine; and, according to the method recom- mended by Cheyne, if incorporated by melting ir- .-1 RHI 288 RHO gentle heat, with an equal part of honey, a much larger dose can be taken without offending the stomach. It is in every case of chronic rheumatism a valuable me- dicine. Another stimulus of considerable utility is the oleum jecoris asselli, the oil of the liver of the cod fish, recom- mended by Dr. Percival. It is in reality the train oil of the shops, and we have found it to relieve when other medicines have failed. It must be long con- tinued, and fortunately the taste soon becomes familiar. From the sensible effects of the liver of the skate (see Rachitis), we should expect some benefit from it in chronic rheumatism. The tonics which determine to the surface are the metallic, of which the principal is mercury; a medicine more successful when combined with antimony. Ca- lomel every night, in the dose of a grain, was, if we recollect rightly, recommended by Dr. Fothergill. Other authors have employed the muriated mercury; but the Plummer's pill, in its original form, assisted by the decoction of mezereon, sometimes by the more complicated formula, the Lisbon diet drinkj we have found more successful. What share in the success the sarsaparilla may have is uncertain. One violent case of chronic rheumatism is said to have been cured by the sarsa in substance, taken in the quantity of a scruple two or three times a clay. The relief, however, was found at the end of a summer, after two winters of peculiar mildness; a change of climate is a well known remedy for this dis- ease. The seasons in this case meliorated our northern region. The only other metal which has been employed is arsenic. From the few trials made by Dr. Bardsley it seemed to be highly useful. We have not been equally successful; but, in the infancy of its use, it is probable that the cases to which it is adapted, have not been suf- ficiently distinguished. See Cullen's First Lines; Smith in the Medical Communications, vol. ii.; Essay on the Nature and Cause of Rheumatism, 8vo. London, 1776; Heister de Rheumatismo; Lancisi de Nativis et Adventitiis Coeli Romani Qualitatibus, ad Calcem; Fordyce's Fragments; Demiani Adversaria; Ploucquet de Myositide et Neuri- tide; Sydenhami Opera, pp. 344 and 732, 8cc.; Saal- nian Descriplio Rheumatismi Acuti; Theden N. Be- markunden, vol. i. p. 130; Stoll Ratio Medendi, p. 3 and 5 ; Bardsley's Reports. RHICNO'SIS, (from pixvos, rugged). Leanness and WRINKLES. RHI'GOS, (from ptyeu, to shake with cold). Rigor; the slight convulsive tremors, most commonly following the cold fit of fevers. Dr. Cullen considers them as the first marks of reaction ; but they appeared to us (see Febris) rather as the effects of debility. They are not confined to fever; but sometimes arise from any dis- gusting object, and in some persons from the introduc- tion of the catheter into the urethra. Bellini seems to confine it to diseases of the head, and Bonetus thinks it peculiar to inflammations of the uterus, pleura, or liver. In general, when heat does not follow, it seems a fatal symptom, and in the worst fevers the cold is often fatal without producing rigor. See Boneti Sepulchre- turn, lib. i. sect. 14. obs. 16. Hippocrates Trept vhtuv ; Ga- lenus de Tremore, &c; Opera torn. iii.; Baglivi Pra xi< Medica, i. 9. Rigor sometimes signifies an inflexible hardness and tension of the muscles; but the more proper appella tion is rigiditas. See Horror. RHO'CAS. See Epiphora. RHO'CHMOS. See Rhenchos. RHODI'NA RADIX,and RHO'DIUM LIGNUM. (from pofov, a rose). See Aspalathus. RHODODE'NDRON, vel RHODODA'PHNE. (from pofov, a rose, and fovfyov, a tree; or fottpvy, the lau- rel,) for its flowers resemble the rose, and its leaves the bay. See Nerion. Rhododendron chrysanthemum. Yellow flow- ered rhododendron, dwarf rose bay, rhododendron chrysanthum Wildenow, vol. ii. p. 605, has been recom- mended in chronic rheumatisms, painful affections of the joints and bones, particularly venereal pains : it is now very generally employed in various parts of Eu- rope, though seldom in Britain. The plant is a native of Siberia, growing in mountainous situations, and flow- ering in June and July. Dr. Koelpin, of Alten-stetin, used an infusion of it in water, kept twenty-four hours in nearly a boiling heat, in the proportion of two drachms of the leaves and tops of the plants to ten ounces of water. It was sometimes made of double this strength, and the dose was two ounces, to be repeated after a few hours, and continued as required. Dr. Home found it an astringent, and powerfully sedative; he directs it in infusion, from half a drachm to three drachms for a dose. When taken internally it produces, according to Koelpin, a feverish heat, intoxication, sometimes a stu- por, with a singular pricking sensation in the limbs, or other parts of the body: the intoxication leaves neither headach nor nausea. During the heat, the patient com- plains of intense thirst; and drinking cold water is fol- lowed by a violent but salutary vomiting, especially in complaints of the bowels; and a copious sweat on the parts affected with rheumatism or gout. In some in- stances the pains grow worse at first; but this increase of disease is soon followed by a remarkable relief: the pulse is rendered weaker and slower, and in venereal rheumatism its effects are very considerable. The in- fusion at first often produces heat and constriction in the fauces; a proof of some little acrimony: but this effect speedily disappears. In robust habits it operates quickly, and with a degree of violence; in the infirm and feeble, more slowly, so that the dose should not be hastily increased. It sometimes proves fatal, and Mor- gagni has recorded the appearances on dissection of a woman who was killed by it, Ep.lix. § 12 and 14, though probably this plant was the nerium oleander Lin. Sp. PI. 305, sometimes called rhododendron. Another spe- cies of this genus, the r.ferrugineum Lin. Sp. PI. 562, has similar powers. RHOMBOI'DES MU'SCULUS, (from f'op&s. a square figure, and eifos,for7n,) rises from the ligamen- tum colli, the spinal processes of the third, fourth, fifth, sixth, and seventh cervical vertebrae; and the first, se- cond, third, and fourth dorsal. It is also attached be- low to some of the ribs, runs beneath the latissimus dorsi, and is inserted into the whole length of the basis of the scapula to bring it upwards and backwards. The rhomboides is sometimes divided into the major R 1 C 289 R I S and minor: the minor is then above, and the major below. RHOPA'LOSIS, (from ponxXov, a club, probably from the increased size of each hair). See Plica po- lonica. RHUS, (from peu, to flow, because it checks fluxes,) byrsodepsicon, rhus coriaria Lin. Sp. PI. 379, common sumach, is a shrub, with oval, pointed, serrated leaves, and clusters of yellowish or greenish flowers, each of which is followed by a small, red, flattish berry, includ- ing a roundish reddish brown seed. It is a native of the south of Europe, and cultivated in our gardens. The berries have an acid, austere taste, are cooling and re- stringent. The leaves and young twigs are powerfully astringent; but it is chiefly used by dyers and tanners, though recommended by foreign authors in haemor- rhages and mucous discharges. The r. typhinum is similar in its virtues. See Tournefort's Materia Me- dica; Neumann's Chemical Works. Rhus sylvestre. See Myrtus brabantica. Rhus vernix, Lin. Sp. PI. 380, is the poison wood tree, whose juices are so acrid as to blister the hands of those who gather them. Internally, in infusion or ex- tract they seem less deleterious; as Fresnoi, a French physician, took twelve of the petioles (for the leaves are pinnated) in infusion, which greatly increased the urine and perspiration. He was from thence led to use this infusion in herpes and palsy, which, in his opinion, were cured by it. The leaves are in their greatest vigour in June, and thirty-two pounds of water, distilled from four pounds of the leaves, yielded a fluid somewhat odorous and highly pungent. Each pound of the leaves yields about half an ounce of extract, highly successful in our author's hands in the cure of pertussis. Half a grain dissolved in syrup was a sufficient dose. RIIY'AS or RHCE'AS, (from pea, to fiow). The existence of this disease has been doubted; but Galen describes it as an affection of the eye, diametrically op- posite to encanthis, consisting of a too great diminution of the lachrymal caruncle. Riverius allows the cause of it to be a consuming, exsiccating, or corrosive matter, succeeding or accompanying a fistula lachrymalis. Eyes thus affected are denominated by iEtius, pvxfo^s, vel povxfos oipixXfMs, Fesius. RHYSSE'META, (from pvo-o-u, to wrinkle). A WRINKLED FACE. RI'BES NI'GRUM, Lin. Sp. PI. 291. Black cur- rants seem to possess a slightly sedative power, and are used in sore throats. They are said also to be diuretic. The leaves of all the currants are narcotic, resembling peach leaves. RI'BES RUBRUM, (from raib, Arab, or rivah, Hebrew,)grossularia non spinosa, ribes rubrum Lin. Sp. PI. 290. Red currant. Currants in general have a cool, acidulous, sweet taste, agreeable both to the palate and the stomach; resembling the other subacid fruits in their medicinal qualities. They may be used with considerable advantage to allay thirst in febrile com- plaints ; lessen the increased secretion of bile; to correct a putrid, or scorbutic state of fluids. Hoffman and Boerhaave had great confidence in the efficacy of these fruits in obstinate visceral obstructions. The white currant tree is merely a variety of the red; the fruit herefore possesses similar properties. RI'CiE, pixos. A veil which covered the heads of VOL. II. the Roman women during the time of sacrifice ; hence rica, the kerchief. The great kerchief, called by the French le grand couvre chef, is used after trepanning. It is made of a square cloth, and, when dexterously ap- plied, confines strictly the dressings. By observation and experience only can a dexterity in the application be obtained. Couvre chef en triangle, is a square cloth, fold- ed in the form of a triangle: the middle of the longest side is applied to the forehead, the two ends tied behind the head, and the angle, which falls behind the head, secured to the confined ends of this kerchief. Its use, in general, is to fix the dressings on the face and head. RICI'NI O'LEUM, (from ricinus, the spurge seed). See Cataputia. RICI'NUS, (quasi ptv xwos, a dog's nose, because they stick to dog's noses). The tick or tyke, a reptile which infests dogs. The name also of the spurge laurel, whose seeds resemble the tick. Rici'nus america'nus ma'jor. See Cataputia minor. Rici'nus mi'nor. See Cassada. RICINOI'DES, (from ricinus, and etfos, likeness). Cataputia minor. See Heliotropium tricoccum. RIGOR. See Rhigos. Rig'or nervo'sus. See Tetanus. RI'MA. A chink, applied in anatomy to any longi- tudinal aperture. RIM'ULA. A diminutive of rima. RIN^E'US, (from ptv, the nose). See Nasalis. RING-WORM. A species of herpes, or rather of lepra, in which the eruptions are annular. RI'SAGON. See Cassumunar. RIST. See Cist. R1SUS, (a ridendo). Laughter scarcely requires a definition. It is occasioned by short, imperfect, con- vulsive expirations after a full inspiration, with a con- traction of the glottis, which produces a sound in men resembling those of o and a, and in women i and e. The lesser degree, a smile, which the verb chiefly im- ports, is unconnected with respiration, and consists only in the contraction of the buccinator and zygomatic mus- cles, white the cheeks are slightly raised, and the eyes in some measure closed. The former is the expression of boisterous mirth, in minds untutored and unregulat- ed ; the latter of complacency and pleasure. It is singular that laughter generally proceeds from a mental cause, in most instances without any corporeal influence, and sometimes from an irritation of the nerves, wholly independent of mirth. Of the former kind is the loud laugh in hysteria; and the convulsive* laugh in hysteric paroxysms, sometimes induced by the most distressing events: of the second, tickling is the cause, which in excess has been used as a kind of tor- ture to induce confession. The causes of laughter are obscure. Pleasure produces cheerfulness and compla- cency ; unexpected happiness more frequently draws tears; and the loud repeated laugh of the bacchanal, or of the spectator of the comic humour of Munden, if analyzed, will be found to arise from a source very different from pleasure. One cause of laughter is a combination of incongruous images. Chrysippus is said to have died from laughing at the idea of an ass being invited to a banquet. A similar fate, according to Va- lerius Maximus, attended Philemon; and we are told of a pope who died in the same wav, from seeing 'h, Oo RIS 290 RO S tiara placed on the head of a monkey. A question which has perplexed both moralists and metaphysicians is the cause of that laughter which ensues from seeing another person fall. It is often irresistible though con- siderable injury be apprehended. The maxim of Roche- toucatilt has been quoted on this occasion, that there is something m the misfortunes of our best friends which does not displease us; but we would, for the honour of humanity, rather refer it to a sudden agitation. We know a gentleman who, on such an accident to himself, and he has often fallen from his horse, is seized with violent laughter; and Binninger has remarked, that a fall on the sinciput is generally attended by this con- vulsive expiration. The conclusion, therefore, must be, that it is a tremulous action of the diaphragm, not necessarily connected with mirth, but rather with surprise. The well regulated mind, accustomed, nil admirari, is, therefore, seldom betrayed into it; and immoderate, frequent laughing is usually the effect of mental imbecility. Such was the decision of lord Ches- terfield ; and whatever ridicule may be thrown on his system of education, it must be admitted that no one was more intimately acquainted with all the intricacies of the human mind. Laughter is peculiar to the human race. It has been observed in a child just born (Ephemerides Naturae Cu- riosorum), and Schelhamner remarks of one of the wild boys found in woods, that he could laugh, but not speak. We have observed dogs and monkeys grin, when pleased, apparently from imitation. The more immediate causes of laughter, or rather the connection between it and surprise, or the titillation of distant nerves, is wholly inexplicable. Laughter is said to be useful from the effect of the succussions in expediting the passage of the blood through the system of the vena portarum. Laughers are proverbially fat, and generally long lived; but weak minds are commonly exempt from care. The injuries from sudden and immoderate laughter are nu- merous. The circulation through the lungs is impeded, and the blood accumulated in the head: the records of medicine are filled with narratives of ruptured vessels in the head and lungs from laughing, with some more consolatory instances of a fortunate rupture of an ab- scess. Castellus mentions a case where a thorn was thrown up from the throat in consequence of immo- derate laughter; and Erasmus was saved from death by a fit of laughter, which burst an abscess. The risus sardonicus is rather a smile, or, more pro- perly, a grin, than real laughter. Even Hippocrates quotes, as an old observation, that it arises from a wound in the diaphragm, which modern authors have confirm- ed from their own experience. (Joubert du Ris apud Halleri Bibliothecam, ii. 135.) Franck records it as a symptom in a bilious peripneumony, connected with rheumatism. The name was derived from the herb sardoa, to which it was attributed. We cannot now exactly ascertain what this plant is; but it had the leaves of parsley, and was sweet, two circumstances which meet in the oenanthe crocata, a powerful narcotic. It is the sardonic grin, which Van Helmont tells us is so unfavourable a symptom in wounds of the nerves. The risus sardonicus has also been owing to swallow- ing the root of the ranunculus palustris (Ephemerides Naturae Curiosorum, Dec. iii. an. 2, obs. 87); and m the same collection of a former year, we find an in- stance where it was induced by terror, and was a fatal symptom in a puerperal case. Saffron has been accused as a cause by Sennertus, apparently with little reason. See Lyserus de Risu; Alberti de Risus Commodo et Incommodo; Plainer de Risu a Splene; Halieri Physio- logia; Plinii Historia, lib. xi. 629; Schelhamner dc Af- fectibus Animi. RIVINIA'NiE GLA'NDULjE. See Sublinguales GLANDULE. ROASTING. A culinary and chemical process. In the latter, metals are exposed to an open fire, to dis- sipate their inflammable or volatile parts. In the former the meat is rendered more moist, perhaps more soluble; but, as we have observed, the empyreuma communi- cated to the fat and skin renders roasted meat often in- convenient in weak stomachs. ROB, (from the Arabic rob, dense,) robub; a ga- lenical form, in which fruits and leaves are preserved by sugar and evaporation, often by the latter alone. Acids, however, suffer some decomposition, and are not afterwards equally miscible with water, or equally salutary in scurvy. See Extractio and Sapa. ROBORA'NTIA, (from roboro, to strengthen). See CORROBORANTIA, ToNICA, and AsTRINGENTIA. ROCCELLA; lichen rocella Lin. Sp. PI. 1622; a blue dye, but, like other lichens, used in hectics. From its allaying coughs, and particularly hysteric coughs, it seems to possess some narcotic power. RODA'TIO, (from redo). See Tarsus. RO'NCHUS. See Renchos. RORE'LLA, RO'RIDA, and ROSA SOLIS. See Ros SOLIS. RORISMARI'NUM SYLVE'STRE. See Ledum PALUSTRE. RORISMARI'NUS. See Rosmarinus. ROS CALABRI'NUS. See Manna. RO'SA, (from porov, or pofov, the rose). White roses are the weakest; so that when the damask, the rosa pallida, or centifolia Lin. can be procured in suffi- cient quantities, they only are used. Their odour is imparted to water and to spirit, but chiefly to the latter; and they lose little by drying, or keeping, if well ma- naged. On distilling large quantities, a small portion of a fragrant butyraceous oil, of a yellowish colour, is obtained, which concretes in a slight degree of cold : both the water and the oil are chiefly used as perfumes. The red rose, rosa centifolia Lin. Sp. PI. 704, has but little of the fine flavour of the pale sort: to the taste the leaves are bitterish and somewhat astringent. The astringency is the greatest before the flower opens, and this quality is improved by hasty drying in a gentle heat; but by slow drying both the colour and astrin- gency are impaired. Water they tinge with a deep red colour, and spirit with a pale one. The extract from a watery infusion is austere, bitter, and subsaline; that from spirit in a greater degree. The fixed matter of the petals is slightly laxative, and the syrup is some- times given for this purpose to children. Former dis- pensatories had a syrupus rosarum solutivus. (See Lewis's Materia Medica.) The London College have directed several preparations. Aqua rose.—Take of the fresh petals of damask roses, the white heels being cut off, six pounds ; water suffi- cient to prevent an empyreuma: draw off one gallon ROS 291 ROS Conserve rosa rubra.—Red roses are to be gathered before the petals are unfolded, the heels cut off, and the leaves treated in the same manner as the worm wood. (See Absinthii maritimi conserva.) The virtue of the roses is supposed to be found in this com- position, and probably their best effect will be produced, when given in substance, and in considerable quantity. In phthisis and haemoptoe they have been employed, sometimes with success, especially when joined with a diet of milk and farinacea, and gentle exercise in open air. At most, two parts of sugar to one of roses would be sufficient, and afford a better medicine than the larger proportion. A cataplasm is made of the conserve, and employed in the latter stages of ophthalmia; one drachm of alum finely powdered is mixed with two ounces of conserve. Mel rosa.—Take the petals of the red rose not yet unfolded, the heels being taken off, first dried, four ounces; boiling distilled water, three pints; clarified honey, five pounds; macerate the petals in the water for six hours; afterwards with the strained liquor mix the honey, and boil the mixture to the consistence of a syrup. Syrupus rosa.—Take of the petals of the damask rose dried, seven ounces; purified sugar, six pounds; dis- tilled boiling water, four pints ; macerate the petals in the water for twelve hours, and strain: evaporate the strained liquor to two pints and a half, and add the su- gar to form the syrup. For infants, the dose, as an aperient, is from half an ounce to an ounce; though its purgative effect is very inconsiderable. hifusum rosa.—Take the petals of the red rose in bud, the heels taken off, half an ounce ; diluted vitrio- lic acid,three drachms by weight; boiling distilled wa- ter, two pints and a half; purified sugar, one ounce and a half. Pour the water first on the petals in a glass vessel, then add the acid, and macerate them for half an hour; strain the liquor cold, and add the sugar. Pharmacopoeia Londinensis 1788. This is an elegant preparation, but its virtue consists more in the vitriolic acid than the roses. See Cullen's Materia Medica. The attar, or essential oil of roses, so highly esteem- ed as a perfume, is prepared in India. Forty pounds of roses, with their calyces, are put into a still with sixty pounds of water. After the ingredients have been well mixed, a gentle fire is lighted, and when fumes begin to arise, the cap and pipe are properly luted on. When the impregnated water begins to come over, the fire is lessened by degrees, and the distillation continued four or five hours, till 30lb. of fluid is come over. This water is to be poured again upon 40lb. of roses, and fifteen or twenty pounds more are to be drawn off. It is then to be poured into pans of earthen ware, or tinned metal, and exposed to the fresh air for the night. In the morning the attar will be found congealed, and floating upon the surface of the water. Its smell exactly resembles that of roses. It is only slightly pungent; but has been recommended as a cordial and analeptic. The roses of India do not appear richer in oil than those of Europe. From two to three drachms of oil are procured from one hundred weight; while Tachcnius procured half an ounce of oil from that quantity, Ham- berger one ounce, and Hoffman two. It is adulterated sometimes with the oil of sandal wood; but this oil does not congeal in common cold, and its peculiar smell predominates, sometimes with that of a sweet grass. The latter imparts a green colour, and the oil does not easily congeal in a moderate temperature. The colour, however, is no criterion of its genuineness, since the real attar differs greatly in this respect. Colonel Polier in the Asiatic Researches, vol. i. Ro'sa cani'na et sylve'stris. See Cynosbatos. ROSA'CEA, (from rosa, a rose). Rosea. Sec GUTTA ROSACEA. ROSA'TUM. See Drosatum. RO'S^E ODO'RiE LIGNUM. See Aspalathus. ROSEOLA, of Willan. See GuTrA rosea. ROSMARINUS, RORISxMARI'NUS, (folia albe- scentia quasi rore, ut in maritimis, inspersa,) libatietis coronaria; dendrolibanus; common rosemary; ros- marinus officinalis Lin. Sp. PI. 33; is a large shrubby plant, with long, narrow, stiff leaves, set in pairs, of a dark green colour, above, and hoary beneath, with flowers of a pale bluish colour. It is a native of the southern parts of Europe, where it grows wild in dry gravelly ground; common in our gardens, where it smells stronger in proportion as the soil is dry and gravelly. Rosemary hath a warm, pungent, aromatic, bitter taste, and a fragrant smell, approaching to that of la- vender, joined with a camphorated odour: the leaves and tender tops are the strongest, and next to these the cup and the flowers. The flowers are the weakest, but most pleasant; and whatever virtue has been attri- buted to them resides in the cup. This plant is said to stimulate and strengthen the nervous system, and is re- commended for nervous headachs, deafness, vertigo, palsy, hysteria, and dyspepsia, yet its active power scarcely extends beyond the stomach, which it gently stimulates ; though recommended by Bergius as an em- menagogue, and chiefly useful in chlorosis. For dis- tillation the calyces and leaves are preferable, partially dried. The leaves and tops yield their fragrance, in a great degree, to rectified spirit, leaving in the extract the greatest share of both their flavour and pungency, with some portion of the aroma. The active matter of the calyces and flowers is more volatile than that of the leaves, the greatest part of it rising with spirit. Spiritus roris77iarini, or Hungary water.—Take of the fresh tops of rosemary, one pound and a half: proof spirit of wine, one gallon. Distil in a water bath, five pints. (Pharm. Lond. 1788.) This with the essential oil are the only preparations now kept; but the rose- mary is an ingredient in compound spirit of lavender, and some other preparations. A conserve formed of its flowers is now expunged both from the London and Edinburgh Pharmacopoeias. To make the Hungary water in perfection, the spirit must be very pure, the leaves at their full growth, ga- thered without bruising. If the flowers are suspended in the retort, and a gentle heat applied just sufficient to raise the spirit, the vapour lightly percolating through them will, it is said, add to the fragrance. Aqueous liquors extract some portion of the virtues O o 3 RUB 292 RUB of rosemary by infusion, which pass over in distillation. With the water a considerable quantity of light, thin, green, or yellowish essential oil rises. See Tournefort's, Lewis's, and Cullen's Materia Me- dica ; and Neumann's Chemistry. ROSMARI'NUM STCE'CHADIS FA'CIE. See POLIUM CRETICUM. ROS SO'LIS, rosa solis,rorella, sponsa solis, rorida; red rot ; sun dew ; drosera rotundifolia Lin. Sp. PI. 402; is a small low plant, with a little fibrous root, from which spring small, round, hollowish leaves, on foot stalks of about an inch long, covered with short red hairs, which make the whole leaf appear red. It grows in boggy ground, and flowers in June and July. It is injurious to cattle if eaten, and very caustic; but has been commended as a cordial. See Raii Historia. ROSSALIA. See Scarlatina. ROSTE'LLUM, (a dim. of rostrum.) A little beak. See Corculum. RO'STRUM, (from rodo, because birds tear their food with it). A beak. RO'STRUM LEPORI'NUM. The piece of flesh which hangs betwixt the division of the hare lip, resem- bling a beak. See Labia leporina. ROTA'TOR MI'NOR, MAJOR, and NA'TIS, (from roto, to turn). See Femoris os. ROTTEN STONE. A partly decomposed granite from which the felt spar has been separated; resem- bling the petuntze of the Chinese, and used in making porcelain. RO'TULA, (a dim. of rota). The Patella, q. v. In pharmacy a round lozenge. ROTU'NDA LIGAME'NTA,(from rota, a wheel). The round ligaments of the womb are two vas- cular ropes, composed of arteries and veins, lymphatics and nerves, arising from the fundus uteri, running under the duplicature of the broad ligaments to the rings of the abdominal muscles, and, passing under Poupart's ligament, are lost on the groin. They run in a contorted form, and are capable of being elongated. The nerves of these ligaments compressed in time of labour, between the uterus and abdominal muscles, may cause the pain felt in the inside of the thighs at that time. ROTU'NDUS MU'SCULUS. See Teres major. ROUCOU. See Achiotl, and Orleana. ROUTROU'S SOLVENT. See Antimony, vol. i. p. 136. RUBE'DO, (from ruber, red).. An uniform redness of the skin, seldom rising into pustules, or even papulae. See Gutta rosacea. t RUBEFACIENTI A, (from rubrumfacere, to redden,) are usually simple stimulants, and such as do not raise vesications. They resemble in their effect blisters, but their power is inferior and more transitory. RUBE'OLA, (from the same). See Morbilli, and RUBIA CYNANCHICA. Rube'ola monta'na od'ora. See Asperula. RUBE'RCUM MA'CULIS, (from the same). See Gutta rosacea. RUBE'TA, (from its living among brambles). See Bufo. , N ™ ,. • T • RU'BIA, (from its red roots.) Rubia tinctorum Lin. Sp. PI- I58 Pi erythrodanum ; rubia major; dyer's madder, is a rough procumbent plant, with square jointed stalks, and five or six oblong pointed leaves, set in the form of a star at every joint; from the top arise greenish yellow flowers, followed by two black berries. The root is long, slender, juicy, red, both externally and internally, with a whitish woody pith in the middle. The plant is perennial, and cultivated in different parts of Europe for the use of dyers. The roots are bitterish, somewhat austere, with very little smell, imparting to water a dark, to rectified spirit and distilled oils a bright, red colour, preserving in each the taste unchanged. Taken internally it renders the urine red and milky; and tinges the bones of animals fed with it, from its affinity, as already shown, to the serum, rather than the calcareous phosphat: the flesh and cartilages continue unaltered. From its supposed effect of tinging the earthy salt of which the bones con- sist, it was considered as a powerful aperient, and from its effects on the urine a diuretic. But it is neither; for it only tinges the serum. Its power as an emmenagogue is equally equivocal. When first recommended, distrusting the author's ac- curacy, we gave it at the same time in a case of mcenor- rhagia and amaenorrhoea. The former complaint disap- peared, the latter continued without any change. In fact, we believe it wholly useless. It has been given in dropsy, in jaundice, and in ecchymosis from bruises, in the dose of a scruple, or from this to half a drachm. It is also a name for the rubeola, a species of cross- wort, and of horse tail. Ru'bia sylva'tica l^'vis ; gallium mollugo Lin. Sp. PI. 155; MOUNTAIN BASTARD, Or WILD MAD- ' der. Its virtues are at least equal to the rubia tinc- torum. Ru'bia cyna'nchica; rubeola cynanchica Lugdun- ensis ; asperula; saxifraga ; asperula cynanchica Lin. Sp. PI. 151; squinancy wort, hath a black, thick, woody root, which runs deep into the earth, with many capillary fibrils divided into a multitude of heads, and shoots up in many smooth, slender, ungulous stalks. At every joint are four short and broad leaves: the *i yvers are on the top of the stalks and branches, form- ing umbels of a red colour, in smell resembling the jasmine; and each flower is followed by two rough seeds, which when dry are of a yellow colour. It is found on chalky grounds, and said to be of use in quinsies; but at present neglected or forgotten. RUBI'NUS VE'RUS, (from ruber). See Carbun- CULUS. RU'BRICA FABRI'LIS, (from the same). See Ochra. RU'BUS, (from its red fruit). See Dumus. Ru'bus Alpi'nus and Palu'stris hu'milis. See Cham^morus. Ru'bus Idje'us, Lin. Sp. PI. 706; batinon, moron; raspberry, is a native of Britain, usually growing about woods and hedges, and in moist situations, pro- ducing its flowers in May and June. The raspberry is commonly cultivated in our gardens, and we find three varieties, the red, white, and smooth. The fruit is sweet tasted, accompanied with a peculiarly grateful flavour; and like other fruits it allays heat, quenches thirst, and promotes urine. A syrup is made of the juice in the common way. R U M 293 R U 8 Ru'bus vulga'ris; common bramble; black or dew berry bush ; rubus fruticosus Lin. Sp. PI. 707 ; batos; chamabatos; grows wild in hedges and in woods. The berries have a faint taste, with a moderately agree- ble flavour, and the leaves are slightly astringent. The flowers appear in July, and the fruit is ripe in August and September; but neither the bush nor its produc- tions are employed in medicine. RUCTA'TIO, RU'CTUS, (from ructo, to belch). A discharge of wind from the stomach; a symptom of dyspepsia. It is usually attributed to flatulent food, and is often owing to a defective digestion; for wre have remarked that the flatus, separated in the early stage of the diges- tive process, is again combined with the food, in the second period. We consequently find that whatever disturbs this function produces flatulence, and conse- quently eructation. This variety of the disease is best remedied by moderately warm stimulants, and rest after eating. If the cause be more violent, or the food of that kind which quickly hastens to putrefaction, the eructations show the peculiar nature of the contents of the stomach by acidity, or what are styled nidorous eructations, in taste resembling a rotten egg. The former are removed by absorbents joined with aroma- tics, and the latter most effectually by vegetable acids. Eructation does not, however, always arise from the contents of the stomach. It is sometimes a convulsive action, and the wind discharged is only the effect of the relaxation of the previous contraction. It is thus a common symptom in hysteria, of a stomach weakened by over distention, drinking spirits, &c. The disease is sometimes alarmingly violent, and we are told has, in one or two instances, induced appearances of hectic. (Commercium Norimbergense, 1743.) It is singular to observe eructations attributed to the imagination; but we find this cause assigned, not only in a disserta- tion by Alberti, but in a tract of Muller de Morbo Motuum Habituali ex Imaginatione. The cure of this nervous eructation is generally at- tempted by tonics: but more immediate relief is often necessary; and opiates, with the fetid gums, are, for . io purpose, chiefly useful. The opium should not, how- ever, be given in such a dose as to produce costiveness ; or rather this state should be counteracted by eccopro- tics, frequently interposed. The best tonic is the bark, to which the valerian is with advantage added; iron, and sometimes zinc, are used; and, from some late ob- servations of Dr. Bardsley, there is reason to suspect that the oxide of bismuth may be beneficial. The oil of amber is recommended by Zacutus Lusitanus, and we find the mineral acids have been occasionally em- ployed. Borborygmi are produced by nearly the same causes, and may be relieved by the same remedies. RU 'FI PI'LULiE ; pilula ex aloe cum myrrha. Two parts of aloes are combined in this composition with one of myrrh, one of saffron, and a sufficient quantity of syrup. See Aloe. RUM. A spirit distilled from the sugar cane. It is oily, and has been supposed more useful on this account in catarrhs and coughs. The difference, however, be- tween this and other spirits is inconsiderable. When new it is injurious, and has been said to produce the Poitou colic. RU'MEX ACETO'SUS, prate'nsis, scuta'tus et helveticus, Linnai, (from ramach, a spear). See Acetosa. Ru'mex aqua'ticus, and hydrola'pathum. See La- pathum A QU ATI CUM. Ru'mex acu'tus. See Lapathum acutum. RUMINATIO. This is a part of the process of di- gestion peculiar to some animals, chiefly belon^i;^ to the pecora of Linnaeus, of which the cow is an example. The herbage received into its first stomach is there ma- cerated, and, by an inverted motion of the oesophagus, is again brought into the mouth, to be more completely masticated. This operation is commonly called chewing the cud. Its object is apparently to combine the vege- table aliment more completely with the saliva. Rumi- nation would be scarcely a part of our subject, if it did not occasionally occur in the human system, and an in- stance of it is recorded by Dr. Cullen. Meyer in 1792, Ackford in 1783, in dissertations published at Erlang and Halle respectively, have mentioned instances of it, and we find numerous descriptions of a similar opera- tion in different foreign authors. We have seen some approaches to it; but the rumi- nation has then not been regular and constant. It has seemed owing to eructation, and the food has come into the mouth with the flatus. The remedies for Ruc- tus, q. v. seem to be chiefly indicated, and will proba- bly be successful. Schurig Chylologia; Slare Philosophical Transac- tions, No. 193; Morgagni de Sedibus, xxix. 4.; Bo- neti Sepulchretum, Lib. iii. § v. 9, 10. RUNCINA'TUS, (from runcina, a saw). Serrat- ed ; leaves of plants with indented edges. RUPICA'PRA, (from rapes, a rock, and capra, a goat). See Capra Alpina. RUPELLE'NSIS SAL, (from Ru/iellum, Rochelle, where it was first made,) sel de seignette, natron tarta- rigatum, and Rochelle salt, is a soluble tartar, made by combining twenty ounces of natron, by weight, with two pounds of crystals of tartar, in boiling distilled wa- ter, ten pints. The natron should be melted by heat, that it may shoot more easily into crystals. Half an ounce or six drachms of this salt is a gentle cooling purge; but it should be mixed with a large proportion of water. RUPTU'RA, (from rumpo, to break). A rupture; the English term for Hernia, q. v.; from the idea that the peritonaeum was ruptured when the intestine pro- truded through the ring of the muscles. The word rupture is most properly applied to a cartilage, a liga- ment, or a tendon, when divided by violence. RU'SCUS, (from the carnation colour of its berries,) bruscus, oxymyrrhine, myrtacantha, myacantha, scopa regia, wild myrtle, knee holly, butcher's broom ; ruscus aculeatus Lin. Sp. PI. 1474, is a low woody plant, with oblong, stiff, prickly leaves, joined immediately to the stalks: from the middle ribs of the leaves, on the upper side, issue small yellowish flowers, succeeded by red berries. The root is thick, knotty, furnished with long fibres matted together, of a pale brownish colour on the outside, and white within. It grows wild in woods and heaths, is perennial and evergreen; flowers in May, and its berries ripen in August. The root tastes sweet, and is slightly bitter; is aperient and diu- retic, yielding its virtues to water and spirit; and on inspissating the tincture they remain in the extract. RUT 294 R YT The young shoots are eaten instead of asparagus. See Miller's Botany. Ru'scus hippoglo'ssus, or latifolius. See Laurus Alexandrina. RUSH NUT. The root of the cyperus esculentus Lin. Sp. PI. 67, which is mucilaginous and oily, resem- bling chestnuts. RUSMA, (nouret of the Arabians,) a depilatory ge- nerally used in the Turkish bagnios, supposed to be so precious as to be equal in value to its weight of gold. We learn, however, from Sonnini, that it is a very common preparation, consisting only of seven parts of lime, with three of orpiment. It must be laid on in a warm bagnio moistened with water, and the effect is almost immediate; but the hair grows again, and the operation must be repeated. Sonnini Voyage dans la Haute et Basse Egypte, vol. i. p. 303; Belon Observat. lib. cap. 33. RU'TA, (from pva, to preserve, because it preserves health). Rue. Armala, besasa, peganon, ruta gra- ■veolens Lin. Sp. PI. 548, large wild rue, is a small shrubby plant, with thick bluish green leaves, divided into numerous roundish segments. On the tops of the branches rise yellowish flowers, followed each by a capsule, divided into four partitions, full of small, black- ish, rough seeds. It is cultivated in gardens, flowers in June, and is an evergreen. Rue hath a strong unpleasant smell, a penetrating, pungent, bitter taste; if much handled, apt to inflame the skin, a property lessened by cultivation. It is com- mended as a powerful stimulant, aperient, antiseptic, and antispasmodic, useful in crudities, indigestion, in uterine obstructions, hysteric diseases, and to guard against infection. It is, however, only a warm anti- spasmodic, of no considerable powers. Externally, in a fomentation, it is thought to be discutient and anti- septic. Its virtues are extracted by water and spirit of wine, but most perfectly by the latter. On inspissating the spirituous tincture, very little of its flavour rises with the menstruum, nearly all the active parts of the rue remaining in the extract, which is warmly and durably pungent, and in smell it is rather less unpleasant than the herb. This is the best preparation of rue : water, in distillation carries over a part of its aroma. The principal virtues reside in the essential oil, which is not very volatile. Distilled with water, a yellowish or brownish essen- tial oil is obtained; and the remaining liquor may be inspissated into a warm, pungent, bitterish extract, in- ferior, however, to the spirituous. Rue leaves, distilled for their essential oil, should be fresh, and gathered when the flowers are ready to fall off: the seeds with their capsules should be added, and macerated previous to distillation. Rue is directed in form of an extract, is a principal ingredient in the pulvis cum myrrha. compositus, and often given in the form of tea. To it was attributed, by Hippocrates, the power of resisting the action of contagion, and other kinds of poisons ; and in this view it is highly extolled by Boerhaave. For making the extract, see Chamom^emeli extractum. See Tournefort's, Lewis's, and Cullen's Materia Me- dica; Neumann's Chemistry. Ru'ta capra'ria. See Galega. Ru'ta ba'ga A coarse esculent beet, highly com- mended as the " root of scarcity ;" but now deservedly neglected. Ru'ta muraria, aspleniu7n ruta muraria Lin. Sp. PI. 1541, white maiden hair, is slightly astringent, and has been used in hectics, though at present ne- glected. Ru'ta sylve'stris. See Harmel. RUTADOSIS. A sinking of the cornea from a wound, old age, or death. RUYSCHI'ANA TU'NICA, (from Ruysch, the dis- coverer). See Choroides. RY'SAGON. See Cassumuniar. RY'THMUS, (from pv6pu>s, measure,) a term used by musicians with respect to time in music ; but, since the era of Herophilus, employed to express the time, mo- tion, or modulation of the pulse. See Arythmus. 295 SAC J^ABADI'LLA. See Cevadilla. SABI'NA, savina, brathu, common or barren savine, juniperus sabina Lin. Sp. PI. 1472, is an ever- green shrub, with short, narrow, prickly leaves. When old it bears blackish berries, like those of the juniper. It is a native of the southern parts of Europe, and is raised in our gardens. The leaves and tops have a strong disagreeable smell; a hot, bitter, and acrid taste; yield- ing a large proportion of their active matter to watery liquors, and the whole to rectified spirit. Distilled with water they afford much essential oil, which smells strongly, and tastes moderately of the savin : its dose is from two to four drops. The decoction yields an extract which retains much of the pungency, warmth, and bitterness of the plant. On inspissating the spirituous tincture, the extract is a yellow, unctuous, or oily, bitterish, and pungent, mixed with a black, resinous, tenacious, subastringent, and less acrid substance. Savin is styled a stimulant and aperient, useful in uterine obstructions, proceeding from a want of irrita- bility in the vessels, heating and stimulating the whole system, and promoting the fluid secretions. It seems to be an efficacious emmenagogue, chiefly suited to relaxed and weak habits, but improper in plethoric ones. Of the powder the dose is from 9 i. to 3 i. twice a- day; of the extract (see Chamom^meli extractum) from ten to thirty grains. Pulvis sabina compositus is composed of equal parts of sabine and aerugo, and employed as an escharotic for warts and excrescences, upon which it is to be sprinkled every day. The powdered savine alone, if fresh, is sufficiently active, when the epidermis is removed. The oil impregnates the urine with its smell, and contains the whole of its virtues. See Lewis's Materia Medica; and for the tinctura sabinae composita, elixir myr- rhae compositum, under Myrrha. Sa'bina bacci'fera. See Cedrus cum foliis CYPRI. Sabi'na goe'nsis. See Cedrus Phcenicia. SABBURRA'TIO, (from saburra, sand). See Are- NATIO. SACCA'TA. See OZ.nus diacheomenus. SA'CCHARUM, (from sachar, Arab). Sugar, fA.eXt, xx/.xfcivov, AAj, hfoxos, sackohar, sakchari, sal- charion, spodian, cantion; and when unrefined, cas- • SAC sonada. It is procured from the saccharum officinarum Lin. Sp. PI. 79, common sugar cane. Sugar seems to have been exclusively the production of India in the old, and of South America and the Ame- rican islands in the new, world. It was apparently brought from India to Arabia, and from the Arabians we seem to have received the first description of the cane and its contents. If any part of the world be- sides those mentioned, can claim the sugar cane, it is the Canary islands. Sugar seems to have been first refined by the Venetians about the end of the eleventh century, but the process only practised in England about the middle of the sixteenth. The form in which sugar was previously imported from the east seems to have been that of sugar candy. Actuarius, the last of the ancients, apparently first used sugar instead of honey in medicinal prescriptions. The expressed juice of the sugar cane is clarified with the addition of lime water, and when boiled down to a thick consistence is removed from the fire, when the saccharine part concretes into a granular mass, the saccharum rubrum, leaving an unctuous liquor, called molazzo, or molasses; from its consistence commonly treacle. This red sugar is clarified in conical moulds, by spreading on the upper broad surface some moist clay, whose watery part, gently percolating through the mass, carries with it a large portion of the treacle; and this is further refined by dissolving it in water, and mixing it with the whites of eggs, or bullock's blood, which, coagulating, carry down the remaining impuri- ties. It is then covered with clay again in the mould, and becomes the saccharum album, Ph. Edinb. This process again repeated produces the saccharum purissi- mum, Ph. Lond. Brown sugar boiled to a proper con- sistence is placed in a hot room, to shoot into crystals upon sticks placed for the purpose, and it is then called saccharumcandidum; andcandum; canthum; saccharum cantion; sugar candy; or clarified, and the thinner parts evaporated, so that it forms a brittle substance, which, when made into small rolls, is called barley sugar. The term sugar candy is only with propriety applied to the crystallized white sugar, unless, with Salmasius, we de- rive the term from xxvnov, angular, or, with other au- thors, from khand, or kend, an eastern appellation of sugar ; the latter is most probable. Sugar, when pure and crystallized, is perfectly trans SAC 296 SAC parent; when in a more confused granular form, opaque, with little shining crystals, soluble in water, and with the assistance of heat in alcohol. It melts into a yel- low, tenacious liquid, and burns with a strong flame, exhaling an acid vapour. It is almost exclusively a vegetable production ; and even the milk may be traced to a vegetable principle, except in animals wholly car- nivorous. It is contained in almost every part of dif- ferent vegetables, the flower, the leaves, the trunk, the root, and the fruit; but in each is confined to the pe- riod of maturity, and contaminated with mucilage and other vegetable principles. In the seeds of the cerealia it is formed by the addition of oxygen and of hydrogen from the decomposition of water. Sugar is an oxide composed of carbon, hydrogen, and oxygen, of which 0.64 are oxygen, 0.28 hydrogen, and 0.08 only carbon. With an excess of oxygen it forms oxalic, or oxalic with malic acid, and with considerably less carbon, and a larger proportion of oxygen, it be- comes the sugar of milk. When distilled without ad- dition, it affords a pungent acid liquor of a yellow co- lour, called the pyromucous acid, which is also furnish- ed by mucilage. Hydrocarbonate gas, mixed with carbonic acid, come over at the same time, and the residuum is a charcoal of peculiar purity. No other substance is contained in this hydrocarbonate oxide, so that it is peculiarly pure. Mucilages are, we have seen, nearly allied to sugar, and we have pointed out one connecting substance whose farther analysis would greatly elucidate the che- mical nature both of sugar and mucilage, viz. Manna, q. v. Mucilages contain the same principles as sugar, with lime and azot. Sugar, in part deoxygenated, re- sembled mucilage in its chemical properties; but gum could not by any process of oxygenation become saccha- rine. In fact, it required that its azote should be sepa- rated. Gum, treated with nitric acid, produces the malic and deposits the mucous acid. The former, by the farther addition of nitric acid, becomes the oxalic. Vegetable farina may become sugar, by the addition of oxygen and water, the last of which is apparently decomposed. Sugar deoxygenated is no longer sus- ceptible of the vinous fermentation, as it is well known to be before, and neither vegetable nor animal muci- lages, alone, afford either vinous or acid fluids. The combination of the principles which form sugar some- times take place a little unexpectedly, as in diabetic urine, and the acetite of lead. The latter, Neumann tells us, may become the subject of a vinous fermenta- tion, and the former affords a true sugar. These sub- jects require a farther examination. Sugar has been procured also from the birch, the skirrett, the white beet, and the sugar maple; but these processes scarcely belong to our subject, which is sugar in the abstract, from whatever source it may be procured, and its ef- fects on the human body. To treat of the advantages and disadvantages of sugar is a difficult task, since with one class of authors it is the most salutary food and the best of medicines; with others, little less than a poison. Sugar, unless it produces heart- burn, is probably harmless; no does it injure the teeth, or contribute to the production of worms. It is highly nutritious; since in the crop season the most sickly ne- e-ro and the leanest pig become fat and healthy. Yet somewhat in these effects must be attributed to the mu- cilage with which the sugar is mixed in the cane, and something to the fresh vegetable substance in which a powerful antiscorbutic property resides, though we can- not detect its source or its nature. If sugar, too, contri- butes to evacuate worms, as Dr. Moseley contends, it must be in part attributed to its laxative power, and in part to its salutary, nutritious tendency; for he describes the amendment in the general health, while he speaks of the discharge of worms. It has been supposed to at- tenuate the juices, by contributing as an intermede to their more intimate mixture, and consequently to re- solve obstructions. On this principle it is said to cure hectics, and to relieve infarctions in the viscera: but this power is wholly chimerical; for we have no proof that it enters the blood in its saccharine state, or that, from its chemical properties, it is capable of assisting the mixture of the oily and watery portions of our fluids. Dr. Stark's experiments seem to show that it really pos- sesses an attenuating power; but his saccharine diet was the last of his wanton experiments, and we cannot depend on the general effects of any medicine from what may have been the result in an exhausted consti- tution. Others have contended that it thickens the fluids, and occasions infarctions; but this effect is equally visionary, and derived only from its nutritious qualities. Sugar is undoubtedly a'demulcent as well as a nutrient; but we have no evidence of any farther advantages : it produces often flatulence and acidity in the primae viae; but we know of no other inconveni- ence. Impure sugar is slightly laxative. Externally to wounds sugar is slightly stimulant and escharotic: burnt sugar, from the evolution of the pyromucous acid, more active in each respect. In experiments out of the body sugar is a very pow- erful and useful antiseptic; but it shows no effect of this kind when internally taken. In pharmacy it is used to preserve vegetable substances; but for this purpose its proportion must be considerable, and the whole inspissated, or it will accelerate the changes it was intended to prevent. It is generally used also to render medicines more palatable, without consulting the taste or often the circumstances of the disease. We have seen antacid lozenges produce more acid from their sugar than their proportion of an absorbent earth could destroy. Sugar, when depurated, boiled in rose water, and cast into troches, is called Christi manus; when pearls are added, manus Christi perlata. By the assistance of heat, sugar dissolves in rectified spirit; but the greatest part separates when cold, con- creting into a crystalline form. On this foundation saccharine concretions are obtained from saturated spi- rituous tinctures of several of our own plants, the sac- charine part separating when the tincture is cooled, while the resinous and other matter separated from the plant remains in the solution. See Moseley on Sugar, second edition; Neumann's Chemistry; Lewis's and Cullen's Materia Medica; Slare on Sugar; Cruickshank's Experiments in Rollo on Diabetes. Sa'ccharum Canade'nse, and Acerinum. See Acer. Sa'ccharum alu'minis. See Alumen. Sa'ccharum lactis : the sugar of milk has been long known and highly esteemed ; probably, SAC 297 SAC however, beyond its real value; but its real nature is not yet generally known. Kempfer has informed us that it was prepared by the Bramins ; though Fabricius Bartoldi first mentioned it in his Encyclopaedia, publish- ed at Bologna in 1619, under the title of manna, or nitre of milk. It was long highly esteemed in the forms prepared in Switzerland, viz. of tablets and crystals. The tablets were only inspissated whey, prepared from rennet. These tablets are dissolved in water, depu- rated by the white of an egg, and set to crystallize. The first crystals are beautifully white; but those which follow require another depuration and evapora- tion. They are not sensibly acid, rendering oils misci- ble with water, and preventing the separation of cream from milk. Sheep's milk, though seemingly the sweet- est, afforded the least proportion, and asses' milk the largest; goats', cows', human, and mares' milk followed that of sheep's in the same order; goats' milk producing the least, and mares' the greatest quantity next to asses' milk. The crystals of the sugar of milk are rhomboidal; their taste is sweetish, or rather mawkish, and they are soluble in four parts of boiling water, and about twelve of cold. It seems to contain the radical of the saccha- rine acid, without any separate acid or alkali, with what is styled a saponaceous substance, but is, however, mucilage. In reality this boasted remedy, which has been used in hectics, &c. is little more than a mucila- ginous substance, with an excess of the radical of sac- charine acid. It was supposed to be the subject of, or at least to assist, the vinous fermentation ; but this sus- picion Fourcroy has shown to be unfounded., Saccharum saturni. See Plumbum. SA'CCHO-LACTIC ACID differs, as will be ob- vious from the former article, from the mucous. It is prepared by treating the sugar of milk repeatedly with nitric acid, during which the saccho-lactic separates in a white powder, and from the remaining sugar some crystals of oxalic acid are formed. This white powder is sparingly soluble in hot water; but it reddens the blue vegetable juices, effervesces with chalk, expelling the carbonic acid, and forms neiatrals, styled saccholats, which have not been examined. It is probably a mu- cilage, with a little saccharine or oxalic acid slightly ad- hering, or what is more probable, an oxalic acid dis- guised by the union of animal matter. See Scheele's Essays; Hemstadt in Crell's Chemical Journal. Sa'ccho-las, (from saccharu7n, sugar, and lac, 7nilk). Saccholats. Salts formed by the union of saccholac- tic acid, with different bases. SA'CCULI ADIPO'SI, (dim. of saccus, a bag, and adips,fat). See Cellulosa membrana. Sv'cculi muco'si. See Burs^e mitcos.«. SA'CCULUS and SA'CCHUS. See Epithema. Sa'cculus chyli'ferus. See Receptaculum chyli. Sa'cculus co'rdis. See Pericardium. Sa'cculus lacryma'lis. The lacrymal sac is an oblong membranous bag, situated behind the caruncle at the inner canthus of the eye, by which the tears are conveyed from the surface of the eye to the nostril on each side. It receives the tears at the lachrymal points, from whence it conveys them to the os turbinatum in- ferius, where it opens into the nostril. The body of the bag is in the grooves of the os unguis, and os max- VOL. II. illare, which form the passage. See Puncta lacry- malia. SA'CCUS, (from the Hebrew term sak, because it is only open at one end). The intestinum cacum, enus diacheomenus. SA'CER MU'SCULUS, (from sagur, Heb. secret,) transverso-spinalis lumborum of Winslow, is composed of several oblique, converging, or transverso-spinal mus- cles, and lies between the spinal and oblique apophyses of the loins, reaching to the os sacrum. The lowest is fixed to the upper lateral parts of the os sacrum, and to the posterior superior spine of the os ilium; the rest are fixed to the three lowest transverse apophyses, and to the four lowest oblique apophyses of the loins and their lateral tuberosities; from thence they run up to all the spinal apophyses of the vetebrae. SACERDO'TIS VIRI'LE. See Arum. SACK. A wine much drank by our ancestors, and celebrated in the pages of Shakspeare. It seems to have been a stronger Rhenish, which is at first sharp and un- pleasant. We suspect it to be of this kind, because it was sometimes adulterated with lime. " There's lime in this sack," says sir John Falstaff. Sugar was occa- sionally added: but this does not furnish an argument on either side; for our ancestors were always fond of sweet liquors. Howell calls it a dry Spanish wine, vin sec; others derive it from the borachios, in which it was probably brought from the mountains; but these were never called sacks. Sack is called by Venner, " a penetrative wine, a quality retarded by sugar;" and we should suspect, that by penetrative he means pun- gent. SA'CKCHAR, SA'KCHARI. See Saccharum. SA'CRA ARTE'RIA, (from saccr,) goes out from the back part of the aorta, at the bifurcation, on each side respectively. Sometimes there are three or four, and sometimes but one. They occasionally rise a little higher from the lumbares, or from the iliacse; and are ramified on the os sacrum and the neighbouring parts of the peritonaeum, rectum, and fat, penetrating into the substance of the bone. Sa'cra herba. See Verbena. Sa'cra ti'nctura, now aloes vinum. Aloetio wine, is made by digesting eight ounces of socotorine aloes, and two ounces of canella, in seven pints of Spa- nish white wine, to which a quart of proof spirit has been added. It will be of use to prevent the aloes, when moistened, from running into concretions, lo" mix the aloes and canella, separately powdered, with pure well washed white sand. (Ph. Lond. 1788.) This is es- teemed a warm purgative, in doses from six to sixteen drachms. Three or four drachms, with a drachm of spirit of lavender, repeatedly taken about noon, or at bed time, have been thought useful in cases of indiges- tion and headachs: large doses of the wine or the tinc- ture of aloes have been directed to produce the bleed- ing piles where they have been suddenly suppressed, and their return supposed to be necessary. Sa'cra va'sa. The arteries and veins which belong to the os sacrum and the adjacent parts. Sa'cra ve'na sometimes proceeds from the bifurca- tion of the vena cava, at others from the origin of the left iliaca, and accompanies the artery of the same name SA'CRl ACU'MEN O'SSIS. See Acumen. Pp SAG 298 S A G SA'CRO LUMBA'RIS, vel Lumba'lis. This mus- cle is a part of the longissimus dorsi at its origin; but soon divides, and is inserted by digitations into the an- gle of every rib. The uppermost tendon is inserted into the transverse process of the last cervical vertebra. Sa'cro lumba'ris accesso'rius ; accessorius sacro lumbalis ; cervicalis descendcns, cervicalis dorsi, is a continuation of the cervicalis dorsi, lies on the outside of the complexus, and coming down from the transverse processes of the lower vertebrae colli, is continued down under the sacro lumbaris to the ribs, which it depresses, as well as the sacro lumbaris. Sa'cro ne'rvi. Five or six branches of nerves from the spine pass through the os sacrum, and from thence obtain their name. The three first join the fourth and fifth lumbar nerves to form the sciatic nerve. The third sacral nerve gives some branches to the pelvis. Sa'cro coccyg^^us. See Coccyg^ius posterior. SA 'CRU M OS, (from its magnitude and importance, since it is the support of the spine,) os basilare, alba- giazi. This bone is of a somewhat triangular shape, broad above, narrow below, convex behind, for the more advantageous attachment of the muscles, and concave before, to enlarge the cavity of the pelvis. In the foetal state it consists of five distinct bones, which in adults are united, though the marks of the. former separation continue. On the outside there is a ridge, which is called the spine; and the bodies of the vertebrae are united to the processes by strong bony bridges, which support the weight of the whole spine. Oblique pro- cesses are only found in the upper bone of the sacrum, and these are connected by strong ligaments to the pro- cesses of the last lumbar vertebra. Where the oblique processes in the bones below should be,*we find only tuberosities. The transverse processes are united, and the three first form two irregular cavities, of which that behind is divided by a transverse ridge. The trans- verse processes of the last two bones are short, and from these to the ilium the sacro sciatic ligaments pass. The spinal processes of the three uppermost bones are nearly erect, short, and sharp: the lower ones are opened be- hind, and the fourth is more blunt or bifurcated, with- out the two legs forming a spine. Sometimes they do not form a canal by their union, but a fossa by their approach. The Canal contains the lower part of the spinal marrow, which gradually grows smaller, termi- nating, as we have seen, in filaments styled cauda equi- na, and the cavity is proportionally diminished. On the fore part there are four pair of holes for the trans- mission of the nerves. The holes on the back part are covered by membranes, which admit of the passage of small nerves, but the largest nerves pass anteriorly. The size of the holes, as of the canal, lessens as they descend. This bone is connected with the ossa inno- minata by synchondrosis, and forms the posterior part of the pelvis; its substance is spongy. Below, the os sacrum is connected with the os coccygis. SA'FFRAN DE TE'RRA, (from the Arabic term xafar, yellow). See Curcuma. SAGAPE'NUM, serapinum, is the gummy resinous juice of an oriental or rather an African plant, supposed to be a species of Ferula, q. v. It is brought from Alexandria, either in distinct tears, or in large masses; externally it is yellow, internally paler, and clear like horn; but sometimes of a greenish hue, soft, and stick- ing to the fingers when handled. Pieces of bdellium, sometimes sold for it, may be distinguished by their weaker smell: that of sagapenum is alliaceous, and re- sembles a mixture of asafoetida and galbanum. The taste is moderately hot and pungent. This gummy re- sin is superior to the opoponax, galbanum, and ammo- niacum, approaching nearest to the asafoetida. It is generally used as an expectorant, deobstruent, and anti- spasmodic, often in the same cases as the ammoniacum, or asafoetida. Boiling water dissolves about three fourths of it; rectified spirit about one half. From 480 grains, 306 of spirituous and 108 of watery extract were obtained; by an inverse operation, 170 of watery and 241 of spirituous extract. Water brings over with it in distillation much of the flavour of the sagapenum, and a small portion of essential oil, but the distilled spirit is not wholly destitute of flavour. It is an ingredient in the pilulae gummi, now pilulae galbani compositae. See Lewis, Tournefort's and Cullen's Materia Medica ; Neumann's Chemistry. SAGI'TTA, an arrow. Arrow head, from its leaves resembling the head of an arrow. Sagittaria sagittifolia Lin. Sp. PI. 1410, /3. At first the leaves of this plant resemble those of plantain, but afterwards the bearded head of an arrow; the fruit consists of a collec- tion of seeds like the strawberry. It is said to possess similar virtues with the plantain, but is rarely used. Its roots are esculent. SAGITTA'LIS SUTU'RA, (from its resemblance to an arrow,) virgata, obelea, rhabdoides, the sagittal or strait suture of the head, which runs from the os frontis to the os occipitis, between the parietal bones. SAGITTARIA ALEXIPHA'RMICA, (from its use in counteracting the poison conveyed by darts,) aguti-guepo-obi Brasiliensis, Malacca radix, canna In- dica, thalia geniculata Lin. Sp. PI. 3, arrow root, dart wort. It is found in the West Indian islands, is two or three inches long, as thick as a man's thumb, jointed and white. See Raii Historia. SAGITTA'TUM, the leaf of a plant shaped like an arrow. SAGOU. (See Palma Japonica.) It is procured from the cycas circinalis Lin. Sp. PI. 1658, which grows in Amboyna, Sumatra, and the Molucca islands, in marshy grounds; and there are two or three species, or at least varieties, of it not accurately described. Its trunk rises to ten or twelve feet in height, and the me- dullary substance is interposed between the fibres. It bears fruit only when arrived at its full growth, or ra- ther when it is near the decline; and as the fruit is nourished at the expense of the medullary farina, the natives endeavour to retard the period of fructification. When the medulla has attained its perfection, the leaves are covered with a white powder, which seems lo be a transudation of this substance. Sometimes the trunk is perforated, a part taken out, and rubbed in the hands, to ascertain the state of the farina. When the period of the collection of this faecula is arrived, the tree is cut down, divided transversely into billets, which are split in three or four pieces. The medulla, then cleared from its involucra, is bruised, agitated in water till it is entirely suspended, and then strained. What remains on the filter is given to the hogs, or thrown into the garden; what has passed through it is separated by rest, and after some time the S A L 299 SAL fluid is poured off. If the more solid parts which do not pass through the filter are thrown into the garden, mushrooms of an exquisite flavour are soon produced, and larvae of weevils, which are not less esteemed as food, soon swarm on the residuum. The faecula which thus subsides is cut into little cakes, and dried in the shade. This is the true sago of which biscuits are made; but as it is not susceptible of fermentation, it will not produce bread. Soups are thickened with it, and it is an ingredient in sauces of every kind in India, and the adjacent islands. Sago, kept dry, may be preserved for an indefinite period; but to bear the vicissitudes in climate in a long voyage it must be roasted in a furnace, and the surface slightly browned. In this last form it is gerterally brought to Europe. With us it is usually eaten in a simple state, boiled with water or milk, sometimes seasoned with spices, sometimes warmed with wine. It is a light and nou- rishing food, adapted to the extreme of either period of life, to hectical patients, as well as those recovering from long fevers, or diseases where the digestive facul- ties are much weakened. Its chief recommendation arises from its not fermenting, and consequently from its being neither flatulent nor acescent. Potatoes, it is said, will afford a similar faecula, and the caryota, with many other palms, contain apparently a medulla of the same kind. SAL, (from xXs, salt). Salt. Difficulties on every side have met those chemists who have with the greatest care attempted to define salts, and the reason will be obvious from what we have often had occasion to observe, that nature has no limits: those which we perceive are the result of our imperfect knowledge, and when the lacunae are filled by progressively extending science, our definitions are useless. The saline taste is a simple idea, of which common salt is a familiar ex- ample ; and if we were to define it, we should say that it is a pungent taste, without heat, or biting acrimony. The best authors who have defined salts from their pro- perties consider them as remarkable for their sapidity, soluble, incombustible, and capable of crystallization. Yet many neutrals have no taste, and some metallic oxyds a sensible one. Vitriolated barytes crystallizes, but is scarcely soluble in water ; and many bodies cer- tainly not saline are incombustible, as the various earths of the micaceous genus. In short, objections rise on every side, nor will chemical analysis assist us. If azot is a principle of some salts, oxygen is of others; if some are apparently simple, others are compounded; if some are fixed, others are volatile. The difficulty, in fact, arises from a name having been assigned when science was in its infancy, and having been obstinately retained when it was found neither scientific nor accurate. We shall, therefore, not consider them in the abstract, but divide them according to the following scheme : I. Simple salts. * Alkaline. Potash, natron, ammonia. bodies ; but these we have already described. (See Pa- rotis.) The maxillary have also been already noticed (See Maxillares glandule.) The sublingual glands are smaller, oblong, and flatted, situated under the anterior portion of the tongue, on the lateral portions of the mylo-hyoidei. The extre- mities are backward and forward; the edges obliquely inward and outward. They are covered by the external membrane of the tongue; their ducts are small and short, opening near the gums in distinct orifices. The mus- culi genio glossi separate the two sublingual glands and the two maxillary ducts. The arteries are derived from the lingual, and the nerves from the fifth pair, which supply the tongue. To these may be added the Molares glandulje, q. v.; the buccales and labiates, which are rather mu- cous follicles than glands. We may just add, that the situation of the salivary ducts is not always constant, and that the calculous concretions are often found in them. They are subject also to tumours from other causes, particularly inflammation. (Murray de Tumo- ribus Salivalibus). When obstructions have taken place in the duct, suppuration is often the consequence, and the saliva flowing through the wound causes a fistulous ulcer. (Memoires de l'Academie de Chirurgerie, iii. and v.) It is cured sometimes by compression, occasionally by the actual cautery (Saviard); by the gluten of parch- ment burnt with opium (Riedlin); sometimes by caus- tics (Gill in the Medical Commentaries, and Louis in the Memoires de Chirurgerie, v. 10. iii. 18); chiefly the lapis infernalis. Tessart employed a seton with success* SALIVA'LIS DU'CTUS STENO'NIS. The up- per salival duct, is the duct which carries the saliva from the parotid gland into the mouth. See Buccinator musculus. SALIVA'NTIA, (from saliva). Medicines which excite a salivation. SALIVA'RIS HE'RBA, (from its exciting a dis- charge of saliva). See Pyrethrum. SALIVA'TIO, (from saliva). A salivation is an extraordinary discharge of spitting, chiefly excited by the use of mercury ; a practice seldom employed in any considerable extent. As it may be, however, requisite to excite a gentle spitting, we shall offer a few remarks on the most convenient method of producing and con- ducting the evacuation, after we have spoken of the in- creased discharge of sativa frdm different causes. A salivation, or ptyalism, is sometimes a symptom ot disease, more often excited for the purpose of curing. As a symptom it is frequently salutary, though at times, as in paralytic patients, the effects of debility onlv. We know, for instance, that in the natural Q q SAL 306 SAL small pox the discharges of saliva, about the acme of the disease, is a favourable symptom; in fevers it has been sometimes found critical, and the fluid of dropsies has been occasionally discharged in this way. Yet we perceive from some references to authors whom we have not been able to procure, that it has been fatal, perhaps from its excess, or from the great debility previously in- duced. Salivation is said to be sometimes periodical, sometimes epidemic. Its causes are numerous. Suppressed evacuations are very frequent ones, and suppressed fluor albus, ischuria (Daniel in the Medical Communications, vol. i), sup- pressed lochia, and perspiration of the hands, have been found to produce it. The state of the stomach is a fre- quent cause, and it is a common attendant on dyspepsia; generally preceding vomiting. From this effect the squills and antimonials have been probably considered as causes. Acrid substances masticated are common causes, and the irritation of tobacco smoke is well known. It is only necessary to add, that the continued use of smoking produces a debility of the salivary glands, and often renders the salivation permanent. From debility, also, it is a common symptom in scurvy, often in jaundice. Neighbouring irritation sometimes excite the action of these vessels. We have seen it, we think, owing to scrofulous tumours; and Dr. Power mentions its arising from wool kept too long in the ear. We know no internal medicine which acts with cer- tainty on the salivary glands, except mercury; for, though we have mentioned the nitric acid, it was in- troduced with doubt and hesitation. See Materia Medica. The cure of salivation will, in general, depend on its causes. Of mercurial salivation we shall afterwards speak at some length; but this discharge from other causes is chiefly relieved by tonics, with astringent gargles. The latter should, however, be employed with caution, for many inconveniences are recorded to have arisen from hastily suppressing the discharge. (Syl- vester's Medical Observations and Inquiries, iii. 241.) Yet these relate rather to what we may style the more acute salivation from mercury : the more chronic kind, from debility, is not so easily suppressed. It often con- tinues for the whole life, without any change, notwith- standing the most active astringents are employed. The chief vicarious evacuation is that by urine. Mercurial salivation is chiefly used in Lues, q. v. but sometimes for other complaints, particularly ob- structions of the liver, and lepra. In the two latter it is seldom carried far; and in the first the discharge is now comparatively slight. It is of little importance by what preparation it is excited, if of sufficient activity to increase the salivary secretion without injuring the stomach or irritating the bowels. Each practitioner has his favourite form, and each may be indulged. In general, mercurial ointment rubbed in externally is the safest; and calomel or mercury, divided by muci- laginous or fatty fluids, are the most general internal preparations ; perhaps inferior to none. The practice of rubbing the calomel iftto the gums and fauces origi- nated with Mr. Clare, not « Mr. Cline," to whom, by a typographical error, it was attributed in the article » Lues " He applies it also under the prepuce and within the labia, by which he thinks the cure is ex- pedited. Mr. Cruikshank, in an Appendix to Mr. Clare's pub- lication, observes, that there is no doubt of the absorption of a fine powder taking place on the inside of the mouth, of the pracputium, of the labia, Sec; fur the particles of the blood, seen in the simple microscope, are at leatt ten times larger than those of the levigated calomel, yet the absorbents are often turgid with red blood. The particles of quicksilver, in the best prepared mercurial ointment, appear in the same microscope as distinc*. from each other as the red globules of the blood; yet they are very readily taken up by the absorbents of the skin. Mr. Hunter hath frequently directed calomel to be rubbed on the skin with the volatile liniment, and it has been followed by the effects of the unguentum hy- drargyri. The inside of the cheek is a better absorbing surface than perhaps any other accessible to friction in the body ; and probably calomel becomes milder in its operation this way, as the divided quicksilver becomes milder when absorbed by the skin. It is also a less tedious, less laborious process than that of rubbing the unguentum hydrargyri. These are undoubtedly ad- vantages; yet they may be considered as affording a favourable view of the comparative merits of the two preparations. The friction is by no means so easy as is represented ; and we have heard* that it has been follow- ed by troublesome sores in the mouth. But by what- ever preparation salivation is excited, the medicine should be slowly accumulated, unl'ess when employed iu the urgent cases of hydrocephalus, hydrophobia, croop, Etc. When used in lues, a warm bath may be used two or three times before the unguentum hydrargyri; and the patient, during its use, should be kept in a warm room, wear a flannel shirt, having previously lived on a low diet for a few days. Except in strong constitutions, from a pint to. a quart is a sufficient dis- charge of the saliva in twenty-four hours. The patient's strength should be supported with a tight, nourishing, and mucilaginous diet; and, if faint, a little wine whey, or mulled wine, may be allowed. The quantity of mercury necessary to excite saliva- tion differs greatly in different circumstances and con- stitutions. In debilitated, scorbutic, and perhaps scro-> fulous habits, we have found three grains of calomel given in the dose, or one grain on three succeeding nights induce the discharge. It has been brought on by sprinkling precipitate on a wound (Hildanus); by a mercurial injection in a fistula; by a mercurial girdle; and the mercurial ointment employed to kill lice. In these cases, the idiosyncracy of the patient seems to, influence the effect; and, therefore, this should be, if possible, ascertained before mercury is exhibited in any considerable quantity. The inflammation which this medicine induces is rather erysipelatous than phleg- monic, and it sometimes attacks the inside of the cheeks, producing small, irritable, creeping ulcers, with a very slight or no affection of the gums. The latter are, however, most commonly inflamed. It is usual at present to produce this discharge in a very moderate degree; hut some action on the gums is necessary, to show that the medicine has been intro- duced into the system. This is particularly the case in lues and chronic inflammations of the liver. In other complaints it is less essential if the symptoms disap-. pear. The effectual relief of these is the only certain criterion by which we are taught to leave off the medi- cine, and it will be prudent to continue it for some time SAL '307 SAL alter these have disappeared. On omitting the mer- cery the salivation gradually subsides. The discharge of saliva is, however, sometimes too violent, or it continues long after the symptoms have disappeared, from the increased irritability induced by excess of excitement. This increased discharge is ob- viated by purgative medicines, by opium, and by sul- phur. If any mercury remains in the system, these will sometimes relieve; but if so long a period has elapsed that we may suppose the whole discharged, the cure must rest on the general indication of increased irritability from debility. The medicines just men- tioned are not all of equal efficacy. Mr. Hunter thinks purgatives useless; and we certainly have not found them highly beneficial, though sometimes they lessen the discharge. Opium we have thought highly useful, particularly in the form of Dover's powder. Sulphur is known to lessen the activity of mercury out of the body; and as it enters the circulation with little change, it may have the same effect in the circulating system. But this, like other finely spun theories, deceives us in practice. Sulphur is by no means highly useful in these circumstances. Diuretics, which seem to excite what appears to be a vicarious discharge, have not been tried, or, if employed, not effectual. We believe every prac- titioner, by the means mentioned, has been able to mi- tigate salivation ; but by no remedies, in every instance, to conquer it wholly. See Hunter, Swediaur, Bell, and Howard on the Ve- nereal Disease; Stahl de Salivatione Mercuriali et Al- berti de Hydrargyrosi. SA'LIX, (from the Hebrew term sola). Itea, the common white or the Dutch willow tree; salixfra- gilis Lin. Sp. PI. 1443, is distinguished by its oblong, pointed serrated leaves, hoary on both sides, though most so on the lower, and in the branches being tough. See Raii Hist. Plant. Philos. Trans. 1763. The bark of the branches of this tree is considerably bitter and astringent; and has been recommended not only in intermittents, but in all those cases which re- quire tonics and astringents. Dr. Cullen thinks it a promising substitute for the bark ; and we have found it equally useful in dyspepsia, profluvia, and every case of chronic weakness. His experiments were made with the bark of the s:\lix pentandria, which, in Bergi- us' hands, failed to relieve intermittent fevers. SALLADS, (a sale). The term is derived from the salt, an ingredient which enters in the smallest propor- tion. This species of vegetable nutriment consists of vegetables, undressed, either etiolated ones, thus de- prived of their acrimony, as endives and celery, or of the tetradynamiae, whose seed leaves are only employed, or the others in their earliest periods. We eat in their natural state chiefly the lettuce, the lamb's lettuce, and the water cresses. With all we usually mix vinegar, and oil united with the vinegar by means of the yolk of an egg. The reason for employing oil we have not heard; but have suspected it to have arisen from the apprehension of the accidental mixture of poisonous plants, and the egg is added to combine it with the vi- negar. In general, sallads are wholesome, but not ad- missible in cold, flatulent stomachs ; though, in these, the water cresses seldom produce any inconvenience. SALIT'NGO-PHARYNCE'US, (from rxxwtyl, a trumpet, and p*gt/yf, the pharynx,) rises near the Eu- stachian tube, and is inserted into the pharynx. Val- salva and Douglas think it one of the origins of the muscle of the pharynx. See Pharynx. Salpin'go-staphyli'nus, (from o-xXiriy%, and o-rx0vXt!, the uvula,) arises fleshy from the bony part of the tube of the ear, and is inserted into the basis of the uvula with that on the other side. They draw the uvula up- ward and backward. Salpi'ngo-staphylinus internus. See Petro sal- PINGO-STAPHYLINI. SALSAPARI LLA. See Sarsaparilla. SALSO'LA. See Kali. SALUTA'RIS DI'GITUS. See Digitus. SALVATE'LLA VE'NA, (from salus, health, from the supposed salutary effects of opening this vein in melancholy,) splenitis, runs on the back of the hand, from the little finger and that next to it. It has been said to proceed from betwixt the thumb and the fore finger, and to run up to the ulna. SA'LVIA, salvus, (from its salutary effects, which were formerly supposed to be so considerable as to justify the axiom, " Cur moriatur homo cui salvia crescit in horto"). Sage, elelisphacos, is a low shrubby plant, with square stalks, obtuse, wrinkled, dry leaves, and large bluish flowers, fixed on loose spikes on the tops of the branches. It is a native of the southern parts of Europe, but bears the cold of our climate, and flowers in May and June. Its seeds are called ebel. Sa'lvia bo'sci. Wild or wood sage, from boscus, a wood, where it grows. Sa'lvia .ethi'opis. See jEthiopis. Sa'lvia ho'rmincm. See Horminum. Sa'lvia ma'jor. Greater or common garden sage, salvia officinalis Lin. Sp. PI. 34. The leaves are nearly oval, but pointed ; of a green, red, or variegated colour; but all are found on the same plant. The leaves are moderately aromatic, and used in debilities and relaxa- tions both of the nervous and muscular system, as a stimulant, carminative, and tonic. Their smell is strong, but not disagreeable; their taste warm, bitter- ish, and subastringent; with a solution of vitriolated iron they strike an inky blackness. This species is more agreeable, but not so strong as the lesser sage; the flowers of both are weaker, but more agreeable than their leaves. The best preparations are the watery in- fusion, and a tincture or extract made with rectified spirit of wine, which contain the whole virtue of the plant. The watery infusion, acidulated with the juice of lemon or of orange, is an agreeable common drink in fevers. From 3 ss. to 3 i- of a conserve made with sage leaves is said to cure weak stomachs, if repeated twice a day. (See Salvia minor.) By distillation with water a small quantity of essential oil is obtained, which possesses only the aromatic part of the herb. See Tournefort and Lewis's Materia Medica. Sa'lvia mi'nor, salvia virtutis. Lesser sage, salvia minor aurita, and non aurita, of Caspar Bauhine; s. officinalis, /2. Linnaei. Its leaves are narrower than those of the greater sage, whitish, and never red; they are stronger, but less agreeable; though in other re- spects the same. Sage has been much employed as a sudorific, for preventing the recurrence of intermittent paroxysms, for restraining colliquative sweats, infused in spirits, or wine (Van Swietcn), and the milk of nurses who had Qq2 S X M 308 S A IN weaned their child: it is also supposed to resist putre- faction. Cullen's Materia Medica. See Salvia major. Sa'lvia sylve'stris, scorodonia, scordotis chama- drys fruticosa, germander sage, wood sage. Teu- crium scorodonia Lin. Sp. PI. 789, grows in woods and hedges. In smell, taste, and medical virtues, it re- sembles the scordium rather than the sage; but is less disagreeable than the former, though more so than the latter. Among the reputed species of sage is the phlomis, or yellow sage, phlomis fruticosa, /3.' Lin. Sp. PI. 818, which is astringent and vulnerary. SAMBU'CUS, (from the Hebrew sabuca, a musical inst7-u7nent made of this tree,) acte, infelix lignum, common elder. Sambucus nigra Lin. Sp. PI. 385. Common black berried elder, is a tree or shrub whose branches are full of fungi, covered with an ash coloured, under which lies a thinner green, bark, and below a while one. It flowers in May, and ripens its berries in September. The young leaves, when budding, are said to be ca- thartic ; but the parts employed medicinally are the inner bark, flowers, and berries. The first has little smell or taste : on first chewing it impresses a degree of sweetishness, followed by a very slight though dura- ble acrimony, in which its powers seem to reside, and which it imparts both to watery and spirituous menstrua. Sydenham directs three handfuls of the inner bark to be boiled in a quart of milk and water to a pint, half of which is to be drank every night and morning, and repeated for several days: it operates upward and downward; and upon the evacuations its utility depends. Boerhaave gave its expressed juice from 3 i- to half an ounce for a similar purpose. In smaller doses it is said to be an aperient and deobstruent in various chronical disorders. These effects are sometimes confined to the ebulus, or dwarf elder; but both have been used with- out any remarkable advantage. An infusion of the fresh flowers is gently laxative, and of the dried ones diaphoretic, and consequently useful in eruptive disor- ders. Externally they are employed in fomentations. Sec. The London college orders the following unguen- tum sa7nbuci. R. Florum sambuci p. jfj iv. sevi ovilli p. Jfo iii. olei olivae m. lb i. decoque flores in sevo et oleo donee friabiles sint, deinde exprime et cola. The juice of the berries, when inspissated to a rob, is styled a dissolvent and aperient: it is gently laxative, promotes urine or perspiration, and is recommended in dyspepsia, and debility of the urinary passages, in doses of from one to two or three drachms. See Lewis's Materia Medica; Anatomia Sambuci per M. Blockwitz; Sydenham's Works. Sambu'cus e'bulus ; herbacea ; and humilis. See Ebulus. Sambu'cus sanamu'nda. See Empetrum thymali foliis. SAMIEL. A poisonous wind in the desert ot Ara- bia, which kills without any apparent change on the body, except a total privation of irritability, and some- times a distention of the blood vessels, and extravasa- tion of their contents. It comes from the north west quarter, announced by a haze in that direction; but the rest of the atmosphere is clear. The Samiel seems to be a blast of hydrogeneous gas, the source of which we shall afterwards explain. See Simoon. SAMP. A preparation of Indian corn, in which the hard coat is first separated by maceration in an alkaline ley, and the grain is next softened by long continued simmering, in a temperature below the boiling point. It is then said to be a palatable food, with some com- mon condiments, and to supply very effectually the place of bread. It is chiefly used by the Aborigines of America, in the back settlements, both north and south. SAMPHIRE. The crythmum maritimum Lin. Sp. PI. 354, feniculum maritimum of Caspar Bauhine, is slightly aromatic, with a taste not unpleasant. It is sometimes used as a pot herb, but is more commonly pickled, and taken as a condiment. SA'MPSU CHUM, (from-4"**>> to preserve, and ^t^?, the 7nind; on account of its cordial qualities). See Ori- ganum. SA'MPSUCHUS. See Marum and Majorana MAJ. FOL. SA'NCTJE HELE'NiE RA'DIX. Cyperus Ameri- canus, cyperus longus Lin. Sp. PI. 67, is a long knotted root, black without, and white within : in taste it re- sembles the galangal root, and is brought from St. Helena, in the province of Florida, where it is used in pains of the stomach, and in nephritic complaints. SA'NCTUM SEMEN. See Santonicum. SANDARA'CHA. Sandarach, (from the Arabic saghad, narak,) a gummy resin, of a yellowish white colour, in small lumps, dry, brittle, of a pleasant smell, of a resinous and gently acrid taste; it is brought from Africa, and is the production of the juniperus cedrus Lin. Sp. PI. 1471. See Juniperus, and Arsenicum, of which it is also an appellation. SA'NDIVER. See Axungia vitri. SANGUIFICATIO, (sanguinem facere). The ani- mal process by which our fluids are converted into blood. We have seen that blood consists of a watery fluid, styled serum, gluten, fibrin, and the red portion, which in the microscope appear to be globular. The serum contains an ammoniacal salt, by which it seems to dissolve a portion of the gluten. The difference be- tween this fluid and the nutriment taken in, then, appa- rently consists in the formation of gluten, of the salt, the fibrin, and the red globules. The nature of am- monia we well know; and as its component parts are found in the system, it is not necessary to inquire anxiously into its source. The gluten, we have seen, differs probably from albumen in its proportion of azot, and the fibrin is a more animalized gluten. The source of the azot we have also attempted to investigate. (See Nutritio and Respiratio.) Of the red globules we know tittle, and their source has not yet been explained. Mr. Hewson supposed them to be manufactured in the spleen, and certainly the red globules are peculiarly co. pious in this viscus; but admitting all the facts, we ad- vance but little in our knowledge of the process of theis manufacture. The formation of the red globules is connected with the strength and vigour of the constitution ; for in the cachectic state they are few, and their colour unusually pale. They are sometimes dissolved in the serum, and escape by every excretory. In other cases the whole of the circulating mass seems to be remarkably di- minished ; and Lieutaud and others have left us ac- counts of dissections, in which the circulating system S A N 309 SAN was found nearly exhausted of its usual contents. Unfortunately we have not been acquainted with the previous symptoms, an omission too common in the collections of that author. SANGUIFLU'XUS, (from sanguis, blood,and fiuo, to flow). See Hjemorrhagia. SANGUINALIS and SANGUINARIA, (a san- guine compescendo). Polygonum aviculare Lin. Sp.Pl. 519. See Polygonum. SA'NGUINIS INO'PIA. A tabes from loss of blood. An instance of the atrophia inanitorum of Cullen. SA'NGUIS, (x7ro to« cxetv yvtx; because it pre- serves the body,) dehene; hama; blood, the fluid which is contained in the arteries and veins. See Blood. Sa'nguis draco'nis ; cinnabaris Gracorum, dra- conthama, asagen, dragon's blood, is a resin of a red colour, obtained from the cala7nus rotang Lin. Sp. PI. 463; dracena draco Wildenow, ii. 155, and ptero- carpus draco Wildenow, iii. 904. The dragon's blood covers the fruit of each tree : one sort is in oval drops, wrapped up in flag leaves; another in large masses, often impure, but sometimes little inferior to the former. Its colour is of a deep red, and when powder- ed, crimson. It readily melts and flames, almost'totally dissolving by the help of heat in rectified spirit of wine, to which it imparts a dead red colour; soluble also in expressed oils; but yielding little or nothing to water. Dragon's blood has no remarkable smell or taste, though when dissolved it seems slightly acrid. The Dutch often adulterate it with mixtures of gum arabic, Brazil wood, alum, Sec. which dissolve in water, crackling without burning in the fire. It is recom- mended as a gentle incrassant, desiccative, and restrin- gent, but owes its credit to its union with other astringents in the pulvis stypticus. It is totally inert, and now disused. Lewis's Materia Medica. See Gummi rubrum astringens gambiense. Sa'nguis draco'nis he'rba. See Lapathum ru- brum. Sa'nguis Hercui.is. See Crocus. SANGUI-SO'RBA, (from sanguis, and sorbeo; be- cause it stops haemorrhages). See Pimpinella. Sangui su'ga, (from sanguis, and sugo, to suck). See Hirudo. SANI'CULA. Sanicle, (from sanando, healing,) cucullata, dodecatheon; symphytwn petraum. Sani'cula alpi'na lute'a. See Auricula •jrsi. Sani'cula mas, diapensia, cortusa, sanicle, self- heal, sanicula Europaa Lin. Sp. PI. 339, is an umbel- liferous plant, with shining, dark green, roundish, ser- rated leaves: the seeds are rough, and stick to the clothes. The plant is perennial and evergreen, grows wild in woods, on hilly grounds, and flowers in May. It is mildly astringent, is slightly rough, and bitter to the taste, with an acrimony which chiefly affects the throat. Both the watery and spirituous extracts re- tain its virtues. Sani'cula eborace'nsis, pinguicula, sanicula montana flore calcari donata viola palustris, butter wort, Yorkshire sanicle, pinguicula vulgaris Lin. Sp. PI. 25, is a small plant, with a few glossy unctuous leaves which lie on the ground ; perennial, grows in elevated marshy grounds, and flowers in spring. Its unctuous glutinous juice is used as a liniment for chaps, and as a pomatum for the hair: it is said also to be purgative, but none of the species are used in gene- ral practice. Sani'cula fcf.mina. See Imperatoria nigra. SANIDO'DES, SANIO'DES, (o-xvifo^, the genitive case of o-xvts, aflat table). Flat chested. SA'NIES, (quad ex sanguine corrupto 7iascitur). See Ichor. S.ANKI'RA. See China orientalis. SA'NTALUM, (from the Arabic, Zandal). Saun- ders. Sa'ntalum a'lbum, white saunders, is similar to the yellow, but so weak that it is now neglected. The santalum citrinum, santalum album Lin., is the me- dullary part of the same tree, of which the santalum albu7n is the alburnum, or outward sappy part. See Alburnum. Sa'ntalum citri'num, vel pallidum, yellow saun- ders, santalum album Lin. Sp. PI. 497, is a pale yel- lowish or brownish coloured wood, with a close even grain, an agreeable smell, and a bitterish aromatic taste, accompanied with a slight pungency. Distilled with water, it affords an oil which thickens into the consistence of a balsam, and smells like ambergris, leaving the remaining decoction bitterish. Rectified spirit extracts more than water; and an extract from this tincture is six times stronger than the wood itself. Hoffman says its virtues are similar to those of amber- gris ; but he has apparently been too extravagant in his praises. Sa'ntalum ru'brum. Red saunders, pterocarpus santolinus, Wildenow iii. 906, is of a dull red colour, with little or no smell, or taste; chiefly used as a colour- ing drug, tinging water with a yellowish hue, and rec- tified spirit with a deep red ; but not dissolving in ex- pressed oil. It is said to be an astringent, probably from its being the product of a species of the genus which affords the Sanguis draconis, q. v. See Lewis's Materia Medica. SA'NTALUS ADULTERI'NUS. See Brasilium lignum. SANTE'RNA,senin-nitra Chald. See Borax. SANTOLI'NA, (because it smells like saunders). See Santonicum. Santoli'na, cham^cypari'ssus. See Abrota- NUM. SANTO'NICUM, (from Santonia, its native place,) sanctum cina et zedoaria, semen contra vermes, lum- bricorum semen, sementina, santolina, worm seed, from the artemisia santonica Lin. Sp. Ph 1183, is a small, light, oval seed, of a yellowish green colour, with a cast of brown ; easily friable ; brought from the Levant, usually mixed with bits of sticks and leaves. These seeds yield their virtue to water and to spirit; but the spirituous infusion is the most agreeable. In evaporating the watery infusion, only a simple bitter remains. They are seldom genuine, but mixed with the seeds of southernwood; and when good are full, of a greenish colour, strong smell, a bitter and aromatic or rather a subacrid taste. They are esteemed to be stomachic, e7nmenagogue, and anthelmintic; but arc chiefly used to destroy and expel worms, from which their appellation is derived. For adults, the dose is from one to two drachms of the powder, twice a day S A P 310 SAP As a bitter, the watery extract is esteemed the best preparation ; but as an anthelmintic, the spirituous ex- tract is preferable. For children, a syrup is made of the infusion, and administered in this form. See Lewis's Materia Medica ; Neumann's Chemical Works. SA'PA, (from its pleasant taste,) apochilisma, suc- cago, robub,rob, and Oenus Siraos; the juice of any vegetable boiled up with sugar to the consistence of honey. See Extractio. SAPHiE'NA VE'NA MA'JOR, (from «-*0«, visi- ble). About an inch below the passage of the cruralis from out of the abdomen, it sends off a large branch, called saphena, in its whole course to the foot only co- vered with the integument. It follows the direction of the sartorius muscle, until it arrives at the inner con- dyle of the thigh bone; then runs on the inside of the tibia, sending off branches as it passes along; and at the lower part of the tibia a branch which runs over the joint of the tarsus to the outer ankle. The extre- mity of the saphena passes on the fore side of the inner ankle, and runs betwixt the first two metatarsal bones, towards the great toe. See Cruralis vena. Saphje'na mi'nor ve'na, is a branch from the saphena major, which separates from it soon after pass- ing from the inguen; and runs down below the ham, communicating with the saphena major. Another branch, which proceeds from the cruralis a little above the ham, and runs to the outer ankle, is called saphena externa. SA'PHERA.. See Cobaltum. SAPIE'NTIjE DENTES, (because they do not ap- pear till the age of wisdom,) cranteres, genuini denies; the last of the molares, which sometimes do not appear till the twenty-sixth year; in a few instances not at all. See Dens. Sapie'nti^e oleum". See Later. SA'PO, (from the Hebrew sapon,) soap, asabon, is a composition of oils and fats, with alkaline salts, incor- porated into a milky semi-transparent liquid. From the principles of this combination the union of every oil with alkaline salts is styled a soap, and the term has been extended to the combination of resins, not only with oil, but with salts of every kind. In the Boerhaavian school saponaceous fluids have been disco- vered in a variety of plants, and these have been styled resolvents, detergents, and deobstruments. In fact, Boer- haave, overlooking the strictness of chemical combina- tion, has transferred the term to milky fluids, to com- binations of oil with water by means of mucilage; while modern chemists have, by a similar laxity of lan- guage, styled the extractive matter saponaceous. We shall adopt the term in all its chemical strictness, and consider soap as the union of oil with salts, whether alkaline or acid. We thus exclude spermaceti, milk, chyle, the blood, and even bile. Soap, in its strickest sense, is a white, solid, insipid substance, soluble in water, precipitated by acids, and by neutrals, whether saline, earthy, or metallic; and from this definition the acid soaps are only excluded, which perhaps scarcely merit the appellation. The purest and most perfect soap is made from olive oil and soda; but there are numerous shades of the less perfect material. Potash we know to have a strong affinity to water, and the soap formed by its means is less solid and granular, until the water is carried off by common salt, and in some manufactories by alum. The alkali in each case must be pure, in the language of the old school, caustic. Various oily substances have been em- ployed, as olive oil, animal fats, rancid butter, rape, poppy, and coleseed ; beech mast, hemp, and lintseed ; horse and whale oil. The seven lasi oily matters sel- dom afford soap of a firm consistence. In general equal parts of the alkali and oil are necessary ; but in the large way about eighty parts of the salt are suffi- cient for one hundred of oil. The addition of common salt has been said to harden the soap by abstracting the water; but it has less affinity to water than the alkali has, though probably greater than the united alkali and oil. The idea of Pelletier is, however, more probable, that a double decomposition takes place, and that the soda of the common salt displaces the potash, while the muriat of potash escapes in the ley. At all events, supposing the common salt to remain, its proportion is not more than two elevenths of the whole, in the best conducted manufactories. The remaining ley is car- bonated, and on that account probably effete and use- less; though Pelletier endeavours to prove, that some carbonic acid is necessary to the production of soap. In this he seems to have refined too far: the truth lies nearer the surface. The other chemical qualities of soap are its absorbing a large quantity of water, and swelling when wetted. Its solution is of a yellowish grey colour, forming frothy iridescent bubbles. It is more soluble in hot than in cold water, and in dry places remains for years unaltered. In moist situations the alkali separates, and, if soda has been employed, effloresces on the surface. When distilled, the oil first rises in tolerable purity; but at the end is fetid. Soap is less perfectly soluble in alcohol. When an acid, which first separates the oil from alkaline soaps, is added in excess, an acid soap is formed ; but the latter union is so slight as to be de- stroyed by a boiling heat. When a solution is curdled by earths, particularly by lime, barytic, or strontian water, the oil unites with the respective earth. The precipitate formed by lime, or rather the union be- tween the lime and oil, for the earth seems to have a stronger affinity for oil than the alkali, is decomposed only by a carbonated alkali, in consequence of the power- ful attraction of the lime for the carbonic acid, which weakens its affinity for the oil. A carbonated am- monia has the same effect, and produces an am7noniacal soap, which is more pungent than common soap, and more soluble in alcohol than in water. This soap is made also by adding muriated ammonia to common soap; but in every mode of compounding it the union of the salt and oil is weak, and the soap never hardens. M. Berthollet, inthe Memoirs of the Royal Academy for 1780, has examined the properties of the different compounds, formed by precipitating the oil in soap by earths or metals. They are of various colours, more or less cohesive, and generally soft, except when acetite of lead is employed; and we know from the former observations (see Emplastra) that oxyds of lead have a powerful attraction for oil. The result of the experiment with this metallic salt is, of course, the dia- chylon. Some of the oleo-metallic compounds are dis- solved by alcohol without heat: others require its assist- ance. Expressed oils do not dissolve the oleo-calcareous S A P 311 SAP or aluminous compounds. We must not pursue a sub- ject wholly chemical; but may express a wish that the medical effects of the oleo-metallic compounds might be cautiously tried. In a medicinal view, though we detract from the warm commendations of the Bocrhaavians, wc shall find soap highly useful. Asa compound it appears to be a demulcent and a laxative. Dr. Cullen attributed the latter quality to the common salt which it con- tains; but this is in a very inconsiderable portion, as we have already remarked, and it is highly probable .that it escapes with the water; for a very small propor- tion of salt will prevent soap from dissolving. In the barilla soaps also no muriated soda is employed. The laxative power of soap most probably arises from the union of its ingredients, since it is efficacious in clys- ters, where there is little probability of its being decom- posed, and no time for the decomposition to take place. As a demulcent it is employed in catarrhs and peripneu- monies, in diseases from acrid poisons, as well as in diarrhoeas and dysenteries. We have already remarked that we can scarcely suppose it to reach the bronchial glands without decomposition; yet that observation supplies some evidence of its demulcent powers even in the secretions of the bronchiae, though similar effects may arise from the oil. When acrid poisons have been swallowed, soap is highly useful, to sheath the very sen- sible coat of the stomach, and often by its alkali either to decompound or neutralize the deleterious substance. (See Venenum.) In old diarrhoeas, where the vil- lous coat of the intestines is preternaturally sensible, in consequence of being deprived of its mucus, the laxative power of the soap must be corrected, either by opium, by uniting it with wax, or by both: in dysen- teries it has also been a custom to combine it with opium or astringents. Soap is supposed to have an an- thelmintic power from the oil which it contains, as every oily matter is supposed to destroy worms, by closing their spiracula. This power is, however, equi- vocal ; and if it has any effect of this kind it is on ascarides, when injected in the form of a clyster. According to Bergius, and some very respectable fol- lowers of Boerhaave, soap is an aperient, a resolvent, and a detergent, useful in obstructions of every kind, particularly in those of the chylopoietic viscera. In different parts of this work we have found it difficult fo affix any precise ideas to these words, except that ob- structions are relieved by gentle laxatives. Soap is one of these; but there is no reason to think it more use- ful than small doSes of rhubarb, of neutral salts, or the saline mineral waters. While speaking of it as a compound, we have been unavoidably led to notice the effects of its oleaginous ingredient. It is, therefore, only necessary now to ob- serve, that its alkali is often highly useful as a dissolv- ent of calculi in the bladder; and the quantity intro- duced into the system, defended by the oil, is more con- siderable than can be taken in any other form. When the pure alkali is given in veal broth, a similar compound is formed, though not strictly saponaceous. It has been supposed that the alkali is equally effectual in dis- solving biliary calculi; but experience has not con- firmed the eager expectations of those who anxiously sought in this remedy a very general solvent. Among other fancies of this kind it has been given in cases where an imaginary pituita prevailed in the blood, to children where the croop was supposed to be heredi- tary, and where mucous discharges were frequent. The most rational of these views seems to have been to dissolve the heavy viscid mucus of the stomach, which is sometinies highly troublesome, resisting every at- tempt to remove it, except by vomiting. In this case also, for it is a fancy we have indulged, it has appeared useless. Soap is used as an intermede for mixing different oily fluids; but is in this respect inferior to the pure alkali, or even mucilage. It is, however, a convenient substance for forming pills; and as it promotes the so- lubility of wax, is an essential ingredient in the exhibi- tion of the latter. In employing it, however, for pills, its levity must be attended to, or they will be otherwise too large; but, in general, soap will combine with an equal quantity of any resinous powder, as rhubarb, or jalap; and will advantageously unite with an equal quantity of wax. Acid soaps arc unknown in medicine. Sulphuric- acid, in nearly an equal proportion, added to oil, by slow degrees, resembles in appearance tar; but, when well washed, it is like brown wax, specifically heavier than water, solid, and brittle, soluble in alcohol, unit- ing with water, and forming a whitish fluid (Jour- nal de Physique, xvi. 411). A pure alkali, magnesia, chalk, oxide of lead, filings of iron, and zinc, as well as many saline, earthy, and metallic neutrals, form a co- agulum, which resembles in appearance and properties wax. Nitrous vapour and oxymuriatic acid produce a similar change. Oxymuriat of potash, with a little oil, forms a soap, which explodes by a slight stroke. Ammoniacal soaps we have already mentioned. These are employed medicinally as external stimulants. .The volatile liniment, as it was formerly styled, is an in- stance of this combination. Essential oil soaps have been styled Starkey's, from their first inventor, or rather from the person who first introduced them. Starkey's process consisted merely in mixing dry carbonate of potash with oil of turpentine, by agitation every day for six months. Baume has re- fined the process, and directed the oil to be rubbed in the proportion of thrice its weight with the potash. When mixed to the consistence of a soft extract, it is suffered to deliquesce, at rest, in damp air. The alkali united with water falls to the bottom, the uncombined oil rises to the top, and the soap occupies the middle of the cucurbit. It is separated by filtering. It has been employed in medicine; but apparently merits little at- tention. The saponaceous liniments chiefly consist of essential oils combined with soap. The eau de luce is of this kind. Black soaps are generally soft, composed of an impure alkali and train or whale oil. They are useful in forming stimulant cataplasms, with more active rubefacients, and sometimes peculiarly active in clysters, though in this form they produce often sickness and general dis- orders of the system. Sa'po a'lbus; sapo Hispanious, hard, or Spa- nish soap, is made in Spain, with olive oil and the Spanish barilla, by a process similar to that directed for the soap of almonds. SAPONA'RIA,(from sa/w,soap). Strulhium,Glo- ria, lychnis sylvestris, ibixuma, bruise wort, soap wort, saponaria officinalis, Lin. Sp. PI- 584, is a smooth herb, with leaves resembling the plantain, and S AR 312 S A R clusters of red, purple, and whitish flowers: the root is long, slender, spreading to a great distance, of a brownish colour on the outside, and white within, with a yellowish fibre in the middle. It grows in moist grounds, and flowers in July. The plant is called saponaria, because its juice, like soap, cleans clothes. The roots and leaves are gluti- nous and sweet to the taste, but in the roots there is also a slight pungency, and in the leaves abitterishness. The soapy matter dissolves either in waterorin spiritof wine. The Germans prefer the root to the sarsaparilla. Andry gave its inspissated juice with success in gonor- rhoea, in the dose of half an ounce daily; and in gene- ral the cure was effected in about a fortnight, without the assistance of any other remedy. Segy orders from two to four pints of the decoction to be daily taken in lues; and, in bad cases, the patient takes at the same time the plant in powder, or in the form of an extract. This is said to be advantageous in venereal, scrofulous, and impetiginous affections; in visceral obstructions and jaundice. This plant is also applied externally to venereal ulcers, either in fomentation, or in a dry form, by sprinkling it in powder over the sores. Two ounces of the root yielded eleven drachms of watery ex- tract ; but this quantity seems to be variable. It is sweetish, followed by some pungency. The spirituous extract is less in quantity, but more pungent. Decoc- tions, the extract, and even the leaves, resemble in ap- pearance and quality solutions of soap: they have even been used for the same purposes. See Lewis's Materia Medica; Neumann's Chemical Works. SAPONA'RIiE NU'CULiE, bacca Bermudenses, vel Bermuda. Soap or Bermudas berries; a spherical fruit about the size of a cherry, from the sa- pindus saponaria Urn. Sp. PI. 526. The cortical part is yellow, glossy, and so transparent as to show the spheres which rattle within, and includes a white ker- nel. It is the produce of a small tree in Jamaica, and other parts of the West Indies: the kernel, when steeped in water, raises a froth like soap suds. These berries are supposed to be powerful in remov- ing obstructions in the liver and spleen; in relieving cachexy, dyspepsia, and chlorosis. The best prepara- tions are, a tincture made with white wine, or spirit, and the extract from the spirituous tincture. See Lewis's Materia Medica; Medical Museum, vol. iii. p. 538. SAPONIS CERATUM. See Plumbum. SAPOTA. The fruit of the achras sapota Lin. Sp. PI. 470, which is highly luscious, resembling marma- lade. It is a native of South America; and its seeds have been used as demulcents. SA'PPAN LI'GNUM. See Campechense lig- num. SAPPHIRI'NA A'QUA, (from its colour). See Cupri AMMONIATI aqua. SA'PROS, (from mxa, to putrefy). See Morti- FICATIO. SA'RA. See Essera. SARA'SSAS. See Coraldodendron. SARCOCE'LE, (from f, flesh, and xoXXxu, to glue dus; but to neither does the disease usually yield, together, from its supposed power of conglutinating The external application of mercury is more successful, wounds,) is a gummy resinous juice, from the pen aa and the mercurial friction has occasionally removed it. 7nucronata or sarcocolla Lin. Sp. PI. 162, brought from Cavillini apparently succeeded with the cold stillicidium, Persia and Arabia, in small spongy grains of a whitish alternated with a cataplasm of bean flour, and Schulte- yellow, sometimes of a deep red colour, about the size tus with a plaster of gum ammoniac. The actual cau-. of a pea : the whitest and most bitter are preferred. tery, and the subsequent discharge from the separation Its bitterish subacrid taste is followed by a slight sweet- of the eschar, is sometimes recommended; but, in gene- ness ; it softens in the mouth; bubbles and catches ral, extirpation is the only successful method. flame from a candle; dissolves freely in water, and in a It is usually remarked that if the spermatic cord is large proportion in spirit of wine; but its medical qua- soft, and of its natural size, castration maybe safely lities are inconsiderable. See Lewis's Materia Medica; performed; but if much enlarged, that the operation is Neumann's Chemistry. not advisable. This is not strictly true; for the sper- SARCO-CIRSOCE'LE. A combination of sarcoma niatic cord may be enlarged by varices, or by effusion, with Cirsocele, q. v. neither of which contra-indicate the operation; but Sarco-epiploce'le, (from vxp\, flesh, eTrrx-Xoov, omen- when the feel is irregular and knotted, when lancinal- turn, and xjjAi?, tumour). A compound rupture, con- ing pains shoot upward or downward, and the unequal sisting of a descent of the epiploon during the existence hardness is too high to admit the ligature above it, the of a sarcocele. Sometimes a rupture of the indurated operation will be useless or dangerous. epiploon, either umbilical or scrotal. The use of the knife is sometimes deferred till darting Sarco-hydroce'le. A combination of sarcoma with pains come on in the loins or testicles. This may not be Hydrocele, q. v. wholly improper; but when these appear, the opera- SARCOLO'GIA, (from xXos, the applied internally and externally, may perhaps be tried, navel). A fleshy excrescence at the navel. with prospect of advantage; and an emetic has been SARCO'PHAGUM, (from vxp%, and >«<. SET 350 SIB because it is salutary to young fawns,) siler montanum, ligu^trum; laserpitiU7n siler Wildenow,v. 1, 1418; com- mon hart wort, is a small umbelliferous plant, with lar:;e leaves set in pairs, and a large, thick, branched root. It is perennial, grows wild in the south of Europe, is raised in our gardens, and flowers in June. All the parts of this plant are aromatic, of an agree- able smell, and warm sweetish taste; the roots are the most warm and pungent, the seeds most pleasant and sweet. A spirituous extract of the seeds is an elegant aromatic sweet. See Lewis's Materia Medica. Se'seli pyreno?.um. See Meum latifolium adul- tum. Se'seli massilie'nse ; fe7iiculum tortuosum; Ita- lian and French hart wort, or hart wort of Mar- seilles ; the seseli tortuosum Lin. Sp. PI. 373, is pe- rennial, and a native of the south of Europe, from whence the seeds are brought. They are aromatic and warm, more pungent than those of the common hart wort, but without their sweetness. See Lewis's Materia Medica. Se'seli ./Ethio'picum. See Laserpitium vul- gatius. Se'seli creticum ; tordylium officinale Lin. Sp. PI. S45. The seeds are diuretic. SE'SELON. See Cochlea. SESQUI; one and a half. SETA'CEUM. A seton; (from seta equina, be- cause horses' hairs were first used ; but now thread or cord is preferred as less painful,) perforatio. Camanu- sali, a physician of Bagdat, who lived previous to 1258, mentions a seton in the cure of a disorder in the eye Rhazes also speaks particularly of this remedy. Originally it was made with a heated needle, but Hol- lerius substituted a cold one. This operation is performed by raising the skin with the finger and thumb, while an assistant does the same at about an inch or two distant; and having armed a large, broad, crooked cutting needle, made for the pur- pose, with the necessary number of threads, pass the needle through the stretched skin, and bring the threads a little way through. They are left in the wound, and as much of the thread as will pass into the seton at each time of dressing must be rubbed with the unguentum resinaeflavae, moved forward every morning and evening, and thus the discharge will be promoted, and continued at pleasure. According to Mr. Bell, when tumours in some situa- tions are large, the seton empties them, whatever their size may be, very gradually ; and effectually prevents the admission of air. The operation is not so painful, the inflammation so great, nor the cicatrix so unsightly as after a large incision. When the patients are other- wise in good health, it commonly succeeds with this advantage, that a cure is frequently obtained in little more than half the time usually found necessary after incision. Setons are commended in Hydrocele, q. v., in complaints of the head and eyes; and all disorders where issues are recommended. They may be used where issues would be inconvenient, and the discharge, as it is deeper and more extensive, is often more bene- ficial. In many cases, however, issues or perpetual blisters are equally advantageous. Blisters are more agreeable, and equally useful methods. See Heister's and Beil'o Surgery, vol. i v. p. 382; Bell on Ulcers, edit. 3. p. 83, 8cc; White's Surgery, p. 184. SE TA'CEUS,(from seta, a bristle,) leaves of plants, covered with a bristly pubescence. SETA'NIUM, (from c-r^xvtos, a year's growth, from the tenderness of the fruit). See Amamelis. SEU'REN. See Bovina affectio. SE'VUM OVI'LLI. See Pr^paratio adipis. Se'vum minerale. A bitumen found on the sea coasts of Finland in 1736, burning with a blue flame, smelling of grease, and leaving a black, almost incom- bustible, matter. It is lighter than tallow, and only 0.770, while tallow is nearly 1. It is partly soluble in alcohol, and wholly in boilingexpressed oils. It is found also in Persia, at Strasburg, and some parts, it is said, of Lancashire. SEXTA'NA, (from sextus, sixth). Erratic, inter- mittent fevers, which return every sixth day. SEXTA'RIUS, (from the same). Chist. This term has been used both in liquid and solid measure, with numerous variations. Galen observes, that it was not formerly an Athenian measure, but received by the Greeks, though different from what it was among the Romans. Among the latter the sextarius included the pound, half pound, and a sixth, making together twenty ounces; the Athenians meant by it a pound and a half, i. e. eighteen ounces. It was sometimes only equal to three ounces. Rhodius distinguishes it into ponderal and mensural, adding that it contained two heminae, or thirteen ounces. The same author asserts that the sextarius of dry ingredients was apou'td; of liquid half a pound; the sextaria of two heminae; the Arabian ponderal was half a drachm, the Italian eighteen ounces of oil, twenty of wine and water, seventeen of honey. The sextarium of wine was also sixteen ounces, and as many scruples; of honey five- and-twenty ounces, according to some others. Castelli. See Cyathus. SE'XTANS. See Cyathus. SEXUAL SYSTEM. The artificial system of Lin- naeus, founded on the sexes of plants. See Botany. SEYDSCHUTZ WATER. See Sedlitz. SHALE. A bituminous ore containing alum, or at least alum is formed during its calcination. It is chiefly found in coal countries, particularly in Derbyshire. SHERBET. An acid perfumed drink, from Turkey and Persia. It is the origin by metaphrasis of shrub, and is often the name of the lemonade previous to its being formed into punch by the addition of spirit. SHINGLES. See^ZosTER. SIALOGO'GA,(from e-txXov, saliva, and xya, duco). Sialogogues comprehend all such medicines as pro- duce a flow of saliva into the mouth. They have been divided by some authors into three classes; those which immediately act upon the salivary glands ; such as oc- casion a flow of saliva into the mouth, by intercepting any discharge from other parts ; and substances sup- posed to break down the mass of blood, and supply the mouth with too great a proportion of the dissolved fluid. At present they are divided into internal and topical- See Materia medica. SI'BBENS. A name of the venereal disease in some parts of Great Britain. In the year 1773, Mr. Hill, a SI G 351 S1L toirgeon in Dumfries, published his cases in surgery; to which he added an account of this disorder, in con- futation of Dr. Freer's thesis, where it was asserted that the sibbcns was different from lues. It is generally agreed nearly to resemble the disease; but mercury is not equally effectual in it. The disease is now little known. See Yaws; Gilchrist's Observations, Physical and Literary, Edinburgh, vol. iii ; Freer de Syphilitide Venerea, Appendix, .1707; Hill's Essays; Adams on Morbid Poisons. SI'BCADI. See Bulbus vomitorius. SICILIA'NA. See Androsalmum. SI'CULA, (from sica, a short sword, from the short- ness of its root.) See Beta. SICYE'DON, (from ctxvos, a cucumber). A trans- verse fracture; broken like a cucumber. SI'CYOS. Single seeded cucumber ; sicyos angu- lata Lin. Sp. PI. 1439; cucumis Canadensis a native of North America and the West Indies. SIDERA'TIO, (from sidus, a planet, because it was supposed to be induced by the influence of the planets). Apoplexy, q. v.; a sphacelus, or a species of erysipelas, vulgarly called a blast. Sidera'tio o'ssis. See Spina ventosa. SIDERI TIS, (from o-tfo^pos, from its iron colour). See Cham. Chemical Essays. See Table of Solubility of Salts, under Sal. Solu'tio per i'gnem. See Fusio. SOLUTIO'NES, (from the same). Fresh wounds whilst yet bleeding. Sagar. SOLUTI'VA, (from the same). Laxatives. SOMNAMBULl'SMUS, (from somnus, sleep, and ambulo, to walk,) hypnobates, hypnobatasis, noctambu- latio, and somnambulatio, a species of oneirodynia. See Somnus. SO'MNIUM, (from somnus, sleep). A dream. See Insomnium. SOMNUS. Sleep, " tired nature's sweet restorer," is essential to the existence of mankind; for those de- prived of its necessary proportion most probably experi- ence some abridgement of the period of their existence. In this regularly returning " semblance of death" the external senses and the voluntary motions are lulled into insensibility and a temporary quiescence, while the involuntary motions are carried on with steadiness, though with some relaxation of their activity. In other words, the functions of the brain are suspended, while those of the ganglionic system (see Nervus), sharing a portion of the insensibility of the brain, from its slight connexion, enjoys with little change its own inherent power. We thus find that, in proportion to the bulk of the brain, or perhaps its activity, sleep is more neces- sary. Birds, which have a small brain, sleep very little in their natural state. We find the recurrence of sleep necessary to recruit the faculties both of body and mind, to which authors have added, that during this suspension of sense, nutri- tion is probably carried on more perfectly and actively. This opinion rests chiefly, however, on the larger pro- portion of sleep which infants require, and those, who adopt it, forget that often in advanced age sleep becomes equally necessary, depending, in fact, merely on the state of debility. How sleep is induced, by what power the activity of the mind and body is restored during this state, and the causes which terminate the insensibility, are little understood. It has been sup- posed that the mental actions excite the arterial system, and that, in consequence, a greater proportion of blood is carried to the head, or to the exhalents, occasioning a greater discharge of their contents. This pressure is supposed to produce sleep, during which the veins or the absorbents carry off the superfluous quantity. In the same way sleeping after a full meal is explained, since the distended stomach presses on the descending aorta, which, of course, assists the circulation through the ascending branch. Each hypothesis is truly ideal; for, were it true, the previous appearances would be those of activity, since such are the effects of deter- mination to the head, before the fulness produces com- pression. The stomach also, after a full meal, presses forward, and its greatest curvature, which in the empty state is below, when full projects against the parietes of the abdomen. This objection was apparently felt; for more lately the narcotic effect of the air, evolved in digestion, has been brought in aid of the system of compression, an effect which, at least in the stomach, is never experienced. Sleep naturally comes on once in twenty-four hours, SOM 359 SOM usually at the accustomed period, generally in the na- tural state soon after the commencement of darkness. When the usual stimuli are withdrawn, if the tempera- ture is moderate, and the posture easy, the usual train of ideas is interrupted ; they are less regularly connected or associated, and a slight delirium ensues, previous to the sound sleep, which consists in a total cessation of the exercise of all sensation and thought; of all motion connected with volition, though volition seems some- times imperfectly exercised, in changing, for instance, an uneasy posture. When this state has continued its due time, which differs in different constitutions, ideas occur with irregular associations, and occasional inter- ruption, as when steep came on. These become more regular and connected, till the labours of the ensuing day, or the anxieties of the past, occur to the recollection, and banish farther repose. The regular trains of sensa- tion and motion gradually take place, at first less ac- tively, but soon with the usual, or rather with renewed vigour. Such is the history of the regular sound sleep of a person in perfect health ; but the variations are infinite. The period, the duration of sleep, its degree of sound- ness, its occasional interruptions, and the fanciful images suggested to the mind, occasion a considerable variety, which it would be useless, and indeed impracticable, to detail. The remote causes are whatever exhausts the vital energy, as constant action; intense thought, light, or noise; violent pain, or considerable mental distress. When the activity of the brain has been completely ex- hausted by the long continuance of any of these causes, neither silence, darkness, an easy posture, or a mode- rate temperature, are necessary to court sleep. It comes on in the most unfavourable circumstances, and con- tinues till the brain has recovered some degree of ac- tivity. Every stimulus in excess, by exhausting the excitability, will induce sleep; but opium, wine, and spirits appear, as we have said, to be truly sedative powers, and to produce irregular instead of excessive excitement. In the perfectly waking state the elastic fluid, on whose state all sensation and action seem to depend, is apparently active, and its communication through every part of the brain free. Delirium we have shown to be connected with an interrupted communication, or an unequal excitement; and palsy, in many instances, on what Dr. Cullen styles a collapse, or that state in which it is incapable of conveying impressions or voli- tion. The collapse is, according to this respectable professor, less complete in sleep. We certainly per- ceive its commencement by the delirium, which shows an interrupted communication through the brain, and the collapse increases in the extreme case of sound sleep, till it is almost complete. When, however, no nar- cotic poison has been administered, the accumulated excitability begins to exert its powers, and rouse the mind to resume its functions. The powers of thought are at first more perfect, the communication becomes more free, till at-last volition again renews its office. There may b© some difficulty in conceiving how the accumulated excitability can take place from mere qui- escence, and this difficulty would, it was supposed, be removed by supposing the brain a gland, which supplies the nervous fluid; but this opinion we found untenable, and the difficulty must remain, though various colla- teral facts support the doctrine just mentioned. One of the most striking of these is the hybernation of ani- mals, who remain torpid during winter. This is a state of a more perfect collapse than sleep itself, and requires some exciting power. (See Torpor.) In cases of sleep no power is necessary but the circulation of* the blood acting on an organ, which by rest has recovered its torpor, or has accumulated excitability. We have said that sleep is more or less perfect, and that volition is, though obscurely, exercised. In the less perfect sleep the brain remains in the state described, when sound steep is coming on, and various fancies, from the interrupted communication between the dif- ferent parts of the brain, are presented to the mind (see Insomnium) ; but there is also a state where vo- lition remains more perfect, where persons talk, and even walk, during sleep. In such cases, however, ca- price or fancy regulates the conduct; and the motions, though directed often to some end, are seldom under the guidance of reason and judgment; mental opera- tions, which we have often shown, require the freest, most uninterrupted, communication through the whole brain. The utmost exertion of reason ever displayed in sonambulism is the extreme caution with which such persons walk in places by no means secure. In every such instance there seems to be an imperfect conscious- ness of the situation which they do not recognize when awakened. Compression of the brain produces torpor; but scarcely in any instance sleep. Narcotic poisons lessen the energy of the brain, and produce a partial collapse, for we find that they always induce delirium ; and so great is the power of opium, in particular, over the as- sociation of ideas, that those of duration are influenced by its operation. In general, opium acts as a narcotic only, and produces sleep indirectly by destroying the irritations#which prevented it; and it is more success; ful when these irritations are peculiarly nervous, than when they have affected the sanguiferous system. The latter, we have said, are often injured by opium, as their best relief is by increasing the discharge from the neighbouring glands or exhalents, which is checked by its narcotic power. The impediments to sleep are cold, light, noise, un- easiness of mind or body. Cold, in an extreme de- gree, produces sleep, or rather the torpor, which is the precursor of death. In a moderate degree it impedes sleep by the uneasy sensation which it produces. The other causes act as stimuli, preventing the collapse, till, by their degree or their continuance, the excitability is exhausted. Sleep is induced by avoiding these causes, by employing the attention on subjects which excite no emotion, by a monotonous sound of no great loud- ness, and by narcotics, sometimes narcotic gases. The hydrocarbonate seems to have some effect in this way. See Anodyna. Sleep is often a capricious visitant, flies the bed of down, while it seals the eyes of the sea boy in the rudest hour. It is often least frequent when most de- sired, and the apprehension of watchfulness is the surest means of precluding the access of this soother of our woes. A close attention to literary labours leaves also an irritability which equally prevents sleep, so that the student fears to leave his midnight lamp, which he must SON 360 SO N exchange only for a state of uneasy restlessness. Yet, as we have said, these hours are borrowed only. Nature cannot be deprived of this interchange of rest, and we never yet knew a case where its period was greatly abridged but that the life was shortened, and the latter part of it spent in languor and distress. Tea, coffee, and those narcotics which give a cheerful hilarity, are often used to prevent the recurrence of sleep ; but often with the worst consequences. A contrary state is no less dangerous, viz. too great indulgence of sleep. Somnolency is generally the con- sequence of distended vessels ; and, if indulged, ends in apoplexy, in dropsy, or fatuity. To indulge sleep after dinner is by no means dangerous or unsalutary ; but it should be allowed only to the infirm; those whose rest at night is disturbed, or who cannot always command sufficient time for the necessary recruit. In other cases, if it does not render the sleep at night less sound, the usual consequences of somnolency follow. The best time for sleep is early in the night, when the evening exacerbation has come on, to prevent its increase by the abstraction of all stimuli. Its greatest violence is from ten at night to one in the morning. This period should, therefore, be spent in sleep, and the two hours before twelve are by far more salutary than any other part of the night. The duration of sleep should depend much on the labours of the day. From six to eight hours are in general sufficient; but some constitutions require more than eight: few can continue healthy with less than six, though those ac- customed to interruptions will be considerably recruited by four hours of rest. If, however, this becomes ha- bitual, the constitution will eventually suffer. If the same hour of retiring to rest be observed, habit will concur with fatigue in inducing sleep. See Fordycc's Elements,part L; Cullen's Institutions; Cheyne on Health and Regimen. SO'NCHUS LM'VIS, (wxpx to o-aov Xt"*> from its wholesome juice). Montanus purpureus andrepens. See Chondrilla, and Hieracium majus. SO'NUS, (from the Arabic term sanah, to cry out). Sound. Sound consists in vibrations of an elastic body, and are either acute or grave as the sounding body is longer or shorter; for a long string, which gives an acute sound, experiences different vibrations in its different portions. This is, however, scarcely a part of our present subject, which relates rather to the medium and communication of sound, as applicable to the organs appropriated to the sense of hearing. We shall therefore speak of each portion of the subject, and perhaps be able to correct some erroneous opinions too generally received. Sound is supposed to be communicated by undulations of the air, resembling those of water when a stone is thrown into it; and if any body is interposed to check these undulations, a new centre is said to be form- ed, from which fresh undulations proceed. This is, however, an erroneous view of the subject, and wholly inconsistent with the phenomena of sound, Avhose intensity only, not its velocity, is diminished by in- terposing bodies. Sir Isaac Newton, who has been quoted as an authority on this subject, has expressly demonstrated, lib. ii. prop. 43, that " every tremulous body in an elastic medium will propagate the motion of pulses every where in a strait line ; but in an inelas- tic medium, will excite a circular motion." What, how- ever, wholly contradicts the common theory of undula- tions of every kind is, that sounds are conveyed through bodies wholly inelastic, through timber, water, wool, and cotton threads; so that if vibrations only convey sound, it must be the vibrations of a body much rarer than air, probably a very rare ether ; and these vibra- tions cannot be circular. Indeed the vibrations by which sound is conveyed through air seem not to be those of the air itself, but of a rarer medium, for the lovdest sounds will not most slightly disturb the flame of a candle. Dr. Franklin, who might have taken the hint from Kircher, first led us to suspect that air, though the common medium of sound, was by no means the best. When the sound, emitted by striking two stones against. each other, was conveyed through water, they were much stronger than when conveyed through air. Dr. Frank- lin heard the sound of two stones, struck against each other, at the distance of a mile, as sharp as if near his ear; and the watermen on the Thames assert, that when the air is still, a small sound may be heard across the river. Bells of no large size may be heard at the distance of four or five miles, when water only is inter- posed ; and we are informed that the explosion of a twelve pounder may be heard nine leagues, in calm weather, at sea. On experiment, a voice scarcely audi- ble at the distance of seventy-six feet on land, was distinctly heard at the distance of one hundred and forty feet over water. Damp walls and houses have echos, which they loose when dried ; and when a canal of water was carried under the theatre of Argentino, at Rome, a voice, on the stage, was heard distinctly at the extremity of the pit, which was scarcely audible before. Another very powerful medium of the communica- tion of sound is bone. Sounds are conveyed with par- ticular distinctness, and increased intensity, through the bones of the head, particularly by the harder ones near the ear, as the os petrosum of the temporal bone. Some facts of this kind are mentioned by Haller (Phy- siologiae Elementa, v. 295), and were noticed by Dr. Monro so early as 1769 ; but the first account, though then abridged, was given by M. Perolle, in the third volume of the Memoirs of the Society of Medicine : some notice was taken of it in Rozier's Journal for 1773. From his experiments, the teeth seemed the most powerful medium, next the bones of the skull, particu- larly the temporal bones, and those on which the portio dura of the 7th pair of nerves was dispersed. His more particular experiments are recorded in the last volume of the Turin Transactions, the fifth of which we shall give a short account, as we do not recollect seeing them in our language. M. Perolle begins with the fundamental experiment of hearing by means of the bones of the head, formerly mentioned. The sound, in the next experiment, was the vibration of a watch, and the communication was made with the meatus auditorius, by means of a small cylinder of wood, or of the substance to be tried; a method not perfectly correct, but sufficiently so for comparative experiments. The order in which woods and metals communicated sound was the following, beginning with the strongest, viz. fir, logwood, box, oak, cherry tree, chestnut, iron, copper, silver, gold, tin, and lead. Strings, extended with apparently little SON 361 SON force, propagated sounds in a still inferior degree in the following order; gut, hair, silk, hemp, flax, wool, and cotton. Zinc, antimony, glass, sal gem, gypsum, dried clay, and marble, were still worse conductors; but their order was not particularly ascertained, except that mar- ble was the weakest, though still better than air. Fluids transmit sounds with different forces. Oil olive, and oil of turpentine, were nearly twice as good conductors as air; water and spirit of wine better conductors than oils. The proportions are 14 and 16; 20 and 21 to 8. In all these experiments the nature of the sound (its " timbre") was altered : but M. Perolle adds that he had no means of ascertaining it. He could not, therefore, mean the tone, the acuteness, or gravity, for either, could have been easily ascertained. The sound of a tuning fork was fortified by the bodies in which it was placed, and, as might be expected, nearly in the orders recited; but the bulk of the body, when applied to musical instruments, seems to have had a considerable influence in increasing the sound. From these results we find scarcely any clue to lead us to the principle on which the different substances act in conveying sound. One distinction will imme- diately occur, that a sonorous body must be very dif- ferent from a conductor of sound, as the action of the former consists in rapid pulses, by which it strikes the surrounding medium, while the other is to the senses perfectly quiescent. Wood or metal will conduct sounds when surrounded with moist clay, and the water through which the vibrations of a watch are con- veyed will not be most slightly agitated. In the experi- ments with woods and strings, their superiority, as con- ductors, seems to be connected with a fibrous structure, where the fibres are continued longest without interrup- tion, or with an uniform texture. Specific gravity has apparently no influence, for water is perhaps the most perfect conductor of sounds hitherto known. Future experiments will not probably confirm all M. Perolle's results, and indeed he speaks of thein as not always uniform. We objected to their accuracy for this reason, that there was in reality three different media of a sound, the conducting body, the air of the meatus auditorius, and the bones of the head : so that the experiments could be styled comparative only. We were led to this objection, from having, many years before, made some similar trials in a manner apparently more unexceptionable. Having closed the ears, and swathed the head with numerous folds of flannel, we placed a watch on a cushion, touching the case or the glass, for we found the result the same, wifh a half penny, a new shilling, and a guinea, successively held between the teeth. The sound was certainly weakest when the copper was employed; and though there were some doubts respecting the power of the silver and the gold, the latter seemed the best conductor. The course of our reasoning has led us to omit some facts respecting the progress of sound in the air. The experimentumcrucis, which supported the claim of the atmosphere to the title of the chief conductor of sound, was that of Mr. Hawkesbee, in the Philosophical Trans- actions. He found that a bell sounded with diminished sharpness in vacuo, and with increased loudness in condensed air. In fact, momentum is in proportion to velocity and density; when the density is increased, the velocity given, the momentum will be proportion- ally augmented. To which we may add, that in vacuo VOL. II. the diminished momentum has to contend with in- creased pressure from without, while in condensed air the contrary circumstances take place. At best it is only comparing air in different degrees of density, and not comparing it as a conductor with any other substance. Another circumstance, which has been misrepresent- ed, relates to the power of winds in diminishing the ve- locity of sounds. Strong winds move about 90 feet in a second; and if they really impede the propagation of sound, they ought to diminish it about T1^. This de- termination from calculation I was happy to find verified by the experiments of the accurate Derham (Philoso- phical Transactions, No. 313). He found that storms really retard sounds, so that the sound which travels 571 feet in five seconds may be accelerated to 600 feet in the same time, or retarded to 560 feet, nearly T1^. These facts will apply particularly to the function of hearing, which we omitted in the former articles, as the facts relative to sound were not before us. The meatus auditorius is, we know, terminated by an inter- posed membrane, the drum, which is kept tense by the handle of the malleus, while the vibrations are com- municated by the other bones to another drum, which closes the foramen ovale. There is, however, still an- other drum closed, according to signor Comparetti, by the membrane of the foramen rotundum, and another at no great distance. The outer drum conveys sound without probably increasing its intensity ; but from its numerous irregularities seems to render it less distinct. These are corrected in the small bones, and the sound is conveyed unbroken by the stapes to the foramen ovale. Into the cavity of the tympanum the Eustachian tube opens, and various uses have been assigned-to it. In fact, it is an essential part to what we may style an air drmn, for, without its assistance, no sound could be conveyed to the interior ear. The whole of the cavity of the tympanum is lined with a membrane, perhaps to deaden all the sounds except those conveyed by the lit- tle bones, which receive a tension, that from their at- tachment they give also to the tympanum, by small muscles, peculiarly adapted for this purpose. When the tympanum is broken, the. sound is apparently con- veyed by the Eustachian tube to the little bones; but when these most essential organs are destroyed, as is sometimes the case, by suppuration, the deafness is in- curable ; though when the stapes remains, a sense of sounds is not wholly lost. Mr. Home contends (Philo- sophical Transactions for 1800) that the membrana tym- pani is muscular, and that this structure concurs with the action of the little muscles in giving a delicacy of hear- ing, or what is styled a musical ear. We cannot deny the fact, but the consequences are not supported by ob- servation, for those in whom the membrana tympani has been ruptured have retained their nice distinction of musical sounds. It has been designedly broken by Mr. Cooper and others, to restore hearing which was destroyed by the'obstrnction of the Eustachian tube; for in that case the tympanum cannot fulfil its office. Minute anatomists, particularly Scarpa and Compa- retti, have greatly added to our knowledge of the ana- tomy of the internal ear. It is of little importance to follow them minutely, and we shall only add the out- line, where the structure is particularly connected with the function of the organ. What we now style the internal ear is not the cavity immediately beyond the tympanum, into which the Zz S C It 362 SCR Eustachian tube enters; but that inclosed by the mem- brane, which covers the foramen ovale, connected with the stapes, and that of the foramen rotundum, which opens into one of the scalae of the cochlea. This part of the ear is styled the labyrinth, and we shall not now be surprised to find it filled with water, though it ap- peared singular to the first discoverer, Cotunnio, and was contested by Meckel. The fact was, however, proved by freezing the water in the cavity, and then sawing through the bones. A remarkable singularity, as we have said, occurs in the openings of the two foramina, for while one, the foramen ovale, opens into the vestibule of the labyrinth, the other communicates with one of the scalae of the cochlea ; and Comparetti observes, that another drum is thus formed, whose umbo seems capable of rendering the membrane tense, producing an effect similar to the action of the muscles on the handle of the malleus. The existence of the two tympana, and each communi- cating with different sides of the cochlea, has occasioned no inconsiderable difficulty to physiologists. Does each drum convey the same sounds, or different ones ? If the former, why is no confusion produced ? If the latter, to what sounds is each tympanum adapted ? It has been observed, that an elastic membrane was necessary to admit, by its yielding, of the vibrations necessary for the perception of sound ; but the authors do not recol- lect, that in an inelastic fluid no vibrations can take place; nor will the face of the question change if we refer the communication of sound to a very rare and highly elastic ether. Water, we have remarked, con- veys sound without the slightest agitation of its surface, and the yielding of an elastic ether in one part would apparently produce only its condensation in another. If the structure of the scalae cochleae be minutely ex- amined, they will be found to be divided by the spiral lamina, but there is a distinct communication between them on the top: the structure is the same; they are supplied by the same fasciculus of nerves, and in no respect is there any real distinction. It is possible, there- fore, that the fenestra rotunda may be a subsidiary tym- panum, to prevent total deafness, should the bones be destroyed by suppuration; for in this case some sense of hearing appears to return; and this idea is sup- ported by its convexity internally. It is, however, on the whole, more probable, that it is intended to yield in cases of violent shocks, to prevent any injury to the tender nerves by the concussion. To this opinion nu- merous objections may, indeed, be offered. The peculiarly multiform and complicated structure of the human ear has occasioned some disquisitions re- specting the peculiar utility of each part of the organ. As the cochlea was peculiarly minute in its structure, and singular in the arrangement of its nerves, it was supposed to be the seat of that acute and distinct per- ception of sounds which we style a musical ear. Un- fortunately for this hypothesis, birds have no cochlea; lmt though they have minute perceptions of sounds, their scale is limited ; while men can, according to Dr. Reid, distinguish four or five hundred variations of tone, and by combination an uncalculable variety. Some animals want many parts of this complicated organ; but no one animal wants a bone or a calculous concretion. When we hear through the bones of the head or the teeth, the sounds are still probably conveyed to the internal ear exclusively by the little bones. We have not, in this disquisition, noticed the form and situation of the different sacculi, or the direction of the minute foramina into which many of the bones surrounding the car are hollowed. Both are designed to enlarge the organ, and consequently to render it more sensible. The sacculi are not in contact with the osse- ous case; and Scarpa, when he traced the nerves to them, found them fibrillous on the external part, but the fibrous structure was lost on the internal; and it there became a soft, apparently an inorganic, pulp. In this respect the organ of hearing resembles that of see- ing. In each, when the nerve is fibrous, it is insensi- ble ; but when the coats are deposited it becomes a smooth acute organ of sense. We are provided with two ears, as with two eyes, to prevent a total loss of the sense, should either be de- stroyed. We know, that if the axis of each eye is dif- ferently directed, we perceive for a time objects double; but it is not so generally known that by disease we hear sounds double. Two singular facts of this kind we shall, however, mention from Sauvages. A musician, blowing the flute, heard at the same time two sounds, viz. the proper sound, and another in the same time, but not in the same tone, and consequently not in har- mony. On considering the subject, he found that, the day before he discovered this double sound, he had been exposed to damp, and felt a catarrh on his right side. On the cessation of the complaint the usual accu- racy of hearing returned. In another case, a person heard the voice of one who spoke to him, and, at the same time, another sound, an octave higher; but it could not have been in unison, for the harshness attend- ing it was intolerable. These facts, compared with the phenomena of sight, show that the sense depends on the coinciding impression, not on the visible image in the retina, or any undulations of a fluid; and these subjects considered in their analogous points will illustrate each other. The diseases of the ear are not so peculiarly distinct apd different as to occasion any very extensive disquisi- tion. Of the morbid state of the internal ear we know little, except that it suffers with the brain from disten- tion of the vessel, from active inflammation, or from palsy. There are, however, some local affections which dissection has traced; but, as usual, which previous ob- servation has not connected with preceding symptoms. The Eustachian tube has been obliterated by inflamma- tion, by ulcers, frequently syphilitic, or increased effu- sion from other causes. This disease impedes the vi- bration of the air and prevents hearing, which is re- stored by breaking the membrana tympani, and admit- ting the sounds through the bones of the ear and of the head, perhaps through the tympanum of the fenestra rotunda also; nor is it very unlikely that the latter con- veys the vibrations from the teeth and bones of the head, while the malleus and its connections convey those through the tympanum. External bodies passing into the meatus produce con- siderable pain; and the motions of a living animal, as a fly or insect, the most painful noises. These may be washed out or destroyed by the appropriate injections. Common soap and water is sufficient for the former, and oil or tobacco smoke for the latter. Inflammation of the meatus often occasions most violent pains, which often terminate in suppuration, the matter either passing externally between the lobe of the ear and the mastoid1 SON 363 S P A process, or into the cavity itself. In a strong light we can, by pulling the lobe backward and downward, see the whole of the meatus, and the state of the ulcer will suggest the proper applications. An herpetic eruption of the ear sometimes extends to the meatus, and the increased discharge closes the passage. This complaint yields readily to alterative mercurials internally, to mercurial applications with the strictest attention to cleanliness. The most useful ap- plication is the unguentum cerussae acetatae, with a small proportion of the unguentum citrinum. A fungus or polypus of the meatus requires no particular treat- ment. Mr. Sanders supposes that they most frequently occur when the tympanum has been broken. Inflammation of the cavity of the tympanum often terminates in suppuration, which has been generally neglected from apprehension of injuring so delicate an organ, or transferring the matter to the brain. The former idea is visionary, and the latter absurd. If sup- puration continues, the small bones will in time suffer, and the patient become irrecoverably deaf. Blisters be- hind the ear, gentle saline purgatives, solutions of the vitriolated zinc, injected into the ear, sometimes with a small proportion of the tincture of opium, will often remove the complaint. .When polypi, which are not unusual in these circumstances, follow, they may be extracted by forceps, or sometimes destroyed, if soft, by pupcturing. The base may be eroded by the argen- tum nitratum. When the tympanum is destroyed, air may be forced through the meatus externus from the lungs, through the Eustachian tube, if the mouth and nostrils are closed; but if the membrane is sound, a distending force is felt against the tympanum. This experiment in each case will not succeed with every one. It shows, however, when the air passes, that the tympanum is at' least in part destroyed, and the degree of injury is known by the quantity of air discharged through the meatus. In this case our plans should be actively pursued to prevent the exfoliation of the bones. When the tube is really obstructed by the effects of inflammations, polypi in the nose extending to the throat, or enlarged tonils, Mr. Ashley Cooper's very judicious plan of puncturing the tympanum often succeeds. The part where the handle of the malleus is fixed should be avoided, and the aperture should not be very small, as it will in that case again close (Philosophical Transac- tions for 1802). When the meatus is not diseased, when by the breath, on closing the mouth and nostrils the tympanum is inflated, and deep seated pain or noises in the ears are attended with deafness, the cause is inflammation, or what is styled nervous deafness. The pain dis- tinguishes the former, and the noises the latter. Eva- cuations of the most active kind are necessary for the pain, and these may be general or topical. Leeches and blisters reach most nearly to the part, when applied near the mastoid process; but general evacuants and the most cooling medicines are chiefly effectual. The nervous deafness, which sometimes arises from palsy, is relieved by tonics; more often by small doses of al- terative mercurials, and stimulating applications to the meatus. See Tinnitus aurium, and Surditas. Sanders on the Human H.-.i- Scarpa Anatomicae Dis- quisitiones de Auditu et Olfactu; Valsalva de Aure Humana; Home in the Philosophical Transactions for 1800 ; Perolle in the Turin Transactions, vol. 5 ; Monro on Fishes. SO'PHIA, (from o-o lead mercury Oxygenated muriat of potash Muriat of potash --------soda --------ammonia --------lime — magnesia — barytes — strontian — zinc • copper lead mercury (oxygenated) tin Tartrite of potash (acidulated) --------soda Acetite of soda ■ time -------- magnesia -------- alumine -------- barytes -------- lead .-------- copper --------■ iron Phosphat of potash (dried) — soda -------- ammonia -------- ammonia and soda -------- magnesia -------- barytes -------- copper -------- mercury Phosphure of lime Borat of soda (of commerce) ----------- (saturated) lime and magnesia mercury Carbonat of potash -----------soda (in mass) ---------------- (crystallized) ammonia magnesia (in powder) alumine Tungstat of ammonia Prussiat of mercury Arseniat of potash Camphor Common sugar 1.58 2.95 1.38 1.22 1.69 4.06 1.93 2.09 1.57 1.62 1.73 1.64 2.91 ' 3.00 2.09 2.17 3.91 1.98 1.93 2.20 1.54 1.76 1.60 2.82 1.44 1.57 1.67 1.82 7.17 5.13 2.29 4.55 1.91 1.74 2.10 1.00 1.37 1.24 1.82 2.34 1.77 1.36 2.85 1.33 1.80 1.50 1.54 1.28 1.41 4.98 0.98 1.72 1.35 0.70 0.99 2.26 2.01 1.35 1.73 0.96 0.29 1.11 1.93 2.76 2.15 0.99 1.40 In these experiments Hassenfralz agrees with New- ton, Muschenbroeck, and Kirwan, so far as their expe- riments were made on the same bodies, if we except the sulphat of zinc. Newton styles it the vitriol of Dantzic, and the difference probably depends on its state of crystallization. We shall add another table from Bergman, contain- ing not only the specific gravities, but specific heats, a subject on which we need not enlarge at present. See Caloric. Table of Specific Gravities and Specific Heats from Bergman. Solid. Swedish glass Flint glass Agate Ice Sulphur Gold Silver Mercury Lead Copper Iron Tin Bismuth Antimony Brass Calx of lead Sp. Grav. 2.386 2.648 19.040 10.001 13.300 11.456 8.784 7.876 7.380 9.861 6.107 8.356 iron tin lead and tin Diaphoretic antimony (washed) Fluid. Distilled water Vitriolic acid (pale) --------- (dark) Pale nitrous acid Red smoking nitrous acid Red wine vinegar Purest concentrated vinegar Oil of tartar per deliquium Pure ammonia Sal Glauberi pars 1. aquae 2.9 Nitre, p. 8. - Sea salt, p. 8 Sal ammoniacum crudum, p. 1- Tartar, pure Magnesia vitriolata, 2 Alum, p. 4.45 Green vitriol, p. Brown sugar dj Olive oil Lintseed oil Spermaceti Oil of turpentine Spiritus vini rectificatus Hepar sulphurus 1.000 1.885 1.872 1.355 1.068 1.346 0.997 -5 - 237.3 4.45 2.5 Aerial. Alkaline air Vital air Common air Carbonic acid air 0.783 0.818 0.132 0.125 0.181 Sp. Heats. 0.181 0.174 0.195 0.900 0.183 0.050 0.082 0.032 0.042 0.114 0.126 0.060 0.043 0.063 0.116 0.086 0.320 0.096 0.102 0.220 1.000 0.751 0.429 0.844 0.578 0.387 0.103 0.759 0.708 0.728 0.646 0.832 0.798 0.765 0.844 0.649 0.734 1.086 0.710 0.528 0.399 0.472 1.086 0.994 0.068 87.000 18.000 0.27C S P E 368 S P E There are some other applications of the term specific, of which we shall only mention specific stimulus, by which is meant the peculiar sensibility of some substances to a particular organ. Thus the white of an egg will, in some stomachs, prove singularly offensive, though void of every irritation, even to the eye. On this principle, the action of some medicines on a par- ticular secretory organ has been explained ; for if any body be brought to glands not disposed to be acted on by them, they prove wholly inert. More attentive observation has, however, disproved many of the facts on which this opinion rested, and shown that the effects are produced by a very different action. Thus antimo- nials and opium produce perspiration by a relaxing power, and cold on the skin induces the action of the kidneys in consequence of altered determination. SPE'CILLUM, (from specio, quo aliquod specimus). A probe, said to have been invented by jEsculapius. SPE'CULUM, (from the same,) diastomotris. An instrument for dilating the natural passages or cavities; also a name for the aranea tunica of the eye. Spe'culum ani, is highly useful in opening fistu- lous ulcers of this part, for even the director is not always a certain guide. The instrument invented under this name by Dr. Mudge is not unlike the gorget, but not so taper, and without the beak. The finger is introduced into the rectum, and the larger speculum on it, the concavity filled by the finger, and the extremity not carried beyond it. When the finger is withdrawn a considerable extent of the gut is seen, and the operation performed in the usual way. The smaller speculum assists in applying the dressings, as so considerable a dilatation is not necessary. Spe'culum oculi. A ring, adapted to a handle with a groove at its upper circumference to fix the edge of the upper eye lid. It is designed to keep the eye open in the operation of the cataract; but is now seldom found necessary. SPE'LTA,(an Italian word, or spelt, German). See Ador. SPE'LTER. See Zincum. SPE'RMACE'TI, (because it was supposed to^be the seed of the whale). The species from which it is procured is the physeter macrocephalus Linnaei, whose enormous head contains in a triangular cavity an unc- tuous substance, from which a pure oil can be pressed, leaving the spermaceti in the form of a white unctuous substance. It is found in a small proportion in the fat of the rest of the body, and is deposited often from the oil. The spermaceti is at last purified by washing it in an alkaline ley. Its colour is a pure silvery white, and it is composed of plates of a crystalline appearance, almost transparent. It is softer than wax, more brittle, and tastes and smells not unlike tallow, without any flavour Its obvious properties distinguish it from other concrete oils, and it congeals at the 112th degree of Fahrenheit. Spermaceti makes very white candles, which burn with a clear white flame without any smell. Spermaceti in distillation yields a fluid oil, which concretes in cooling, leaving in the retort a very small proportion of coal. If the distillation is repeated the oil becomes permanently fluid. It seems scarcely de- composed in the process, as the heat required is incon- siderable; and on that account probably there is no ap- pearance of any acid. Crell, however, found the oil thus procured, partly white and partly brownish, yield- ing by repeated distillations a yellowish acid, which was never permanently fluid. The acid carefully recti- fied is wholly colourless, and seems^o resemble his sebacic acid. The oil unites with ahrmonia into a saponaceous emulsion. This substance is slightly and with difficulty soluble in alcohol; the whole seeming to be deposited on cooling. Warm ether and oil of turpentine dissolve it copiously, but do not retain it when cold. With pure kali it forms a soap soluble in warm water. Fluid ammonia when cold has no action on it, but when warm unites with it, and does not separate on cooling, or on adding water. With concentrated sulphuric acid it forms a brown solution, which, when dropped into water, yields the spermaceti unaltered, and dis- solves sulphur like other fat oils. By long exposure to the air it becomes brown and rancid. On removing the bodies from a large burying ground in Paris, the animal matter was found to have assumed the appearance and properties of spermaceti. A long continuance in the earth seemed sufficient to produce this change ; but it appeared to be greatly assisted by a current of water. This discovery Dr. Gibbes has at- tempted to render useful; but the fetor cannot be wholly expelled, except at very disproportioned ex- pense. This substance, which has been called adipocere, melts in a less heat than spermaceti, and, on cooling, becomes more brittle. The adipocere is much more soluble in alcohol, and liquid ammonia also dissolves it. The difference is, however, inconsiderable, and adi- pocere has almost superseded the name of spermaceti. This concrete is much used in coughs, dysenteries, erosions of the bowels, chiefly as a relaxant and a de- mulcent. It readily dissolves in oils, and unites with wax, by the assistance of heat, so as to form a conve- nient external remedy. For internal use it may be formed into an emulsion with water, by the interven- tion of the mucilage of gum arabic, the yolk of egg, or of almonds. It has been generally used in internal inflammations, as if its demulcent qualities could be conveyed through the circulating system; in inward bruises; and was for ages commonly given after de- livery. The College of London order an ointment to be formed of this, called unguentum spermatis ceti, sper- maceti ointment, formerly the linimentum album, by melting six drachms of spermaceti, two drachms of white wax, and three ounces of olive oil, together, over a slow fire, and constantly and quickly stirring the solu- tion till it cools. 'See Lewis's Materia Medica; Neu- mann's Chemical Works. SPERMA'TICjE ARTE'RIA, (from sperma,seed). The spermatic arteries. Each rises from the an- terior part of the aorta, between the emulgent and the inferior mesenteric arteries, passes obliquely down- wards and outwards, runs upon the psoas muscle to the brim of the pelvis, and then through the aperture in the external oblique. They are behind and con- tiguous to the peritonaeum, and do not lie in the cavity of the belly, are connected bythe cellular mem- brane to each other, and their corresponding veins, all which run in a serpentine manner, form, with other vessels, the spermatic cord. Sperma'tica cho'rda, the spermatic cord, corpus varicosum, corpus pyramidale, plexus and corpus pam- piniforme, vasa spermatica, preparantia vasa, capreo- laris, and capreolaria, is composed of the spermatic S P H 369 S P II artery and vein, of nerves, lymphatics, the vas deferens, the cremaster muscle, and aponeurotic membrane, de- rived from the^opening of the external oblique, con- nected by cellular membrane. Sperma'tice ve'nje. Spermatic veins. A lit- tle below the emulgent veins the vena cava sends out the right spermatic; but the left commonly springs from the left emulgent, for the sake, it is said, of avoid- ing the aorta in its passage, by which the motion of its fluid might be retarded. This is, however, improba- ble; for the motion of the fluids in the emulgent is not affected by the action of this artery. SPERMATOCE'LE, (from o-xepfLx, semen, and xt-m, a tumour,) epididymis distensa, is a morbid distention of the epididymis and vas deferens, from a stagnation of semen, produced by tumours, too rigid continence, stricture, or inflammation, about the caput gallinaginis, or in the course of the vas deferens; but the last is the most frequent cause. When from an inflammatory affection, general and topical blood letting, gentle laxatives^ a low cooling diet, and rest, will commonly be found effectual; but when tumours are discovered to press upon the vas de- ferens, they ought either to be brought to suppuration, or their extirpation should if possible be attempted. Sometimes the tumours depend on a venereal cause; and a well directed course of mercury hath been known to remove them. When all other means having failed, castration has at last, it is said, been found requisite. See Bell's Surgery, vol. i. p. 495. SPHA'CELUS, (from ctpci^u, to destroy). See MORTIFICATIO. Spha'celus o'ssis. See Spina ventosa, and Caries. SPHACELFSMUS, (from spxxxXi^u, to destroy). See Phrenitis. SPHENOIDAL SUTURE. This, with the eth- moidal suture, surrounds, and joins the irregular pro- cesses of these two bones with the contiguous ones. SPHENOI'DES OS, (from , palate). These muscles rise, one on each side, from the os sphenoides, and are inserted into the sides of the glandula palati, and back part of the uvula. A name also of a lower maxillary branch of the fifth pair of nerves, distributed to the musculus pterygoidaeus internus, the back part of the nares, the sinus sphenoi- dalis, and the Eustachian tube. Sphe'no pharyng^e'i, (pharynx). These muscles rise, one on each side, from the alary processes of the sphenoid bone, and run to the sides of the pharynx. Sphe'no ptervgo-pala'tinus. Valsalva discover- ed that this muscle does not belong to the uvula, but to the tuba Eustachiana. It rises from the os sphenoides, and is inserted into the fore part of the palate. Sphe'no salpingo-pharyng. t0 pour, because the food is poured into it as into a mouth,) ventriculus, anocelia, gaster, nedys, is situated under the left side of the diaphragm, just below the lesser lobe of the liver, from which it passes down a little way, and then crosses the spine towards the right side, in shape resembling the pouch of a bagpipe. It lies, therefore, in an oblique direction from left to right, and hath a substance called mesogastrio7i in its concave part, between the orifices, attaching it to the subjacent parts. Its superior orifice is called the cardia, and is on the left side, the inferior toward the right side is called pylorus. The stomach is not equal in its bulk; but the larger part is on the left, contiguous to the upper orifice the cardia, which is immediately under the diaphragm. The smaller extremity on the right is lower, and more inclined than the former. For this reason Dr. Monro contends, with great propriety, that they should be called the superior and inferior orifices. The superior orifice is turned backward, where the oesophagus enters. The small extremity and the inferior orifice bend ob- liquely backward towards the upper, so that the two orifices are not distant, and when the stomach is full they are less so. When the stomach is distended it does not press downward; but its greatest curvature is raised against the parietes of the abdomen, though it sinks somewhat lower, and the smaller curvature is against the spine. The contraction of the long fibres also brings the ori- fices nearer together, and these changes contribute to detain the food longer in the stomach for the purposes of digestion. It is necessary also to remark, that the two orifices are not in the same plane. If a plane passes through both curvatures the superior orifice is in the portion behind, and the inferior in that before; for the cardia, so far from lying in the plane of the oesophagus, is turned backward. (See Plate.) This appears to be contrived for the purpose of preventing the contents of the stomach from being too easily dis- charged, and, in the act of vomiting, an obstruction is felt, in consequence of this structure'of the cardia. The stomach is composed of four coats, the outer peritonaeal, the muscular, the nervous, and the villous. The muscular coat is composed of two planes of fibres, external and internal: the former is longitudinal, fol- lowing the curvatures and convexities; and it is this plane which contracts the stomach, drawing its orifices nearer to each other: the latter is transversely circular. Their united or opposed action presses on the food, assisting its union with the different fluids, and shifting it by a kind of peristaltic motion from one side to the other. More minute anatomists, by coagulating the fluids, have rendered the muscular fibres more conspicuous, and they find the fibres of the external plane not wholly longitudinal, but occasionally oblique. The fibres of the internal plane are, as may be expected, stronger, STO 387 S TO since these chiefly propel the food. They are not, as in every hollow muscle, entire circles, but segments of circles, the joint action of which is obviously more con- siderable than the action of a larger portion of, or an entire, circle, and these segments are connected by liga- mentous fibres, which give a fixed point for their sepa- rate action. We say separate action; for we shall find that different portions of this viscus often act indepen- dent of the rest. When these segments reach the great curvature, they diminish gradually, leaving a point, which they seem to surround. Round the cardia there are two distinct planes of muscular fibres crossing each other obliquely, intersect- ing others, where they meet on the sides. These form a kind of sphincter, which gives an additional obstruc- tion to the discharge of food upwards. There is no such guard to the pylorus, but a ligamentary band runs along the middle of each side of the small curvature, ending in the pylorus. The cellular substance connect- ing the peritonaeal with the muscular coat, is, in some places, very loose, and this has occasioned anatomists to describe a tunica cellulosa. It is, however, only com- mon cellular membrane. The nervous coat is composed of vessels and nerves, connected by cellular substance, and supported by liga- mentary filaments, intersecting each other obliquely. It is of a loose spongy texture, swelling in water, and resembling fine cotton. The last is the villous coat; because its internal surface, when seen in water, re- sembles the pile of velvet. The ancients called it tunica fungosa. These two coats are of a much greater ex- tent than the containing ones, so that they are raised in rugae, or plaits, chiefly transverse and waving ; but at the pylorus becoming longitudinal. At the cardia, they appear radiated, and seem to be continued from the oesophagus ; but they are thicker, and surround the cardia like a crown. The design of this structure is to enlarge the surface, and increase the exhalation from the arteries, and the mucus from the glands. The in- terstices of the rugae are usually filled with mucus, which is the matter styled the gastric fluid. The stomach is supplied with arteries from the two coronaries and the vasa brevia, already mentioned in the article Splen. Its veins contribute to form the vena portae. The nerves arise chiefly from the eighth pair, the middle sympathetics, which run down in cords upon the oesophagus, under the denomination of nervi sto- machici, and are expanded on a plexus, termed corona- rius stomachicus, to which the intercostal nerve contri- butes by filaments from the plexus splenicus, and the semilunar ganglions of the plexus hepaticus. (See Digestio.) We thus perceive that the action of the stomach is not wholly involuntary. Many persons can excite vomiting, for instance, at will. See Nervi. The bulk of the stomach varies considerably from the portion of food usually swallowed. From inanition it has been contracted almost to the size of a small in- testine* (Ruysch, Obs. 68), and, in the famous stone- eater, it almost filled the abdomen. An instance also of its extending to an enormous size occurs in Mor- gagni de Sedibus, &c. xxxix. 15. The situation is often altered, and it is displaced by a variety of causes. Garengeot (Memoires de l'Academie de Chirurgie, vol. i.) describes a hernia of the stomach from violent exertion in dancing, and in this, as in other cases, he remarks, that it protrudes by the side of the cnsiform cartilage, through a triangular space formed between the sheath of the rectus. It is generally, however, pro- truded through the muscular fibres of the diaphragm, either by steatomata or enlarged viscera, particularly the liver. In many instances this has occurred in con- sequence of a wound in the diaphragm. (Morgagni de Sedibus, &c. xxxix. 15, 16.1xv. 15; Parey's Works, ix. 30.) It has been occasionally forced through the pa- rietes of the abdomen, covered with the peritonaeum, and sometimes pressed wholly into the left side. Of the principal function of the stomach, digestion, we have already spoken, and, from its structure, we see that the whole viscus admits of contraction in different directions. When living animals have been opened, it appears to have a peristaltic motion, similar to that of the intestines. When vomiting comes on, this mo- tion is inverted; but some resistance is felt at the cardia, from the angle which it makes. We must consider this operation on another occasion (see Vomitus); but must now observe, that, from the tendinous lines interspers- ed, the whole stomach does not always act together. The motion of the upper part is often inverted, without any affection of the other portions, and one half of it frequently, when the greater curvature is wholly unin- fluenced. Thus eructations bring up often only the oily matter which swims on the surface; spontaneous vomiting the fluid portions exclusively, while active emetics discharge the heavy mucus; and calomel, which, from its weight, descends, often escapes the common exertions of vomiting. Bile also, which is heavy, is not discharged without violent straining. These circumstances, in all their bearings, are not con- sidered in practice so much as they deserve, and we have, therefore, more fully enlarged on them. The function of the stomach is digestion; but from whence does it arise that the cauldron itself is not affected by the fire which acts on its contents ? The reason is simple; but it has not been sufficiently con- sidered in its consequences; that nothing, which pos- sesses life, is subject to this process. The conclusion is, we think, obvious, that it is not wholly a chemical operation; and, when we pursue this view, when we perceive that whatever weakens the vital power im- pedes or prevents digestion, we shall see that it is ra- ther connected with the nervous system than the na- ture of any secreted fluid. This argument, at the first view, will not appear to militate against the digestion of the stomach itself by the solvent power of its fluids after death. If, however, digestion depends on the activity of the vital power, we should scarcely expect it to go on, when that power is extinct; but admitting the activity of the solvent, and the capacity of the sol- vend, were the fact true, it must have been long since placed beyond doubt. Few, however, are the instances where it has occurred ; and, though limited to cases of violent death, how numerous are the victims of the laws subjected to the knife of the anatomist ? Even the eager panegyrist of Mr. Hunter, Dr. Adams (Essay on Morbid Poisons, Ed. 2d.), admits that the stomach is not often found in this imperfectly digested state. Were the power equal to the effect, it would be in- cumbent on the advocates of this opinion to show, why the solution does not always take place. The original question will, however, recur, and we think every 3 C 2 STO 388 8TR sagacious physiologist will agree that digestion is not a purely chemical process: it cannot be imitated out of the body ; it will not proceed while the vital power is injured. Erosions of the stomach are not uncommon ; and, in the agitation of a violent death, the process of digestion may be disturbed, and an acid produced. This we know is effected in a moment, during life, by distress, by ter- ror, by apprehension. We find, however, no instance in the records of medicine of this effect by acids, though it has been produced by arsenic, by corrosive sublimate, and even quod miremur, by the nux vomica. Murray Bibliotheca Practica, ii. 429. Other causes of wounds and perforations in the sto- mach have been shocks from falls, abscess of the neigh- bouring organs, increased force of the absorbents (Cruickshank), worms, repletion, sharp stones of fruit, black bile, Sec. Several instances are mentioned where a portion of the liver and omentum had accreted to and filled the aperture. Sandifort found the stomach rup- tured in a new born child, and in Halter's Collection of Chirurgical Dissertations is the history of a young woman with a perforation in the stomach, through which she was nourished for twenty-seven years. In- stances of fistulous ulcers occur also in the Medical Facts and Observations, v. 17; and in the Irish Trans- actions, iv. 12. Wounds in the stomach, supposed by some authors to be always fatal, have in many instances been cured. (Morgagni de Sedibus, xxxvi. 31. liv. 8. 12, Sec; His- toire de l'Academie des Sciences, Annee 1723, 39, and De l'Academie de Chirurgia, i. 591.) Even when the stomach was full of food art has equally succeeded; and in such cases Morand has told us to evacuate the contents by an emetic. While wounds, however, are easily healed, blows, and often slight ones, are soon fatal (Lancisi de Subitanea Morte), though we are in- formed by a German author, that a gun shot wound in the stomach has been cured. The effects of blows are on this organ singular and unaccountable. Abscesses and cancers of the stomach are not un- common. Of the latter we have different instances in our own language. (Medical Communications, i. 28, 29. ii. 31; Philosophical Transactions, xlii. 2.) The symptoms of these disorders, are commonly, however, vague and uncertain. A general pain, not always con- fined to the organ, but apparently wandering to different sides of the thorax, without any marked shivering or nocturnal exacerbation, point out general disease, with- out fixing any particular seat of the complaint. When suppuration has arisen from common inflammation, the disease has been confounded often with inflammation of the lungs; but the quantity and nature of the discharge are different. Pus from the stomach is copious, its dis- charge free, and its appearance, not curdly, but truly laudable. It might be a mark of distinction, whether it is brought up by coughing or vomiting; but that either sometimes produces the other, and common peo- ple either cannot or will not distinguish. As they are always apprehensive of pulmonary complaints, they will always contend that matter comes from the lungs. The very extensive sympathy of the stomach renders all distinction of its diseases a task of peculiar difficulty. It is the centre of almost the whole nervous system, and aptly chosen by Van Helmont as the residence of his archaeus, the anima 7nedica of Stahl and Nichols. Its chief connection is with the head, with the uterus; probably from a striking fact recorded by Van Hel- mont, and the common symptoms of gout, with the joints, and apparently with the testicles ; for a slight bruise on these will produce both sickness and syncope. Bartholine mentions a sympathetic connection between the stomach and face; Percival (London Medical Jour- nal, iv. 10), with the lungs. The chief disease of the stomach is debility, occa- sioning indigestion, cardialgia, flatus, eructations, 8cc. Of these we have spoken under the articles Apepsia and Dyspepsia, q. v.; but these symptoms sometimes arise from defective or injured organization, particularly scirrhous hardness or callosities in the stomach itself, the pylorus or cardia: the last, however, is seldom affected, though a case of this kind is described by Triller. This disease is often attributed to the abuse of spirituous liquors; but Haller (Pathology, Obs. 26) found it to arise from the abuse of acids ; and Plater, from heating an ulcer. We think we have observed it from the use of cosmetics. Bruner mentions dyspepsia as arising from obstructions of the glands of the duo- denum; Bonetus from a relaxation of, or a mucous crust on, the internal surface of the stomach, sometimes from a disease of the omentum. Among the remedies we omitted to mention one that has become fashionable since the translation of Daubenton's tract, viz. small doses of ipecacuanha. We perceive also the magistery of bismuth, recommended by Carminati, in his Opus- cula Therapeutica. Substances of very different kinds have been found in the stomach, and even grain rejected in a germinat- ing state. Numerous instances, too numerous to de- tain us, have been recorded of substances retained in the stomach for a long period with little inconvenience. Derham, if we recollect rightly, mentions some grape stones retained ten years; and Hildanus speaks of the discharge of a piece of bacon which had been eaten two years before. The Medical Transactions, the Medical Commentaries, the Journal de Medecine, and the Jour- nal des Savans, record a variety of similar instances. Calculi have been sometimes found in the human stomach, which, in a paper in the Philosophical Trans- actions, have been attributed to the excessive use of ab- sorbents. Scirrhous glands, infarcted vessels, hydatids, and steatoma, are not uncommon appearances on dis- section : unfortunately they have not been connected with the symptoms. The stomach is sometimes di- vided into cells, in one instance from the pressure of a diseased pancreas. A singular instrument for clearing the stomach, styled a brush, has been mentioned by different authors, and it seems to have varied in its construction. It is styled by Wedel excutia ventriculi, and is mentioned by ScriboniusLargus,by Bartholine, by Teichmeyer,and even by Tacitus, Annal. xii. 13. It is now wholly disused. STO'RAX, (, to continue). See In- flammatory FEBRIS. SY'NOCHUS, (from the same). A continual fever; synochus of Sauvages; febris lenta of Lin- naeus; phrenitis of Vogel; febris continua putrida of Boerhaave; febris anabatica, acmastica, and continens. Dr. Cullen places this disease in the order febres. defining it a contagious disease; a fever composed of a synocha and typhus, in the beginning a synocha; in its progress and towards its termination, a typhus. " Since many fevers," he adds, " are neither altogether inflammatory, nor nervous; neither, therefore, can they be referred to the synocha nor typhus: the ge- nus of synochus, whose type is frequently seen in this country, I have here inserted; still between the typhus and synocha I cannot place any accurate limits ; and I doubt whether they should, in fact, be deemed different genera, or placed differently : to each of them the synonymes of authors are to be referred." The necessity of introducing the synochus is the strongest proof of the simple nature of fever; for, in fact, this may be truly styled fever, while the others are varie- ties only. In this climate, ninety-nine of a hundred fevers, independent of topical inflammation, are synochi. See Febris. Sy'nochus pleuri'tica, hiema'lis, and rheuma- tizans, fevers more strictly inflammatory. SYNOSTEOGRA'PHIA, (from «*, ott, are continued through the tunica albuginea, and unite into one canal, which, by several windings, forms the epididymis ; and by its continuation the vasa deferentia. The arteries from the spermatic artery are convoluted in a serpen- tine direction, forming little masses of tortuous vessels, separated by cellular partitions. In each partition there is a duct receiving the semen, on which the arte- ries appear to branch as larger arteries over the intes- tine, or as the vasa vasorum over the arteries them- selves. The testicles have many lymphatics, which terminate in the inguinal glands. The nerves of the testicle are branches of the lumbar and the great in- tercostal, and there is no organ of the body more disobedient to the will. The semen, separated in the testicle, is further perfected in the epididymis, and then conveyed to the vesiculae seminales, and from thence into the urethra. The testicles are subject to a variety of appearances and complaints. Sometimes there is only a single one; but in such instances the other has been usually retained in the abdomen (see Parorchydium) : it is at least certain that this defect, even when it exists, does not injure the generative power. Sometimes there are said to be three, occasionally five, without any increase of this power; but the supposed additional testis is sometimes merely a larger epididymis. In some instances, the testicle sticks at the ring of the muscle, resembling a hernia ; and when this circum- stance is known, if the testicle lies obliquely, it renders the person subject to hernia, which cannot be retained, as he cannot wear a truss. The testicles.have some- times gradually decreased, and this has happened (Ha- milton in the Medical Journal, xi.) after the metastasis of a parotid tumour in the cynanche parotidaea. We have witnessed the same consequence, after a tumour in the testicles, without any evident cause ; sometimes. according to Mr. Hunter, it happens after a venereal tumour. The testicle has also been destroyed by hy- datids. We have already mentioned the sympathy of this organ with the stomach, and we find a case recorded, where inflammation came on from a blow on the pit of the sto- mach ; and Pouteau mentions many instances of its sym- pathy with the breast. Is it from this cause that hectic patients (at least men) are commonly salacious ? Inflammation of the testicle is a disease very trouble- some and obstinate ; for we have observed that the ar- teries are small and tortuous, so that obstructions are not easily removed; leeches to the part must be repeat- edly applied, cold cataplasms, and discutient fomenta- tions freely used, while the bowels are to be kept open by neutral salts; a recumbent posture is highly neces- sary, and the suspensory bandage, even in this posture, useful: in any other it is indispensable. In the vene- real inflammation, J. Hunter advises emetics ; and we find that Rhazes in his Continens mentions a case where an abscess of the testicle was relieved by this re- medy. In general, abscess of the testicle requires no peculiar management. Petit Memoires de l'Academie de Chirurgie, iv. 323. The testicles have been sometimes found of a carti- laginous hardness, and sometimes ossified portions have been discovered in them. Tumours have been found also to contain osseous concretions. Tumours, infarctions, and scirrhi. The causes of tu- mours are various. The chief source of these swellings is said to be a suppression of the gonorrhoeal discharge, and the principal means of cure its renewal : a fresh infection has been even employed for this purpose. See Hernia humoralis. A suppressed discharge of the seminal fluid, ischu- ria, and even worms of the intestines, as well as the metastasis from parotid tumours, already mentioned, have been accused, and frequently induce the com- plaint. To the former remedies, mentioned under the article already referred to, we may add the hemlock (Baylie's Practical Essays), electricity (London Medical Journal, 1786), aqua ammoniae acetatae, gum ammo- niac, recommended by Plater, which has also the 3 G 2 T E S 4^0 T E T authority of Rhazes (Continens, lib. i.), the pulsatilla and dulcamara, though these narcotics and the gum ammoniac are rather adapted to the chronic state, when pain and inflammation have ceased. Scirrhi in the testicles are the diseases of advanced life, when the diminishing vessels concrete with the gland into hard unequal tumours. The size of these is often considerable, and they frequently degenerate into the most painful cancers. The suspensory bandage is highly necessary, to support the weight; and, in the early state, leeches may be frequently applied with ad- vantage. The bowels should be kept freely open, opi- ates given occasionally, and every cause of stimulus avoided. In this way the patient's life may be often preserved in tolerable comfort; but a cure is scarcely to be ex- pected, except from an operation. Small doses of mu- riated mercury, with the decoction of sarsa and meze- reon, the hemlock, the dulcamara, the aconite, and the Pulsatilla, have been employed both externally and in- ternally with little success. Electrical sparks seem oc- casionally to have been injurious; nor will the gum ammoniac, with the vinegar of squills applied to the part, produce any very salutary effect. When a scirrhus or cancer of the testicles is fairly characterized, castration is the only cure. Mr. Fearon, in his Treatise on Cancers, advises it to be performed in the following manner: the patient being placed in a proper situation, the integuments over the spermatic vessels in the groin are to be divided by an incision, be- ginning opposite to the opening in the abdominal mus- cle, and continuing it nearly to the bottom of the scro- tum. The surrounding membranes of the spermatic cord must be then separated, and the operator is to pass a large crooked needle round the cord about half an inch below the abdominal ring. The ligature should be well waxed, oiled, and tied in one running knot, so tight only as to prevent the spermatic artery from bleed- ing and not to give pain by bruising the nerves. The whole cord should be divided about half an inch below the ligature. The testicle is then to be dissected out from the scrotum, beginning at the upper part, and going downwards. If any branch of an artery should bleed freely, it is to be taken up by a pair of dissecting forceps, drawing out the mouth of the vessel, while an assistant passes a ligature round it. About the second or third day the ligature may be drawn out without any sloughing between it and that part of the cord from which the testicle was separated. The parts from whence the testicle was removed are then to be gently laid together, and the edges of the in- cision to be evenly and exactly brought into contact from one end to the other, and retained in that situa- tion by slips of adhesive plaster, or a suture if found necessary. Should any part of the scrotum be ulcerat- ed, it will be necessary to make a second incision, be- ginning a little above the ulcerated part, and continued in as direct a line as the inclusion of that part will ad- mit of, down to the extremity of the first incision. These two incisions will enable the operator to dissect away the testicle, in the same manner as if there had been but one : nor will they give more pain than if the diseased part had been dissected away along with the testicle, as recommended by Mr. Sharp and Mr. Pott. The parts are then to be brought together, and retained in the same manner as if there had been but one inci- sion, that they may unite by the first intention. It is recommended to perform the whole of this operation with a straight knife, as well as the excision of a can- cerous breast. See Warner's Account of the Testicles and the Dis- eases to which they are liable ; Hunter on the Vene- real Disease; Fearon on Cancers ; Morgagni de Sedi- bus, &c. xlii. 42, xliii. 43; Schurig's Spermatologia ; Wilmer's Cases, 8cc. There are some protuberances of the brain which bear this name, from their resemblance. See Cere- bellum. TESTICULA'TUS, (from testiculus). Testicu- lated, or having roots like the orchis. TESTFCULUS CANI'NUS, (from the resem- blance of its roots to a testicle). See Orchus. TESTU'DO. See Talpa. TE'TANUS, (from retva, to stretch,) convulsio Indi- ca, holotonicos, rigor ne7-vosus, is a general spasmodic contraction of all the muscles. If the body is rigidly- bent forward, it is styled emprosthotonos; if to one side, tetanus lateralis; if bent backward, opisthotonos. Dr. Cullen thinks that Sauvages' genus catochus is by no m means natural, as it unites species of a dissonant na- ture : he has retained, however, the species collected under this head, dependingon spastic rigidity, and placed them under tetanus. The species are the catochus hole- tonicus, an universal affection ; cervinus, particularly affecting the neck; and diurnus, considered as symp- tomatic. See Cullen, Nosologia Methodica; Sauvages' Nosologia Methodica, p. 546, vol. i. It is defined a spastic rigidity of almost the whole body; to which has been added with sensibility re- maining and sometimes increased. This disorder is most frequent in hot climates, though it occasionally happens in the milder, particularly in the topical affec- tion styled a locked jaw, a variety of this disease. Aretaeus, Celsus, and Coelius Aurelianus consider cold as a principal cause, and direct rubbing the disordered parts, warm bathing, &c.; but the chief source of the disease is an irritation from a wound on a nerve, though it is said to arise also from diarrhoeas or dysenteries im- prudently checked, from the corrupted air of hospitals (Theclen), from sea air, from purulent accumulations in the head, from caries of the bones of the neck, from fever (Storck Annus Medicus, ii. 98), from debility, repelled gout, poisons, and from worms. The less de- gree of the disease, the locked jaw, arises often in chil- dren from accumulations intheprimae viae, from retained meconium, and from improperly tying the navel string, After operations in warm climates, where the nerves have been properly divided, tetanus often comes on ; sometimes from wounds apparently the most trifling, and of every different part of the body. It has been also attributed to a fit of passion, after a surgical opera- tion. When caused by a puncture or other injury of the nerves, it is commonly more violent and difficult of cure than from cold : when it comes on suddenly, and advances quickly to a violent degree, it is always more dangerous than when slower in its process. If the pa- tient passes the fourth day, hopes may be entertained ; and every day adds to the favourable prospect of reco- T ET 421 T II E very, though the danger is not wholly at an end long after the fourth, for when its force is considerably abated it will often return with its former violence. The cases of tetanus, like other nervous diseases, are those of debility or of irritation ; often of both combin- ed, particularly in the disease of warm climates ; and they prove very strongly the principle already laid down, that spasms, including convulsions, are chiefly connected with debility. Opium is principally depended on as an internal re- medy; four or five grains may be given every two hours, until the symptoms abate, and then the dose should be gradully lessened. If it cannot be swallow- ed, six times that quantity may be injected in clysters until the patient can swallow. Warm baths greatly as- sist the efficacy of opium; and the wound, if such be the cause, should be dressed with the Peruvian balsam, or turpentine. It is justly observed by Dr. Chalmers, that the quantity of opium can only be limited by the violence of the spasms. Other antispasmodics are infe- rior in power, and in their efficacy in this disease; but the musk, asafoetida, and oil of amber, are frequently advised. Bleeding is recommended seemingly with the same views, and cupping glasses, leeches, Scc/with blisters to the neck, are employed, especially in the tetanus of fevers. The warm bath is equally a relax- ant, and from the time of Hippocrates has been em- ployed, though not with uniform success, or general commendation. Warm sudorifics have been equally commended. The remedies which connect the relaxants with the tonics are the indirect stimulants, viz. wine, spirits, and ether. These in warm climates are highly useful; but not equal to the relief of the disease in the more temperate ones. A more steady stimulant is mercury ; and numerous authors have spoken highly of its effica- cy : when there is time for its operation, it has been chiefly used externally; but in many instances it has been freely, and it has been said successfully, employed internally. Other stimulants are the Barbadoes tar, mustard, frictions, electricity. (Watson.) The tonics employed have been bark, arnica, and cold bathing, or cold aspersions on the spine or different parts. We find the most decided testimonies in favour of cold, while bark and arnica seem to have been of little service. When the cause is some injury received by a nerve, Dr. Cullen advises, if possible, to cut off that part from all communication with the sensorium, either by divid- ing the nerves in their course, or destroying, to a cer- tain length, their affected portion. See the London Medical Observations and Inquiries, i. 51, 8cc. 87, &c. ii. 130; iii. 326; vi. 22; the London Medical Transactions, ii. 39 ; Cullen's First Lines, vol. iii. edit. 4; London Medical Journal, vol. vii. p. 424; Edinburgh Medical Commentaries, vol. vi. p. 386 ; Memoirs of the Medical Society of London, vol. i. p. 65; Chalmers on the Diseases of South Carolina; Grainger on the more common Epidemic Diseases of the West Indies; De Haen Ratio Medendi, x. 3, and 4; Morgagni de Sedibus, &c. liv. 49, x. 234; Rush, Transactions of the American Society, vol. ii; Rush's Medical Inquiries; Lind on the Diseases of Warm Climates; ThedcnN.Bemerkungen; Moseley on Tropi- cal Diseases. Te'tanus latera'lis. See Tetanus. TETARTOPHI'A, (from rerxpros, fourth, and vu, nasco,) an epithet of a fever resembling a tertian, but with obscure or short intermissions. Lin- naeus calls it a continued tertian. Erotianus defines it a fever which gives signs of approaching paroxysms, but though the intervals are regular, it never arrives at perfection. Its name is derived from its great resem- blance of a tertian ; and it is often called a small semi- tertian. Dr. Cullen properly considers it as a remittent fever of the tertian type. TRI'TICUM, (from tero, to thresh). Wheat; frumentum, triticum hybernum Lin. Sp. PI. 126. Whe- ther in the form of flour or of starch, it is the most gluti- nous of the farinacea, and this is the farinaceous food most generally used by the superior classes over the whole of Europe. It can be formed into a more per- fect kind of bread than any other of the cerealia yet known. See Panis, Bread, and Cerelia. Tri'ticum re'pens. See Gramen caninum. Tri'ticum vacci'num. See Melampyrum. TRITO'RIUM, (from trito, to beat small). See Depuratio. TRITURA'TIO, (from triturare, to rub or grind). Trituration. The reducing a solid body into a sub- tile powder, or grinding with some liquid. Powders are united by trituration with a view to their subse- quent division into doses. TRO'CAR. The name of an instrument used to discharge the water in an ascites; from the French words mm trois quart, a three quarters, expressive of the triangular point of the instrument. It is furnished with a canula for the fluid to pass through; but as this, whatever be its tenuity, must furnish some resistance in passing through the integuments, it is now con- structed to sink into a circular shoulder, and room is made for withdrawing it by the elasticity of the canula, slightly divided a little way from its extremity. TROCHANTE'RES, (from TpeXa, to run, because several muscles that move the thigh are inserted into them). Two processes of the thigh bone, of unequal size. See Femoris os. TROCHI'SCI, (a dim. of t^oXos, a wheel,) artiscus, tabella bacilli, pasta regia, pastillias, cyclisci, dactylios, morsellus, morsulus; troches also called tablets and cakes are made by mixing the medicine with a pro- per quantity of sugar, and the mucilage of gum tra- gacanth; and when formed into a stiff paste it is cut into proper portions, and dried. This form is adapted TUB 441 TUM for medicines designed to be slowly swallowed, as de- mulcents, which chiefly sheath the epiglottis, and the remedy for the bronchocele. Modern refinement has extended their use, and we have peppermint, cinna- mon, ginger, paregoric, and even ipecacuanha drops, since it has been fashionable to take small doses of ipe- cacuanha for indigestion. These lozenges are of easy conveyance, and ready when suddenly wanted. The chief objection to this form is when an antacid is re- quired, since the sugar sometimes creates more acid than the absorbent neutralizes. See Collix. TROCHI'SCI CY'PHEOS. See Cyphi. TROCHI'TiE. See Entrochus. TRO'CHLEA. TpoxiXex, a pulley, (from rpex«>, to run,) a cartilaginous pulley, through which the tendon of one of the muscles of the eye passes. TROCHLEA'RES, (from trochlea). See Pathe- TICUS. TROCHLEA'RIS MU'SCULUS. See Obliquus major oculi, or Superior amatorius. TROCHOI'DES, (from rpoxos, rota, and eifos for- ma, similar to awheel,) axea commissura, an epithet of an articulation, or juncture of bones, when one is in- serted into the other like an axletree, which has the motion of a wheel. The first and second vertebrae of the neck are articulated in this manner. TROFSIEME, LE, MUSCLE DU TRICEPS. See Abductor femoris, Tertius and Magnus. TRO'MPA. See Cete admirabile. TSI'AM PA'NGAM. See Campechense lig- num. TSIANAKU'A. See Costus. TSJE'RU-CA'NSJAVA. See Bangue. TU'BA EUSTACHIA'NA, (from tubus, a hollow pipe,) aquaducus, aquaductus F'allopii, meatus cacus, ductus auris palatinus, meatus a palato ad aurem, was first discovered by Alcmenon, a disciple of Pythagoras, who called it the auditory passage; but Eustachiusclaims the honour, and from him its present name is derived. Fallopius calls it the aquaeduct; others ductus auris palatinus. This tube passes from the fore part of the drum of the car to the back part of the nose, above the root of the velum pendulum palati, and allows the air to pass inwards. See Auditus, Sonus and Sur- ditas. TU'B^E FALLOPIA'N^E, parastata varicosa of Rufus Ephesius, rise from the uterus, and are there large enough to receive a hog's bristle; they then pro- ceed in a tortuous course, and terminate near the ova- ria, in an irregular fringe, where their diameter is about a third of an inch. This fringe is called mo7-sus diaboli, orfoliaceum ornamentum, and is hung upon a membrane like the mesentery, between the doublings of which the vessels run to the tubes. Their use is to supply a passage for the ovum, from the ovarium into the uterus, subsequent to impregnation. These tubes are some- times found-cartilaginous, sometimes a foetus has been found in them, so that the animation of the ovum pre- cedes its escape from the ovary. In one instance it has been found ossified, and frequently from different causes imperforated. (Sandifort Observationes Ana- tomico Pathologicae ; Weitbrecht in Comment. Pctro- politan, iv. 261). It has prolapsed through a fissure in the vagina. See Generatio. vol. II. Tu'bje no'vus Valsa'lv^e mu'sculus. See Circum- flex us PALATI. TUBERA, (from tabur, Hebrew). Tumours of the solid parts, not containing a fluid. See Amanita. TUBE'RCA CERVI'NA, (from tuber,a round ball). See Amanita. TUBE'RCULA MAMILLA'RIA. See Papilla: MAMILLARES. TUBE'RCULA qUADRlGEMINA, CORPORA qUADRIGEMINA, eminenti.s quadrigeminje, four white oval tubercles of the brain, two of which are situated on each side over the posterior orifice of the third ventricle and the aquae- duct of Sylvius. See Nates and Testes. TUBE'RCULUM, (a dim. of tuber,) epanastasis; phyma ; a hard superficial tumour, circumscribed, and permanent, or proceeding very slowly to suppuration. See Vomica. Tube'rculum Lowe'ri. See Cor. Tube'rculum annula're. See Medulla oblongata. TU'BULI LACTI'FERI, (a dim. of tubus, a pipe). See Lactiferi ductus. TU'BULO'SUM FO'LIUM. Se Farctus. TU'BULUS DENTA'LIS. See Dentalium. Tu'bulus mar'inus. See Antalium. TU'GUS. See Amomum. TUMIDO'SI, (from tumeo, to swell). See Intu- MESCENTIiE. TU'MIDUM, (from the same). See Broncho- cele. TUMOR, (from the same). Bothor, Arab. q. v. epanastasis. The morbid enlargement of a particular part, without being caused by inflammation. This de- finition, though plain and simple, is not, however, un- exceptionable ; for dropsical swellings, from their ex- tent, would be excluded, and yet hydrocele must be introduced, unless it be alledged that in this case the tu- mour extends above the organ affected. Mr. Aberne- thy limits, on the contrary, the meaning of the word too strictly, confining it to such swellings as arise from new productions; yet he is compelled to admit enlarged glands, as their contents may be such, though it will be obvious that extirpation or death must take place before it be ascertained whether any given dis- ease is in reality a tumour. With all these difficulties before our eyes, we may have erred in our arrangement (see Nosology): but this is now of little importance; nor shall we stay to defend it. The only other classification we have met with is in a work which seems to have rarely reached this country, since Mr. Abernethy has not seen it, Plenck's. The first part was published in Latin, at Vienna, in octavo, 1767, and about three afterwards, in the German language, at Dresden and Leipsic. He divides tumours into sixteen genera, inflammatory, purulent, gangrenous, indurated, watery, bloody, encysted, excrescential, bony, earthy, airy, salivary, bilious, milky, spurious herniary, and organic. As the work is rare, we shall mention a few examples of the more important classes. The inflamma- tory tumours are the true erysipelatous ones without fever; the Indurated the strumous; the aqueous the lym- phatic, which is a smooth round, white,indolent, and clas- tic swelling,arising from a ruptured lymphatic. Among the cystic tumoursnementions///2ow VAR this form appears to be the most common appearance of the disease, when it is supposed to occur a second time. The eruptions in the second kind are hard and horny, and in this form the small pox of negroes often appears. The inoculated pustule, in this race, is dis- tinguished by a peculiar hardness. When a bilious epidemic prevails, the small pox partakes of its nature (Grant), and the disease then re- quires more frequent and more active laxatives. When a putrid fever is epidemic, the small pox is attended with a similar one, and very early in the eruption the interstices are filled with petechiae. These alone are seldom attended with any bad consequence; but, when conjoined with extreme debility, passive haemorrhages, deliquium, Sec, the bark with the mineral acids, and the strongest cordials with wine, are necessary. We have spoken of the small pox as combined with mea- zles, but with itch the disease is said to be more mild : with scarlatina and miliary fever it proceeds with little disturbance; but with violent catarrhs, or rather with asthenic influenzas, its periods are altered, and it be- comes much more dangerous. We have learnt, however, greatly to diminish the danger of this disease by inoculation ; and in the more improved practice, instead of one in seven, not one in three hundred, probably not one in a much larger proportion dies. Unfortunately, however, the infection is thus generally disseminated, and though individuals are benefited, the community suffers. More than forty thousand are said to die annually of smallpox; nor can we think that this alarming mortality should be per- mitted while the remedy in vaccination is so easy. If, for instance, each person of opulence was to-pay five pounds for a license to inoculate, with a security to perform a rigorous quarantine, the sums thence arising would establish small pox hospitals for the poor, and indiscriminate inoculation might be prevented under heavy penalties. In this way, after no long period, the small pox would be comparatively uncommon; and, if then it were by accident introduced, it might, as al- ready hinted, be easily prevented from spreading; and, though vaccina be not the perfect security it has been supposed, it would be so within a few years. It is, however, our present business to speak of this method as it is usually practised. Its history need not detain us; but we may only remark, that the custom of " buying" the small pox was prevalent in Wales long before the introduction of inoculation by lady M. W. Montague. After an opposition equally violent and virulent with that which vaccination has experienced, it is at length established, and its advantages are better known than readily explained. Of these a considerable one is, that the disease is usually mild, and very rarely confluent; but if it should be so, it is less dangerous, because there is no secondary fever. The latter cir- cumstance is a peculiar and distinctive character of ino- culated small pox. In explaining these advantages, the choice of time, of matter, and of habits, has been insisted on; but by experiments, perhaps scarcely jus- tifiable, we find the matter of the confluent or even a putrid kind will produce a favourable crop; that consti- tutions, exhausted by disease, do not suffer considera- bly ; and that the time of life or the season, with mode- rate precautions, have little influence. The only dif- VOL. II. fererice wc can perceive is, that in the inoculated small pox the infection is received under the skin ; in the natural kind in the lungs or throat, perhaps the stomach ; but the lungs or throat is the more probable seat, and the sensation felt in the stomach, after infec- tion of every kind, seems rather from sympathy than actual impression. We know not that air, in any in- stance, except in combination, enters the latter organ. The prevention of the secondary fever is a problem of peculiar difficulty. We have attributed it to the matter absorbed: but, though it occurs at the period of absorption, this cannot be the only cause; for even a considerable load of inoculated small pox disappears without its occurrence. We pretend not to solve the problem, but have distinctly stated it to excite attention. Inoculation is not by choice practised on very old persons or young infants. If the mother is the nurse, her anxiety will often injure the milk, and add to the irritation ; nor should we omit the consideration, that fits at this period are not uncommon, and, though usu- ally the harbingers of a mild kind, may themselves prove fatal. After about six months the irritation of teeth offers another obstacle, which is not completely avoided until the second year, a period of considerable risk in a large town, where small pox is seldom ab- sent. These precautions are, however, frequently over- looked without considerable inconvenience. Children are often inoculated within the first six months, and afterwards, if n6 swelling of the gums shows the near approach of a distending tooth. Unexpected occur- rences sometimes undoubtedly derange our plans; but though these give often the appearance of danger, the disease is seldom rendered truly dangerous. Advanced age offers no real impediment, and ex- hausted constitutions often go through the disease more mildly than others. We once, on an emergency, ino- culated a whole family, and among the rest, an infant at the breast, then labouring under a severe fever, cal- culating, from the circumstances, that this might be checked before the variolous fever came on. Its crisis was only on the morning before the accession of the latter, and the child escaped better than seven others. We mean not to recommend the practice; but, sur- rounded by small pox, even in the house, it was the only chance which remained. We know of no con- stitutional disease that should prevent inoculation. The season of the year is not important. We gene- rally prefer the milder seasons, when free air, out of doors, may be constantly breathed, and when the tem- perature is sufficiently low to employ cold as a remedy. The spring is avoided by some practitioners as the pe- riod of inflammatory complaints; the autumn, by others, as that of putrid ones ; the summer as too hot, the win- ter as too cold : but these are idle refinements, which merit no attention. The extremes of heat and cold, for the reasons assigned, are not to be selected by choice. Equal refinement has prevailed respecting the pre- paration, and each practitioner had for a time his fa- vourite medicine, of which calomel and tartarized anti- mony were usually parts. If a person is full, active, and strong, the diet may for a time be lowered, and as it is proper to prevent accumulations in the bowels, calomel may be employed as a purgative, as well as 3 O VAR 474 VAR any other medicine. As a vermifuge, in children, it may be superior to any other. In general, except in inflammatory habits peculiarly full, and children grossly fed, there is sufficient time for the preparation, after the matter is inserted. Should the wound inflame ra- pidly, our exertions in reducing the strength must be increased. The operation itself is the simplest possible, consist- ing, like vaccination, only in raising the skin, and intro- ducing under it the variolous matter. Sutton attributed much of his success to using fluid matter at an early period of the pustule, and it is certainly preferable ; for at a more advanced stage, it partakes of the nature of common pus, and produces more inflammation than would arise from matter exclusively variolous. In ge- neral it is safer to procure a drop of blood, which should not be wiped away, but suffered to congeal. The puncture sometimes remains many days, with- out the slightest change, and occasionally the mark ap- pears to lessen. If the operation, however, has been successful it does not heal, and this is often the only foundation for supposing that the infection has taken place. In other circumstances it begins to inflame in a few hours, and after four-and-twenty becomes a highly inflammatory pustule: a rapid advance, which usually portends a violent disease. In the greater number of cases, after about twenty-four, or, at most, forty-eight, hours, a little swelling may be observed on the wound, and on examining it with a tens, a little orange co- loured circle appears around. On the fourth or fifth day a hardness may be per- ceived where the puncture was made, an itching is felt, and a slight inflammation observable. On the sixth day a pain and stiffness are generally felt in the axilla, which continue until the tenth or eleventh day, fore- telling the near approach of the eruption, and a favour- able progress. On the seventh or eighth day the erup- tive symptoms appear, such as slight pains in the head and back, stiffness in the arm pits, transient shiverings, with alternate heats, Sec. which continue more or less until the eruption is completed: the inflammation in the arm spreads, and little pustules surround the wound, which increase in size as the disease advances. On the tenth or eleventh day an efflorescence round the punc- ture sometimes extends half way round the arm; and the larger it is, the fewer the pustules and the milder the disease. When it accompanies the eruption, the fever and other uneasy symptoms suhside, and all clan- ger is at an end. If none of the appearances on the arm appear before the eighth day, the inflammation, 8cc. about the punc- ture rise suddenly ; and this is generally, though with- out reason, regarded as a mark of danger. Mr. Sutton repeats the evacuations from the time of infection to this period, and observes, that when the skin is hot and dry, repeated doses of salts are more useful than the mercurial medicine. The favourable symptoms are, an orange coloured stain about the edges of the puncture on the second day, followed by an itching and a vesication, without much inflammation; on the third or fourth day, but not delayed beyond the sixth; a pain and stiffness in the axilla ; the large efflorescence about the puncture on the tenth or eleventh day j a hardness which spreads from the puncture as from a centre, and a little dry scab on the inflamed part when it rises to an apex. The less favourable symptoms are, a purplish instead of a red coloured inflammation or a narrow deep red circle surrounding the puncture, and when the incrus- tation around it is depressed or concave in the middle. When the fever has come on no particular medicines are required, but if every circumstance be not favour- able, our conduct must be the same as in the natural small pox already described, where similar symptoms occur. Boerhaave first suggested that an eruption was not necessary, and there is little doubt but that the real disease consists in the fever at the proper period after infection. Even after eruptions have appeared, we have seen them checked without maturation, by free exposure to cold air ; nor did the patient experience the slightest inconvenience. If then a portion of our fluids is to be assimilated by the ferment, it is necessa- rily a small one, and soon disappears. In fact, how- ever, the assimilatory process takes place only in the pustules. We need not enlarge farther on this subject, and in- deed we may appear to have been more full than the disease requires. We trust that in a future edition the whole article will be-expunged as unnecessary, and our posterity read with surprise that such things have been. It is a consummation devoutly to be wished for. On the small pox, see Syndenham and Mead's Works; Huxham on the Small Pox; Thompson's Enquiry into the Origin, Sec. of the Small Pox; Tissot's Practical Observations on the Inoculation. See Kirkpatrick, Dimsdale, and Woodville's History of Inoculation; Percival on the Advantages and Disadvantages of Ino- culating Children; Blake's Letter to a Surgeon on Ino- culation : also Baker, Burges, Matty, Watson, Glas's two Letters; Bromfield; Gatty, and Chandler on In- oculation; Cullen's First Lines, edit. 4. vol. ii.; White's Surgery, p. 423. Vari'ola chole'rica. See Morbilli. Vari'ola lympha'tica. See Varicella. VA'RIUM OS, (from varius, unequal). See Bu- BOIDES. VARIX, (from varius, irregular,) ixia; bidella; cur- sos; a preternatural distention of portions of the veins^ between their valves, defined by Dr. Cullen a soft tu- mour not pulsating above a vein. When seated, how- ever, over an artery it sometimes pulsates, and has been styled aneurismatic (Medical Observations and In- quiries, i. and iii.). When in the larger veins it is often fatal. Tozzetti discovered it after death in the vena azygos (Prima Raccolta di Observationi Mediche); and Michaelis in Richter's Bibliotheca describes a varix of the jugular vein which terminated fatally. Some- times varices are formed in the legs, and are so large and troublesome as to require being removed. (See Gooch's Treatise on Wounds, p. 188.) They are common in the legs of pregnant women, and, it is said, of those who labour under a scirrhous liver. Generally a tight stocking,or spiral bandage, is only necessary for relieving the inconveniences occasioned by this com- plaint. Varices have sometimes burst spontaneously, and been sometimes punctured, when the cicatrix gives a firmness to the relaxed coat of the vein (Petit). VAS 475 VEG Astringents are sometimes employed with advantage. A very powerful one is the following, though we do not recollect its author. An ounce and a half of blue vi- triol, with as much alum, is dissolved in a pint of rain water, to which half an ounce of vitriolic acid and a drachm of aerugo are added. The leg affected must be firmly bandaged, and the bandage frequently wetted with this embrocation. Severinus recommends the actual cautery, and Richter a solution of sal ammoniac in vinegar or wine. See Heister's Surgery; Bell on Ulcers, edit. 3. p. 260; White's Surgery, p. 125. VA'RUS. A pimple; cossi; ionthos. See Gutta rosacea. A bending of the legs inwardly. See Valgus, Cyllos. VAS, a vessel, entale; alkalia; angos. In ana- tomy, those canals are called vessels through which the fluids are circulated, or by which some of them are absorbed, secreted, or excreted. When we confine this general term to the circulat- ing vessels, some observations worth recording occur. We have styled them primordial parts, and incapable of extension beyond certain limits, but have given full force to Mr. Hunter's opinions (see Blood), and Mr. Abernethy's (see Tumores). We need not, there- fore, resume the subject. Air has been sometimes found in them ; but it appears to have separated after death, should it not have been its cause, since air in- jected into the aterial system soon induces convul- sions. The circulating system is sometimes confined by concretions either cartilaginous, osseous, polypous, or steatomatous, in their cavities. A steatom was found by Stenzel in the aorta, and the coronary artery sometimes cartilaginous, in other instances osseous (Crell and Par- ry) ; but we could not admit, with the latter, that this was the cause of Angina pectoris, q. v. The ob- structions in the smaller vessels, usually producing in- ductions and scirrhi of the liver and other viscera, seem to arise from their want of irritability, either in consequence of shocks, too great excitement from pre- vious repeated inflammation, indolence, the abuse of spirituous liquors, Sec. Hence arises, as we have ex- plained, the utility of mercury in small doses, long continued. The only other disease of the vessels to which we mean now to advert is the inflammation of their coats. Mr. Hunter has explained how the internal surface of a vein is inflamed after bleeding, and we have been will- ing to refer rheumatism to this cause. We suspect it to be more often a cause of inflammatory pain than has been supposed; but can trace it but a tittle way. An author, whose work we have tried in vain to procure, may perhaps elucidate the subject. E. J. Smuck Ob- servationes Medicae de Vasorum Sanguiferorum In- flammatione, Heidelburg, 1793. In chemistry, vessels are employed for containing substances, and for the various processes, Sec. viz. alembics, aludels, worm-still, receivers, cucurbits, sand- baths, cones, retorts, pelicans, 8ec. In botany, the vessels are of three species, viz. vasa propria} utri- culi; and trachea. See Planta. Vas urina'le. See Cucurbita. VA'SA BRE'VIA. See Splenica arteria, and Splen Va'sa lympha'tica. See Lymphs ductus. Va'sa sperma'tica. See Spermatica chorda. Va'sa succo'sa. See Vas. VA'STUS EXTE'RNUS, and INTE'RNUS,(from vastus, large,) crureus. These may be considered a*> one muscle, whose outer part rises from the external, the inner from the internal, and the middle from the anterior part of the femur, in such a manner as to sur- round the whole thigh, except the linea aspera. The tendons are joined with those of the rectus. See Cru- reus. VE'CTIS, (a vehendo, from carrying different kinds of ware,) the simple lever, not greatly differing from the single blade of the forceps. (See Parturitio). Dr. Hamilton is of opinion that it may be employed where a slight stimulus is sufficient to rouse the pains, or where little force is necessary to alter the position of the head, by introducing it in the same manner, and with the same precautions, as a blade of the forceps, either at the lateral parts of the pelvis under its arch, or diagonally; but as there is great hazard of bruising the mother by the resistance of the instrument, unless managed so that the hand of the operator is the fulcrum. or support on which its action turns; and as it can only be used when the head is sufficiently protruded for applying the forceps, it has been considered as a dangerous instrument in the hands of a young practi- tioner. Iir Bland, whose experience and judgment demand the highest respect, thinks that it may be in many circumstances highly usefuL VEGETABILIS, (from vegeo, to shoot out). Ve- getable. (See Planta and Chemia.) Under the former of these articles we have considered the anatomy, the physiology, and pathology, of plants at some length; but, as was intended, under the latter only a general abstract of vegetable chemistry is in- serted. Its imperfections we shall now supply, though in a general summary way. The vegetable principles are the woody fibre, the extractive, tanin, mucilage, faecula, volatile oil, camphor, resin, and balsam, gum resin, and vegetable acids. Alumen, fibrin and gelatin, benzoic and phos- phoric acids, sugar and fixed oil, are common both to the vegetable and animal kingdom. Of these we shall speak in their order. The woody fibre is the firm, solid support of the tree; and, if divested of the bark, which contains the sub- stances to be afterwards mentioned, as generally insipid, though sometimes, as in the guaiacum, quassia, Sec. (see Lignum), it possesses obvious and medicinal qua- lities. It yields, in distillation, hydrocarbonated gas, carbonic acid, empyreumatic acetous, or pyroligneous acid, with a little ammonia, and a small proportion of volatile oil. It consequently contains, with the other component parts of vegetables, a small proportion of azot, and indeed the minuter chemistry discovers this principle in many kinds of vegetable matter, where it was not before suspected. The remaining charcoal is in a large proportion, and there is no analogous sub- stance in the animal system. Extractive matter is a vegetable product, with a very slight decomposition, sometimes separated with little change. It seems a combination of the gum, the resin, and albumen, or gluten. It yields, however, ammonia 3 O 2 VEG 476 V E N when combined with quick lime. In distillation the ammonia is covered by an empyreumatic acid, though separated by alkalis. In this vegetable princi- ple we find also azot, and nothing analogous to it in the animal kingdom. Tanin seems to contain no ammonia, though a prin- ciple resembling it is found in animal substances, as Mr. Hatchett procured it from many of these, previ- ously charred by the action of the nitrous acid. The mucilage of the vegetable kingdom seems analo- gous to the albumen of the animal, which we have supposed to be converted into gluten by the union of azot. It contains a large proportion of this last princi- ple, which appears to disguise its acid. It is found in the substance of some plants, in the bulbous roots of others, and occasionally in the woody fibres of the roots. The facula is nearly allied to the mucilage, and in many of the palms is contained in a separate state; but sometimes requires much artificial preparation to ex- tract it. It is contained in all seeds, and, in a smaller proportion, in tuberous, bulbous, and other fleshy roots; but seems to contain no ammonia except by ac- cidental impregnation. Some faeculae, in this way, con- tain it in considerable quantity, as indigo. Volatile oil also affords no ammonia, and there is no analogous fluid in animals, except in their secretions. It is found in the bark, the wood, and many seeds, and contains the usual principles of vegetables, except the azot. The cerumen of the ears and the bile may be considered as resembling in some of their chemical pro- perties these oils. Camphor, resin, and balsams are more compound ve- getable principles, and seem to contain an acid, dis- guised by a superabundance of oxygen. They contain, as may be suspected from the excess of oxygen, no azot. The aromatic animal products, apparently resin- ous, as musk, civet, and ambergis, contain a large pro- portion of azot. The gum resins possess a large propor- tion of the same principle in their mucilage. The acids, truly vegetable, are the tartarous, the ci- tric, and the gallic. The malic and oxalic, evolved in the fruits and leaves of plants, the acetic the production of spontaneous fermentation, and the prussic contained in the bitter almonds, in the laurel and peach leaves, may also be separated from animal substances. The acids common to both kingdoms, though more strictly connected with the animal than those last men- tioned, are the benzoic and phosphoric. The former is found in the vegetable balsams and the urinary calculi; the latter combined with lime and potash occurs in the vegetable kingdom but rarely ; though common in the animal, as the basis of bones. Sugar is a vegetable oxide, and would have been ar- ranged among vegetable productions, if it had not oc- curred in the milks of all animals. The saccharine matter in diabetes is the effect of disease only. Gluten and caoutchouc are vegetable substances; but very nearly connected in their principles with the ani- mal kingdom, as their proportion of azot is considera- ble without any acid. Albumen, fibrin, and gelatin, though in general animal productions, are yet sometimes found in vegetables, and contain always a large proportion of azot. Fixed oil, on the contrary, is more strictly vegetable, and is found only in the cellular membrane, the milk and the bile of animals, but very copiously in vegetable seeds and many fruits. All these vegetable principles may be resolved into oxygen, carbon, hydrogen, azot, and sulphur. These only seem essential to their existence as vegetable matter, and even sulphur may be perhaps abstracted. The varied forms of vegetables depend on numerous other ingredients, as the phosphoric and mu- riatic acids, oxides of iron and magnesia, potash and soda, lime, magnesia, silex and alumine. As vegetables are the food of animals, it is much easier to trace the source of the animal products than of those which are derived from water and vegetable mould; a substance of no very intricate or complicated combina- tion. But the vegetable, as the animal, forms its own juices, and the narcotic bitter does not differ more from the mould with which it is nourished than the semen from the blood, from whence it is secreted. Each is elaborated in organs too minute for our sight, in a manner that eludes the subtilest investigation. VELAME'NTUM BOMBYCI'NUM, (from velo, and bombyx, a silk-worm,) the interior soft membrane of the intestines. VE'LUM PE'NDULUM PALATI, (from velo). See Fauces. Ve'lum pupi'LLiE. See Pupillaris membra- na. VENA, a vein ; a thin, ramifying, elastic tube, arising in the extremities of the body, and terminating in the heart or in the liver. The blood is distributed through the body by the aorta and the pulmonary artery; and it is returned by three kinds of veins, viz. the cava, the pulmonary, and the vena portae. The arteries have their correspondent veins, and the course of one is known by that of the other. They begin where the arteries end, and proceed from the branches to the trunk, enlarging in diameter in their course. The extremities of the arteries in the brain are con- tinued into their veins, but the former enter the brain at its basis, and are soon minutely divided: the trunks of the veins, on the contrary, are extended on the sur- face of the brain, and discharge their blood into si- nuses ; nor do the veins of the brain accompany their ar- teries as in other parts, and as the arteries and veins, of the dura mater do. In the corpora cavernosa penis, and perhaps in the spleen, they are not continued from the arteries, but open, like lymphatic vessels, from cavities. The veins subject to frequent compression, from the action of the muscles, have numerous valves, which open towards the heart to prevent regurgitation ; and indeed in all the veins except those of the uterus, the cerebrum, and portae, valves prevent the return of the blood when the course of the fluid is occasionally checked. The superficial veins prevent the circulation being interrupted by the action of the muscles com- pressing the more internal. The coats of the veins are thinner than those of the arteries,'but these fibres run in all directions, and are not muscular: their coats are thicker in the extremities than among the viscera, particularly in the saphena. The capacity of the veins is much larger than the arteries, except in the pulmonary vessels, where the four veins taken together are not equal to the artery. VE N 477 YEN Veins are occasionally ruptured, and their internal sur- face sometimes inflamed from bleeding. See Phlebo- tomia and Vasa. See Winslow's Anatomy; Haller's Physiology. Ve'na sple'nica bra'chii media'na basi'lica. See Basilica vena. Ve'na medine'nsis. See Dracunculi. Ve'na si'ne pa'ri and ju'go. See Azygos vena. Vena cava. (See Cava and Cor). This vein is sometimes varicose (Morgagni Opuscula Miscellanea, i. 10), occasionally closed (Albini Annotationes Acade- mical, vii. 9); in one instance was found ruptured, (Morgagni de Sedibus, Sec. xvi. 27, 28). In this case the pulmonary vein was also ruptured. See Haller de Aortae Venaeque Cavae, Gravioribus quibus dam mor- bis Observationes. Ve'na jugula'ris. (See Jugulares venje). We resume this subject chiefly to mention the advantages supposed to be derived from opening it. In chil- dren the other veins are often too small to admit of a sufficient discharge in a given time, and in cases of suf- focation it is particularly advantageous, as it tends to deplete the neighbouring vessels, and, of course, to re- move accumulations. Chabert in. the History of the Academy of Surgery, ii. 94, has described a machine for this purpose, and Tralles has highly recommended a discharge from this vein in diseases of the breast and head. Tralles de Vena Jugulari frequentius secanda. Vena ranina. The vein under the tongue, not unfrequently opened in the diseases of children; but many inconveniences are recorded as resulting from this operation, and it should not, therefore, be at- tempted, as the advantages are equivocal. VE'Nii LA'CTEjE. See Lactea vasa. Ve'n.«-se'ctio, (from vena, a vein, and seco, to cut). See Phlebotomia. VENE'NUM, (fieXevtov, from /SeAe?, a dart, as usu- ally conveyed by darts). Poisons, as we have often had occasion to observe, differ from medicines, not in qualities, but in doses; and we usually annex the idea of poison to those things which produce deleterious effects in very small quantities, and of whose action we are imperfectly acquainted. What kills by its mecha- nical action externally is not styled poison. Medicines of a peculiar nature, which unavoidably kill, but whose bad effects are occasionally relieved by specifics, or for which we have no cure, are commonly called poisons. In this way, though we speak of the poison of can- cer, of variola, and of putrid fever in common lan- guage, it forms no part of the present subject; nor in- deed when a person breathing the miasma of pestis confined in fomites falls down without life, is he pro- perly considered as having been poisoned; for these are causes of disease which, if not violent and sudden in their termination, might be removed by medicines sug- gested by indications; yet when suffocated by carbone, by azote, Sec. a person is said to be poisoned, because no specific disease results from a less degree of the ap- plication. The distinction is not perfectly correct and scientific; but it is unnecessary in this place to innovate on popular opinions and common language. Poisons may be divided into animal, vegetable, and mineral. The volatile animal poisons are the vapours of putrefaction. Those from vaults have proved fatal in France. The vapours of graves, hastily opened and incautiously breathed, have had the same effect; and the highly fetid vapours from numerous persons labouring under dysentery and putrid fever have proved very suddenly fatal. The breath of some serpents is said to prove fatal; but this idea is now left, with the other tales of the nursery, to ignorance and superstition; nor is it even admitted that the breath of the black snake fascinates birds. The more fixed animal poisons are those of serpents, of the scorpion, if really poisonous, of fish, and perhaps of the mad dog. The toad is said to be poisonous; but facts are wanting to establish its de- leterious quality. Of the serpents and scorpion we have already spoken (vide in verbis). Fishes of many kinds are poisonous; but few at all times, and in every constitution, so that, as in muscles^ it seems to depend on their food. (See Mytilus). The cancer terrestris also of the West Indies is only poisonous in dry seasons, when the defi- ciency of other food compels it to feed on the bark and leaves of the manchineel tree. The lobster, probably from its food, is occasionally poisonous. Fish, in the more strict sense, are sometimes dangerous; but the de- leterious kinds are chiefly inhabitants of the tropical seas. and, in the fishermen's opinion, may be distinguished by their want of scales. The yellow billed sprat is highly poisonous, while the black billed, scarcely distinguish- able from it by sight, is innocent. The baracuta is sometimes poisonous, though occasionally eaten with- out danger. The cavallee (the scomber of Brown) is usually poisonous; and the varieties styled bottlenose and ambar are the same, though the greenback is inno- cent. The king fish (xiphias of Brown) is highly de- licious, and only at some seasons injurious. The smooth bottle fish (ostracion glabellum) is at times very dan- gerous. The rock fish (perca marina of Catesby) is apparently only dangerous when caught in particular situations. In general, the poison of fish appears to lie in the in- testines, as it probably arises from their food ; for it is found that if these are immediately taken away, the fish well washed and salted, little danger results from even the baracuta. The symptoms are alarming, but not highly dangerous. Cardialgia and nausea are suc- ceeded by severe vomiting and purging, cold sweats, fainting, and vertigo. The face is highly flushed, the eyes inflamed, and agitated by spasmodic contractions. A burning soon comes on in the face and eyes, extend- ing to the extremities, accompanied, or succeeded, by a general efflorescence, with a pricking of the skin, and this affection of the surface attends the injuries received from every kind of fish; in some constitutions from even the most innocent. The skin at last peels off, and shooting pains in the joints often continue for some time, and at intervals for many years. The poi- son'must be soon evacuated, and the vitriolated zinc is recommended for this purpose. The bowels must also be relieved, and after this the warmest cordials of every kind are alone sufficient. The capsicum in large doses is often highly useful, and as a remedy always at hand, when a ready active one is wanted, it is peculiarly advantageous. The sea insects, the blubbers, and many other inha- bitants of the ocean are undoubtedly poisonous; but YEN 478 VEN their effects are little known, for their appearance is too disgusting to allow of their being eaten. Of other insects the meloe vesicatorius (cantharis) is the only poison with which we arc distinctly acquainted, but may add from Plenck's Toxicologiaa list of the insects supposed to be venomous. Furia infernalis; meloe majalis and proscarabaeus; scorpio Africanus; phalan- gium aranoides; sirex gigas; buprestis; araneadomes- tica and tarantula; pulex penetrans; culex pipiens; pulicaris and lanio; apis mellifica; vespis vulgaris and crabo. The poisonous worms are, gordius medinensis and marinus ; hirudo medicinalis venenatus; tethys ma- rina; urtica marina. Among the poisonous amphibia are, rana bufo; lacerta goeko and salamandra. The poison of many of these, however, consists only in their sting. To the fish formerly mentioned as poisonous we may add, from Plenck, the tetraodon ocellatus and lineatus, perca venenosa and sparus pagurus. Ander- son in the Philosophical Transactions, lxv. 544. Halitus. Anagyridis. Dracunculi. Juglandis. Sambuci. Santali albi. Alceae moscatae. Mancinellae. Cannabis. Lini. Toxicodendri. Vernicis. Dracontii polyphylli. .. i foetidi. Hellebori albi. The odours are, Violarum. Rosarum. Liliorum alborum. Caprifolii. Polyanthes. Phaseoli. Fceni recentis. Oleandri. Caryophyllorum. Asae foetidae. Ambrae. They are divided by Plenck, in which he is followed by almost every author, who is, however, anxious to keep him concealed, into narcotic, narcotico acrid, mushrooms, acrid, and glutinous poisons. The two first distinctions we cannot perceive, nor do the effects of Animal substances that have passed through a con- siderable part of the process of putrefaction are often highly deleterious, and the mildest in its natural state is the most injurious, when putrefied, the egg. It has been doubted whether animals killed with poisoned weapons may be eaten with safety; but we believe the inno- cence of such food is now well established, though some facts seem to oppose. It has been alleged that some poisons kill by their aroma, which spreads readily, and adheres tenaciously. This is, however, an apparent refinement of little utility in our inquiries. The vegetable poisons are very numerous, and may be divided into the volatile and fixed. The former rather refer to medical police than to a practical treatise; but it may be of use to enumerate those vegetable sub- stances which exhale an offensive, possibly an injurious, effluvium. The odours which we shall add are some- times when diluted pleasing, but oftener injurious. These are the Moschi. Castorei. Zibethi Cautharidum. Hyosciami. Stramonii. Opii. Croci. Tabaci. Lolii temulenti. Cicutae. Conii maculati. Fungorum venenatorum. the poisonous mushrooms appear to us to differ from those of the other narcotics. We shall include them therefore under the general title of narcotics, distinguish- ing each by the Greek letters x, /3, y. I. NARCOTIC POISONS. a Papaver somniferum. Physalis somnifera. Solanum lycopersicum. ------- mammosum. — insanum. — dulcamara. — nigrum. Datura stramonium. ------metel. ------ferox. ------ tatula. Atropa mandragora. Hyoscyamus niger. -----------albus. .----------physalodes. .----------scopolia Azelea pontica. Antirrhinum orontium. Actae spicata. Lollium temulentum. Ervum ervilia. Lathyrus cicera. Peganum harmela. Chaenopodium hybridum. Taxus baccata. Chelidonium glaucium. Lactuca scariola. Prunus laurocerasus. Paris quadrifolia. (0 Hippomane mancinella. -----------biglandulosa. Menispermum coculus. Coriaria myrtifolia. Strychnos nux vomica. ■ colubrina. Ignatia amara. Nerium oleander. Atropa belladonna. Nicotiana tabacum. rustica. panicula. glutinosa. Bryonia alba. Chaerophyllum sylvestre. ————— bulbosum. Chaerophyllum temulentum. jEthusa cynapium. Sium latifolium. Cicuta virosa. Conium maculatum. Mercurialis perennis. - y Agaricus muscarius. ----------integer venenatus. ■----------lactifluus venenatus. -- viscidus. -- piperatus. — fimetarius. ■- pustulatus. -- necator. •- sanguineus. - viscidus. - clypeatus. Boletus versicolor ------elegans. Boleti parasitici. Phallus impudicus. ------mukusin. Lycoperdon carcinomalis. VEN 479 VEN II. ACRID poisons. Delphinia staphisagria. Semen sabadilli. Rhododendron crysanthemum. Fritillaria imperialis. Colchicum autumnale. Pedicularis palustris. Digitalis purpurea. Lobelia siphilitica. ------longiflora. Cyclamen europaeum. Plumbago europaea. Convolvulus scamonea. Cucumis colocynthis. Momordica elaterium. Cambogia gutta. Cerbera ahovai. ------manghas. Cynanchum erectum. -----------vimiale. Apocynum androsaemifolium. -----------canabinum. • venetum. Asclepias gigantea. Hydrocotile vulgaris. Oenanthe fistulosa. crocata. Scandix infesta. Thapsia foetida. Alisma plantago aquatica. Clematis vitalba. --------flamula. --------erecta. --------integrifolia. Anemone palmata. --------- pulsatilla. ------— pratensis. .--------narcissiflora. — nemorosa. — ranunculoides. Helleborus albus. niger. ----.-----foetidus. Veratrum nigrum. Caltha palustris. Aconitum napellus. ---------cammarum. ---------lycoctonum. ---------anthora. Pastinaca sativa, annosa, Polygonum hydropiper. Saelanthus quadragonus. ---------glandulosus. ——-----forskalii. Jatropha curcas. --------multifida. --------manihot. Ricinus communis. Phytolaca decandra. Croton tiglium. Daphne mezereum. -------thymelaea. -------laureola. Euphorbia Iathyris. -. ' helioscopia. ----------verrucosa. ----------platyphyllos. ----------esula. ----------cyparissias. ■ pallustris. ----------hiberna. ----------characias. ----------amygdaloides. ----------sylvatica. ----------exigua acuta. ----------mauritanica. ----------nerifolia. Ranunculus sceleratus. -----------thora. -- cneorum. gnidium. Cneorum tricoccum. Amyris toxifera. Rhus vernix. —-- radicans. -----toxicodendron. Scilla maritima. Excaecaria agallocha. Anacardium occindentale. -----------orientate. Caryota urens. Arum maculatum. -----dracunculus. ——— dracontium. -----colocasia. ■ esculentum. -----virginicum. ■ arborescens. - flamula. -lingua. ■ ficaria. ■ illyricus. • bulbosus. • alpestris. ■ polyanthemos. • aeris. ■ arvensis. • gramineus. ■ asiaticus. ■ aquatilis. ■platanifolius. ■ breynius. ■sardous. -----seguinum. Calla pallustris. Euphorbia officinalis. ---------antiquorum. ---------canariensis. ---------tirucalli. ----—— peplus. Raphanus raphanistrum. Secale cornutum. Ustilago frumenti. Caries frumenti. Rubigo frumenti. HI. GLUTINOUS POISONS; Gluten aucuparium. visci querni. Fungus cynosbatos. Spongia marina. Mr. Wilmer in his Observations on the Poisonous Vegetables found in Great Britain distinguishes, 1st. Those from which maniacal symptoms are to be ex- pected, or different nervous affections from a vertigo to a fatal apoplexy, including the Hyoscyamus niger, Solanum lethale, Aconitum, Mercurialis sylves- tis, Stramonium, Cicuta major fct-.tida, Agaricus muscarius, Agaricus piperatus, q. q. v. Second- ly, Those which produce epileptic symptoms, a loss of understanding, speech, and all the senses, within a few minutes after they are taken in the sto- mach : the muscles will be convulsed, and death will close the scene in a few hours. OZnanthe ch^ero- phylli foliis, Cicuta aquatica, and Laurocera- sus, q. q. v. The danger of the last is very great, as they do not offend the palate, nor produce any sick- ness in the stomach, so that they are not likely to be discharged without the assistance of art j and are so quickly active, that they scarcely afford an opportuni- ty for assistance. He adds, that poisonous vegetables appear to act by oppressing the nervous system, rather than by in- flaming the stomach and duodenum; and that these vegetable poisons, in different constitutions, will have various and sometimes opposite effects. The antidotes of the narcotic poisons are said to be the vegetable acids, given by the mouth, or in clysters, and coffee: blisters to the neck, rubefacients, and stimu- lants of every kind must be added. As the face is full and flushed, bleeding has been generally recommended; but the plethora is venous only from relaxation, and bleeding decidedly injurious. Of the effects of mush rooms, and their treatment, we have already spoken at some length. See Amanita. The effects of the acrid vegetable poisons are relieved chiefly by narcotics and by demulcents. If we know VEN 480 VEN that they arc naturally determined to any particular excretory, the discharge from the same organ must be promoted by the mildest means to dilute the acrimony which will be soon brought there, and every means of soothing general irritation adopted. Oils, as demul- cents, are perhaps inferior to mucilages, and better adapted to mineral poisons; and soap, as containing an alkali, is the appropriated antidote of the latter. We need not add, that the chemical nature of vegetable poisons is too little known to enable us to add an an- tidote from affinity. The 7nineral kingdom, as it affords the most active remedies, so it abounds with the most deleterious poi- sons, which are sometimes fatal in the form of gas, more frequently given with the most wicked designs, or accidentally injurious when prescribed by quacks, or the most undiscrintinating inexperience. The vapour of calcareous earth we have already mentioned in a former part of this article, under the title of carbonic acid air; the vapour of arsenic is often diffused in smelting houses, and undermines the health of the workmen ; of mercury in the quicksilver mines of Almaden and Idria; of lead in various manuiactures. Copper is not apparently raised into vapour in an inju- rious form. Internal poisons are sometimes mechanical, as the filings of tin, given as anthelmintics, leaden bullets, and quicksilver, the supposed remedy of ileus. The others act by their violent irritation chiefly on the primae viae, but occasionally on the secretory organs, or their excretory ducts. We need not, however, be anxious on the latter point, as our chief attention must be di- rected to them while still retained in the stomach and bowels. They may be divided into alkaline, earthy, acid ; neutral alkaline, neutral earthy, neutral metallic; metallic oxides ; metals, and inflammables. The pure alkalis are highly caustic; nor can they be swallowed without discovery, so that the victims are the incautious and the suicides. Their obvious anti- dotes are the acids, and, if the throat is not so much excoriated as to bear them, the vegetable acids soon re- lieve from immediate danger. Should the excoriation be considerable, water impregnated with fixed air, or diluted acids sheathed with mucilaginous substances, must be taken. The consequences are, however, often highly inconvenient. Digestion is impaired ; the sto- mach seems a cold heavy mass ; the bowels are consti- pated, and the strength decays. For many months these inconveniences have remained, though they gra- dually recede, and are in a great degree, though not wholly, removed. The earthy poisons are little known. Pure lime, by its causticity, may be poisonous if swallowed, and there is much reason to suppose the barytes highly dan- gerous. Of the strontia, as a medical agent, we know little, and the effects of the other newly discovered earths on the human body have not been ascertained. The amianthus, under the name of plumose alum is sometimes injurious from its spiculae, which produce itching on the surface, and may, therefore, be wholly referred to mechanical action. The poisonous acids are the stronger mineral, and the effects are the same, though the antidotes are more ready and easy. Alkalis may not be easily swallowed; but soap diffused in milk, oils combined with water by means of pure alkalis, will always relieve. The ef- fects, like those of alkalis, arise from excessive excite- ment. Neutral alkaline salts are seldom injurious, and wc have preserved this title only to remark, that nitre swallowed in large doses is often poisonous. It seems to act as an indirect stimulus; but is chiefly fatal by producing violent haemorrhages. Neutral earthy salts are the calcareous sulphat (gyp- sum) and the muriated barytes, perhaps, if incautiously administered, the 7nuriated lime. History has recorded the treachery of one of the Byzantine emperors who mixed powdered gypsum with the meal designed for the army of Conrad III. by which the greater part is said to have been destroyed. It sometimes produces inconvenience when found in water, in that proportion which constitutes it hard, by bringing on constipation;" but it is seldom, in common life, dangerous or fatal. Neutral metallic salts are highly injurious, and their number is almost as great as that of the metals whose medical power is known. The vitriolated copper and zinc are well known ; nor is the vitriolated iron in large doses innocent. Nitrated and muriated silver are highly caustic and injurious. Dr. Fordyce remarked, that gold is only a cordial in the pocket, so it is only a poison to the mind. It is innocent of all bodily good or harm. The muriated antimony is extremely caustic, and the oxymuriat of mercury, the corrosive sublimate, equally so. The other preparations of these metals are not equally active and deleterious, though the saline com- pounds of each possess considersble acrimony, particu- larly the vitriolated and nitrated mercury ; and in large doses are often injurious. Lead is chiefly offered to us in a saline form as combined with the vegetable acid; and so many are the opportunities for this union, that its bad effects are supposed to be extensively diffused. This unreasonable apprehension we have endeavoured in part to remove. (See Plumbum.) Copper is solu- ble in such a variety of menstrua, that its introduction into the system has been universally dreaded, and we are taught to guard against it in our culinary vessels, our medicines, and our spirit, as well as in the construc- tion of our reservoirs for water. The fears of mankind are sufficiently alive to prevent them from incurring these perils, unless from accident, and the taste of cop- per is too striking to prevent its incautious introduc- tion. It is discovered by the aqua ammoniae, which precipitates the copper in a blue colour, except when combined with spirit. In this case soap is the crite» rion, and it dissolves in the spirit in greenish striae. (See Cuprum.) The arsenicated soda is highly dele- terious. Theoxides of mercury and antimony, in particular cir- cumstances, are highly acrid. The red and white pre- cipitates of mercury are dangerous, and often poison- ous : the crocus metallorum, the powder of algaroth, and the glass of antimony, scarcely less so; but the most destructive of the oxides is Arsenic, q. v. The only dangerous metal that we are acquainted with is lead, and the only poisonous inflammable phos- phorus. Copper, if it meets with no acid, is innocent, but from the accidental occurrence of an acid in the sto- mach, may become violently deleterious. There are, however, very few circumstances in which it is likely to be swallowed, and no inconveniences seem to have VE-N 481 V E N been observed, where swallowing is almost unavoida- ble. The counter poisons are chiefly sulphur, in different forms; but the power of the metallic salts is weakened by the addition of those acids which have a stronger affinity to the metal than that with which it is combin- ed, and which form a milder combination; or alkalis, which leave the metal in a comparatively inert oxide. Our chief dependancc, however, is on emetics and laxa- tives, first to discharge what may continue to irritate, and afterwards to sheath the bowels by demulcents. Oil with milk, soap dissolved in water, mucilaginous fluids of every kind, often with opium, when the pain is violent, will succeed, if success remains in our power. Some other poisons remain, of whose composition history has fortunately left us no traces. The aqua toffana was pure and tasteless, but certainly fatal, and might be given in any liquid. The "powder of suc- cession" was sweetish, adapted for children, and equally certain. Infernal miscreants, whose poverty rather" perhaps than their wills consented, mixed freely in this horrible traffic from the tenth to the fifteenth centu- ries; but we trust that the formulae are now lost for ever, and those acquainted with the powers of natural bodies, who may approach the composition, would do well to conceal it. The upas, the celebrated poison tree of Java, is now known to be fabulous ; and the ti- cunas is much less virulent than it has been represent- ed, or it has lost its powers by keeping. (Fontana.) The stories told of the formidable preparation of poison in South America are, we understand, very greatly ex- aggerated, perhaps wholly invented. It is necessary to add, that the power of poisons, as we have seen in those of fish, are relative to the habits and constitution of the patient. Like the tyrant of an- tiquity, who used himself to all kinds of poisons that he might be proof against their attack, some may feed on what would be destruction to others. This immu- nity is, however, limited. No constitution is proof against the great variety of mineral poisons which we now possess; but we can fortunately trace their symp- toms, their progress, and even detect the substance in the stomach of the victims. No poisoner can now ESCAPE WITH IMPUNITY. Animals are singularly exempt from the powers of some medicines highly deleterious to man. A horse can take a drachm of arsenic daily, and improve in his coat and condition; and the nux vomica is not pecu- liarly dangerous to man, except in considerable doses, though it soon destroys brutes. The aloes is a poison to dogs and foxes, and somewhat virulent in a horse; for it is his only certain laxative. The coculus indicus is deleterious to fish and lice; yet it makes, we believe, a very salutary ingredient in the best London porter. The phellandrium aquaticum is fatal to horses and in- nocuous to oxen: the doronicum kills dogs; but fat- tens ahtelopes, thrushes, and swallows. Parsley seed is injurious to birds, and pepper to swine. Bitter almonds kill foxes, cats, and chickens. The seeds of hemlock are eaten without injury by stares, of stramonium by pheasants, of the lollium temulentum by jays, and the roots of henbane by pigs. We are generally led to suspect the exhibition of a violent and active poison by the sudden attack. If a VOL. II. healthy man, after a plain dinner, a common drink, or an unsuspected medicine, is soon seized with vertigo, cardialgia, colic, vomiting, cholera, spasms, convul- sions, great debility, faintings, or coma; or, if the lips, the tongue, the fauces, and the stomach swell, with a sense of heat, we may suspect that poison has been swallowed. If the discharge from the stomach given to a dog or cat kills it, or produces some violent disease, the suspicion will be strengthened. We must, how- ever, keep in view what we have just said, that animals will often safely eat what is deleterious to man. If death ensues, and we have an opportunity of in- specting the body, the suspicion will be farther con- firmed if the stomach is inflated, or spasmodically con- tracted, gangrened, or spotty, without any previous disease to occasion these changes. If in the contents of the stomach, on dissection, we find any seed, root, leaf, or vegetable powder which we know to be dan- gerous; or if any such are found in the house of the deceased, the suspicion will almost amount to a cer- tainty. Should the poison be of the mineral kind, mo- dern chemistry has resources to discover it from the smallest quantity, however disguised. The peculiar properties of each occur in the respective articles from which a discovery may be made, and many circum- stances will lead to a probable suspicion of what it may have been. See Sprogel Experimenta circa Venena ; Fontana sur le Venin de Vipere, Sec; Graevius de -Venenis: Plcnck's Toxiculogia ; Gmelin de Venenis; Murray's Apparatus; Thomas in the Memoirs of the Medical Society, vol. v.; Puihn Materia Venenaria regni Vege- tabilis ; Mead on Poisons ; Baccius and Androynus de Venenis; Bell's Surgery, vol. i. p. 312 ; London Medi- cal Journal, vol. iv.; Houlston and Wilmer on Poi- sons ; Edinburgh Medical Commentaries, vol. iii. p. 121 ; Morgagni de Sedibus, Sec. iii. 59. VENO'SUS, (from vena, a vein). Botanically ap- plied to a leaf, covered with anastomosing vessels. VE'NTER, (from evlepov, intestinum). In the most extensive sense it is taken for a remarkable cavity, in which any of the principal viscera is contained; and the whole body is consequently divided into three ven- ters, viz. the head, the breast, and belly. (See Abdo- men). Hippocrates applies the word xotXtx sometimes to the cavity of the breast and abdomen, and sometimes calls the thorax the upper, and the abdomen the lower, belly; venter is a term usually confined to the lower belly. Among the chemists, venter is the same as terra, and venter equi is horse-dung. Among lawyers, it v» the fruit of a single marriage. VENTRI'CULI MO'RBUS. See C